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Sample records for methods fifty patients

  1. Selective angiography in fifty patients with primary hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Shou-Zhong, Wang; Xing-Rong, Chen; Gong-Xian, Wang

    1983-06-01

    Selective angiography is of great importance in the diagnosis of primary hepatocellular carcinoma. It offers information on the findings, multicentricity, localisation, extension, and type of growth. This paper discusses angiography from the methodical point of view, the findings to be obtained, the types of hepatocellular carcinoma, and the diagnostic efficiency of selective angiography in the evaluation of this type of tumour.

  2. Muscular variations during axillary dissection: A clinical study in fifty patients

    Directory of Open Access Journals (Sweden)

    Upasna

    2015-01-01

    Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year. Results: In a period of one year, two patients (4% with axillary arch and one patient (2% with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified. Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer.

  3. Image-guided radiotherapy for fifty-eight patients with lung cancer

    International Nuclear Information System (INIS)

    Liang Jun; Zhang Tao; Wang Wenqin

    2009-01-01

    Objective: To study the value of image-guided radiotherapy (IGRT) in lung cancer. Methods: From Mar. 2007 to Dec. 2007,58 patients with lung cancer were treated with IGRT. Set-up errors in each axial direction was calculated based on IGRT images of each patient. The change of GTV was evaluated on both cone-beam CT and CT simulator images. Results: Twenty-two patients with left lung cancer,30 with right lung cancer, 5 with mediastinal lymphanode metastasis and one with vertebra metastasis were included. The set-up error in x, y and z axes was (0.02±0.26) cm, (0.14±0.49) cm and ( -0.13± 0.27) cm, respectively,while the rotary set-up error in each axis was -0.15 degree ± 1.59 degree, -0.01 degree ± 1.50 degree and 0.12 degree ±1.08 degree, respectively. The set-up errors were significantly decreased by using of IGRT. GTV movement was observed in 15 patients (25.9%) ,including 5 with left upper lung cancer. GTV moving to the anterior direction was observed in 9 patients,including 4 with]eft upper lung cancer. GTV reduced in 23 (44.2%) patients during treatment. Asymmetric GTV reduction of 22 lesions was observed,with a mean reductive volume of 4.9 cm 3 . When GTV began to shrink,the irradiation dose was 4 -46 Gy, with 20 -30 Gy in 9 patients. Conclusions: The use of IGRT can significantly reduce set-up errors. GTV movement and reduction are observed in some cases. The time to modify the target volume needs to be further studied. (authors)

  4. Fifty Shades of Stigma: Exploring the Health Care Experiences of Kink-Oriented Patients.

    Science.gov (United States)

    Waldura, Jessica F; Arora, Ishika; Randall, Anna M; Farala, John Paul; Sprott, Richard A

    2016-12-01

    The term kink describes sexual behaviors and identities encompassing bondage, discipline, domination and submission, and sadism and masochism (collectively known as BDSM) and sexual fetishism. Individuals who engage in kink could be at risk for health complications because of their sexual behaviors, and they could be vulnerable to stigma in the health care setting. However, although previous research has addressed experiences in mental health care, very little research has detailed the medical care experiences of kink-oriented patients. To broadly explore the health care experiences of kink-oriented patients using a community-engaged research approach. As part of the Kink Health Project, we gathered qualitative data from 115 kink-oriented San Francisco area residents using focus groups and interviews. Interview questions were generated in collaboration with a community advisory board. Data were analyzed using a thematic analysis approach. Themes relating to kink-oriented patients' experience with health and healthcare. Major themes included (i) kink and physical health, (ii) sociocultural aspects of kink orientation, (iii) the role of stigma in shaping health care interactions, (iv) coming out to health care providers, and (v) working toward a vision of kink-aware medical care. The study found that kink-oriented patients have genuine health care needs relating to their kink behaviors and social context. Most patients would prefer to be out to their health care providers so they can receive individualized care. However, fewer than half were out to their current provider, with anticipated stigma being the most common reason for avoiding disclosure. Patients are often concerned that clinicians will confuse their behaviors with intimate partner violence and they emphasized the consensual nature of their kink interactions. Like other sexual minorities, kink-oriented patients have a desire to engage with their health care providers in meaningful discussions about

  5. [Vitamin D deficiency prediction by patient questionnaire and secondary hyperparathyroidism in a cohort of 526 healthy subjects in their fifties].

    Science.gov (United States)

    Laroche, Michel; Nigon, Delphine; Gennero, Isabelle; Lassoued, Slim; Pouilles, Jean-Michel; Trémolières, Florence; Vallet, Marion; Tack, Ivan

    2015-01-01

    Can vitamin D deficiency be predicted by patient questionnaire? Does it lead to secondary hyperparathyroidism that may cause excessive bone resorption? We studied non-osteoporotic subjects in their fifties, in whom vitamin D levels are often tested. Patients hospitalised for degenerative osteoarthritis or consulting for assessment of menopause, without renal failure and not treated with vitamin D, completed a questionnaire on sun exposure and underwent measurement of serum calcium, creatinine, 25OH vitamin D, PTH and CTX. Five hundred and twenty-six subjects, mean age 54.6 years (71% women), were investigated throughout the year. 25OH vitamin D levels were correlated with sun exposure and varied according to the month of the year, unlike PTH and CTX levels. From November to May, over 90% of subjects had 25OH vitamin D levelssecondary hyperparathyroidism, characterised by serum calcium65pg/mL, associated with increased CTX levels. Vitamin D deficiency can be predicted by patient questionnaire. It very rarely leads to secondary hyperparathyroidism. Copyright © 2015. Published by Elsevier Masson SAS.

  6. Clinical course, complications and predictors of mortality in patients with tuberculous meningitis - an experience of fifty two cases at civil hospital karachi, pakistan

    International Nuclear Information System (INIS)

    Salekeen, S.; Mahmood, K.; Naqvi, I.H.; Baig, M.Y.; Akhtar, S.T.; Abbasi, A

    2013-01-01

    Objective: To assess the clinical course, complications and predictors of mortality in reducing the consequent morbidity and mortality in patients with tuberculous meningitis. Methods: A prospective study was carried out at Civil Hospital Karachi from January 2009 to January 2011. Fifty-two confirmed cases of tuberculous meningitis were included. The entire clinical course with complications and predictors of mortality were assessed. Data was analyzed using kSPSS version 17.0. Results: The mean age of the patients was 36.29+-16.7 years with an equal gender distribution. The presenting complaints were fever 51 (98.1%), neck-stiffness 44 (84.61%), and altered level of consciousness 40 (76.9%), headache 31 (59.6%), vomiting 19 (36.5%) and focal weakness 10 (19.2%). Among CNS signs, 47 (90.4%) patients had signs of meningeal irritation, 14 (26.9%) had cranial nerve palsies with abducent nerve being the most commonly involved cranial nerve (25%). Mean GCS was 11.4+-2.9 and most of the patients presented with medical research council Stage 2 of tuberculous meningitis (which is minimally altered level of consciousness with minor focal neurological signs). Overall mortality was 21.1%. Univariate analysis revealed old age; advanced stage of tuberculous meningitis, serum sodium 9000/mL development of hydrocephalus and use of mechanical ventilation as major predictors of mortality. Conclusion: Tuberculous meningitis is a frequently reported problem in our part of the world. Hydrocephalus along with other sequelae are common complications. All patients should be assessed for the presence of risk factors affecting mortality of the disease. (author)

  7. The next fifty years

    International Nuclear Information System (INIS)

    Scaldwell, Reg

    1995-01-01

    The General Manager of the reactor division of Centronics, a world class manufacturer of reactor control systems and radiation detectors, describes its achievements and looks forward to speculate on what the next fifty years may mean in terms of technological development. Tables are given of the locations of Centronics Fission Chambers and of reactors controlled with Centronic Detectors. (UK)

  8. Fifty seven years of follow-up of the Israeli cohort of Laron Syndrome patients-From discovery to treatment.

    Science.gov (United States)

    Laron, Zvi; Kauli, Rivka

    2016-06-01

    Clinical and laboratory investigations of dwarfed children newly Jewish immigrants from Yemen and Middle East and who resembled patients with isolated growth hormone deficiency were started by our group in 1958. In 1963 when we found that they have high serum levels of hGH, we knew that we had discovered a new disease of primary GH insensitivity. It was subsequently coined Laron Syndrome (LS, OMIM #262500). The etiopathogenesis was disclosed by 2 liver biopsies demonstrating a defect in the GH receptor. Subsequent investigations demonstrated deletions or mutations in the GHR gene. The defect lead to an inability of IGF-I generation, resulting in severe dwarfism, obesity, and other morphologic and biochemical pathologies due to IGF-I deficiency. With the biosynthesis of IGF-I in 1986, therapeutic trials started. Following closely our cohort of 69 patients with LS enabled us to study its features in untreated and IGF-I treated patients. This syndrome proved to be a unique model to investigate the effects of IGF-I dissociated from GH stimulation. In recent studies we found that homozygous patients for the GHR mutations are protected lifelong from developing malignancies, opening new directions of research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. The role of computed tomography in assessment of endocrine adrenal disorders in adult patients. Report of fifty-six cases

    International Nuclear Information System (INIS)

    Laissy, J.P.; Genevois, A.; Assailly, C.; Janvresse, A.; Louvel, J.P.; Benozio, M.; Fournier, L.; Denizet, D.; Clement, J.F.

    1987-01-01

    A prospective CT study has been performed in 56 patients in order to define its usefulness in the diagnosis of adrenal masses accompanying an endocrine syndrome. CT data have been compared with clinical, biological and surgical data. CT scan accuracy is variable with different endocrine disorders, better in pheochromocytoma than in Cushing syndrome. In this syndrome, size of the mass and density after contrast media injection may differentiate adenoma from hyperplasia in difficult cases. In hyperaldosteronism, significant differences in densities contribute to the diagnosis between adenoma and hyperplasia [fr

  10. Deutsches Atomforum turns fifty

    International Nuclear Information System (INIS)

    Geisler, Maja

    2009-01-01

    Fifty years ago, the Deutsches Atomforum e. V. was founded to promote the peaceful uses of nuclear power in Germany. On July 1, 2009, the organization celebrated its fiftieth birthday in Berlin. The anniversary was celebrated in the Berlin electricity plant, Germany's oldest existing building for commercial electricity generation. DAtF President Dr. Walter Hohlefelder welcomed some 200 high-ranking guests from politics, industry, and from the nuclear community, above all, the Chancellor of the Federal Republic of Germany, Dr. Angela Merkel, and, as keynote speaker, Professor Dr. Arnulf Baring. (orig.)

  11. Fifty years after Hiroshima

    International Nuclear Information System (INIS)

    Imai, R.

    1997-01-01

    Any discussion of the nuclear-proliferation regime in the post-Cold War era, its present role and expected function in the future must take into account the outcome of the New York Non-proliferation Treaty Review Conference held in 1995, and the four factors that shaped the twentieth century: fascism and communism, nuclear energy and environmental concerns, as well as the interaction between them. none of the factors can be handled within the boundaries of a single state. After fifty years of nuclear competition both for military and energy generation purposes, international conferences on disarmament, Non-proliferation Treaty, Comprehensive Test Ban Treaty, START negotiations and agreements, there are still remaining nuclear issues. Population growth, energy demands and supplies, all related to global environmental changes must be taken into account

  12. Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting

    Directory of Open Access Journals (Sweden)

    Riksman Janine S

    2011-02-01

    Full Text Available Abstract Background An instrument known as the Mechanical and Inflammatory Low Back Pain (MAIL Scale was drafted using the results of a previous expert opinion study. A pilot survey was conducted to test the feasibility of a larger study designed to determine the MAIL Scale's ability to distinguish two potential subgroups of low back pain: inflammatory and mechanical. Methods Patients with a primary complaint of low back pain (LBP presenting to chiropractic clinics in Perth, Western Australia were asked to fill out the MAIL Scale questionnaire. The instrument's ability to separate patients into inflammatory and mechanical subgroups of LBP was examined using the mean score of each notional subgroup as an arbitrary cut-off point. Results Data were collected from 50 patients. The MAIL Scale did not appear to separate cases of LBP into the two notionally distinct groups of inflammatory (n = 6 or mechanical (n = 5. A larger "mixed symptom" group (n = 39 was revealed. Conclusions In this pilot study the MAIL Scale was unable to clearly discriminate between what is thought to be mechanical and inflammatory LBP in 50 cases seen in a chiropractic setting. However, the small sample size means any conclusions must be viewed with caution. Further research within a larger study population may be warranted and feasible.

  13. Fifty consecutive pancreatectomies without mortality

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    Enio Campos Amico

    Full Text Available Objective: to report the group's experience with a series of patients undergoing pancreatic resection presenting null mortality rates. Methods: we prospectively studied 50 consecutive patients undergoing pancreatic resections for peri-ampullary or pancreatic diseases. Main local complications were defined according to international criteria. In-hospital mortality was defined as death occurring in the first 90 postoperative days. Results: patients' age ranged between 16 and 90 years (average: 53.3. We found anemia (Hb < 12g/dl and preoperative jaundice in 38% and 40% of cases, respectively. Most patients presented with peri-ampullary tumors (66%. The most common surgical procedure was the Kausch - Whipple operation (70%. Six patients (12% needed to undergo resection of a segment of the mesenteric-portal axis. The mean operative time was 445.1 minutes. Twenty two patients (44% showed no clinical complications and presented mean hospital stay of 10.3 days. The most frequent complications were pancreatic fistula (56%, delayed gastric emptying (17.1% and bleeding (16%. Conclusion : within the last three decades, pancreatic resection is still considered a challenge, especially outside large specialized centers. Nevertheless, even in our country (Brazil, teams seasoned in such procedure can reach low mortality rates.

  14. Fifty years of Erlangen radiochemistry

    International Nuclear Information System (INIS)

    Morell, W.

    2007-01-01

    On June 29, 2006, the Radiochemical Laboratory of AREVA NP GmbH (formerly Siemens AG) in Erlangen celebrated its fiftieth anniversary. The occasion was marked by an event attended by more than 1,000 guests, among them Werner Gebauhr, the 85-year-old founder and first head of the Laboratory; the Managing Directors of AREVA NP GmbH, Ralf Gueldner and Ruediger Steuerlein; representatives of universities, research institutions, power utilities, and public authorities. The present head of the Radiochemical Laboratory, Wilfred Morell, sketched the highlights of the work performed over the past fifty years, which ranged from solid-state and very-high-purity materials technologies to development and service activities for nuclear technology. Manfred Erve, head of the Technical Center of AREVA NP GmbH, of which the Radiochemical Laboratory is a part, emphasized the changes in priorities over the past fifty years, which had always been met successfully by Radiochemistry. In the scientific part of the event, Wolfgang Schwarz (E.ON Kernkraftwerk GmbH, KKW Isar), Ulf Ilg (EnBW Kraftwerk AG, KKW Philippsburg), and Hans-Josef Allelein (Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH) explained 3 major subject areas in which Erlangen Radio-chemistry over many years has contributed basic findings (see other articles in this atw issue). On the occasion of the anniversary, a comprehensive booklet was published under the title of '50 Jahre Radiochemie Erlangen - 1956-2006'. (orig.)

  15. The clinical spectrum and therapeutic management of hypocomplementemic urticarial vasculitis: data from a French nationwide study of fifty-seven patients.

    Science.gov (United States)

    Jachiet, Marie; Flageul, Béatrice; Deroux, Alban; Le Quellec, Alain; Maurier, François; Cordoliani, Florence; Godmer, Pascal; Abasq, Claire; Astudillo, Leonardo; Belenotti, Pauline; Bessis, Didier; Bigot, Adrien; Doutre, Marie-Sylvie; Ebbo, Mikaël; Guichard, Isabelle; Hachulla, Eric; Héron, Emmanuel; Jeudy, Géraldine; Jourde-Chiche, Noémie; Jullien, Denis; Lavigne, Christian; Machet, Laurent; Macher, Marie-Alice; Martel, Clotilde; Melboucy-Belkhir, Sara; Morice, Cécile; Petit, Antoine; Simorre, Bernard; Zenone, Thierry; Bouillet, Laurence; Bagot, Martine; Frémeaux-Bacchi, Véronique; Guillevin, Loïc; Mouthon, Luc; Dupin, Nicolas; Aractingi, Selim; Terrier, Benjamin

    2015-02-01

    Hypocomplementemic urticarial vasculitis (HUV) is an uncommon vasculitis of unknown etiology that is rarely described in the literature. We undertook this study to analyze the clinical spectrum and the therapeutic management of patients with HUV. We conducted a French nationwide retrospective study that included 57 patients with chronic urticaria, histologic leukocytoclastic vasculitis, and hypocomplementemia. We assessed clinical and laboratory data and evaluated the patients' cutaneous and immunologic responses to therapy. We evaluated treatment efficacy by measuring the time to treatment failure. Urticarial lesions were typically more pruritic than painful and were associated with angioedema in 51% of patients, purpura in 35%, and livedo reticularis in 14%. Extracutaneous manifestations included constitutional symptoms (in 56% of patients) as well as musculoskeletal involvement (in 82%), ocular involvement (in 56%), pulmonary involvement (in 19%), gastrointestinal involvement (in 18%), and kidney involvement (in 14%). Patients with HUV typically presented with low C1q levels and normal C1 inhibitor levels, in association with anti-C1q antibodies in 55% of patients. Hydroxychloroquine or colchicine seemed to be as effective as corticosteroids as first-line therapy. In patients with relapsing and/or refractory disease, rates of cutaneous and immunologic response to therapy seemed to be higher with conventional immunosuppressive agents, in particular, azathioprine, mycophenolate mofetil, or cyclophosphamide, while a rituximab-based regimen tended to have higher efficacy. Finally, a cutaneous response to therapy was strongly associated with an immunologic response to therapy. HUV represents an uncommon systemic and relapsing vasculitis with various manifestations, mainly, musculoskeletal and ocular involvement associated with anti-C1q antibodies, which were found in approximately half of the patients. The best strategy for treating HUV has yet to be defined

  16. Fifty years with nuclear fission

    International Nuclear Information System (INIS)

    Behrens, J.W.; Carlson, A.D.

    1989-01-01

    The news of the discovery of nucler fission, by Otto Hahn and Fritz Strassmann in Germany, was brought to the United States by Niels Bohr in January 1939. Since its discovery, the United States, and the world for that matter, has never been the same. It therefore seemed appropriate to acknowledge the fiftieth anniversary of its discovery by holding a topical meeting entitled, ''Fifty years with nuclear fission,'' in the United States during the year 1989. The objective of the meeting was to bring together pioneers of the nuclear industry and other scientists and engineers to report on reminiscences of the past and on the more recent developments in fission science and technology. The conference highlighted the early pioneers of the nuclear industry by dedicating a full day (April 26), consisting of two plenary sessions, at the National Academy of Sciences (NAS) in Washington, DC. More recent developments in fission science and technology in addition to historical reflections were topics for two full days of sessions (April 27 and 28) at the main sites of the NIST in Gaithersburg, Maryland. The wide range of topics covered by Volume 2 of this topical meeting included plenary invited, and contributed sessions entitled, Nuclear fission -- a prospective; reactors II; fission science II; medical and industrial applications by by-products; reactors and safeguards; general research, instrumentation, and by-products; and fission data, astrophysics, and space applications. The individual papers have been cataloged separately

  17. Fifty years with nuclear fission

    International Nuclear Information System (INIS)

    Behrens, J.W.; Carlson, A.D.

    1989-01-01

    The news of the discovery of nuclear fission, by Otto Hahn and Fritz Strassmann in Germany, was brought to the United States by Niels Bohr in January 1939. Since its discovery, the United States, and the world for that matter, has never been the same. It therefore seemed appropriate to acknowledge the fifieth anniversary of its discovery by holding a topical meeting entitled, ''Fifty Years with Nuclear Fission,'' in the United States during the year 1989. The objective of the meeting was to bring together pioneers of the nuclear industry and other scientists and engineers to report on reminiscences of the past and on the more recent development in fission science and technology. The conference highlighted the early pioneers of the nuclear industry by dedicated a full day (April 26), consisting of two plenary sessions, at the National Academy of Sciences (NAS) in Washington, DC. More recent developments in fission science and technology in addition to historical reflections were topics for two fully days of sessions (April 27 and 28) at the main site of the NIST in Gaithersburg, Maryland. The wide range of topics covered in this Volume 1 by this topical meeting included plenary invited, and contributed sessions entitled: Preclude to the First Chain Reaction -- 1932 to 1942; Early Fission Research -- Nuclear Structure and Spontaneous Fission; 50 Years of Fission, Science, and Technology; Nuclear Reactors, Secure Energy for the Future; Reactors 1; Fission Science 1; Safeguards and Space Applications; Fission Data; Nuclear Fission -- Its Various Aspects; Theory and Experiments in Support of Theory; Reactors and Safeguards; and General Research, Instrumentation, and By-Product. The individual papers have been cataloged separately

  18. Atoms for peace plus fifty

    International Nuclear Information System (INIS)

    Eisenhower, S.

    2003-01-01

    One of Dwight Eisenhower's most significant political legacies stemmed from his management of the nuclear question. Five decades after Eisenhower's 'Atoms for Peace' speech before the United Nations, the nuclear dilemma persists but the world is a different, and I would submit, a better place today than it might have been had that vision not been articulated, or its proposals not advanced. The 'Atoms for Peace' speech had a number of objectives, but it is over arching goal was to propose a set of ideas, a nuclear strategy, which would call on the Soviets to cooperate internationally for the betterment of mankind. This would reengage the Soviets in discussions on nuclear matters at a time when arms control talks had stalled, but it would also offer hope, and a practical set of ideas, to the developing world. 'Atoms for Peace' spawned many developments, including the establishment of the International Atomic Energy Agency, and eventually the Nuclear Non-Proliferation Treaty. While 'Atoms for Peace', as well as the institutions it created, has come under fire in recent years, it is hard to imagine what the world would have been like without it. Largely through the international Atomic Energy Agency, nations around the world have participated in research and development programs, including the use of nuclear energy in important civilian applications. Nuclear electric power accounts for nearly one-fifth of the world's electricity - reducing global tensions by replacing oil in many applications, and providing much of the world's electricity that is generated without the release of greenhouse gases or other destructive emissions. Many other nuclear and radiation-related technologies, especially radiopharmaceuticals and medical advances involving radiation, have resulted in large part from research spawned by 'Atoms for Peace'. Millions of lives have been saved in the process. While the 'nuclear dilemma' remains a challenge almost as complex as it was fifty years ago, the

  19. Fifty years of pacemaker advancements.

    Science.gov (United States)

    Steinhaus, David

    2008-12-01

    A 1957 power blackout in Minnesota prompted C. Walton Lillehei, MD, a pioneer in open heart surgery, to ask Earl Bakken, the co-founder of Medtronic, Inc., to create a battery-operated pacemaker for pediatric patients. That conversation led to the development of the first external battery-operated pacemaker. That first bulky device is far removed from the tiny implantable computers available to heart patients today. Now, the size of two silver dollars stacked on top of one another, a pacemaker is prescribed for a person whose heart beats too slowly or pauses irregularly. Slightly larger devices have more recently evolved from pacing and regulating the heartbeat to being able to provide therapeutic high voltage shocks when needed to stop runaway fast heart rates, recording heart activity, and other physiologic functions, even resynchronizing the heart's chambers-all while providing information on the patient's condition and device performance to the doctor remotely or in the office.

  20. Fifty years of nuclear magnetic resonance

    International Nuclear Information System (INIS)

    Martinez Valderrama, Juan Crisostomo

    1997-01-01

    Short information about the main developments of nuclear magnetic resonance during their fifty existence years is presented. Beside two examples of application (HETCOR and INADEQUATE) to the structural determination of organic compounds are described

  1. The American oil industry and the Fifty-Fifty Agreement of 1950

    International Nuclear Information System (INIS)

    Anderson, T.H.

    1988-01-01

    This paper traces the history of the Fifty-fifty Agreement of 1950, and the role of the American oil industry in that agreement. Regardless of the definition one chooses for the term foreign policy, it can now be argued with considerable force that the Fifty-fifty Agreement was, in fact, the product of American foreign policy. Defining the term narrowly as the enunciated policy of the Executive Branch of Government on matters outside the national boundary, it is clear that a consistent policy had been in place for a long time supporting exactly the type of action which was taken hear. Defining the term broadly, as the defacto cumulative thrust of all competing interest groups within a nation-state (both governmental and private) outside the national boundary, makes the assertion even more clear. Including Aramco and the parent companies in the equation leaves little doubt that the Fifty-fifty Agreement was the product of American foreign policy

  2. Columbia physics in the fifties: Untold tales

    Directory of Open Access Journals (Sweden)

    J. Sucher

    2000-07-01

    Full Text Available Eyvind Wichmann and I were both graduate students at Columbia University in the fifties, a decade of remarkable creativity by a star-studded physics faculty, which included some ten Nobel Laureates. I share some reminiscences about our time there and explain the role played in our relationship by an eightball.

  3. Information Systems Curricula: A Fifty Year Journey

    Science.gov (United States)

    Longenecker, Herbert E., Jr.; Feinstein, David; Clark, Jon D.

    2013-01-01

    This article presents the results of research to explore the nature of changes in skills over a fifty year period spanning the life of Information Systems model curricula. Work begun in 1999 was expanded both backwards in time, as well as forwards to 2012 to define skills relevant to Information Systems curricula. The work in 1999 was based on job…

  4. Fifty years ago - nuclear physics at Cambridge

    International Nuclear Information System (INIS)

    Burcham, W.E.

    1982-01-01

    Fifty years ago, the Cavendish saw the first nuclear transformations using artificially accelerated particles, and was soon to provide confirmation of the discovery of the positron. In 1932, the Cavendish Laboratory under the guiding hand of Rutherford was a world focus for research and with these discoveries saw the birth of modern particle physics. (orig.).

  5. Fifty challenging problems in probability with solutions

    CERN Document Server

    Mosteller, Frederick

    1987-01-01

    Can you solve the problem of ""The Unfair Subway""? Marvin gets off work at random times between 3 and 5 p.m. His mother lives uptown, his girlfriend downtown. He takes the first subway that comes in either direction and eats dinner with the one he is delivered to. His mother complains that he never comes to see her, but he says she has a 50-50 chance. He has had dinner with her twice in the last 20 working days. Explain. Marvin's adventures in probability are one of the fifty intriguing puzzles that illustrate both elementary ad advanced aspects of probability, each problem designed to chall

  6. First Fifty Years of Chemoresistive Gas Sensors

    Directory of Open Access Journals (Sweden)

    Giovanni Neri

    2015-01-01

    Full Text Available The first fifty years of chemoresistive sensors for gas detection are here reviewed, focusing on the main scientific and technological innovations that have occurred in the field over the course of these years. A look at advances made in fundamental and applied research and leading to the development of actual high performance chemoresistive devices is presented. The approaches devoted to the synthesis of novel semiconducting materials with unprecedented nanostructure and gas-sensing properties have been also presented. Perspectives on new technologies and future applications of chemoresistive gas sensors have also been highlighted.

  7. Fifty years of sociological leadership at Social Science and Medicine.

    Science.gov (United States)

    Timmermans, Stefan; Tietbohl, Caroline

    2018-01-01

    In this review article, we examine some of the conceptual contributions of sociology of health and illness over the past fifty years. Specifically, we focus on research dealing with medicalization, the management of stigma, research on adherence and compliance, and patient-doctor interaction. We show how these themes that originated within sociology, diffused in other disciplines. Sociology in Social Science and Medicine started as an applied research tradition but morphed into a robust, stand-alone social science tradition. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Nuclear fission discovered fifty years ago

    International Nuclear Information System (INIS)

    Weis, M.

    1988-01-01

    Fifty years ago, Otto Hahn, Lise Meitner and Fritz Strassmann discovered the process of nuclear fission which, more than other scientific discoveries to date, profoundly has changed the world and continues to influence our life significantly: This discovery made the up to then incontestable physicists' view of the atom as an inseparable whole suddenly shatter to pieces. It has brought about the invaluable advantages of a peaceful utilization of nuclear energy, and at the same time put scientists in the position to build the most terrible weapon ever, threatening mankind and earth with complete destruction. All this certainly is reason enough to recall the scientists, their work and the spirit of the time. (orig.) [de

  9. Fifty shades of exploitation: Fan labor and Fifty Shades of Grey

    Directory of Open Access Journals (Sweden)

    Bethan Jones

    2014-03-01

    Full Text Available This exploration of the debates that have taken place in fandom over the ethics of pulling fan fiction and publishing it as original work draws on the notion of the fannish gift economy, which postulates that gifts such as fan fiction and fan art have value in the fannish community because they are designed to create and cement its social structure. Tension exists between fans who subscribe to the notion of a fannish gift economy and those who exploit fandom by using it to sell their pulled-to-publish works. An examination of E. L. James's 2012 Fifty Shades trilogy (comprising the books Fifty Shades of Grey, Fifty Shades Darker, and Fifty Shades Freed, which began as Twilight fan fiction, in addition to Twilight fan art sold through sites such as Redbubble and Etsy, demonstrates a tension between the two modes of fan expression: sale of artworks appears to be an acceptable practice in fandom, but the commercial sale of fan fic, even when marketed as original fiction, is widely contested.

  10. Nuclear magnetic resonance evaluation of fifty children with cancer

    International Nuclear Information System (INIS)

    Cohen, M.D.; Klatte, E.C.; Smith, J.A.; Carr, B.E.; Martin-Simmerman, P.

    1985-01-01

    Fifty children with cancer have been studied by MR. The patients studied include ten with lymphoma, nine with neuroblastoma, five with rhabdomyosarcoma, six with leukemia, five with Ewings sarcoma, four with Wilms tumor and several with other miscellaneous tumors. The results of scanning show that MR is well tolerated by children. Primary tumor has been identified in every case. Metastases have been identified in many patients. MR has proved helpful in identifying the organ of origin of a tumor. Because of excellent vessel visualization it is helpful in planning surgical resection of a tumor. In addition, in a number of patients MR has proved helpful in monitoring the response of tumor to nonsurgical therapy. With continued improvement in image quality it is believed that MR has a major role to play in pediatric tumor imaging [fr

  11. Methods of patient warming during abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Li Shao

    Full Text Available BACKGROUND: Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. METHODS: Patients (n = 160 scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients' nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. RESULTS: When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. DISCUSSION: The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed.

  12. FIFTY-FIVE GALLON DRUM STANDARD STUDY

    International Nuclear Information System (INIS)

    Puigh, R.J.

    2009-01-01

    Fifty-five gallon drums are routinely used within the U.S. for the storage and eventual disposal of fissionable materials as Transuranic or low-level waste. To support these operations, criticality safety evaluations are required. A questionnaire was developed and sent to selected Endusers at Hanford, Idaho National Laboratory, Lawrence Livermore National Laboratory, Oak Ridge and the Savannah River Site to solicit current practices. This questionnaire was used to gather information on the kinds of fissionable materials packaged into drums, the models used in performing criticality safety evaluations in support of operations involving these drums, and the limits and controls established for the handling and storage of these drums. The completed questionnaires were reviewed and clarifications solicited through individual communications with each Enduser to obtain more complete and consistent responses. All five sites have similar drum operations involving thousands to tens of thousands of fissionable material waste drums. The primary sources for these drums are legacy (prior operations) and decontamination and decommissioning wastes at all sites except Lawrence Livermore National Laboratory. The results from this survey and our review are discussed in this paper

  13. Fifty years of 'Atoms for Peace'

    International Nuclear Information System (INIS)

    Heller, W.

    2004-01-01

    Fifty years ago, on December 8, 1953, the then U.S. President, Dwight D. Eisenhower, in his famous speech before the General Assembly of the United Nations proclaimed his 'Atoms for Peace' program, which was to initiate a policy of international cooperation. The event had been preceded by a policy of the United States intended to guarantee to the United States the monopoly in the production and use of nuclear weapons, which ultimately failed because of the resistance of the Soviet Union. The doctrine of a technological monopoly in the nuclear field was to be changed in favor of cooperative ventures under the rigorous control of the United States. The 1954 Atomic Energy Act clearly formulated the will to cooperate. Following a U.S. initiative, the International Atomic Energy Agency (IAEA) was founded in 1956 to assist in transfers of nuclear technology and assume controlling functions to prevent abuse for non-peaceful purposes. Quite a number of countries used the 'Atoms for Peace' offer to develop nuclear power in very close cooperation with American industry and depending on U.S. nuclear fuel supply. On the whole, 'Atoms for Peace' has paved the way to a worldwide peaceful use of nuclear power. (orig.)

  14. The Kramers problem: Fifty years of development

    International Nuclear Information System (INIS)

    Mel'nikov, V.O.

    1990-09-01

    In the last fifty years the seminal work by Kramers of 1940 has been greatly extended both by elaboration of new theoretical approaches and through applications to new experimental systems. The most interesting case turns out to be the regime of weak-to-medium damping, in which case the Fokker-Planck equation can be reduced to an equation or to a system of integral equations of the Wiener-Hopf type. Exact solutions can then be given for the escape rate from single- and double-well potentials. This general scheme can be naturally extended to include quantum penetration through a semiclassical barrier and the effect of quantum noise. Finally, we consider the Brownian motion in a tilted washboard potential using Josephson junctions as an illustrative example. In that context we calculate (i) fluctuation-induced voltage-current characteristics, (ii) the lifetime of a zero-voltage state, (iii) the lifetime of the running state, (iv) partial probabilities of the phase jumps by 2πn (n is an integer) and (v) retrapping current distribution in both classical and quantum regimes. (author). 61 refs, 17 figs

  15. ``Fifty-fifty`` - an unexpectedly successful start. Implementation of Agenda 21 results in energy savings in school buildings; ``Fifty-fifty`` - ein erfreulich erfolgreicher Start. Energieeinsparung durch praktizierte Agenda 21 in Schulen

    Energy Technology Data Exchange (ETDEWEB)

    Schafhausen, F. [Bundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit, Bonn (Germany)

    1998-10-01

    The idea of the `Fifty-Fifty` pilot project was conceived at the environmental department of the Hamburg municipal authority; its implementation took place in close cooperation with the department for schools, the young, and vocational training (`BSJB`). It started in October 94 and was finalized in June 97. After its successful completion, `Fifty-Fifty` meanwhile has the status of a permanent project.- For decades it has been known that public buildings consume added energy (power and heat) as well as water not only because technical devices are lacking or obsolete but also because of negligence and carelessness. `Fifty-Fifty` endeavours to bring about a change. (orig.) [Deutsch] Geschichte des `Fifty-fifty`-Modells: Die Idee wurde von der Hamburger Umweltbehoerde entwickelt und in enger Zusammenarbeit mit der Behoerde fuer Schule, Jugend und Berufsbildung (BSJB) umgesetzt. Der Modellversuch wurde im Oktober 1994 gestartet und im Juni 1997 abgeschlossen. Nach der erfolgreichen Beendigung des Modellversuchs hat `Fifty-fifty` mittlerweile den Status eines Dauerprojekts. Seit Jahrzehnten ist bekannt, dass in oeffentlich genutzten Gebaeuden nicht nur aufgrund fehlender oder veralteter technischer Ausstattung, sondern insbesondere auch wegen eines unsachgemaessen oder gedankenlosen Verhaltens mehr Energie (Strom und Waerme) und mehr Wasser verbraucht werden. `Fifty-fifty` tut etwas dagegen. (orig.)

  16. Diabetes mellitus during pregnancy: a study of fifty cases

    International Nuclear Information System (INIS)

    Randhawa, M. S.; Moin, S.; Shoaib, F.

    2003-01-01

    To review and critically evaluated the incidence, epidemiology, clinical pattern, diagnosis, management, complications and outcome of diabetes mellitus during pregnancy in hospital based study. Results: Total number of women delivered were 11271. Fifty cases of diabetes mellitus during pregnancy were studied. Mostly the patients were more than 30 years of age, multiparous ladies with gestational diabetes in 80% of cases, Type-II diabetes in 16% and only in 4% Type-I diabetes was reported. Insulin was required in 40% of patients. Eight women out of 50 had spontaneous miscarriage, 5 underwent preterm delivery while 36 reached term with one intrauterine death. Total number of babies delivered alive were 41. There was one stillbirth and 3 neonatal deaths. Conclusion: Management of diabetes mellitus in pregnancy involves teamwork of obstetricians, physicians and neonatologists. (author)

  17. Fifty-seven cases of osteoarthritis of knee joint treated with needling method of Canggui Tanxue%苍龟探穴针法治疗膝关节骨性关节炎57例

    Institute of Scientific and Technical Information of China (English)

    胡伟民; 东贵荣

    2011-01-01

    @@ Osteoarthritis (OA) of knee joint is a common chronic joint disease in community.It is seen in middle-aged and old people generally.In clinic, a great deal of attention is paid because of its serious pain and motor impairment of knee joint.These symptoms become the important factors affecting the survival quality of the middle-aged and old people.The authors adopted the needling method of Canggui tanxue (needling manipulation for promoting qi) to treat 57 cases of the disease in Community Health Service Center.The report is as follows.

  18. German Atomic Energy Act turns fifty

    International Nuclear Information System (INIS)

    Schneider, Horst

    2009-01-01

    The German Atomic Energy Act entered into force on January 1, 1960. It turns fifty at the beginning of 2010. Is this a reason to celebrate or rather the opposite? Lawyers, in principle, can view old pieces of legislation from 2 perspectives: On the one hand, aged laws are treated in a spirit of veneration and are celebrated as proven. On the other hand, an anniversary of this kind can be a welcome reason for demands to abolish or, at least, fundamentally renew that law. Over the past half century, the German Atomic Energy Act went through stormy and varied phases both of a legal and a political character. Its 50 th anniversary is likely to spark off very conflicting evaluations as well. A review of legal history shows that the German or, rather, the Federal German Atomic Energy Act (AtG) was not a first-of-its-kind piece of legislation but stemmed from the 1957 EURATOM Treaty, in a way representing a latecomer of that treaty. The Atomic Energy Act experienced a number of important developments throughout its history: - In 1975, compulsory licensing of fuel element factories was introduced. - The back end of the fuel cycle, especially final storage, were incorporated in the Atomic Energy Act comprehensively first in 1976. - In 1985, legislators decided in favor of unlimited nuclear liability. - In 1994 and 1998, only some innovations in special items were introduced under the headings of environmental impact assessment and suitability for repository storage because the controversy about nuclear power did not permit a fundamental alignment towards a more comprehensive modern safety law. - The decision to opt out of the peaceful uses of nuclear power in 2002 drew the final line so far of decisions about directions of nuclear law in a major amendment. In parallel, the decisions by the Federal Constitutional Court and the Federal Administrative Court in the late 1970s and, above all, the 1980s provided important assistance which has remained valid to this day. What is

  19. Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study.

    Science.gov (United States)

    Epinette, Jean-Alain; Harwin, Steven F; Rowan, Fiachra E; Tracol, Philippe; Mont, Michael A; Chughtai, Morad; Westrich, Geoffrey H

    2017-03-01

    To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age. A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis. There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants. Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.

  20. Analysis of Body Constitution of Fifty-two Patients with Stevens-Johnson Syndrome (SJS) Using Kampo Medical Questionnaires: Prediction of SJS based on Body Constitution Using Decision Tree

    OpenAIRE

    大嶋, 繁; 羽鳥, 有紀子; 本間, 精一; 寺澤, 捷年; 齋藤, 侑也; 小林, 大介

    2011-01-01

    Reports have indicated a relationship between adverse drug reaction (ADR) and Human Leukocyte Antigen (HLA) polymorphism and a relationship between Body Constitution (BC) and HLA polymorphism. Thus, a relationship between ADR and BC is suggested. We therefore created a questionnaire (hereinafter “Questionnaire”) to survey the typical BC of Stevens-Johnson Syndrome (SJS) patients to determine how they differ from healthy persons, and studied the relationship between the development of SJS and ...

  1. Fifty years after Hiroshima and Nagasaki

    International Nuclear Information System (INIS)

    Nishiwaki, Y.

    1996-01-01

    factors such as those mentioned above must be considered in interpreting the effect of the atomic bombing, instead of ascribing all the effects solely to ionizing radiation. Fifty years ago, in 1945, the first three atomic bombs in human history were produced by the United States; one of these bombs was exploded experimentally at the testing ground in the desert 80 km from Alamogordo, New Mexico, on 16 July. The remaining two were used against Japan; the one called L ittle Boy , using Uranium 235 was dropped on Hiroshima on 6 August, the other F at Man , using Plutonium 239 on Nagasaki on 9 August, 1945

  2. Fifty Years of HF Doppler Observations

    Directory of Open Access Journals (Sweden)

    T Ogawa

    2009-04-01

    Full Text Available High frequency Doppler observations of the ionosphere began in August of 1957 in Kyoto. The number of the observation points worldwide were about 40 in 1980 and are about 20 at present. By this method the movement of the ionosphere reflection height and electron density below the height can be observed. Such variations are occurred by a wide variety of sources.

  3. The fifty-year-old woman and midlife stress.

    Science.gov (United States)

    Campbell, S

    It has been assumed that the fifties are a relatively stable decade; however, women in their fifties are susceptible to many stresses, internal and external. The possibilities of widowhood, divorce, or poverty, combined with intra- and interpersonal strains, make this a time of insecurity about aging for many women. Some suggestions as to why women nonetheless cope successfully with aging are considered.

  4. Display methods of electronic patient record screens: patient privacy concerns.

    Science.gov (United States)

    Niimi, Yukari; Ota, Katsumasa

    2013-01-01

    To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

  5. Fifty Years of Physics of Living Systems.

    Science.gov (United States)

    Latash, Mark L

    2016-01-01

    The equilibrium-point hypothesis and its more recent version, the referent configuration hypothesis, represent the physical approach to the neural control of action. This hypothesis can be naturally combined with the idea of hierarchical control of movements and of synergic organization of the abundant systems involved in all actions. Any action starts with defining trajectories of a few referent coordinates for a handful of salient task-specific variables. Further, referent coordinates at hierarchically lower levels emerge down to thresholds of the tonic stretch reflex for the participating muscles. Stability of performance with respect to salient variables is reflected in the structure of inter-trial variance and phenomena of motor equivalence. Three lines of recent research within this framework are reviewed. First, synergic adjustments of the referent coordinate and apparent stiffness have been demonstrated during finger force production supporting the main idea of control with referent coordinates. Second, the notion of unintentional voluntary movements has been introduced reflecting unintentional drifts in referent coordinates. Two types of unintentional movements have been observed with different characteristic times. Third, this framework has been applied to studies of impaired movements in neurological patients. Overall, the physical approach searching for laws of nature underlying biological movement has been highly stimulating and productive.

  6. Fifty Years of Innovation in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Richard M Kwasnicki

    2016-03-01

    Full Text Available BackgroundInnovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years.MethodsPatents and publications related to plastic surgery (1960 to 2010 were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored.ResultsBetween 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued.ConclusionsThe application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

  7. Fifty years of hemodialysis access literature: The fifty most cited publications in the medical literature.

    Science.gov (United States)

    Skripochnik, Edvard; O'Connor, David J; Trestman, Eric B; Lipsitz, Evan C; Scher, Larry A

    2018-02-01

    Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960-2014. Articles were selected based on a subject search and were ranked according to the number of times they were cited in the medical literature. Results The 50 most frequently cited articles were selected for further analysis and the number of annual publications was tracked. The landmark publication by Dr Brescia et al. was unequivocally the most cited article dealing with hemodialysis access (1109 citations). The subject matter of the papers included AV fistula and graft (9), hemodialysis catheter (9), complications and outcomes (24), and other topics (8). Most articles were published in nephrology journals (33), with fewer in surgery (7), medicine (7), and radiology (3) journals. Of the 17 journals represented, Kidney International was the clear leader, publishing 18 articles. There has been an exponential rise in the frequency of publications regarding dialysis access with 42 of 50 analyzed papers being authored after 1990. Conclusion As the number of patients on hemodialysis has increased dramatically over the past five decades, there has been a commensurate increase in the overall number of publications related to hemodialysis access.

  8. EDITORIAL: Semiconductor lasers: the first fifty years Semiconductor lasers: the first fifty years

    Science.gov (United States)

    Calvez, S.; Adams, M. J.

    2012-09-01

    Anniversaries call for celebrations. Since it is now fifty years since the first semiconductor lasers were reported, it is highly appropriate to celebrate this anniversary with a Special Issue dedicated to the topic. The semiconductor laser now has a major effect on our daily lives since it has been a key enabler in the development of optical fibre communications (and hence the internet and e-mail), optical storage (CDs, DVDs, etc) and barcode scanners. In the early 1960s it was impossible for most people (with the exception of very few visionaries) to foresee any of these future developments, and the first applications identified were for military purposes (range-finders, target markers, etc). Of course, many of the subsequent laser applications were made possible by developments in semiconductor materials, in the associated growth and fabrication technology, and in the increased understanding of the underlying fundamental physics. These developments continue today, so that the subject of semiconductor lasers, although mature, is in good health and continues to grow. Hence, we can be confident that the pervasive influence of semiconductor lasers will continue to develop as optoelectronics technology makes further advances into other sectors such as healthcare, security and a whole host of applications based on the global imperatives to reduce energy consumption, minimise environmental impact and conserve resources. The papers in this Special Issue are intended to tell some of the story of the last fifty years of laser development as well as to provide evidence of the current state of semiconductor laser research. Hence, there are a number of papers where the early developments are recalled by authors who played prominent parts in the story, followed by a selection of papers from authors who are active in today's exciting research. The twenty-fifth anniversary of the semiconductor laser was celebrated by the publication of a number of papers dealing with the early

  9. Las notas al pie en la traducción de Fifty Shades (Footnotes in the Translation of Fifty Shades

    Directory of Open Access Journals (Sweden)

    Xinia Valverde Jara

    2017-11-01

    Full Text Available Se analiza el recurso de las notas a pie de página insertas en la traducción independiente de literatura comercial en versión digital, de la trilogía Fifty Shades of Grey, Fifty Shades Darker y Fifty Shades Freed, de E. L. James. Se examina el grado de influencia de esos elementos extratextuales, y se concluye que todos ellos, organizados en un complejo proceso de traducción, en especial los del contexto de llegada, condicionan la estrategia traductológica. Abstract This study examines the use of footnotes as a translation strategy in the independent translation of commercial literature in digital format, based on the trilogy written by E. L. James, Fifty Shades of Grey, Fifty Shades Darker and Fifty Shades Freed. The analysis measures the influence of these extratextual elements within the complex translation process, specifically those of the target language context, and it is concluded that they condition the translation strategies used.

  10. Prediction of prognosis in patients with epidural hematoma by a new stereological method

    International Nuclear Information System (INIS)

    Kalkan, E.; Cander, B.; Gul, M.; Girisgin, S.; Karabagli, H.; Sahin, B.

    2007-01-01

    Epidural hematoma (EH) is a serious clinical event observed in 2% of head trauma patients. Studies regarding the effects of epidural hematoma volume (EHV) on prognosis are not sufficient. In this study, we applied the volume fraction approach of the stereological method to estimate the hematoma to brain volume fraction (HBVF), and investigated the relation between the HBVF and prognosis. Fifty-nine EH patients (46 male and 13 female subjects, with average age of 21 years) admitted to the emergency clinic were included. The HBVF was estimated on the printed films of cranial computed tomography scans. For this purpose, common point counting grids were superimposed over the scan frames. According to the clinical results, patients were divided into three groups as complete recovery (43), disability (8) and exitus (8). The HBVF was compared with the clinical results. HBVF was determined as 4.6% in the patients with recovery, 8.1% in disability, and 7.6% in exitus patients. The HBVF values were lowest in recovery patients, and the difference between the recovery and the other two groups was statistically significant (p=0.007). However, there was no statistically significant difference in HBVF between disability and exitus patients (p>0.05). In conclusion, the HBVF can be an important tool to determine prognosis, and it can be measured using the volume fraction approach of stereological methods as developed in the present study. (author)

  11. Domain analysis of computational science - Fifty years of a scientific computing group

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, M.

    2010-02-23

    I employed bibliometric- and historical-methods to study the domain of the Scientific Computing group at Brookhaven National Laboratory (BNL) for an extended period of fifty years, from 1958 to 2007. I noted and confirmed the growing emergence of interdisciplinarity within the group. I also identified a strong, consistent mathematics and physics orientation within it.

  12. 1977 flywheel technology symposium proceedings. [Fifty-two papers

    Energy Technology Data Exchange (ETDEWEB)

    Chang, G.C.; Stone, R.G. (eds.)

    1978-03-01

    Fifty-two papers, four paper abstracts, and four brief summaries of panel discussions are presented on flywheel energy storage technology. A separate abstract was prepared for each of 41 papers for inclusion in DOE Energy Research Abstracts (ERA). Eleven papers were processed previously for inclusion in the data base. (PMA)

  13. A seasonal variation of the three Leading diagnoses over fifty ...

    African Journals Online (AJOL)

    A seasonal variation of the three Leading diagnoses over fifty months at the Duk Lost. Boys Clinic, South Sudan reed, williama, Dannan, Tomb, Friedman Danielc, MD, Manyok gabrield, Connor Barbarae, MD, reed Davidf, MD. Introduction. The Duk Lost Boys Clinic, a Primary Health Care Clinic in Duk Payuel, is the only ...

  14. Use of multiple methods to determine factors affecting quality of care of patients with diabetes.

    Science.gov (United States)

    Khunti, K

    1999-10-01

    The process of care of patients with diabetes is complex; however, GPs are playing a greater role in its management. Despite the research evidence, the quality of care of patients with diabetes is variable. In order to improve care, information is required on the obstacles faced by practices in improving care. Qualitative and quantitative methods can be used for formation of hypotheses and the development of survey procedures. However, to date few examples exist in general practice research on the use of multiple methods using both quantitative and qualitative techniques for hypothesis generation. We aimed to determine information on all factors that may be associated with delivery of care to patients with diabetes. Factors for consideration on delivery of diabetes care were generated by multiple qualitative methods including brainstorming with health professionals and patients, a focus group and interviews with key informants which included GPs and practice nurses. Audit data showing variations in care of patients with diabetes were used to stimulate the brainstorming session. A systematic literature search focusing on quality of care of patients with diabetes in primary care was also conducted. Fifty-four potential factors were identified by multiple methods. Twenty (37.0%) were practice-related factors, 14 (25.9%) were patient-related factors and 20 (37.0%) were organizational factors. A combination of brainstorming and the literature review identified 51 (94.4%) factors. Patients did not identify factors in addition to those identified by other methods. The complexity of delivery of care to patients with diabetes is reflected in the large number of potential factors identified in this study. This study shows the feasibility of using multiple methods for hypothesis generation. Each evaluation method provided unique data which could not otherwise be easily obtained. This study highlights a way of combining various traditional methods in an attempt to overcome the

  15. Extreme Markup: The Fifty US Hospitals With The Highest Charge-To-Cost Ratios.

    Science.gov (United States)

    Bai, Ge; Anderson, Gerard F

    2015-06-01

    Using Medicare cost reports, we examined the fifty US hospitals with the highest charge-to-cost ratios in 2012. These hospitals have markups (ratios of charges over Medicare-allowable costs) approximately ten times their Medicare-allowable costs compared to a national average of 3.4 and a mode of 2.4. Analysis of the fifty hospitals showed that forty-nine are for profit (98 percent), forty-six are owned by for-profit hospital systems (92 percent), and twenty (40 percent) operate in Florida. One for-profit hospital system owns half of these fifty hospitals. While most public and private health insurers do not use hospital charges to set their payment rates, uninsured patients are commonly asked to pay the full charges, and out-of-network patients and casualty and workers' compensation insurers are often expected to pay a large portion of the full charges. Because it is difficult for patients to compare prices, market forces fail to constrain hospital charges. Federal and state governments may want to consider limitations on the charge-to-cost ratio, some form of all-payer rate setting, or mandated price disclosure to regulate hospital markups. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Conceptualising patient empowerment: a mixed methods study

    NARCIS (Netherlands)

    Bravo, P.; Edwards, A.; Barr, P.J.; Scholl, I.; Elwyn, G.; Mcallister, M.

    2015-01-01

    BACKGROUND: In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess

  17. Nuclear spin: Fifty years of ups and downs

    Energy Technology Data Exchange (ETDEWEB)

    Pines, A. [Lawrence Berkeley National Lab., CA (United States)

    1996-12-31

    Rumors of its demise notwithstanding, nuclear magnetic resonance (NMR) continues to flourish fifty years after our birth. The lecture will be a reminiscence about moments of excitation, coherence and relaxation in the history of NMR which produced, among other developments, spin echoes and time reversal, Fourier transform and multidimensional spectroscopy, magnetic resonance imaging, and high resolution solid state NMR. Applications of modern NMR spectroscopy cut across the boundaries of physics, chemistry, materials, biology and medicine.

  18. Fifty years of Cuba's medical diplomacy: from idealism to pragmatism.

    Science.gov (United States)

    Feinsilver, Julie M

    2010-01-01

    Medical diplomacy, the collaboration between countries to simultaneously produce health benefits and improve relations, has been a cornerstone of Cuban foreign policy since the outset of the revolution fifty years ago. It has helped Cuba garner symbolic capital (goodwill, influence, and prestige) well beyond what would have been possible for a small, developing country, and it has contributed to making Cuba a player on the world stage. In recent years, medical diplomacy has been instrumental in providing considerable material capital (aid, credit, and trade), as the oil-for-doctors deals with Venezuela demonstrates. This has helped keep the revolution afloat in trying economic times. What began as the implementation of the one of the core values of the revolution, namely health as a basic human right for all peoples, has continued as both an idealistic and a pragmatic pursuit. This article examines the factors that enabled Cuba to conduct medical diplomacy over the past fifty years, the rationale behind the conduct of this type of soft power politics, the results of that effort, and the mix of idealism and pragmatism that has characterized the experience. Moreover, it presents a typology of medical diplomacy that Cuba has used over the past fifty years.

  19. Seizure threshold and the half-age method in bilateral electroconvulsive therapy in Japanese patients.

    Science.gov (United States)

    Yasuda, Kazuyuki; Kobayashi, Kaoru; Yamaguchi, Masayasu; Tanaka, Koichi; Fujii, Tomokazu; Kitahara, Yuichi; Tamaoki, Toshio; Matsushita, Yutaka; Nunomura, Akihiko; Motohashi, Nobutaka

    2015-01-01

    Seizure threshold (ST) in electroconvulsive therapy (ECT) has not been reported previously in Japanese patients. We investigated ST in bilateral ECT in Japanese patients using the dose-titration method. The associations between demographic and clinical characteristics and ST were analyzed to identify the predictors of ST. Finally, the validity of the half-age method for the stimulus dose was evaluated. Fifty-four Japanese patients with mood disorder, schizophrenia, and other psychotic disorders received an acute course of bilateral ECT using a brief-pulse device. ST was determined at the first session using a fixed titration schedule. ST was correlated with age, sex, body mass index, history of previous ECT, and psychotropic drugs on multiple regression analysis. Furthermore, the rate of accomplished seizures was calculated using the half-age method. Mean ST was 136 mC. ST was influenced by age, sex, history of previous ECT, and medication with benzodiazepines. The accomplished seizure rate using the half-age method was 72%, which was significantly lower in men and subjects on benzodiazepines. ST in Japanese patients was equal to or slightly higher than that previously reported in other ethnic groups, which might be attributable, at least in part, to high prevalence of and large-dose benzodiazepine prescription. Higher age, male gender, no history of ECT, and benzodiazepines were related to higher ST. The half-age method was especially useful in female patients and subjects without benzodiazepine medication. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  20. Age-related changes in the macula. A histopathological study of fifty Indian donor eyes

    OpenAIRE

    Biswas Jyotirmay; Raman Rajiv

    2002-01-01

    PURPOSE: Age-related macular degeneration (ARMD) is clinically less common in India compared to the West. Therefore, clinicians are unfamiliar with histopathologic evidence of age-related macular changes in the Indian population. METHODS: Fifty consecutive human donor eyes removed for corneal grafting were studied for gross, microscopic and histochemical features of age-related changes in the macula in the Indian population. A horizontal block was cut from the globe including the optic disc, ...

  1. Stressors and coping methods among chronic haemodialysis patients in Hong Kong.

    Science.gov (United States)

    Mok, E; Tam, B

    2001-07-01

    The purpose of the study was to determine the stressors and coping methods of chronic haemodialysis patients in Hong Kong. Relationships among treatment-related stressors, coping methods and length of time on haemodialysis were explored. Fifty subjects completed the Haemodialysis Stressor Scale (HSS) and Jalowiec Coping Scale (JCS). Results revealed that limitation of fluid was the most frequently identified stressor, followed by limitation of food, itching, fatigue and cost. The most common coping methods are 'accepted the situation because very little could be done', followed by 'told oneself not to worry because everything would work out fine' and 'told oneself that the problem was really not that important.' It was found that the traditional philosophies of the Chinese--Confucianism, Buddhism, and Taoism--share an approach to the understanding and management of life stressors as different from that adopted by Western philosophies. The findings of this study can further facilitate nurse practitioners in providing support, information, and alternative solutions when assisting patients in coping with long-term haemodialysis.

  2. Fluorescence In Situ Hybridization and Immunohistochemistry as Diagnostic Methods for ALK Positive Non-Small Cell Lung Cancer Patients

    Science.gov (United States)

    Martinez, Pablo; Hernández-Losa, Javier; Cedrés, Susana; Castellví, Josep; Martinez-Marti, Alex; Tallada, Natalia; Murtra-Garrell, Nuria; Navarro-Mendivill, Alejandro; Rodriguez-Freixinos, Victor; Canela, Mercedes; Ramon y Cajal, Santiago; Felip, Enriqueta

    2013-01-01

    Background Anaplastic Lymphoma Kinase (ALK) positivity represents a novel molecular target in a subset of Non-Small Cell Lung Cancers (NSCLC). We explore Fluorescence in situ Hybridization (FISH) and Immunohistochemistry (IHC) as diagnostic methods for ALK positive patients and to describe its prevalence and outcomes in a population of NSCLC patients. Methods NSCLC patients previously screened for Epidermal Growth Factor Receptor (EGFR) at our institution were selected. ALK positive patients were identified by FISH and the value of IHC (D5F3) was explored. Results ninety-nine patients were identified. Median age was 61.5 years (range 35–83), all were caucasians, eighty percent were adenocarcinomas, fifty-one percent were male and thirty-eight percent were current smokers. Seven (7.1%) patients were ALK positive by FISH, thirteen (13.1%) were EGFR mutant, and 65 (65.6%) were negative/Wild Type (WT) for both ALK and EGFR. ALK positivity and EGFR mutations were mutually exclusive. ALK positive patients tend to be younger than EGFR mutated or wt patients. ALK positive patients were predominantly never smokers (71.4%) and adenocarcinoma (71.4%). ALK positive and EGFR mutant patients have a better outcome than negative/WT. All patients with ALK FISH negative tumours were negative for ALK IHC. Out of 6 patients positive for ALK FISH with more tissue available, 5 were positive for ALK IHC and 1 negative. Conclusions ALK positive patients represent 7.1% of a population of selected NSCLC. ALK positive patients have different clinical features and a better outcome than EGFR WT and ALK negative patients. IHC is a promising method for detecting ALK positive NSCLC patients. PMID:23359795

  3. Patient Satisfaction With Postpartum Teaching Methods.

    Science.gov (United States)

    Wagner, Debra L; Washington, Cynthia

    2016-01-01

    Postpartum discharge instructions are a crucial part of a mother's birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother's satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers' interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class.

  4. Deutsches Atomforum turns fifty; 50 Jahre Deutsches Atomforum

    Energy Technology Data Exchange (ETDEWEB)

    Geisler, Maja [Deutsches Atomforum e.V., Berlin (Germany). Bereich Oeffentlichkeitsarbeit, Informationskreis KernEnergie

    2009-07-15

    Fifty years ago, the Deutsches Atomforum e. V. was founded to promote the peaceful uses of nuclear power in Germany. On July 1, 2009, the organization celebrated its fiftieth birthday in Berlin. The anniversary was celebrated in the Berlin electricity plant, Germany's oldest existing building for commercial electricity generation. DAtF President Dr. Walter Hohlefelder welcomed some 200 high-ranking guests from politics, industry, and from the nuclear community, above all, the Chancellor of the Federal Republic of Germany, Dr. Angela Merkel, and, as keynote speaker, Professor Dr. Arnulf Baring. (orig.)

  5. Methods and complications of septic induced abortion in patients managed at a tertiary care hospital.

    Science.gov (United States)

    Jabeen, Alia; Dawood, Nasira Sabiha; Riaz, Shazia; Tanveer, Shamaila

    2013-01-01

    To study the methods used for the termination of pregnancy and associated complications of induced abortion. This descriptive study was conducted in the department of obstetrics and gynaecology, Fauji Foundation Hospital Rawalpindi. One Hundred patients were included in the study who was admitted with the history of induced abortion. The patients were assessed by detailed history and thorough clinical examination according to the study protocol. Data was collected on a specially designed Performa. Patients were interviewed in privacy and factors contributing to termination of pregnancy like age, parity, socioeconomic status and contraceptive failure were determined. Methods used for the procedure, status of abortionist were asked. Complications were determined by history, clinical examination and ultrasound examination. In view of all above data recommendations of preventing unwanted pregnancies were made. All patients were married and 57% of women belonged to age group of 31-40 years. Fifty-four 54% were grand multipara. In 63% of patients, induced abortion was carried out by Dai's. Most commonly used method was instrumentation (72%). Financial problems (46.7% ) and high parity (40%) were the most common factors contributing to termination of pregnancy. Serious complications like uterine perforation with or without bowel injury were accounted in 13% of women, septicaemia in 61%, peritonitis in 15% and DIC in 2%. During the study period illegally induced abortion accounted for 2% maternal deaths. Prevalence of poverty, illiteracy, grand multiparity and non-compliance of contraception were strong determinants of induced abortion, instrumentation being the most commonly used procedure resulting in high morbidity and mortality.

  6. Fifty years of mathematical physics selected works of Ludwig Faddeev

    CERN Document Server

    Faddeev, Ludwig; Niemi, Antti J

    2016-01-01

    This unique volume summarizes with a historical perspective several of the major scientific achievements of Ludwig Faddeev, with a foreword by Nobel Laureate C N Yang. The volume that spans over fifty years of Faddeev's career begins where he started his own scientific research, in the subject of scattering theory and the three-body problem. It then continues to describe Faddeev's contributions to automorphic functions, followed by an extensive account of his many fundamental contributions to quantum field theory including his original article on ghosts with Popov. Faddeev's contributions to soliton theory and integrable models are then described, followed by a survey of his work on quantum groups. The final scientific section is devoted to Faddeev's contemporary research including articles on his long-term interest in constructing knotted solitons and understanding confinement. The volume concludes with his personal view on science and mathematical physics in particular.

  7. Fifty years in fusion and the way forward

    International Nuclear Information System (INIS)

    Jacquinot, J.

    2010-01-01

    This particular 'Fusion Pioneers Memorial lecture' was given 50 years after the first historical FEC conference in 1958. It was a unique occasion to perform a global reflection on thermonuclear fusion which is summarized in this paper. We first consider the case for fusion energy then move on to the scientific achievements during the past five decades. Finally, the lessons drawn from the past give a framework to consider the challenges ahead of us. The 1958 pioneers had the vision of the vital importance of international collaboration to succeed in this unique endeavour. Fifty years later, this vision has amply proven its worth. Looking at the way forward, this vision constitutes a strong basis to harness fusion energy in the decades to come.

  8. Fifty years of fuzzy logic and its applications

    CERN Document Server

    Rishe, Naphtali; Kandel, Abraham

    2015-01-01

    This book presents a comprehensive report on the evolution of Fuzzy Logic since its formulation in Lotfi Zadeh’s seminal paper on “fuzzy sets,” published in 1965. In addition, it features a stimulating sampling from the broad field of research and development inspired by Zadeh’s paper. The chapters, written by pioneers and prominent scholars in the field, show how fuzzy sets have been successfully applied to artificial intelligence, control theory, inference, and reasoning. The book also reports on theoretical issues; features recent applications of Fuzzy Logic in the fields of neural networks, clustering, data mining, and software testing; and highlights an important paradigm shift caused by Fuzzy Logic in the area of uncertainty management. Conceived by the editors as an academic celebration of the fifty years’ anniversary of the 1965 paper, this work is a must-have for students and researchers willing to get an inspiring picture of the potentialities, limitations, achievements and accomplishments...

  9. The decision book fifty models for strategic thinking

    CERN Document Server

    Krogerus, Mikael

    2011-01-01

    Most of us face the same questions every day: What do I want? And how can I get it? How can I live more happily and work more efficiently? A worldwide bestseller, The Decision Book distils into a single volume the fifty best decision-making models used on MBA courses and elsewhere that will help you tackle these important questions - from the well known (the Eisenhower matrix for time management) to the less familiar but equally useful (the Swiss Cheese model). It will even show you how to remember everything you will have learned by the end of it. Stylish and compact, this little black book is a powerful asset. Whether you need to plot a presentation, assess someone's business idea or get to know yourself better, this unique guide will help you simplify any problem and take steps towards the right decision.

  10. Mathematical card magic fifty-two new effects

    CERN Document Server

    Mulcahy, Colm

    2013-01-01

    Mathematical card effects offer both beginning and experienced magicians an opportunity to entertain with a minimum of props. Featuring mostly original creations, Mathematical Card Magic: Fifty-Two New Effects presents an entertaining look at new mathematically based card tricks. Each chapter contains four card effects, generally starting with simple applications of a particular mathematical principle and ending with more complex ones. Practice a handful of the introductory effects and, in no time, you'll establish your reputation as a "mathemagician." Delve a little deeper into each chapter and the mathematics gets more interesting. The author explains the mathematics as needed in an easy-to-follow way. He also provides additional details, background, and suggestions for further explorations.Suitable for recreational math buffs and amateur card lovers or as a text in a first-year seminar, this color book offers a diverse collection of new mathemagic principles and effects.

  11. Chevy Corvette: Icon Of American Life In The Fifties

    Directory of Open Access Journals (Sweden)

    Wishnoebroto Wishnoebroto

    2007-11-01

    Full Text Available Cars not only function simply as a mean of transportation. Like paintings, the design of a car could represent a certain cultural and social phenomenon of a country. The design of Chevrolet (Chevy Corvette is very different compared to its competitors in the 50s. The size, engine, weight, and the materials of this car were chosen based on the assumption that speed and agility is on top of everything. It was not surprising that in the 50s, the year when the first Corvette was designed and launched, The US was involved in a cold war with the Soviets. Arm race and competition to be the first was the major issue and Corvette was the first car that suggests this spirit. This paper tries to show the distinctiveness of Corvette and how it can be used to explain the character of American people in the fifties

  12. Evaluation of perioperative nutritional status with subjective global assessment method in patients undergoing gastrointestinal cancer surgery.

    Science.gov (United States)

    Erdim, Aylin; Aktan, Ahmet Özdemir

    2017-01-01

    This study was designed to evaluate the perioperative nutritional status of patients undergoing surgery for gastrointestinal cancer using Subjective Global Assessment and surgeon behavior on nutritional support. We recruited 100 patients undergoing surgery for gastrointestinal cancer in one university and two state teaching hospitals. Subjective Global Assessment was administered to evaluate preoperative and postoperative nutritional status. Fifty-two patients in the state hospitals (Group 1) and 48 in the university hospital were assessed. Anthropometric and biochemical measurements were performed. Changes in preoperative Subjective Global Assessment scores and scores at the time of discharge and types of nutritional support were compared. Subjective Global Assessment-B was regarded as moderate and Subjective Global Assessment-C as heavy malnutrition. Ten patients had Subjective Global Assessment-B and 29 had Subjective Global Assessment-C malnutrition in Group 1 and nine had Subjective Global Assessment-B and 31 had Subjective Global Assessment-C malnutrition in Group 2 during preoperative assessment. Respective numbers in postoperative assessment were 12 for Subjective Global Assessment-B and 30 for Subjective Global Assessment-C in Group 1 and 14 for Subjective Global Assessment-B and 26 for Subjective Global Assessment-C in Group 2. There was no difference between two groups. Nutritional methods according to Subjective Global Assessment evaluation in pre- and postoperative periods were not different between the groups. This study demonstrated that the malnutrition rate is high among patients scheduled for gastrointestinal cancer surgery and the number of surgeons were inadequate to provide perioperative nutritional support. Both university and state hospitals had similar shortcomings. Subjective Global Assessment is an easy and reliable test and if utilized will be helpful to detect patients requiring nutritional support.

  13. Comparison of multiple fluid status assessment methods in patients on chronic hemodialysis.

    Science.gov (United States)

    Alexiadis, Giannis; Panagoutsos, Stelios; Roumeliotis, Stefanos; Stibiris, Ilias; Markos, Angelos; Kantartzi, Konstantia; Passadakis, Ploumis

    2017-03-01

    Control of hydration status is an important constituent of adequate and efficient hemodialysis (HD) treatment. Nevertheless, there are no precise clinical indices for early recognition of small changes in fluid status of patients undergoing chronic hemodialysis therapy. This study aimed to evaluate and compare the widely used and reliable method of indexed inferior vena cava diameter (IVCDi) with established and more recently available techniques (bioelectrical impedance analysis [BIA], continuous blood volume monitoring [Crit-line], and the B-line score [BLS] with lung ultrasonography) for estimating the hydration status of patients on HD. Fifty-three patients undergoing chronic HD thrice weekly were included in the study. Evaluation of hydration status methods (IVCDi, BLS, BIA, and Crit-line) was performed thrice weekly before and after HD. Receiver operating characteristic curve analysis was performed to evaluate the discriminative power of (methods) the BLS, BIA, and Crit-line for predicting over- and underhydration of patients, as determined by the reference method, IVCDi. BLS showed the most promising results in predicting overhydration, as determined by IVCDi, compared with BIA and Crit-line and presented a sensitivity of 77% and specificity of 74%. The accuracy of the BLS was higher than that of BIA (0.81 vs. 0.71, p = 0.032) and Crit-line (0.61, p = 0.001). BLS also showed more promising results in predicting underhydration, as determined by IVCDi, than BIA and Crit-line and presented a sensitivity of 78% and a specificity of 73%. The accuracy of the BLS was higher than that of BIA (0.83 vs. 0.76, p = 0.035) and Crit-line (0.50, p < 0.001). The BLS is a useful and easily performed technique that has recently become available for accurate evaluation of dry weight and fluid status in patients with end-stage renal disease undergoing chronic HD. This method might help recognize asymptomatic lung congestion in these patients.

  14. Fifty Cases of Parkinson's Disease Treated by Acupuncture Combined with Madopar

    Institute of Scientific and Technical Information of China (English)

    REN Xiao-ming

    2008-01-01

    objective;To search for an effective therapy for trealing motor disorder due to Parkinson's disease(PD).Methods;Fifty cases in a treatrnent group were treated by acupuncture combined with madopar,and 30 cases in a control group treated by madopar only.Results;A total effective rate of 92%was achieved with obvious alleviation of motor disorder in the treatment group,which was significantly higher than that in the control group(P<0.05).Conclusion;Acupuncture can enhance therapeutic effects of western medicine and lessen the dose of the medicine needed.

  15. The anomaly of Marquesan ceramics : a fifty year retrospective

    International Nuclear Information System (INIS)

    Allen, M.S.; Dickinson, W.R.; Huebert, J.M.

    2012-01-01

    Fifty years ago pioneering archaeologist Robert Suggs reported a small number of pottery sherds from the Marquesas Islands. The first such finds in East Polynesia, at the time they were considered indicative of both a Marquesan homeland and local ceramic manufacture. In the intervening years, additional sherds have been recovered from three other Marquesan localities resulting in a total of 14 specimens. Prior petrographic studies demonstrate unambiguously that some derive from Fiji. Others have been interpreted historically as representative of an indigenous Marquesan ceramic industry. Here we bring together key petrographic analyses from Polynesia, recent chronological assessments of the Marquesan sequence, and insights from new field research to reassess the origins and chronology of Marquesan pottery. We suggest that there is little support for an indigenous Marquesan ceramic industry, and most likely all of the specimens are imports. With respect to the timing of ceramic arrivals, three hypotheses are explored: 1) with founding settlers, 2) as a component of long-distance exchange networks operating between the 12th to 16th centuries AD, or 3) as late prehistoric or historic imports. The preponderance of evidence points to the second alternative, although the other two cannot be completely discounted for the assemblage as a whole. (author). 63 refs., 5 figs., 3 tabs.

  16. The Proton Synchrotron, going strong at fifty years

    CERN Multimedia

    Django Manglunki

    It was on the evening of 24 November 1959 that an incredulous Hildred Blewett, on detachment to CERN from the Brookhaven laboratory, exclaimed “Yes! We’re through transition!” The first beam of ten billion protons had not only broken through the 5.2 GeV barrier but gone on all the way to 24 GeV, the machine’s top energy at that time.   An operational screenshot from the PS, taken on its 50th anniversary. The three white peaks depict different phases (cycles) of the PS’s operation. In the first and third cycle, the PS is producing a very low-intensity beam for LHC commissioning. In the second cycle, protons are being spilled out for use in the East Area. Fifty years ago the PS, the first strong-focusing proton synchrotron using alternating gradient technology, first began to circulate beams at an unprecedented level of energy. Over the years, a complex of linear and circular accelerators and storage rings grew up around the PS. In the mid-1990s ...

  17. Methods to score vertebral deformities in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Lems, W. F.; Jahangier, Z. N.; Raymakers, J. A.; Jacobs, J. W.; Bijlsma, J. W.

    1997-01-01

    The objective was to compare four different scoring methods for vertebral deformities: the semiquantitative Kleerekoper score and three quantitative scores (according to Minne, Melton and Raymakers) in patients with rheumatoid arthritis (RA). Lateral radiographs of the thoracic and lumbar vertebral

  18. Ranking Tehran’s Stock Exchange Top Fifty Stocks Using Fundamental Indexes and Fuzzy TOPSIS

    Directory of Open Access Journals (Sweden)

    E. S. Saleh

    2017-08-01

    Full Text Available Investment through the purchase of securities, constitute an important part of countries economic exchange. Therefore, making decisions about investing in a particular stock has become one of the most controversial areas of economic and financial research and various institutions have began to rank companies stock and determine priorities of stock purchase to investment. The current research, with the determination of important required indexes for companies ranking based on their shares value on the Tehran stock exchange, can greatly help to the accurate ranking of fifty premier listed companies. Initial ranking indicators are extracted and then a decision-making group (exchange experts with the use of the Delphi method and also non-parametric statistic methods, determines the final indexes. Then, by using Fuzzy ANP, weight criteria are obtained with taking into account their interaction with each other. Finally, using fuzzy TOPSIS and information extraction about the premier fifty listed companies of Tehran stock exchange in 2014 are ranked with the software "Rahavard Novin”. Sensitivity analysis to criteria weight and relevant analysis presentation was conducted at the end of the study procedures.

  19. Methods to improve patient recruitment and retention in stroke trials

    DEFF Research Database (Denmark)

    Berge, Eivind; Stapf, Christian; Al-Shahi Salman, Rustam

    2016-01-01

    Background: The success of randomized-controlled stroke trials is dependent on the recruitment and retention of a sufficient number of patients, but fewer than half of all trials meet their target number of patients. Methods: We performed a search and review of the literature, and conducted...... a survey and workshop among 56 European stroke trialists, to identify barriers, suggest methods to improve recruitment and retention, and make a priority list of interventions that merit further evaluation. Results: The survey and workshop identified a number of barriers to patient recruitment...... and retention, from patients’ incapacity to consent, to handicaps that prevent patients from participation in trial-specific follow-up. Methods to improve recruitment and retention may include simple interventions with individual participants, funding of research networks, and reimbursement of new treatments...

  20. Methods for teaching effective patient communication techniques to radiography students.

    Science.gov (United States)

    Makely, S

    1990-07-01

    Teaching students to communicate effectively with patients has always been part of the radiography curriculum in the USA. However, developing these skills has become even more important in recent times due to several factors. Patients who have been well versed in what to expect from the examination being conducted are in a better position to co-operate with the radiographer. This increases the chances of producing optimal results from an examination at the first attempt, thus reducing radiation exposure, patient discomfort and the overall cost of conducting the procedure. Also, increased competition among health care providers has resulted in more emphasis being placed on patient, or customer, satisfaction. Radiographers are in the 'front line' of patient care. Patients often have more interaction with radiographers than with physicians or other medical specialists. Radiographers who practise effective communication techniques with their patients can alleviate anxiety and make an important contribution to the overall satisfaction of the patient with respect to the quality of service and care they receive. This article describes instructional methods being used in the USA to help develop effective patient communication techniques, and reports the findings of a study among radiography educators as to which of these methods are thought to be most successful.

  1. Using qualitative methods to understand factors contributing to patient satisfaction among dermatology patients: a systematic review.

    Science.gov (United States)

    Gibbons, Caitlin; Singh, Sanminder; Gibbons, Brittany; Clark, Caitlin; Torres, Josefina; Cheng, Michelle Y; Wang, Elizabeth A; Armstrong, April W

    2018-05-01

    In this systematic review, we aimed to synthesize data that identify factors contributing to patient satisfaction in dermatology care using qualitative methods. We performed a comprehensive search of the literature using the PubMed database for articles published between January 1, 2000 and February 9, 2015. The initial search yielded 186 articles, of which 13 were included after applying inclusion and exclusion criteria. The systematic review of 13 articles included a total of 330 patients. Using in-field observations and semistructured interviews, studies found that qualitative methods and analysis increased the provider's sensitivity to patient needs and enhanced patient care. Analyses using qualitative methods found increased patient satisfaction in their healthcare provider is associated with (1) confidence in the provider's diagnosis, (2) perception of patient-centered, individualized recommendations and (3) quality of patient education and provider explanation during a visit. Patient satisfaction is measured using either quantitative or qualitative methods. Quantitative methods result in standardized data that often does not capture the nuances of patient experience. In contrast, qualitative methodology is integral to gathering patient perspectives on patient care and satisfaction and should be included in future research models.

  2. Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

    Science.gov (United States)

    Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

    2012-07-01

    A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

  3. Qualitative Methods in Patient-Centered Outcomes Research.

    Science.gov (United States)

    Vandermause, Roxanne; Barg, Frances K; Esmail, Laura; Edmundson, Lauren; Girard, Samantha; Perfetti, A Ross

    2017-02-01

    The Patient-Centered Outcomes Research Institute (PCORI), created to fund research guided by patients, caregivers, and the broader health care community, offers a new research venue. Many (41 of 50) first funded projects involved qualitative research methods. This study was completed to examine the current state of the science of qualitative methodologies used in PCORI-funded research. Principal investigators participated in phenomenological interviews to learn (a) how do researchers using qualitative methods experience seeking funding for, implementing and disseminating their work; and (b) how may qualitative methods advance the quality and relevance of evidence for patients? Results showed the experience of doing qualitative research in the current research climate as "Being a bona fide qualitative researcher: Staying true to research aims while negotiating challenges," with overlapping patterns: (a) researching the elemental, (b) expecting surprise, and (c) pushing boundaries. The nature of qualitative work today was explicitly described and is rendered in this article.

  4. Comparing Exercise Prescription Methods in Knee Osteoarthritis Patients in Malaysia

    Directory of Open Access Journals (Sweden)

    D’Gasper Dineesha

    2018-03-01

    Full Text Available Aim: This study was a qualitative study that investigated the exercise prescription method in knee osteoarthritis patients in Malaysia. It purposed to find out the most common and effective method used by physiotherapist in prescribing exercises for knee osteoarthritis patients in Malaysia. Method: This study used a self-administered survey questionnaire. The subjects recruited for this study were diagnosed with knee osteoarthritis, age range of between 50 to 80 years old.The methods of delivery were divided into three categories, which include only verbal instructions, verbal instruction together with demonstration and lastly a combination of all three methods including verbal instruction, demonstration and handouts with diagrams. Results: The results showed that 52% received their exercise prescription with verbal instruction and together with demonstration, about 43% of them received all three types of methods which included the verbal instruction, demonstration and take home handouts and 5% of them only received verbal instruction. Out of 5% who received verbal instruction alone, only 1% understood the exercises and the remaining 4% did not and 45% out of 52% who received verbal and demonstration method understood the exercises and the remaining 7% did not. 5% who received only verbal instruction did not seem to continue the exercises at home. 52% received verbal instruction together with demonstration, with about 44% of them having continued their exercises but the remaining 8% did not. 43% who received all three methods reported to continue. Conclusion: The best method of delivering exercises to knee osteoarthritis patients was proven to be the method with a combination of verbal instruction, demonstration together with a take home handout. This method showed very positive outcome and should be implemented and emphasized more in both the government and private sectors of physiotherapy departments.

  5. A Method for Developing Standard Patient Education Program.

    Science.gov (United States)

    Lura, Carolina Bryne; Hauch, Sophie Misser Pallesgaard; Gøeg, Kirstine Rosenbeck; Pape-Haugaard, Louise

    2018-01-01

    In Denmark, patients being treated on Haematology Outpatients Departments get instructed to self-manage their blood sample collection from Central Venous Catheter (CVC). However, this is a complex and risky procedure, which can jeopardize patient safety. The aim of the study was to suggest a method for developing standard digital patient education programs for patients in self-administration of blood samples drawn from CVC. The Design Science Research Paradigm was used to develop a digital patient education program, called PAVIOSY, to increase patient safety during execution of the blood sample collection procedure by using videos for teaching as well as procedural support. A step-by-step guide was developed and used as basis for making the videos. Quality assurance through evaluation with a nurse was conducted on both the step-by-step guide and the videos. The quality assurance evaluation of the videos showed; 1) Errors due to the order of the procedure can be determined by reviewing the videos despite that the guide was followed. 2) Videos can be used to identify errors - important for patient safety - in the procedure, which are not identifiable in a written script. To ensure correct clinical content of the educational patient system, health professionals must be engaged early in the development of content and design phase.

  6. Pattern of Family Planning Methods used by Antenatal Patients in ...

    African Journals Online (AJOL)

    This study aimed at assessing the pattern of family planning methods used by antenatal patients at Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December,2007 and February,2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical committee of ...

  7. Modeling patient safety incidents knowledge with the Categorial Structure method.

    Science.gov (United States)

    Souvignet, Julien; Bousquet, Cédric; Lewalle, Pierre; Trombert-Paviot, Béatrice; Rodrigues, Jean Marie

    2011-01-01

    Following the WHO initiative named World Alliance for Patient Safety (PS) launched in 2004 a conceptual framework developed by PS national reporting experts has summarized the knowledge available. As a second step, the Department of Public Health of the University of Saint Etienne team elaborated a Categorial Structure (a semi formal structure not related to an upper level ontology) identifying the elements of the semantic structure underpinning the broad concepts contained in the framework for patient safety. This knowledge engineering method has been developed to enable modeling patient safety information as a prerequisite for subsequent full ontology development. The present article describes the semantic dissection of the concepts, the elicitation of the ontology requirements and the domain constraints of the conceptual framework. This ontology includes 134 concepts and 25 distinct relations and will serve as basis for an Information Model for Patient Safety.

  8. Automated patient and medication payment method for clinical trials

    Directory of Open Access Journals (Sweden)

    Yawn BP

    2013-01-01

    Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient

  9. Targeted methods for measuring patient satisfaction in a radiological center

    International Nuclear Information System (INIS)

    Maurer, M.H.; Stein, E.; Schreiter, N.F.; Renz, D.M.; Poellinger, A.

    2010-01-01

    Purpose: To investigate two event-oriented methods for evaluating patient satisfaction with radiological services like outpatient computed tomography (CT) examinations. Materials and Methods: 159 patients (55 % men, 45 % women) were asked to complete a questionnaire to provide information about their satisfaction with their examination. At first, patients were asked to spontaneously recall notably positive and negative aspects (so-called 'critical incidents', critical incident technique = CIT) of the examination. Subsequently a flow chart containing all single steps of the examination procedure was shown to all patients. They were asked to point out the positive and negative aspects they perceived at each step (so-called sequential incident technique = SIT). Results: The CIT-based part of the questionnaire yielded 356 comments (183 positive and 173 negative), which were assigned to one of four categories: interaction of staff with patient, procedure and organization, CT examination, and overall setting of the examination. Significantly more detailed comments regarding individual aspects of the CT examination were elicited in the second part of the survey, which was based on the SIT. There were 1413 statements with a significantly higher number of positive comments (n = 939, 66 %) versus negative comments (n = 474, 34 %; p < 0.001). Conclusion: The critical and sequential incident techniques are suitable to measure the subjective satisfaction with the delivery of radiological services such as CT examinations. Positive comments confirm the adequacy of the existing procedures, while negative comments provide direct information about how service quality can be improved. (orig.)

  10. MAYAK production association ``the fifty year old secret''

    Science.gov (United States)

    Chikshov, A. I.; Glagolenko, Y. V.; Malykh, Y. A.; Langley, Roger; Latham, Ian

    1998-06-01

    This paper details the history, production capability, facilities and capacity of MAYAK Production Association. The paper also gives technical details of reactors, storage ponds and handling facilities used for fabrication of Co-60 and Cs-137 sources for Gamma Irradiation Plants and other applications, and describes the quality assurance system and methods.

  11. The Fifty Minute Ethnography: Teaching Theory through Fieldwork

    Science.gov (United States)

    Trnka, Susanna

    2017-01-01

    Ethnography is becoming an increasingly popular research methodology used across a number of disciplines. Typically, teaching students how to write an ethnography, much less how to undertake "fieldwork" (or the ethnographic research upon which ethnographies are based), is reserved for senior- or MA-level research methods courses. This…

  12. Anniversary Paper: Nuclear medicine: Fifty years and still counting

    International Nuclear Information System (INIS)

    Williams, Lawrence E.

    2008-01-01

    The history, present status, and possible future of nuclear medicine are presented. Beginning with development of the rectilinear scanner and gamma camera, evolution to the present forms of hybrid technology such as single photon emission computed tomography/computed tomography (CT) and positron emission tomography/CT is described. Both imaging and therapy are considered and the recent improvements in dose estimation using hybrid technologies are discussed. Future developments listed include novel radiopharmaceuticals created using short chains of nucleic acids and varieties of nanostructures. Patient-specific radiotherapy is an eventual outcome of this work. Possible application to proving the targeting of potential chemotherapeutics is also indicated

  13. Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Osman Son

    2014-01-01

    Full Text Available Objective. The results from Diabetes Control and Complications Trial (DCCT have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM. During this study, we tried to inquire carbohydrate (Kh count method’s positive effects on the type 1 DM treatment’s success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method.

  14. Patient-generated aspects in oral rehabilitation decision making I. Comparison of traditional history taking and an individual systematic interview method

    DEFF Research Database (Denmark)

    Øzhayat, Esben Boeskov; Gotfredsen, Klaus; Elverdam, Beth

    2009-01-01

    it with a traditional history taking, in generating information to be used in decision making in oral rehabilitation. Fifty-seven participants in need of oral rehabilitation were enrolled in the study. The participants underwent a traditional history taking and were interviewed using the SEIQoL-DW method. The SEIQo......Decision making in oral rehabilitation is often based on diagnoses related to impairment of different oral functions. In making the decision when to treat, the dentist must work in cooperation with the patient. By incorporating patient-generated aspects into the decision making process, the dentist...... percentage of the participants were positive towards the use of the SEIQoL-DW method in their treatment planning. The SEIQoL-DW was considered to be a viable tool for decision making in oral rehabilitation....

  15. DMPD: Fifty years of interferon research: aiming at a moving target. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available mmunity. 2006 Sep;25(3):343-8. (.png) (.svg) (.html) (.csml) Show Fifty years of interferon research: aiming at a moving target. Pubm...edID 16979566 Title Fifty years of interferon research: aiming at a moving target.

  16. An configuration method of patient service cloud for the home patient with multi sensor network

    International Nuclear Information System (INIS)

    Noji, Tamotsu; Arino, Masashi; Saito, Mayuko; Horii, Minoru; Ogino, Tadashi; Suto, Yasuzo; Sasaki, Hitoshi; Mansei, Kouiti

    2010-01-01

    We are advancing the research of patient service cloud in the global medical collaboration network system based on 3D electronic referral letters. In this paper it proposes one configuration method of private cloud that aims at the home care patient's health care and independence support based on voice navigation system (VONAVS). We evaluate 3D image compression rate, try image compositing Cloud's configuration by the multi sensor network, and search for the configuration method of the remote image diagnosis. The proposed configuration method expands the possibility to the global medical collaboration network system for new large areas such as a telemedicine, an emergency care, and home medical care. (author)

  17. Economic evaluation in patient safety: a literature review of methods.

    Science.gov (United States)

    de Rezende, Bruna Alves; Or, Zeynep; Com-Ruelle, Laure; Michel, Philippe

    2012-06-01

    Patient safety practices, targeting organisational changes for improving patient safety, are implemented worldwide but their costs are rarely evaluated. This paper provides a review of the methods used in economic evaluation of such practices. International medical and economics databases were searched for peer-reviewed publications on economic evaluations of patient safety between 2000 and 2010 in English and French. This was complemented by a manual search of the reference lists of relevant papers. Grey literature was excluded. Studies were described using a standardised template and assessed independently by two researchers according to six quality criteria. 33 articles were reviewed that were representative of different patient safety domains, data types and evaluation methods. 18 estimated the economic burden of adverse events, 3 measured the costs of patient safety practices and 12 provided complete economic evaluations. Healthcare-associated infections were the most common subject of evaluation, followed by medication-related errors and all types of adverse events. Of these, 10 were selected that had adequately fulfilled one or several key quality criteria for illustration. This review shows that full cost-benefit/utility evaluations are rarely completed as they are resource intensive and often require unavailable data; some overcome these difficulties by performing stochastic modelling and by using secondary sources. Low methodological transparency can be a problem for building evidence from available economic evaluations. Investing in the economic design and reporting of studies with more emphasis on defining study perspectives, data collection and methodological choices could be helpful for strengthening our knowledge base on practices for improving patient safety.

  18. Metallography at the Met Lab -- The first fifty years

    International Nuclear Information System (INIS)

    Lee, R.H.

    1995-01-01

    The Met Lab at the University of Chicago was established to build the world's first nuclear reactor. The object was to see if a pile (CP-1) could be built to create a sustained chain reaction, i.e., controlled nuclear fission. New materials of the very best quality were needed and people of many skills worked together to achieve the goal as quickly as possible. This is the story of a select group of people who were scientific and engineering pioneers in this new field. Research continued at new sites on more advanced reactors and cooling systems. Many problems were encountered in the fabrication of reactor components, and metallography was a crucial method of analyzing the reactions and quality of consolidation. 1996 will be the 50th anniversary of the beginning of the National Laboratories, so it is appropriate to commemorate and recall some pioneering achievements

  19. Fifty Years of THERP and Human Reliability Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring

    2012-06-01

    In 1962 at a Human Factors Society symposium, Alan Swain presented a paper introducing a Technique for Human Error Rate Prediction (THERP). This was followed in 1963 by a Sandia Laboratories monograph outlining basic human error quantification using THERP and, in 1964, by a special journal edition of Human Factors on quantification of human performance. Throughout the 1960s, Swain and his colleagues focused on collecting human performance data for the Sandia Human Error Rate Bank (SHERB), primarily in connection with supporting the reliability of nuclear weapons assembly in the US. In 1969, Swain met with Jens Rasmussen of Risø National Laboratory and discussed the applicability of THERP to nuclear power applications. By 1975, in WASH-1400, Swain had articulated the use of THERP for nuclear power applications, and the approach was finalized in the watershed publication of the NUREG/CR-1278 in 1983. THERP is now 50 years old, and remains the most well known and most widely used HRA method. In this paper, the author discusses the history of THERP, based on published reports and personal communication and interviews with Swain. The author also outlines the significance of THERP. The foundations of human reliability analysis are found in THERP: human failure events, task analysis, performance shaping factors, human error probabilities, dependence, event trees, recovery, and pre- and post-initiating events were all introduced in THERP. While THERP is not without its detractors, and it is showing signs of its age in the face of newer technological applications, the longevity of THERP is a testament of its tremendous significance. THERP started the field of human reliability analysis. This paper concludes with a discussion of THERP in the context of newer methods, which can be seen as extensions of or departures from Swain’s pioneering work.

  20. Clinical management methods for out-patients with alcohol dependence

    Directory of Open Access Journals (Sweden)

    Boulze Isabelle

    2006-02-01

    Full Text Available Abstract Background In France outpatient centres for the care of alcoholics are healthcare establishments providing medical, psychological and social support. Although they meet the practical needs of these patients, their degree of use in each of these domains and the respective mobilisation of different skills by the care team are not well understood. Our aim was therefore to determine in detail the management involved as a function of the severity of alcohol dependence. For this purpose, all the procedures involved were compiled in a thesaurus describing its type (psychological, medical, social, reception, its scheduled or unscheduled nature, its method (face-to-face, telephone, letter and its duration. The severity of dependence was evaluated using the Addiction Severity Index (ASI. Results 45 patients were included and followed-up during 291 ± 114 days. The mean initial ASI scores (± SD were: medical (M = 0.39 ± 0.3, working-income (ER = 0.5 ± 0.3, alcohol (A = 0.51 ± 0.2, illicit drugs (D = 0.07 ± 0.08, legal (L = 0.06 ± 0.13, familial and social environment (FS = 0.34 ± 0.26, psychological (P = 0.39 ± 0.22. The total number of procedures was 1341 (29.8 per patient corresponding to 754.4 hours (16.7 per patient. The intensity of management peaked during the first month of treatment, and then declined rapidly; the maximum incidence of abstinence was observed during the 3rd month of management. Interviews with patients, group therapy and staff meetings represented 68.7%, 9.9% and 13.9% of all procedures, respectively. In patients with severe dependence, as compared to moderate, management was twice as intense in the psychological and social domains, but not in the medical domain. The ASI questionnaire was completed a second time by 24 patients, after an average of 3.2 months. The improvement was significant in the M, A, D and P domains only. Conclusion This study provided an overview of the methods employed in managing a sample of

  1. The comparison between two different methods of radiotherapy in palliation and survival of patients with esophageal cancer

    Directory of Open Access Journals (Sweden)

    Keshvary M

    2001-10-01

    Full Text Available Esophageal cancer is one of the most common malignancies in our country. Patients often seek medical advice in advanced and inoperable stages or with cervical esophageal cancer, in which operation is accompanied by sever morbidity. In this conditions many of them cannot tolerate chemo-radiation, or refuse it. Therefore radiotherapy is applied as a single modality in palliation of many patients with esophageal cancer. One of the palliative radio therapeutic methods is application of 5000 CGY in 20 fractions (Long Course; but considering the great number of our patients and limited capacity of radiotherapy centers, as well as emphasis of literature on palliation with 4000 CGY in 13 fractions (short course, we decided to compare these two methods (which are both used in our departments. In this retrospective analytic study, the files of 283 patients with esophageal cancer referred to cancer institute of Imam Khomeini Hospital from 1989-1999 were studied. Patients were between 27-97 years old (mean age=58.3 and most of them were male (53.7 percent. The mean length of lesion was 8.5 cm. The most common site of lesion was middle third at esophagus (48.1 percent and the most common pathology was squamous cell carcinoma (99.6 percent. Fifty-four percent of patients were hot tea drinkers habitually. From the mentioned variables, only length of lesion had significant relationship with overall survival (P=0.04. Thirty-eight of 283 patients were excluded from analytic study because of incomplete follow-up. The number of patients had been treated by long course (5000 CGY in 20 fractions was 137 and the remainder (108 patients by short course (4000 CGY in 13 fractions. No significant difference was seen statistically between these two groups in overall and dysphagia-free survival (Kaplan-Meyer test. Also total dosage of spinal cord is lower in the short course. Thus regarding to less required time in short course and comparable palliation and survival between

  2. Nuclear chemistry fifty years after the discovery of artificial radioactivity

    International Nuclear Information System (INIS)

    Lefort, M.

    1984-01-01

    In January 1934, the observation and the chemical identification of radiophosphorus as a reaction product in the bombardment of Aluminium by alpha particles have been the first step of a new scientific branch: Nuclear Chemistry. We describe here how this discovery in itself contains the frame of all the development which has followed. It consisted in four stages, each of them being a crucial starting point. The first one is the possibility for a total balance of the nuclear reaction in the exit channels, so that reaction mechanisms can be studied. The second, the most important perhaps, is the opening of nuclear synthesis. Nuclear chemists can now interfere into nuclear matter and instead of staying as observers of the radioactive decays of natural isotopes, they were able to build up a numerous chart of various nuclear species, going step by step further and further away from the nuclear stability conditions. The third aspect of the discovery was the appearance of a new mode of radioactive decay with the production of the first particle an antimater. 50 years later, the instability due to a much larger excess of protons is known to induce the proton emission radioactivity for new species like 109 I or 115 Cs, in the vicinity of proton unstability. Finally, the last point, so fertile for the future, was the observation of a neutron in the exit channel, so that neutron fluxes could result from alpha induced nuclear reactions and became such a strong tool for the production of transuranium elements and for nuclear fission. In the present survey, the wide interest of the second point, i.e. the nuclear synthesis, is emphasized, as well as the huge change in the technical methods

  3. Bibliometric analysis of fifty years of physica status solidi

    Energy Technology Data Exchange (ETDEWEB)

    Marx, Werner [Max Planck Institute for Solid State Research, Stuttgart (Germany); Hoffmann, Dieter [Max Planck Institute for the History of Sciences, Berlin (Germany)

    2011-12-15

    Bibliometric methods are used to analyze quantitatively the journal physica status solidi (pss) 50 years after its inception. First, the coverage of the journal by the relevant citation indices accessible under the Web of Science (WoS) and the field-specific INSPEC database is examined. The number of papers published per year by the journal as a whole and by the specific pss series is given. The time evolution of the pss output in terms of papers per year is compared with the output evolution of some major competing journals in the field of condensed-matter physics. The top-12 most frequently cited pss papers published within the complete time period 1961-2010 and within the two separate time periods 1974-1989 and 1990-2010 (before and after the German reunification) are listed. The citation time curves (citation history) of the three most frequently cited pss papers are presented. Furthermore, the Journal Impact Factors (JIFs) of the pss journal series (a) and (b) are discussed and their time evolution is shown. Moreover, the distribution of the pss papers over their document types and the authors is given. The countries of authors are ranked for the complete time period 1961-2010 as well as for the time periods 1973-1989 and 1990-2010. The complete ensemble of the citing papers of the pss papers is analyzed and discussed. The journals citing most often the pss papers published in the year 2000 are listed. Finally, the distribution of the pss papers over the various subject areas and classification terms based on the INSPEC database is tabled. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  4. Systematization of types and methods of radiation therapy methods and techniques of irradiation of patients

    International Nuclear Information System (INIS)

    Vajnberg, M.Sh.

    1991-01-01

    The paper is concerned with the principles of systematization and classification of types and methods of radiation therapy, approaches to the regulation of its terminology. They are based on the distinction of the concepts of radiation therapy and irradiation of patients. The author gives a consice historical review of improvement of the methodology of radiation therapy in the course of developing of its methods and facilities. Problems of terminology are under discussion. There is a table of types and methods of radiation therapy, methods and techniques of irradiation. In the appendices one can find a table of typical legends and examples of graphic signs to denote methods of irradiation. Potentialities of a practical use of the system are described

  5. The First Fifty ABO Blood Group Incompatible Kidney Transplantations: The Rotterdam Experience

    Directory of Open Access Journals (Sweden)

    Madelon van Agteren

    2014-01-01

    Full Text Available This study describes the single center experience and long-term results of ABOi kidney transplantation using a pretransplantation protocol involving immunoadsorption combined with rituximab, intravenous immunoglobulins, and triple immune suppression. Fifty patients received an ABOi kidney transplant in the period from 2006 to 2012 with a follow-up of at least one year. Eleven antibody mediated rejections were noted of which 5 were mixed antibody and cellular mediated rejections. Nine cellular mediated rejections were recorded. Two grafts were lost due to rejection in the first year. One-year graft survival of the ABOi grafts was comparable to 100 matched ABO compatible renal grafts, 96% versus 99%. At 5-year follow-up, the graft survival was 90% in the ABOi versus 97% in the control group. Posttransplantation immunoadsorption was not an essential part of the protocol and no association was found between antibody titers and subsequent graft rejection. Steroids could be withdrawn safely 3 months after transplantation. Adverse events specifically related to the ABOi protocol were not observed. The currently used ABOi protocol shows good short and midterm results despite a high rate of antibody mediated rejections in the first years after the start of the program.

  6. Fifty Violins.

    Science.gov (United States)

    Hurwitz, Sol

    1999-01-01

    Roberta Guaspari-Tzavoras teaches 125 young violinists in 2 East Harlem elementary schools. Students are chosen by lottery. The only prerequisite is a willingness to do the hard work of practicing and learning. Her success in coaching inner-city students to a performance in Carnegie hall is the subject of a documentary and a feature film. (MLF)

  7. Representasi Perempuan Dalam Film (Analisis Semiotika Representasi Perempuan Dalam Film “Fifty Shades of Grey”)

    OpenAIRE

    Aviomeita, Friska

    2016-01-01

    This study entitled "Representation of Women In Film ( Roland Barthes Semiotics Analysis In the film Fifty Shades of Grey ) " . The purpose of this study to find out how women are represented in the film " Fifty Shades of Grey " by denotation , connotation and myths . Film has always influenced and shaped the public based on the contents of the message behind it. Messages or values contained in the film may affect the audience. In this study, researchers used several theorie...

  8. Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan.

    Science.gov (United States)

    Jalil, Aisha; Zakar, Rubeena; Zakar, Muhammad Zakria; Fischer, Florian

    2017-02-21

    Patient satisfaction with doctor-patient interactions is an indicator of physicians' competence. The satisfaction of diabetes patients is rarely studied in public diabetes clinics of Pakistan. Thus, this study aims to analyse the association between patient satisfaction and five dimensions of medical interaction: technical expertise, interpersonal aspects, communication, consultation time, and access/availability. A cross-sectional mixed methods study was conducted during July and August 2015 in the largest public diabetes outpatient clinic in Punjab province. We used the criterion sampling method to identify 1164 patients who: (i) were adult (18 years and above), (ii) had diabetes mellitus, (iii) had made at least three previous visits to the same clinic. The data was collected through face-to-face interviews. The structured part of the questionnaire was based on demographic characteristics and the Patient Satisfaction Questionnaire (PSQ-III). We translated the questionnaire into Urdu and pretested it with 25 patients in a similar context. Data storage and analysis were carried out using SPSS (version 22.0). Bivariate analyses and multinomial logistic regression model were used to generate the quantitative findings. Out of the 1164 eligible patients approached for interviews, 1095 patients completed the structured questionnaire and 186 respondents provided qualitative information in comments section. We conducted a thematic content analysis of qualitative responses in order to explain the quantitative findings. Demographic characteristics such as gender, education and occupation were significantly associated with the levels of patient satisfaction. The dimensions of doctor-patient interaction were significantly associated with patient satisfaction: technical expertise (OR = .87; 95% CI = .84-.91), interpersonal aspects (OR = .82; 95% CI = .77-.87), communication (OR = .83; 95% CI = .78-.89), time dimension (OR = .90; 95% CI = .81

  9. Age-related changes in the macula. A histopathological study of fifty Indian donor eyes

    Directory of Open Access Journals (Sweden)

    Biswas Jyotirmay

    2002-01-01

    Full Text Available PURPOSE: Age-related macular degeneration (ARMD is clinically less common in India compared to the West. Therefore, clinicians are unfamiliar with histopathologic evidence of age-related macular changes in the Indian population. METHODS: Fifty consecutive human donor eyes removed for corneal grafting were studied for gross, microscopic and histochemical features of age-related changes in the macula in the Indian population. A horizontal block was cut from the globe including the optic disc, and the macula. Six sections, 6 microns thick, were cut from three levels in the macula at a distance of 140 microns. These were stained with haemotoxylin-eosin, periodic acid-Schiff, Mallory, Masson trichrome, alcian blue and von Kossa stains. The presence of basal laminar deposits, drusen and thickening and calcification of Bruch′s membrane in the macula were assessed at 400 x magnification using a modified version of Sark′s classification. RESULTS: Twenty-four donor eyes (48% had some form of age-related macular change. These included basal laminar deposits, hard drusen, soft drusen, extensive retinal pigment epithelium atrophy of the macula, and disciform degeneration of macula. A combination of changes was often seen. Age-related changes were more common in the seventh and eighth decade. CONCLUSION: Our study shows that histological changes characteristic of the early stages of age-related macular degeneration are fairly common in the Indian population. However, advanced macular changes are significantly rare.

  10. [Experience feedback committee: a method for patient safety improvement].

    Science.gov (United States)

    François, P; Sellier, E; Imburchia, F; Mallaret, M-R

    2013-04-01

    An experience feedback committee (CREX, Comité de Retour d'EXpérience) is a method which contributes to the management of safety of care in a medical unit. Originally used for security systems of civil aviation, the method has been adapted to health care facilities and successfully implemented in radiotherapy units and in other specialties. We performed a brief review of the literature for studies reporting data on CREX established in hospitals. The review was performed using the main bibliographic databases and Google search results. The CREX is designed to analyse incidents reported by professionals. The method includes monthly meetings of a multi-professional committee that reviews the reported incidents, chooses a priority incident and designates a "pilot" responsible for investigating the incident. The investigation of the incident involves a systemic analysis method and a written synthesis presented at the next meeting of the committee. The committee agrees on actions for improvement that are suggested by the analysis and follows their implementation. Systems for the management of health care, including reporting systems, are organized into three levels: the medical unit, the hospital and the country as a triple loop learning process. The CREX is located in the base level, short loop of risk management and allows direct involvement of care professionals in patient safety. Safety of care has become a priority of health systems. In this context, the CREX can be a useful vehicle for the implementation of a safety culture in medical units. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. [Treatment Methods for Patients with Dupuytren's Disease in Switzerland].

    Science.gov (United States)

    Marks, M; Krefter, C; Herren, D B

    2016-06-01

    The objective of this study was to investigate what treatment options are currently used in Switzerland for Dupuytren's disease. Furthermore, regional preferences and treatment differences based on surgeon experience were analysed. In this survey, an electronic questionnaire was sent to all members of the Swiss Society for Hand Surgery. Participants were asked to indicate their current treatment methods for Dupuytren's disease. In addition, 8 standard patient cases were presented to identify the preferred treatment option. Furthermore, sociodemographic data of the participants were gathered. In total, 70 questionnaires were completed, corresponding to a response rate of 34%. Fasciectomy is performed by 94% of participants, while 59% inject collagenase in certain cases, 40% perform open fasciotomy, and 24% carry out percutaneous needle aponeurotomy if the indication is given. 20% of responders offer one of these techniques, 50% offer 2, 23% offer 3, and 7% offer all 4 treatment techniques. In the case of isolated metacarpophalangeal joint contracture, 51% of participants inject collagenase, whereas fasciectomy is preferred for the treatment of proximal interphalangeal joint contractures or in cases of recurrence. In German-speaking Switzerland, the treatment strategy has changed towards applying collagenase injections in the past 5 years. In this part of the country, 83% of surgeons now use more collagenase than 5 years ago, whereas only 33% of surgeons in French-speaking Switzerland have changed their treatment strategy in favour of collagenase injections (p=0.027). Surgeons with less than 10 years of experience apply more collagenase than their more experienced colleagues (79 vs. 54%, p=0.131). In Switzerland, fasciectomy is the preferred option for treating patients with Dupuytren's disease. In recent years, however, collagenase injection has become more and more popular. More research is needed to define guidelines for the treatment of patients with Dupuytren

  12. A method for developing standard patient education program

    DEFF Research Database (Denmark)

    Lura, Carolina Bryne; Hauch, Sophie Misser Pallesgaard; Gøeg, Kirstine Rosenbeck

    2018-01-01

    for developing standard digital patient education programs for patients in self-administration of blood samples drawn from CVC. The Design Science Research Paradigm was used to develop a digital patient education program, called PAVIOSY, to increase patient safety during execution of the blood sample collection...... of the educational patient system, health professionals must be engaged early in the development of content and design phase....

  13. Serum protein profile of Malaria patients through SDS-PAGE method ...

    African Journals Online (AJOL)

    Serum protein profile of Malaria patients through SDS-PAGE method. ... reliable method in the diagnosis of antibodies produced against Plasmodium spps. ... of malaria patients may be undertaken for study to develop possible future vaccine.

  14. [Origin exploration of "the fifty-nine acupoints for febrile disease"].

    Science.gov (United States)

    Li, Guangyi

    2017-02-12

    Fifty-nine acupoints for febrile disease is recorded in Huangdi Neijing ( Huangdi's Internal Classics ). By analyzing the combination of these acupoints, the writer discovered the acupoint composition and detected their origins from Huangdi's Internal Classics , in which the terms biaoben, qijie and beishu are involved in the theoretic evidence. The writer thought the "fifty-nine acupoints for febrile disease" implied the self-evolution of some acupuncture school in ancient time, which was formed by absorbing the theoretic experiences of the other schools. It is necessary to analyze and interpret the other literatures besides Huangdi's Internal Classics and probably obtain the further reorganization on it.

  15. Novel bed integrated ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Kokora, Monika

    2014-01-01

    This study presents a novel method for advanced ventilation of hospital wards leading to improved air quality at reduced ventilation rate. The idea is to evacuate the bio-effluents generated from patients’ body by local exhaustion before being spread in the room. This concept was realized by using...... a mattress having a suction opening from which bio-effluents generated from human body are exhausted. Experiments were conducted in a full-scale two-bed hospital room mock-up, 4.7 x 5.3 x 2.6 m3 (W x L x H). Only one of the patients’ beds was equipped with the ventilated mattress. The room was air...... conditioned via mixing total volume ventilation system supplying air through a ceiling mounted diffuser. All experiments were performed at room air temperature of 23ºC. A thermal manikin was used to simulate a polluting patient on the bed equipped with the ventilated mattress. Two heated dummies were used...

  16. Fiction or not? Fifty Shades is associated with health risks in adolescent and young adult females.

    Science.gov (United States)

    Bonomi, Amy E; Nemeth, Julianna M; Altenburger, Lauren E; Anderson, Melissa L; Snyder, Anastasia; Dotto, Irma

    2014-09-01

    No prior study has empirically characterized the association between health risks and reading popular fiction depicting violence against women. Fifty Shades--a blockbuster fiction series--depicts pervasive violence against women, perpetuating a broader social narrative that normalizes these types of risks and behaviors in women's lives. The present study characterized the association between health risks in women who read and did not read Fifty Shades; while our cross-sectional study design precluded causal determinations, an empirical representation of the health risks in women consuming the problematic messages in Fifty Shades is made. Females ages 18 to 24 (n=715), who were enrolled in a large Midwestern university, completed a cross-sectional online survey about their health behaviors and Fifty Shades' readership. The analysis included 655 females (219 who read at least the first Fifty Shades novel and 436 who did not read any part of Fifty Shades). Age- and race-adjusted multivariable models characterized Fifty Shades' readers and nonreaders on intimate partner violence victimization (experiencing physical, sexual and psychological abuse, including cyber-abuse, at some point during their lifetime); binge drinking (consuming five or more alcoholic beverages on six or more days in the last month); sexual practices (having five or more intercourse partners and/or one or more anal sex partner during their lifetime); and using diet aids or fasting for 24 or more hours at some point during their lifetime. One-third of subjects read Fifty Shades (18.6%, or 122/655, read all three novels, and 14.8%, or 97/655, read at least the first novel but not all three). In age- and race-adjusted models, compared with nonreaders, females who read at least the first novel (but not all three) were more likely than nonreaders to have had, during their lifetime, a partner who shouted, yelled, or swore at them (relative risk [RR]=1.25) and who delivered unwanted calls/text messages

  17. Evaluation methods on the nutritional status of stroke patients.

    Science.gov (United States)

    Wang, J; Luo, B; Xie, Y; Hu, H-Y; Feng, L; Li, Z-N

    2014-01-01

    This study was designed to assess the effect of particular tools on the nutritional status of patients with stroke risk factors; to analyze these risk factors; to construct an assessment table; and to enable nurses to conduct fast and accurate assessment of the nutritional status of patients with stroke. Various nutritional assessment tools were employed to assess the nutritional status of stroke patients [(Nutritional Risk Screening 2002, NRS2002); (mini nutritional assessment, MNA), (subjective global assessment SGA), (malnutrition universal screening, MUST); (body composition, BCA)]. The leading disease-related factors of cerebral apoplexy were observed in patients with malnutrition. And a statistical analysis was conducted. The significant risk factors of cerebral apoplexy in malnourished patients older than 70 years were swallowing dysfunctions, disturbance of consciousness and reliance or half-reliance on feeding practices. The significant risk factors of malnutrition in patients with cerebral apoplexy were the decline in upper limb muscle strength, decline in the performance of various activities, loss of appetite and gastrointestinal symptoms. Disorders that affect the nutritional status of stroke patients can be used as evaluation tools, as described in the evaluation table. The clinical relevance of this study includes the following: to enable the clinical nursing staff to easily assess the patient's nutritional status in a timely manner; to improve compliance with nutritional evaluation; to provide clinical nutrition support to patients with stroke; and to provide a scientific basis for the improvement of the clinical outcomes of patients with cerebral apoplexy.

  18. What history tells us XIII. Fifty years of the Central Dogma

    Indian Academy of Sciences (India)

    2008-05-14

    May 14, 2008 ... Home; Journals; Journal of Biosciences; Volume 33; Issue 2. What history tells us XIII. Fifty years of the Central Dogma. Michel Morange. Series Volume 33 Issue 2 June 2008 pp 171-175. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/jbsc/033/02/0171-0175 ...

  19. Fifty years of continuous improvement: (What has DOE done for analytical chemistry?)

    Energy Technology Data Exchange (ETDEWEB)

    Shults, W.D.

    1993-11-01

    Over the past fifty years, analytical scientist within the DOE complex have had a tremendous impact on the field of analytical chemistry. This paper suggests six ``high impact`` research/development areas that either originated within or were brought to maturity within the DOE laboratories. ``High impact`` means they lead to new subdisciplines or to new ways of doing business.

  20. The history of fifty years of institute of electrical engineers 1947-1996

    International Nuclear Information System (INIS)

    1997-07-01

    This book starts with the survey of a century of Korea electrical industry. It includes a business of electric power and electrical machinery industry. Next, it deals with the survey of fifty years of Korea institute electrical engineers. Then, it enumerates the articles of association, organization, board members, the role of the administrative organization, study and institute business activities in detail.

  1. Fifty Shades a way readers put sex back in their lives

    DEFF Research Database (Denmark)

    Knudsen, Gry Høngsmark

    2014-01-01

    This is a guest blog from Gry Høngsmark Knudsen, a former student, who visited my “Women’s Economy” class this winter to report on her project about the reception of Fifty Shades of Grey. We all enjoyed her report, so I asked her to write a short blog for Double X Readers....

  2. Sexist Attitudes Among Emerging Adult Women Readers of Fifty Shades Fiction.

    Science.gov (United States)

    Altenburger, Lauren E; Carotta, Christin L; Bonomi, Amy E; Snyder, Anastasia

    2017-02-01

    Stereotypical sexist representations of men and women in popular culture reinforce rigid views of masculinity (e.g., males as being strong, in control, masterful, and aggressive) and femininity (e.g., women as being fragile and weak, unassertive, peaceful, irrational, and driven by emotions). The present study examined associations between the fictional series Fifty Shades-one popular culture mechanism that includes pervasive traditional gender role representations-and underlying sexist beliefs among a sample of 715 women ages 18-24 years. Analyses revealed associations between Fifty Shades readership and sexism, as measured through the Ambivalent Sexism Inventory. Namely women who reported reading Fifty Shades had higher levels of ambivalent, benevolent, and hostile sexism. Further, those who interpreted Fifty Shades as "romantic" had higher levels of ambivalent and benevolent sexism. Our findings support prior empirical studies noting associations between interacting with aspects of popular culture, such as television and video games, and individual beliefs and behaviors.

  3. Deterrence, denuclearization, and proliferation: Alternative visions of the next fifty years

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, R.F. II

    1994-02-12

    The great library of Alexandria may have contained fewer volumes than the number which have been written on the subject of nuclear weapons in the Cold War. With the end of the Cold War, a new nuclear library is in the making. Much thought is being given to the next steps in nuclear policy, strategy, forces, arms control, and nonproliferation. For this very distinguished conference, however, I have been asked to look further ahead indeed, forward fifty-years. Prognostication is always a risky business. Detailed predictions beyond the shortest duration are difficult to label as ``scientific`` even in the social sciences. Forecasting ahead fifty years in an age of ever accelerating change would seem to be hopeless. Projecting the future of nuclear weapons, however, may not be as complex as one might think. Detailing the future fifty years from now is not necessary. We want to inform upcoming decisions by examining the possibilities, not write a history in advance of what is to happen. Our look forward con benefit from a brief look back fifty years. In retrospect, those years passed quickly, and with each additional year, analysts make them appear more simple than they seemed at the time. This paper contributes further to this process of oversimplification, as we say, ``for heuristic purposes.`` When in doubt, I have erred on the side of being provocative.

  4. Deterrence, denuclearization, and proliferation: Alternative visions of the next fifty years

    International Nuclear Information System (INIS)

    Lehman, R.F. II.

    1994-01-01

    The great library of Alexandria may have contained fewer volumes than the number which have been written on the subject of nuclear weapons in the Cold War. With the end of the Cold War, a new nuclear library is in the making. Much thought is being given to the next steps in nuclear policy, strategy, forces, arms control, and nonproliferation. For this very distinguished conference, however, I have been asked to look further ahead indeed, forward fifty-years. Prognostication is always a risky business. Detailed predictions beyond the shortest duration are difficult to label as ''scientific'' even in the social sciences. Forecasting ahead fifty years in an age of ever accelerating change would seem to be hopeless. Projecting the future of nuclear weapons, however, may not be as complex as one might think. Detailing the future fifty years from now is not necessary. We want to inform upcoming decisions by examining the possibilities, not write a history in advance of what is to happen. Our look forward con benefit from a brief look back fifty years. In retrospect, those years passed quickly, and with each additional year, analysts make them appear more simple than they seemed at the time. This paper contributes further to this process of oversimplification, as we say, ''for heuristic purposes.'' When in doubt, I have erred on the side of being provocative

  5. Multidisciplinary study: DCD method applied to patients with eating disorders

    Directory of Open Access Journals (Sweden)

    Marina Conese

    2009-06-01

    Full Text Available Eating disorders are quite common in clinical practice and can include out-of-control behaviours and thoughts that powerfully reinforce unhealthy eating patterns. They include anorexia nervosa and bulimia nervosa and Binge Eating Disorder. We conducted a trial on 102 patients (89 females and 13 males to investigate the efficacy of “DCD method” (appropriate dietary education associated to New-Electrosculpture on patients with obesity and eating disorders. The study underlines the efficacy of “DCD method”, especially when supported by behavioural therapy, in obese and overweight patients.

  6. Chronic Pain in the Emergency Department: A Pilot Mixed-Methods Cross-Sectional Study Examining Patient Characteristics and Reasons for Presentations

    Directory of Open Access Journals (Sweden)

    Patricia A. Poulin

    2016-01-01

    Full Text Available Background. Chronic pain (CP accounts for 10–16% of emergency department (ED visits, contributing to ED overcrowding and leading to adverse events. Objectives. To describe patients with CP attending the ED and identify factors contributing to their visit. Methods. We used a mixed-method design combining interviews and questionnaires addressing pain, psychological distress, signs of opioid misuse, and disability. Participants were adults who attended the EDs of a large academic tertiary care center for their CP problem. Results. Fifty-eight patients (66% women; mean age 46.5, SD = 16.9 completed the study. The most frequently cited reason (60% for ED visits was inability to cope with pain. Mental health problems were common, including depression (61% and anxiety (45%. Participants had questions about the etiology of their pain, concerns about severe pain-related impairment, and problems with medication renewals or efficacy and sometimes felt invalidated in the ED. Although most participants had a primary care physician, the ED was seen as the only or best option when pain became unmanageable. Conclusions. Patients with CP visiting the ED often present with complex difficulties that cannot be addressed in the ED. Better access to interdisciplinary pain treatment is needed to reduce the burden of CP on the ED.

  7. The Olson method for detection of acute myocardial ischemia in patients with coronary occlusion.

    Science.gov (United States)

    Lindow, Thomas; Olson, Charles W; Swenne, Cees A; Man, Sumche; Pahlm, Olle

    An automated ECG-based method may provide diagnostic support in the management of patients with acute coronary syndrome. The Olson method has previously proved to accurately identify the culprit artery in patients with acute coronary occlusion. The Olson method was applied to 360 patients without acute myocardial ischemia and 52 patients with acute coronary occlusion. This study establishes the normal variation of the Olson wall scores in patients without acute myocardial ischemia, which provides the basis for implementation of the Olson method for triage of patients with acute coronary syndrome. All patients with acute occlusion had Olson wall scores above the upper limit of normal. The Olson method can be used for ischemia detection with very high sensitivity. Future studies are needed to explore specificity in patients with non-ischemic ST elevation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. [Ultrasonic methods and semiotics in patients with vasculogenic erectile dysfunction].

    Science.gov (United States)

    Zhukov, O B; Zubarev, A R

    2001-01-01

    The authors have developed criteria for ultrasonic assessment of cavernous bodies, arterial and venous circulation in normal penile vessels and in erectile dysfunction in 125 patients; describe modern ultrasound modalities in differential diagnosis of various forms of vasculogenic erectile dysfunction basing on the experience with 92 patients; validate hydrodynamic role of the tunica albuginea in pathogenesis of venocorporal dysfunction and pathological venous drainage. Early ischemic signs of arterial insufficiency were revealed.

  9. Caring for LGBTQ patients: Methods for improving physician cultural competence.

    Science.gov (United States)

    Klein, Elizabeth W; Nakhai, Maliheh

    2016-05-01

    This article summarizes the components of a curriculum used to teach family medicine residents and faculty about LGBTQ patients' needs in a family medicine residency program in the Pacific Northwest region of the United States. This curriculum was developed to provide primary care physicians and physicians-in-training with skills to provide better health care for LGBTQ-identified patients. The curriculum covers topics that range from implicit and explicit bias and appropriate terminology to techniques for crafting patient-centered treatment plans. Additionally, focus is placed on improving the understanding of specific and unique barriers to competent health care encountered by LGBTQ patients. Through facilitated discussion, learners explore the health disparities that disproportionately affect LGBTQ individuals and develop skills that will improve their ability to care for LGBTQ patients. The goal of the curriculum is to teach family medicine faculty and physicians in training how to more effectively communicate with and treat LGBTQ patients in a safe, non-judgmental, and welcoming primary care environment. © The Author(s) 2016.

  10. [New methods of patient selection for improved anticholinergic therapy].

    Science.gov (United States)

    Neuhaus, J; Schwalenberg, T; Schlichting, N; Schulze, M; Horn, L-C; Stolzenburg, J-U

    2007-09-01

    M3-specific inhibitors are currently preferred for anticholinergic therapy of OAB. However, not all of the patients profit from this regimen. This might reflect a heterogeneity of the patient group. The aim of this work is to define subgroups of patients with specific alterations of receptor expression and to profile the receptor expression individually. These receptor profiles might be used for the development of evidence-based "tailored" therapies. Detrusor probes from bladder carcinoma patients (BCa, n=9 F, n=7 male) and interstitial cystitis patients (IC, n=9 female) were examined using confocal immunofluorescence and PCR. M2, M3, P2X1-3, and H1-3 mRNAs were demonstrated in detrusor tissue. As revealed by immunofluorescence, the M2 receptor expression was significantly higher in female compared to male BCa tissues. In addition, the M2 receptor was further upregulated in IC vs BCa in female detrusor. IC patients showed specific alterations of their receptor profile. Individual receptor profiles might be used to optimize medicinal therapies.

  11. Young Women's Perceptions of the Relationship in Fifty Shades of Grey.

    Science.gov (United States)

    Bonomi, Amy E; Nichols, Emily M; Carotta, Christin L; Kiuchi, Yuya; Perry, Samantha

    2016-02-01

    Millions of women are interacting with Fifty Shades of Grey-a best-selling novel and film. Yet, to date, no social science study has been undertaken to examine women's perceptions of the Fifty Shades relationship narrative in its film adaptation-what they deem appealing, what they deem unappealing, and what they would welcome or resist in their own relationship. In the present study, we used focus groups to examine women's perceptions of the relationship patterns in the Fifty Shades of Grey film. Focus groups were conducted with 35 young adult women (randomly sampled from the registrar's office of a large Midwestern university) immediately after watching the Fifty Shades film with the study team at a local theater within two days of the film's release. Seven semistructured questions concentrating on reactions to the relationship patterns between Christian Grey and Anastasia Steele depicted in the Fifty Shades film were asked, including general reactions, appealing and unappealing characteristics, romantic and dangerous elements, and aspects that participants would tolerate (or not tolerate) in their own relationships. While participants assessed parts of the relationship between Christian and Anastasia as exciting and romantic, they consistently indicated an unappealing lack of health in the relationship. Participants expressed grave concerns over Christian's stalking, controlling, manipulative, and emotionally abusive behavior, anger in sexual interactions, and neglect of Anastasia's needs. At the same time, they sympathized with and rationalized Christian's behaviors as a function of his personality, needs, and abilities. A small contingent implicated Anastasia in the unhealthy relationship process, whereas a broader majority of participants highlighted the challenges with trying to "speak up" in an unhealthy relationship like Christian and Anastasia's. When asked where participants would draw the line in their own relationship, participants indicated they would

  12. Fifty years experiences in nuclear engineering education at Tokyo Institute of Technology

    International Nuclear Information System (INIS)

    Fujii, Yasuhiko; Saito, Masaki; Aritomi, Masanori

    2008-01-01

    Nuclear engineering education has been initiated in 1957 at the graduate school of Tokyo Institute of Technology. Educational activities have been conducted for fifty years under the support of the Research Laboratory for Nuclear Reactors. In the past fifty years, about 1000 Master students and 200 Doctoral students and 200 Doctoral students graduated from our Nuclear Engineering Department at Tokyo Institute of Technology. Many of them found their jobs in nuclear industries and institutes. International course of nuclear engineering was initiated in 1994, and so far about 90 students from 15 overseas countries have graduated from our Master and Doctoral Programs. In 2003, our proposal of 'Innovative Nuclear Energy System for the Sustainable World' was adopted as the Center of Excellent Program sponsored by Ministry of Education, Science and Technology. Recently a collaborative education network has been developed among Kanazawa University, Fukui University, Ibaraki University, Okayama University, Tokyo Institute of Technology and Japan Atomic Energy Agency. (author)

  13. Women in Management - A Movement from the Fifties to the New Millenium

    OpenAIRE

    Parikh Indira J; Engineer Mahrukh

    2002-01-01

    "Women in Management - A Movement from the Fifties to the New Millennium", views the evolution and changes that have occurred from the 1950s onwards and looks at new opportunities for women managers in the new millennium. Women in Management are coming of age. The transformation of the Indian woman from an enigmatic figure, covered in meters of fabric, to todays educated, successful and accomplished professional has not been without great personal sacrifices. These are women who have broken t...

  14. Statement to the fifty-fifth session of the United Nations General Assembly

    International Nuclear Information System (INIS)

    ElBaradei, M.

    2000-01-01

    In his statement to the fifty-fifth session of the United Nations General Assembly, the Director General of the IAEA briefly presented the three fundamental functions of the IAEA, namely: its role as a catalyst for the development and transfer of peaceful nuclear technologies, the efforts to prevent the proliferation of nuclear weapons and move towards nuclear disarmament, and the work to build and maintain a global nuclear safety regime

  15. L'etat, c'est moi. Fifty years of history and philosophy of evolutionary biology.

    Science.gov (United States)

    Ruse, Michael

    2016-01-01

    I reflect on my fifty-year history as a philosopher of biology, showing how it has taken me from rather narrow analytic studies, through the history of ideas, and now on to issues to do with science and religion. I argue that moral concerns were and still are a major motivation behind what I do and write. Copyright: © 2016 by Fabrizio Serra editore, Pisa · Roma.

  16. The Henderson Question? The Melbourne Institute and fifty years of welfare policy

    OpenAIRE

    R. G. Gregory

    2013-01-01

    We discuss selected research contributions of the Melbourne Institute of Applied Economics and Social Research, to fifty years of welfare policy for those of work force age and focus particularly on the policy focus of R. F. Henderson, the inaugural director. Following the spirit of his 1960s poverty research, government, in the mid-1970s, doubled unemployment allowances in real terms and increased pensions by approximately forty per cent. Both income support payments were to be indexed by av...

  17. Fifty years of entomological publications in the Revista de Biología Tropical.

    Science.gov (United States)

    Hanson, Paul

    2002-01-01

    Over its fifty year history nearly twenty percent of the papers published in the Revista de Biología Tropical have been about insects and arachnids. In the 1950's papers on arthropods of medical importance were dominant, in the 1960's there was a poliferation of papers on bees, and in more recent years the subjects have become increasingly diverse. In terms of nationality of contributing authors, the journal appears to have become increasingly international in later years.

  18. Radiant Ceiling Panels Combined with Localized Methods for Improved Thermal Comfort of Both Patient and Medical Staff in Patient Room

    DEFF Research Database (Denmark)

    Mori, Sakura; Barova, Mariya; Bolashikov, Zhecho Dimitrov

    2012-01-01

    The objectives were to identify whether ceiling installed radiant heating panels can provide thermal comfort to the occupants in a patient room, and to determine a method for optimal thermal environment to both patient and medical staff simultaneously. The experiments were performed in a climate...... mattress were used to provide local heating for the patient. The effects of the methods were identified by comparing the manikin based equivalent temperatures. The optimal thermal comfort level for both patient and medical staff would obtained when two conventional cotton blankets were used with extra...... chamber resembling a single-bed patient room under convective air conditioning alone or combined with the ceiling installed radiant heating panels. Two thermal manikins simulated a patient lying in the bed and a doctor standing next to the patient. Conventional cotton blanket, electric blanket, electric...

  19. Content validity across methods of malnutrition assessment in patients with cancer is limited

    NARCIS (Netherlands)

    Sealy, Martine J.; Nijholt, Willemke; Stuiver, Martijn M.; van der Berg, Marit M.; Roodenburg, Jan L. N.; Schans, van der Cees P.; Ottery, Faith D.; Jager-Wittenaar, Harriet

    Objective: To identify malnutrition assessment methods in cancer patients and assess their content validity based on internationally accepted definitions for malnutrition. Study Design and Setting: Systematic review of studies in cancer patients that operationalized malnutrition as a variable,

  20. Content validity across methods of malnutrition assessment in patients with cancer is limited

    NARCIS (Netherlands)

    Sealy, Martine; Nijholt, Willemke; Stuiver, M.M.; van der Berg, M.M.; Roodenburg, Jan; Ottery, Faith D.; van der Schans, Cees; Jager, Harriët

    2016-01-01

    Objective To identify malnutrition assessment methods in cancer patients and assess their content validity based on internationally accepted definitions for malnutrition. Study Design and Setting Systematic review of studies in cancer patients that operationalized malnutrition as a variable,

  1. A phantom based method for deriving typical patient doses from measurements of dose-area product on populations of patients

    International Nuclear Information System (INIS)

    Chapple, C.-L.; Broadhead, D.A.

    1995-01-01

    One of the chief sources of uncertainty in the comparison of patient dosimetry data is the influence of patient size on dose. Dose has been shown to relate closely to the equivalent diameter of the patient. This concept has been used to derive a prospective, phantom based method for determining size correction factors for measurements of dose-area product. The derivation of the size correction factor has been demonstrated mathematically, and the appropriate factor determined for a number of different X-ray sets. The use of phantom measurements enables the effect of patient size to be isolated from other factors influencing patient dose. The derived factors agree well with those determined retrospectively from patient dose survey data. Size correction factors have been applied to the results of a large scale patient dose survey, and this approach has been compared with the method of selecting patients according to their weight. For large samples of data, mean dose-area product values are independent of the analysis method used. The chief advantage of using size correction factors is that it allows all patient data to be included in a survey, whereas patient selection has been shown to exclude approximately half of all patients. (author)

  2. Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

    Directory of Open Access Journals (Sweden)

    Vardosanidze S.L.

    2010-12-01

    Full Text Available 158 patients with ischemic heart disease (IHD have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients received clinical way method of treatment. Patients of the comparison group (40 patients after provided treatment were cared by their local therapeutists (cardiologists. The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-patient conditions enabled to raise patient motivation to treatment, thereby assisting them to feel better, promoting normalization of arterial pressure data. The research results stated that clinical way method of treatment may be considered as rational and effective

  3. Investigation of the clinical features and therapeutic methods for the ...

    African Journals Online (AJOL)

    Purpose: To establish if there are different classes of inflammatory lacrimal punctum diseases (ILPDs) and to examine the various strategies by which they can be managed therapeutically. Methods: Two hundred and fifty nine (259) patients with inflammatory punctum lacrimal disease were identified and used as subjects for ...

  4. En Route Patient Safety: A Mixed-Methods Study

    Science.gov (United States)

    2014-03-01

    Army, Navy, volunteers, and civilians who meet the planes lack proper safety training First-names-only rule • MCD often refuses to give report...record; EMED = emergency medical; GPMRC = Global Patient Movement Requirements Center; MCD = medical crew director; MDG = Medical Group; OI...crews voiced concerns that “the biggest issue as far as taking report from the MCD is it’s always second hand.” However, several nurses who filled

  5. Classification of Patients Treated for Infertility Using the IVF Method

    Directory of Open Access Journals (Sweden)

    Malinowski Paweł

    2015-12-01

    Full Text Available One of the most effective methods of infertility treatment is in vitro fertilization (IVF. Effectiveness of the treatment, as well as classification of the data obtained from it, is still an ongoing issue. Classifiers obtained so far are powerful, but even the best ones do not exhibit equal quality concerning possible treatment outcome predictions. Usually, lack of pregnancy is predicted far too often. This creates a constant need for further exploration of this issue. Careful use of different classification methods can, however, help to achieve that goal.

  6. Heat-washout - an objective method for diagnosing neuropathy and atherosclerosis in diabetic patients

    DEFF Research Database (Denmark)

    Midttun, M; Snorgaard, O

    2013-01-01

    The heat-washout method is an objective method that measures cutaneous blood flow rate (BFR) in ml (100 g. min)(-1), previously found useful for measuring toe BFR in non-diabetic patients with claudication.......The heat-washout method is an objective method that measures cutaneous blood flow rate (BFR) in ml (100 g. min)(-1), previously found useful for measuring toe BFR in non-diabetic patients with claudication....

  7. Comparative study between the hand-wrist method and cervical vertebral maturation method for evaluation skeletal maturity in cleft patients.

    Science.gov (United States)

    Manosudprasit, Montian; Wangsrimongkol, Tasanee; Pisek, Poonsak; Chantaramungkorn, Melissa

    2013-09-01

    To test the measure of agreement between use of the Skeletal Maturation Index (SMI) method of Fishman using hand-wrist radiographs and the Cervical Vertebral Maturation Index (CVMI) method for assessing skeletal maturity of the cleft patients. Hand-wrist and lateral cephalometric radiographs of 60 cleft subjects (35 females and 25 males, age range: 7-16 years) were used. Skeletal age was assessed using an adjustment to the SMI method of Fishman to compare with the CVMI method of Hassel and Farman. Agreement between skeletal age assessed by both methods and the intra- and inter-examiner reliability of both methods were tested by weighted kappa analysis. There was good agreement between the two methods with a kappa value of 0.80 (95% CI = 0.66-0.88, p-value <0.001). Reliability of intra- and inter-examiner of both methods was very good with kappa value ranging from 0.91 to 0.99. The CVMI method can be used as an alternative to the SMI method in skeletal age assessment in cleft patients with the benefit of no need of an additional radiograph and avoiding extra-radiation exposure. Comparing the two methods, the present study found better agreement from peak of adolescence onwards.

  8. Relative efficacy for radiation reducing methods in scoliotic patients

    International Nuclear Information System (INIS)

    Aikenhead, J.; Triano, J.; Baker, J.

    1989-01-01

    Radiation dosages to sensitive organs in full spine radiography have in recent years been a concern of physicians as well as the general public. The spine is the prime target for exposure in scoliosis radiography, though the exposure usually necessitates irradiation of several radio-sensitive organs. In recent studies, various protection techniques have been used including various lead and aluminum filtration systems, altered patient positioning and varied tube-film distances. The purpose of this study was to evaluate the efficiency for radiation dosage reduction of three filtration systems used frequently in the chiropractic profession. The systems tested were the Nolan Multiple X-ray Filters, the Clear-Pb system and the Sportelli Wedge system. These systems were tested in seven configurations varying breast shielding, distance and patient positioning. All systems tested demonstrated significant radiation reductions to organs, especially breast tissue. The Clear-Pb system appeared to be the most effective for all organs except the breast, and the Sportelli Wedge system demonstrated the greatest reduction to breast tissue

  9. Patient and staff dose optimisation in nuclear medicine diagnosis methods

    International Nuclear Information System (INIS)

    Marta Wasilewska-Radwanska; Katarzyna Natkaniec

    2007-01-01

    , control of detector uniformity. The test for rotating gamma camera additionally demands controlling precision of rotation and image system resolution. The radioisotope and chemical purity of the radiopharmaceuticals are controlled, too. The process of 99m Tc elution efficacity from 99 Mo-generator is tested and the contents of 99 Mo radioisotope in eluate is measured. The radioisotope diagnosis of brain, heart, thyroid, stomach, liver, kidney and bones as well as lymphoscintigraphy are performed. The procedure used for patient and staff's dose optimisation consists of: 1) control dose measurement performed with dosemeter on the tissue-like phantom including selected radiopharmaceutical of the same radioactivity as the one which will be applied to patient, 2) calculation of the patient dose rate, 3) calculation of the staff dose based on the results of personnel dosemeters (films or TLD), 4) preparation of the Quality Assurance instruction for the staff responsible for patient's safety. Independently of the patient and staff dose optimisation, the Quality Control of gamma camera equipments e.g. SPECT X-Ring Nucline (MEDISO) is checked for uniformity of the image from a radiopharmaceutical sample and center of rotation according to the producer's manual instruction. In addition, special lectures and courses for staff are organized several times per year to ensure a Continuous Professional Development (CPD) in the field of Quality Assurance and Quality Control.

  10. Comparison of Two Educational Methods on Nurses' Adoption of Safe Patient Handling Techniques

    Science.gov (United States)

    Folami, Florence

    2010-01-01

    Musculoskeletal injuries caused by patient lifting and transfers are a concern to health care workers. The Safe Patient Handling Act calls for all health care organizations to move to mechanical assistance from previous manual methods of transfers. This research analyzed two different educational programs that addressed safe patient handling for…

  11. Reliability testing of tendon disease using two different scanning methods in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bruyn, George A W; Möller, Ingrid; Garrido, Jesus

    2012-01-01

    To assess the intra- and interobserver reliability of musculoskeletal ultrasonography (US) in detecting inflammatory and destructive tendon abnormalities in patients with RA using two different scanning methods.......To assess the intra- and interobserver reliability of musculoskeletal ultrasonography (US) in detecting inflammatory and destructive tendon abnormalities in patients with RA using two different scanning methods....

  12. One hundred and fifty years of combustion of fossil hydrocarbons: The emergent alternatives

    International Nuclear Information System (INIS)

    Laine, Jorge

    2009-01-01

    After one hundred fifty years of drilling first commercial petroleum wells that led to the intensive use of liquid fuels to move transport vehicles, we are arriving at the peak of the world-wide petroleum reserves. Yet, we still have a good portion for spending, with the hope that the consequences will be better than in the first part, which has implied several wars and deteriorations of the environment. This assay brings a review about the history of fossil fuels and with the prospective of the emergent energetic alternatives, placing emphasis on bioenergy as an alternative for the transition between the actual combustion age and the new age of clean energy.

  13. Tied Up In Knots: Irony, Ambiguity, and the 'Difficult' Pleasures of FIFTY SHADES OF GREY

    OpenAIRE

    McCulloch, Richard

    2016-01-01

    Upon its release in February 2015, Sam Taylor-Johnson’s Fifty Shades of Grey met with vehement critical derision, finding itself reproached on both artistic and ideological grounds. While the precise focus of this indignation varied between reviews, complaints broadly fell into three categories: (1) it isn’t titillating enough (2) it\\ud is misogynistic, and (3) the love story and characters are clichéd and unrealistic.\\ud \\ud In this article, however, I demonstrate that the film is far more s...

  14. The patient radiation protection in external radiotherapy: specificity and methods; La radioprotection du patient en radiotherapie externe: specificites et methodes

    Energy Technology Data Exchange (ETDEWEB)

    Beauvais March, H. [Hopital Val de Grace, 75 - Paris (France)

    1999-07-01

    The daily use of high level radiation doses to fight against carcinomas has often led to consider radiation protection as a marginal problem, in this area. But the therapeutic advances, by increasing the life time and life quality have made the side effects unacceptable and revealed the appearance of radioinduced carcinomas. So, it is necessary to practice a patient radiation protection. The general principles of radiation protection are applicable to radiotherapy. (justification, optimization and dose limit, planning of the treatment, quality control of installations). (N.C.)

  15. Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.

    Science.gov (United States)

    Patak, Lance S; Tait, Alan R; Mirafzali, Leela; Morris, Michelle; Dasgupta, Sunavo; Brummett, Chad M

    2013-01-01

    This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features. We conducted a prospective survey study of postoperative pain control among patients using a PCA device. The survey was designed to evaluate patient satisfaction with pain control, understanding of PCA, difficulties using PCA, lockout-period management, and evaluation of new PCA design features. A total of 350 eligible patients completed the survey (91%). Patients who had difficulties using PCA were less satisfied (P PCA. Forty-nine percent of patients reported not knowing if they would receive medicine when they pushed the PCA button, and of these, 22% believed that this uncertainty made their pain worse. The majority of patients preferred the proposed PCA design features for easier use, including a light on the button, making it easier to find (57%), and a PCA button that vibrates (55%) or lights up (70%), alerting the patient that the PCA pump is able to deliver more medicine. A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.

  16. Quality of life among dermatology patients: a systematic review of investigations using qualitative methods.

    Science.gov (United States)

    Singh, Sanminder; Ehsani-Chimeh, Nazanin; Kornmehl, Heather; Armstrong, April W

    2017-07-13

    Quality of life may be assessed using quantitative or qualitative methods. Quantitative methods are commonly used in research settings; however, they may fail to capture the full range of patient experiences and impact on quality of life. Qualitative methods may be used to address this limitation. In this systematic review, we aim to synthesize data from articles utilizing qualitative methods to assess quality of life in dermatology patients. We performed a systematic review search using the MEDLINE, EMBASE, and SCOPUS databases. The search was conducted using the following search criteria: ("Dermatology" [MeSH]) AND ("Quality of Life" [MeSH]), AND ("Qualitative Research" [MeSH]), searching literature spanning from January 1, 1946- October 5, 2016. The systematic review of 15 articles included 533 dermatology patients. Patients expressed frustration over the unpredictability of disease symptoms and having to compensate for the subsequent limitations by altering their daily routines. Patients also reported profound helplessness due to chronic skin disease and social isolation in an effort to hide their disease. Patients noted the patient-provider relationship as a source of support and information exchange, with the goal to form easy to use treatment plans that met both physician and patient expectations. Qualitative assessment of patient quality of life can provide new insights into the patient experience and the impact of their skin disease. Qualitative methodology may capture meaningful information that may be overlooked by quantitative methods, and it should be included in quality of life research.

  17. Sampling for Patient Exit Interviews: Assessment of Methods Using Mathematical Derivation and Computer Simulations.

    Science.gov (United States)

    Geldsetzer, Pascal; Fink, Günther; Vaikath, Maria; Bärnighausen, Till

    2018-02-01

    (1) To evaluate the operational efficiency of various sampling methods for patient exit interviews; (2) to discuss under what circumstances each method yields an unbiased sample; and (3) to propose a new, operationally efficient, and unbiased sampling method. Literature review, mathematical derivation, and Monte Carlo simulations. Our simulations show that in patient exit interviews it is most operationally efficient if the interviewer, after completing an interview, selects the next patient exiting the clinical consultation. We demonstrate mathematically that this method yields a biased sample: patients who spend a longer time with the clinician are overrepresented. This bias can be removed by selecting the next patient who enters, rather than exits, the consultation room. We show that this sampling method is operationally more efficient than alternative methods (systematic and simple random sampling) in most primary health care settings. Under the assumption that the order in which patients enter the consultation room is unrelated to the length of time spent with the clinician and the interviewer, selecting the next patient entering the consultation room tends to be the operationally most efficient unbiased sampling method for patient exit interviews. © 2016 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust.

  18. Physical therapy methods in the treatment and rehabilitation of cancer patients

    International Nuclear Information System (INIS)

    Kucherova, T. Ya.; Choinzonov, E. L.; Tuzikov, S. A.; Vusik, M. V.; Doroshenko, A. V.; Velikaya, V. V.; Gribova, O. V.; Startseva, Zh. A.

    2016-01-01

    The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

  19. The Research of Dr. Joanne Simpson: Fifty Years Investigating Hurricanes, Tropical Clouds and Cloud Systems

    Science.gov (United States)

    Tao, W. -K.; Halverson, J.; Adler, R.; Garstang, M.; Houze, R., Jr.; LeMone, M.; Pielke, R., Sr.; Woodley, W.; O'C.Starr, David (Technical Monitor)

    2001-01-01

    This AMS Meteorological Monographs is dedicated to Dr. Joanne Simpson for her many pioneering research efforts in tropical meteorology during her fifty-year career. Dr. Simpson's major areas of scientific research involved the "hot tower" hypothesis and its role in hurricanes, structure and maintenance of trade winds, air-sea interaction, and observations and the mechanism for hurricanes and waterspouts. She was also a pioneer in cloud modeling with the first one-dimensional model and had the first cumulus model on a computer. She also played a major role in planning and leading observational experiments on convective cloud systems. The launch of the Tropical Rainfall Measuring Mission (TRMM) satellite, a joint U.S.-Japan project, in November of 1997 made it possible for quantitative measurements of tropical rainfall to be obtained on a continuous basis over the entire global tropics. Dr. Simpson was the TRAM Project Scientist from 1986 until its launch in 1997. Her efforts during this crucial period ensured that the mission was both well planned scientifically and well engineered as well as within budget. In this paper, Dr. J. Simpson's nine specific accomplishments during her fifty-year career: (1) hot tower hypothesis, (2) hurricanes, (3) airflow and clouds over heated islands, (4) cloud models, (5) trade winds and their role in cumulus development, (6) air-sea interaction, (7) cloud-cloud interactions and mergers, (8) waterspouts, and (9) TRMM science, will be described and discussed.

  20. Comparison of methods for urinary albumin determination in patients with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    C. Khawali

    2002-03-01

    Full Text Available We tested the correlation of the albumin-to-creatinine ratio (A/C in an early-morning urine sample, measured with a commercial kit (DCA 2000®, with the conventional immunoturbidimetric determination in the laboratory and with overnight albumin excretion rate (reference method. Fifty-five type 1 diabetic adolescents had their first-morning urine collected on the 1st and 8th day of the period. Urinary albumin and creatinine were determined immediately using the DCA 2000® kit. Samples were also stored for laboratory analysis. To evaluate the correlation between early-morning urinary A/C ratio and overnight albumin excretion rate, 16 subjects had a timed overnight urine collection. A/C ratios determined with the DCA 2000® kit and by the laboratory method were 13.1 ± 20.5 and 20.4 ± 46.3 mg/g, respectively. A/C results by both methods proved to be strongly correlated (r = 0.98, P<0.001. DCA 2000®-determined A/C showed 50% sensitivity and 100% specificity when compared to the reference method. Spot urinary A/C of the subset of 16 subjects significantly correlated with their overnight albumin excretion rate (r = 0.98, P<0.001. Intraindividual variation ranged from 17 to 32% and from 9 to 63% for A/C and overnight albumin excretion rate, respectively. In conclusion, an early-morning specimen should be used instead of timed overnight urine and the A/C ratio is an accurate, reliable and easily determined parameter for the screening of diabetic nephropathy. Immediate measurement of the A/C ratio is feasible using the DCA 2000® kit. Intraindividual variability indicates the need for repeated determinations to confirm microalbuminuria and the diagnosis of incipient diabetic nephropathy.

  1. A randomized clinical multicentre trial comparing enamel matrix derivative and membrane treatment of buccal class II furcation involvement in mandibular molars. Part III: patient factors and treatment outcome.

    NARCIS (Netherlands)

    Hoffmann, T.; Richter, S; Meyle, J.; Gonzales, J.R.; Heinz, B.; Arjomand, M.; Sculean, A.; Reich, E.; Jepsen, K.J.; Jepsen, S.; Boedeker, R.H.

    2006-01-01

    OBJECTIVE: Evaluation of effects of patient factors on the outcome of regenerative treatment of buccal mandibular class II furcation defects. MATERIAL AND METHODS: Fifty-one patients were recruited. In the intention-to-treat population 21 patients were allocated into the sequence left treatment with

  2. Qualitative indices and enhancement rate of CT pulmonary angiography in patients with suspected pulmonary embolism: Comparison between test bolus and bolus-tracking methods

    Directory of Open Access Journals (Sweden)

    Maryam Moradi

    2016-01-01

    Full Text Available Background: The aim of the present study was to assess the qualitative indices and enhancement rate of computed tomographic pulmonary angiography (CTPA in patients with suspected pulmonary embolism using Test bolus and Bolus-tracking techniques. Materials and Methods: Fifty-two patients with suspected pulmonary embolism that passed informed consent were randomly divided in the two groups. In each group, demographic characteristics, qualitative indices, and enhancement rate of CTPA were recorded. Results: The diagnostic result obtained in majority of the participants in the two groups (88.5 % in Test bolus group vs. 73.1% in the Bolus tracking group. In the case of quantitative variables, no statistically significant differences were found between the groups (P > 0.05. The only statistically significant difference between the two groups is average of "X-ray dose". Conclusion: The results of our study show that there is no statistically significant difference between the Bolus Tracking and Test Bolus techniques for producing more homogeneous enhancement.

  3. Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients.

    Science.gov (United States)

    Osera, Shozo; Yano, Tomonori; Odagaki, Tomoyuki; Oono, Yasuhiro; Ikematsu, Hiroaki; Ohtsu, Atsushi; Kaneko, Kazuhiro

    2015-10-01

    Percutaneous endoscopic gastrostomy (PEG) using the direct method is generally indicated for cancer patients. However, there are little available data about peritonitis related to this method. The aim of this retrospective analysis was to assess peritonitis related to PEG using the direct method in patients with cancer. We assessed the prevalence of peritonitis and the relationship between peritonitis and patients' backgrounds, as well as the clinical course after peritonitis. Between December 2008 and December 2011, peritonitis was found in 9 (2.1 %) of 421 patients. Of the 9 patients with peritonitis, 4 had received PEG prior to chemoradiotherapy. Emergency surgical drainage was required in 1 patient, and the remaining 8 recovered with conservative treatment. Peritonitis occurred within 8 days of PEG for 8 of the 9 patients and occurred within 2 days of suture removal for 4 of the 9 patients. Peritonitis related to PEG using the direct method was less frequent for cancer patients. Peritonitis tended to occur within a few days after removal of securing suture and in patients with palliative stage.

  4. Nuclear power: A look at the future. International Conference on Fifty Years of Nuclear Power: The Next Fifty Years, 27 June 2004, Moscow, Russia

    International Nuclear Information System (INIS)

    ElBaradei, M.

    2004-01-01

    other electricity sources. Critical Issues in Shaping the Future are: Carbon Emissions and the Growth in Demand; Security of Supply; Public Perceptions and Misconceptions: Shaping National Choices; Performance in Addressing Key Concerns: Nuclear Safety, Management and Disposal of Spent Nuclear Fuel, Nuclear Security, Technological and Policy Innovation, Fuel for Transportation (Growing Interest in the Potential for a 'Hydrogen Economy'). Although it is difficult to predict with any confidence what the next fifty years holds for nuclear power, the factors that will shape the future of nuclear power are relatively evident, and action should ne taken to address those factors, to enhance the prospects that nuclear energy remains a viable source of safe, secure and environmentally benign energy

  5. [Research advances in indices and methods for nutritional status evaluation in patients with liver cirrhosis].

    Science.gov (United States)

    Li, H; Zhang, L

    2017-03-20

    In recent years, malnutrition in patients with liver cirrhosis has been taken more and more seriously in clinical physicians, and patients' nutritional status is closely associated with prognosis. At present, there are many methods for the evaluation of nutritional status in patients with liver cirrhosis, but there are still no unified standards. This article reviews the common evaluation indices and methods used in clinical practice in China and foreign countries, in order to provide a basis for accurately evaluating nutritional status and guiding nutritional therapy in patients with liver cirrhosis.

  6. Comparison of three instrumental methods for the objective evaluation of radiotherapy induced erythema in breast cancer patients and a study of the effect of skin lotions

    Energy Technology Data Exchange (ETDEWEB)

    Nystroem, Josefina; Lindholm-Sethson, Britta [Dept. of Chemistry, Umeaa Univ ., Umeaa (Sweden); Centre for Biomedical Engineering and Physics, Umeaa Univ., Umeaa (Sweden); Geladi, Paul [Unit of Biomass Technology and Chemistry, SLU Roebaecksdal en, Umeaa (Sweden); Svensk, Ann-Christine; Larson, Johan; Franzen, Lars [Dept. of Oncology, N orthern Univ. Hospital, Umeaa (Sweden)

    2007-10-15

    A non-blinded three armed study of the effect of Aloe vera, Essex and no lotion on erythema was performed. The erythema is an effect of radiotherapy treatment in breast cancer patients. The study required testing of objective methods for measuring the erythema. The chosen experimental methods were Near Infrared Spectroscopy, Laser Doppler Imaging and Digital Colour Photography. The experimental setup was made in such a way that in parallel with testing the effect of the lotions there was also a test of the sensitivity of the instruments. Fifty women were selected consecutively to participate in the study. They were all subjected to treatment with high-energy electrons (9-20 MeV) after mastectomy, 2 Gy/day to a total dose of 50 Gy. Measurements were performed before the start of radiotherapy and thereafter once a week during the course of treatment. Aloe vera and Essex lotion were applied twice every radiation day in selected sites. The increase in skin redness could be monitored with all techniques with a detection limit of 8 Gy for Digital Colour Photography and Near Infrared Spectroscopy and 18 Gy for Laser Doppler Imaging. In clinical practice our recommendation is to use Digital Colour Photography. No significant median differences were observed between the pairs no lotion-Essex, no lotion-Aloe vera and Essex-Aloe vera for any of the techniques tested.

  7. Comparison of three instrumental methods for the objective evaluation of radiotherapy induced erythema in breast cancer patients and a study of the effect of skin lotions

    International Nuclear Information System (INIS)

    Nystroem, Josefina; Lindholm-Sethson, Britta; Geladi, Paul; Svensk, Ann-Christine; Larson, Johan; Franzen, Lars

    2007-01-01

    A non-blinded three armed study of the effect of Aloe vera, Essex and no lotion on erythema was performed. The erythema is an effect of radiotherapy treatment in breast cancer patients. The study required testing of objective methods for measuring the erythema. The chosen experimental methods were Near Infrared Spectroscopy, Laser Doppler Imaging and Digital Colour Photography. The experimental setup was made in such a way that in parallel with testing the effect of the lotions there was also a test of the sensitivity of the instruments. Fifty women were selected consecutively to participate in the study. They were all subjected to treatment with high-energy electrons (9-20 MeV) after mastectomy, 2 Gy/day to a total dose of 50 Gy. Measurements were performed before the start of radiotherapy and thereafter once a week during the course of treatment. Aloe vera and Essex lotion were applied twice every radiation day in selected sites. The increase in skin redness could be monitored with all techniques with a detection limit of 8 Gy for Digital Colour Photography and Near Infrared Spectroscopy and 18 Gy for Laser Doppler Imaging. In clinical practice our recommendation is to use Digital Colour Photography. No significant median differences were observed between the pairs no lotion-Essex, no lotion-Aloe vera and Essex-Aloe vera for any of the techniques tested

  8. Medication adherence in type 2 diabetes patients: study of patients ...

    African Journals Online (AJOL)

    Medication adherence in type 2 diabetes patients: study of patients in ... impact of medication adherence on the clinical outcomes of type 2 diabetes patients at ... the review of case notes of one-hundred and fifty two randomly selected patients.

  9. [The effectiveness of physical therapy methods (Bobath and motor relearning program) in rehabilitation of stroke patients].

    Science.gov (United States)

    Krutulyte, Grazina; Kimtys, Algimantas; Krisciūnas, Aleksandras

    2003-01-01

    The purpose of this study was to examine whether two different physiotherapy regimes caused any differences in outcome in the rehabilitation after stroke. We examined 240 patients with stroke. Examination was carried out at the Rehabilitation Center of Kaunas Second Clinical Hospital. Patients were divided into 2 groups: Bobath method was applied to the first (I) group (n=147), motor relearning program (MRP) method was applied to the second (II) group (n=93). In every group of patients we established samples according to sex, age, hospitalization to rehab unit as occurrence of CVA degree of disorder (hemiplegia, hemiparesis). The mobility of patients was evaluated according to European Federation for Research in Rehabilitation (EFRR) scale. Activities of daily living were evaluated by Barthel index. Analyzed groups were evaluated before physical therapy. When preliminary analysis was carried out it proved no statically reliable differences between analyzed groups (reliability 95%). The same statistical analysis was carried out after physical therapy. The results of differences between patient groups were compared using chi(2) method. Bobath method was applied working with the first group of patients. The aim of the method is to improve quality of the affected body side's movements in order to keep both sides working as harmoniously as possible. While applying this method at work, physical therapist guides patient's body on key-points, stimulating normal postural reactions, and training normal movement pattern. MRP method was used while working with the second group patients. This method is based on movement science, biomechanics and training of functional movement. Program is based on idea that movement pattern shouldn't be trained; it must be relearned. CONCLUSION. This study indicates that physiotherapy with task-oriented strategies represented by MRP, is preferable to physiotherapy with facilitation/inhibition strategies, such the Bobath programme, in the

  10. Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton.

    Science.gov (United States)

    Bech, P

    2009-01-01

    From the moment Max Hamilton started his psychiatric education, he considered psychometrics to be a scientific discipline on a par with biochemistry or pharmacology in clinical research. His clinimetric skills were in operation in the 1950s when randomised clinical trials were established as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without success. Using modern psychometric methods, the solution to this problem is a simple matter of reallocating the Hamilton scale items according to the scientific hypothesis under examination. Hamilton's original intention, to measure the global burden of the symptoms experienced by the patients with affective disorders, is in agreement with the DSM-IV and ICD-10 classification systems. Scale reliability and obtainment of valid information from patients and their relatives were the most important clinimetric innovations to be developed by Hamilton. Max Hamilton therefore belongs to the very exclusive family of eminent physicians celebrated by this journal with a tribute. 2009 S. Karger AG, Basel.

  11. Õige valu õiges kohas. Lahinguväljal näeme! Noor veri vemmeldab : Slide-Fifty

    Index Scriptorium Estoniae

    2006-01-01

    9.-10. juunil Järvakandis toimuval festivalil Rabarock esinevatest ansamblitest: The Skreppers, Metsatöll, Slide Fifty (vt. www. rabarock. ee, www.skreppers.com, www.metsatoll.ee, www.slidefifty.com)

  12. The richness of discovery : Amoco's first fifty years in Canada (1948-1998)

    International Nuclear Information System (INIS)

    McKenzie-Brown, P.

    1998-01-01

    A review of Amoco's first fifty years of operations in Canada, including investments, discoveries, and policies was presented. While no claim is made for this attractively produced slim volume to be a definitive history, it does manage to shed light on some of the great achievements and outstanding deeds of the people behind the company. The book provides a glimpse into how Amoco contributed to the growth of the Canadian petroleum industry in diverse areas including the manufacturing sector, the petroleum service sector, oil field technology, oil field infrastructure and petrochemical development. The company enjoyed spectacular success during the 1950s and 1960s. As evidence of that success, in 1997 Amoco Canada was the largest Canadian producer and exporter of natural gas and NGLs, the largest cold producer of heavy oil, the second largest in situ producer of heavy oil, and one of the 10 largest producers of conventional oil. refs., tabs., figs

  13. The continuous time random walk, still trendy: fifty-year history, state of art and outlook

    Science.gov (United States)

    Kutner, Ryszard; Masoliver, Jaume

    2017-03-01

    In this article we demonstrate the very inspiring role of the continuous-time random walk (CTRW) formalism, the numerous modifications permitted by its flexibility, its various applications, and the promising perspectives in the various fields of knowledge. A short review of significant achievements and possibilities is given. However, this review is still far from completeness. We focused on a pivotal role of CTRWs mainly in anomalous stochastic processes discovered in physics and beyond. This article plays the role of an extended announcement of the Eur. Phys. J. B Special Issue [open-calls-for-papers/123-epj-b/1090-ctrw-50-years-on">http://epjb.epj.org/open-calls-for-papers/123-epj-b/1090-ctrw-50-years-on] containing articles which show incredible possibilities of the CTRWs. Contribution to the Topical Issue "Continuous Time Random Walk Still Trendy: Fifty-year History, Current State and Outlook", edited by Ryszard Kutner and Jaume Masoliver.

  14. Gauge evolution of elementary particles physics during the last fifty years

    International Nuclear Information System (INIS)

    Khodjaev, L.Sh

    2002-01-01

    Gauge evolution of the elementary particle physics has been remarked by outstanding and exiting discoveries during the last fifty years of X X century. We review a new tendency in the development of the modern elementary particle physics. The phenomenological basis for the formulation of Standard Model has been reviewed. The Standard Model based on the fundamental postulates has been formulated. The concept of the fundamental symmetries has been introduced to look for not fundamental particles but fundamental symmetries. The Standard Model is renormalizable and therefore potentially consistent in all energy scales. The Standard Model in principle can describe the properties of the Universe beginning at 10 -43 sec. after Big Bang. In searching of more general theory obvious program is to searching the first of all global symmetries and then learn consequences connected with the localization of these global symmetries

  15. Proceedings of the fifty sixth congress of Indian Society of Theoretical and Applied Mechanics: souvenir

    International Nuclear Information System (INIS)

    Pradhan, V.H.

    2011-01-01

    The fifty sixth congress of Indian Society of Theoretical and Applied Mechanics had been organized from December 19-21, 2011. Mathematics has been playing a key role in the development of society right from the use of geometry in land measurement to satellite launching. The appropriate mathematical tools are right answers to real world problems which has increase many fold because of the advancement in various branches of applied sciences, engineering and technologies with the advanced development of high speed super digital computers. The topics such as wireless communication, health systems, financing, budgeting, planning, management and decision making which plays important role in day to day lives have been covered in this meet. Papers relevant to INIS have been indexed separately

  16. Venice: Fifty years after the great flood of November 4, 1966

    Science.gov (United States)

    Rizzoli, P. M.

    2017-12-01

    Fifty years ago Venice and its lagoon suffered the most devastating flood in their millennial history. The causes of the increasingly recurring floods will be examined, namely the man-induced subsidence in the period 1925-1970 and the storm surges of the Adriatic sea. The engineering solution designed for their protection , named the MOSE system, will be discussed in detail. The MOSE was started in 2003 and is near completion. It consists of four barriers , invisible in normal conditions, which will close the inlets to the lagoon under the prediction of a forthcoming flood. Finally, the perspective of the MOSE capability of protecting the city under scenarios of future global sea level rise will be assessed. This assessment must critically take into account that Venice and its lagoon are confined in the northernmost corner of the semi-enclosed, marginal Mediterranean sea for which the uncertainties of future sea level rise greatly exceed the uncertainties of the global averages.

  17. Organ Transplantation and the Uniform Anatomical Gift Act: A Fifty-Year Perspective.

    Science.gov (United States)

    Sadler, Blair L; Sadler, Alfred M

    2018-03-01

    Fifty years ago this summer, the Uniform Anatomical Gift Act was adopted by the National Conference of Commissioners on Uniform State Laws and approved by the American Bar Association. The UAGA has provided a sound and stable legal platform on which to base an effective nationwide organ donation system. The cardinal principles of altruism, autonomy, and public trust are still important. At a time when confidence and trust in our government and many private institutions has declined, maintaining trust and confidence in our health care system and its commitment to "first, do no harm" has never been more important. Any policies that override these core ethical principles could cause irreparable damage to the public's faith in our transplant system. While progress has been made to increase organ registration and the number of organs transplanted, much more must be done to realize the potential of life-saving therapy without jeopardizing ethical principles. © 2018 The Hastings Center.

  18. Circulations, debates and appropriations of the Fifty Shades of Grey in Argentina

    Directory of Open Access Journals (Sweden)

    Karina Felitti

    2018-01-01

    Full Text Available This article studies the social effects of the circulation and reception of the phenomenon of Fifty Shades of Grey in Argentina, in the context of sexualization of culture, postfeminism and the local agenda on gender policies. It analyzes the discussions that it aroused in the academy and the feminist militancy, its repercussions in the press and in the market of erotic goods and services, and the opinions and experiences of a set of readers. It is a qualitative study that combines textual analysis and in-depth interviews. Similarities are observed with analyzes carried out in other countries and also we pointed local specificities related to the discussions on gender violence, its manifestations and women’s agency.

  19. What makes a champion! over fifty extraordinary individuals share their insights

    CERN Document Server

    2014-01-01

    What drives great and successful individuals — be they athletes, artists, or scientists — or businesses, to achieve the extraordinary? Over fifty champions from all walks of life, brought together by Allan Snyder, draw on their experiences to explore the secrets of success in this inspiring, revealing and thought-provoking book. Hear from the authors what made a McDonalds' branch become the most successful in the world; how a cottage business is catapulted into a world brand; how a visual artist's works crosses almost every medium imaginable; how an Ernst and Young setup becomes a top-notch employer; or why many geniuses or brilliant individuals never become champions, while many 'ordinary' individuals do; why many people don't know about their talent; what constitutes a champion outcome; and the neurological explanation for championship. Straddling academia and practitioners in all fields — government, entertainment, sports, business, arts, education, medicine, media — the authors include business...

  20. Fifty years of fat: news coverage of trends that predate obesity prevalence.

    Science.gov (United States)

    Davis, Brennan; Wansink, Brian

    2015-07-10

    Obesity prevalence has risen in fifty years. While people generally expect media mentions of health risks like obesity prevalence to follow health risk trends, food consumption trends may precede obesity prevalence trends. Therefore, this research investigates whether media mentions of food predate obesity prevalence. Fifty years of non-advertising articles in the New York Times (and 17 years for the London Times) are coded for the mention of less healthy (5 salty and 5 sweet snacks) and healthy (5 fruits and 5 vegetables) food items by year and then associated with annual obesity prevalence in subsequent years. Time-series generalized linear models test whether food-related mentions predate or postdate obesity prevalence in each country. United States obesity prevalence is positively associated with New York Times mentions of sweet snacks (b = 55.2, CI = 42.4 to 68.1, p = .000) and negatively associated with mentions of fruits (b = -71.28, CI -91.5 to -51.1, p = .000) and vegetables (b = -13.6, CI = -17.5 to -9.6, p = .000). Similar results are found for the United Kingdom and The London Times. Importantly, the "obesity followed mentions" models are stronger than the "obesity preceded mentions" models. It may be possible to estimate a nation's future obesity prevalence (e.g., three years from now) based on how frequently national media mention sweet snacks (positively related) and vegetables or fruits (negatively related) today. This may provide public health officials and epidemiologists with new tools to more quickly assess the effectiveness of current obesity interventions based on what is mentioned in the media today.

  1. Optimal Scoring Methods of Hand-Strength Tests in Patients with Stroke

    Science.gov (United States)

    Huang, Sheau-Ling; Hsieh, Ching-Lin; Lin, Jau-Hong; Chen, Hui-Mei

    2011-01-01

    The purpose of this study was to determine the optimal scoring methods for measuring strength of the more-affected hand in patients with stroke by examining the effect of reducing measurement errors. Three hand-strength tests of grip, palmar pinch, and lateral pinch were administered at two sessions in 56 patients with stroke. Five scoring methods…

  2. Gender and age effects on the continuous reaction times method in volunteers and patients with cirrhosis

    DEFF Research Database (Denmark)

    Lauridsen, Mette Munk; Grønbæk, Henning; Næser, Esben

    2012-01-01

    Abstract Minimal hepatic encephalopathy (MHE) is a metabolic brain disorder occurring in patients with liver cirrhosis. MHE lessens a patient's quality of life, but is treatable when identified. The continuous reaction times (CRT) method is used in screening for MHE. Gender and age effects...

  3. The portfolio method as management support for patients with major depression.

    Science.gov (United States)

    Nunstedt, Håkan; Nilsson, Kerstin; Skärsäter, Ingela

    2014-06-01

    To describe how patients with major depression in psychiatric outpatient care use the portfolio method and whether the method helps the patients to understand their depression. Major depressive disorder is an increasing problem in society. Learning about one's depression has been demonstrated to be important for recovery. If the goal is better understanding and management of depression, learning must proceed on the patient's own terms, based on the patient's previous understanding of their depression. Learning must be aligned with patient needs if it is to result in meaningful and useful understanding. Each patient's portfolio consisted of a binder. Inside the binder, there was a register with predetermined flaps and questions. The patients were asked to work with the questions in the sections that built the content in the portfolio. Individual interviews with patients (n = 5) suffering from major depression according to Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) (American Psychiatric Association 1994) were repeatedly conducted between April 2008 and August 2009 in two psychiatric outpatient clinics in western Sweden. Data were analysed using latent content analysis. The results showed that the portfolio was used by patients as a management strategy for processing and analysis of their situation and that a portfolio's structure affects its usability. The patients use the portfolio for reflection on and confirmation of their progress, to create structure in their situation, as a management strategy for remembering situations and providing reminders of upcoming activities. Using a clearly structured care portfolio can enable participation and patient learning and help patients understand their depression. The portfolio method could provide a tool in psychiatric nursing that may facilitate patient understanding and increase self-efficacy. © 2013 John Wiley & Sons Ltd.

  4. Ball tip method for thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis

    International Nuclear Information System (INIS)

    Watanabe, Kota; Matsumoto, Morio; Iizuka, Shingo

    2008-01-01

    The purpose of this study was to evaluate the efficacy of ball tip method for thoracic pedicle screw placements in idiopathic scoliosis patients. 24 patients with adolescent idiopathic scoliosis were included in this study. Conventional method was performed in 12 patients. Ball tip method was performed in 12 patients. Accuracy of the pedicle screw placement was evaluated based on the postoperative CT. In the ball tip method, a probe which was consisted of ball tip with flexible shaft was used. After removing of cortical bone at a starting point, the probe was inserted manually or sometimes with gently tapping by hammer. During the maneuver, the probe will gradually progress into cancellous bone in the pedicle, without perforating cortical bone in the pedicle. Following expansion of the hole by a rigid gear shift probe, screw was placed in the pedicle. 65.1% of screws were located within pedicle in the conventional group and 86.5% in the ball tip group. 5.3% of screws were located out of pedicle within 2 mm in the conventional group and 8.2% in the ball tip group. 15.8% of screws were located out of pedicle beyond 2 mm and 1.8% in the ball tip group. The ball tip method enhanced the accuracy of thoracic pedicle screw placements in adolescent idiopathic scoliosis patients. The ball tip method may be effective for accurate pedicle screw placement in patients with adolescent idiopathic scoliosis. (author)

  5. Low-Fiber Diet in Limited Bowel Preparation for CT Colonography: Influence on Image Quality and Patient Acceptance

    NARCIS (Netherlands)

    Liedenbaum, Marjolein H.; Denters, Maaike J.; de Vries, Ayso H.; van Ravesteijn, Vincent F.; Bipat, Shandra; Vos, Frans M.; Dekker, Evelien; Stoker, Jaap

    2010-01-01

    OBJECTIVE. The purpose of this study was to determine whether a low-fiber diet is necessary for optimal tagging-only bowel preparation for CT colonography. SUBJECTS AND METHODS. Fifty consecutively enrolled patients received an iodine bowel preparation: 25 patients used a low-fiber diet and 25 used

  6. Evaluating resective surgery targets in epilepsy patients: A comparison of quantitative EEG methods.

    Science.gov (United States)

    Müller, Michael; Schindler, Kaspar; Goodfellow, Marc; Pollo, Claudio; Rummel, Christian; Steimer, Andreas

    2018-05-18

    Quantitative analysis of intracranial EEG is a promising tool to assist clinicians in the planning of resective brain surgery in patients suffering from pharmacoresistant epilepsies. Quantifying the accuracy of such tools, however, is nontrivial as a ground truth to verify predictions about hypothetical resections is missing. As one possibility to address this, we use customized hypotheses tests to examine the agreement of the methods on a common set of patients. One method uses machine learning techniques to enable the predictive modeling of EEG time series. The other estimates nonlinear interrelation between EEG channels. Both methods were independently shown to distinguish patients with excellent post-surgical outcome (Engel class I) from those without improvement (Engel class IV) when assessing the electrodes associated with the tissue that was actually resected during brain surgery. Using the AND and OR conjunction of both methods we evaluate the performance gain that can be expected when combining them. Both methods' assessments correlate strongly positively with the similarity between a hypothetical resection and the corresponding actual resection in class I patients. Moreover, the Spearman rank correlation between the methods' patient rankings is significantly positive. To our best knowledge, this is the first study comparing surgery target assessments from fundamentally differing techniques. Although conceptually completely independent, there is a relation between the predictions obtained from both methods. Their broad consensus supports their application in clinical practice to provide physicians additional information in the process of presurgical evaluation. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Value of ultrasound in the determination of drainage methods in patients with tuberculous pleural effusion

    International Nuclear Information System (INIS)

    Kang, Eun Young; Suh, Bo Kyoung; Shim, Jae Jeong

    1997-01-01

    To evaluate the utility of ultrasonography (US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, as follows : anechoic (n=5), linear septa (n=15), and honeycomb septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycomb septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion

  8. Value of ultrasound in the determination of drainage methods in patients with tuberculous pleural effusion

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Young; Suh, Bo Kyoung; Shim, Jae Jeong [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-01-01

    To evaluate the utility of ultrasonography (US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, as follows : anechoic (n=5), linear septa (n=15), and honeycomb septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycomb septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion.

  9. [Proposal of a conceptual method of supportive care for co-active patients].

    Science.gov (United States)

    Abidli, Yamine; Piette, Danielle; Casini, Annalisa

    2015-01-01

    There is a broad consensus on the importance for health professionals to support co-active patients. However, in practice, very few "patient care partnership" approaches have been developed. We hypothesized that the lack of investment in supporting patient care partnerships is due to the lack of interest in the skills needed by caregivers to provide such support. This paper intends to address thisgap. The patient care partnership method is studied, adapted and developed from existing models. It complements, harmonizes and integrates various schools of thought arising from the need to place the patient at the center of care and life in general. The patient care partnership method includes 7 stages during which the professional accompanies the patient through the process of care. The methodological approach for training professionals is designed to ensure that professionals experience the change as well as its difficulties of the change they expect from the patient in the care relationship. This method now needs to be validated by the experience of other professionals in order define the limits of application and to allow further development.

  10. Preferences for partner notification method: variation in responses between respondents as index patients and contacts.

    Science.gov (United States)

    Apoola, A; Radcliffe, K W; Das, S; Robshaw, V; Gilleran, G; Kumari, B S; Boothby, M; Rajakumar, R

    2007-07-01

    There have been very few studies focusing on what form of communication patients would find acceptable from a clinic. This study looks at the differences in preferences for various partner notification methods when the respondents were index patients compared with when they had to be contacted because a partner had a sexually transmitted infection (STI). There were 2544 respondents. When the clinic had to notify partners, respondents were more likely to report the method as good when a partner had an STI and they were being contacted compared with when the respondents had an infection and the partner was being contacted. The opposite was true for patient referral partner notification. Therefore, there are variations in the preferences of respondents for partner notification method, which depend on whether they see themselves as index patients or contacts.

  11. Multicentre evaluation of a novel vaginal dose reporting method in 153 cervical cancer patients

    DEFF Research Database (Denmark)

    Westerveld, Henrike; de Leeuw, Astrid; Kirchheiner, Kathrin

    2016-01-01

    Background and purpose Recently, a vaginal dose reporting method for combined EBRT and BT in cervical cancer patients was proposed. The current study was to evaluate vaginal doses with this method in a multicentre setting, wherein different applicators, dose rates and protocols were used. Materia...

  12. Content validity of methods to assess malnutrition in cancer patients: a systematic review

    NARCIS (Netherlands)

    Sealy, Martine; Nijholt, Willemke; Stuiver, M.M.; van der Berg, M.M.; Ottery, Faith D.; van der Schans, Cees; Roodenburg, Jan L N; Jager-Wittenaar, Harriët

    Content validity of methods to assess malnutrition in cancer patients: A systematic review Rationale: Inadequate operationalisation of the multidimensial concept of malnutrition may result in inadequate evaluation of nutritional status. In this review we aimed to assess content validity of methods

  13. Music as a method of coping with cancer: A qualitative study among cancer patients in Sweden.

    Science.gov (United States)

    Ahmadi, Fereshteh

    2013-06-01

    Background : This study investigated patients' understanding of the role of music in coping and in influencing their well-being. Methods : A qualitative study was conducted based on semi-structured interviews with 17 cancer patients. Participants were chosen from a group of patients who had listened to or played music as a means of coping with their illness. Results : The study shows the importance of considering the roles that different kinds of music play in coping with cancer. The music of nature, healing music, religious music and cheerful music each have different benefits for patients. Conclusions : A patient's situation and his or her individual characteristics determine the types of music that can act as a useful or harmful coping strategy. Therefore, it is essential to investigate the types of individual characteristics that can make listening to different kinds of music a helpful or harmful coping method.

  14. South African Sugar Technologists' Association. Proceedings of the fifty-ninth annual congress held at Durban and Mount Edgecombe, 17 to 21 June 1985

    International Nuclear Information System (INIS)

    1985-01-01

    This publication presents the proceedings of the fifty-ninth annual congress of the South African Sugar Technologists' Association, held in Durban and Mount Edgecombe, from 17 to 21 June 1985. Almost every facet of the sugar industry is covered including topics such as milling, irrigation, growth, crystal elongation and crystal size distribution, pans, stirrers and boilers used in the industry, evaporation, sucrose losses, radiometric and other gauges, the use of x-ray techniques and chemical methods of analysis, diseases, cooling waters, refining, maintenance, efficiency, operation, production and performance of a sugar station

  15. "Double crap!" abuse and harmed identity in Fifty Shades of Grey.

    Science.gov (United States)

    Bonomi, Amy E; Altenburger, Lauren E; Walton, Nicole L

    2013-09-01

    While intimate partner violence (IPV) affects 25% of women and impairs health, current societal conditions-including the normalization of abuse in popular culture such as novels, film, and music-create the context to support such violence. Fifty Shades of Grey, a best-selling novel, depicts a "romantic" and "erotic" relationship involving 28-year-old megamillionaire, Christian Grey, and a 22-year-old college student, Anastasia Steele. We argue that the relationship is characterized by IPV, which is harmful to Anastasia. All authors engaged in iterative readings of the text, and wrote narrative summaries to elucidate themes. Validity checks included double review of the first eight chapters of the novel to establish consistency in our analysis approach, iterative discussions in-person and electronically to arbitrate discrepancies, and review of our analysis with other abuse and sexual practice experts. To characterize IPV, we used the U.S. Centers for Disease Control and Prevention's definitions of emotional abuse (intimidation/threats; isolation; stalking; and humiliation) and sexual violence (forced sex acts/contact against a person's will, including using alcohol/drugs or intimidation/pressure). To characterize harm, we used Smith's conceptualizations of perceived threat, managing, altered identity, yearning, entrapment, and disempowerment experienced by abused women. Emotional abuse is present in nearly every interaction, including: stalking (Christian deliberately follows Anastasia and appears in unusual places, uses a phone and computer to track Anastasia's whereabouts, and delivers expensive gifts); intimidation (Christian uses intimidating verbal and nonverbal behaviors, such as routinely commanding Anastasia to eat and threatening to punish her); and isolation (Christian limits Anastasia's social contact). Sexual violence is pervasive-including using alcohol to compromise Anastasia's consent, as well as intimidation (Christian initiates sexual encounters

  16. A conservative method of retaining an interim obturator for a total maxillectomy patient

    Directory of Open Access Journals (Sweden)

    Nirmal Famila Bettie

    2017-01-01

    Full Text Available Interim obturators are indicated during the postsurgical phases. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Retention is gained by wiring, surgical suturing, and other noninvasive methods to enable functional rehabilitation and easy replacement with a permanent obturator. Interim obturators serve as an easy guide for replacing with definitive obturators by indicating prosthesis extensions and the required method of retention. A more conservative and noninvasive method of retaining an interim obturator for a maxillectomy patient is described in this case report.

  17. A Conservative Method of Retaining an Interim Obturator for a Total Maxillectomy Patient.

    Science.gov (United States)

    Bettie, Nirmal Famila

    2017-11-01

    Interim obturators are indicated during the postsurgical phases. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Retention is gained by wiring, surgical suturing, and other noninvasive methods to enable functional rehabilitation and easy replacement with a permanent obturator. Interim obturators serve as an easy guide for replacing with definitive obturators by indicating prosthesis extensions and the required method of retention. A more conservative and noninvasive method of retaining an interim obturator for a maxillectomy patient is described in this case report.

  18. Applying Multiple Methods to Comprehensively Evaluate a Patient Portal’s Effectiveness to Convey Information to Patients

    Science.gov (United States)

    Krist, Alex H; Aycock, Rebecca A; Kreps, Gary L

    2016-01-01

    Background Patient portals have yet to achieve their full potential for enhancing health communication and improving health outcomes. Although the Patient Protection and Affordable Care Act in the United States mandates the utilization of patient portals, and usage continues to rise, their impact has not been as profound as anticipated. Objective The objective of our case study was to evaluate how well portals convey information to patients. To demonstrate how multiple methodologies could be used to evaluate and improve the design of patient-centered portals, we conducted an in-depth evaluation of an exemplar patient-centered portal designed to promote preventive care to consumers. Methods We used 31 critical incident patient interviews, 2 clinician focus groups, and a thematic content analysis to understand patients’ and clinicians’ perspectives, as well as theoretical understandings of the portal’s use. Results We gathered over 140 critical incidents, 71.8% (102/142) negative and 28.2% (40/142) positive. Positive incident categories were (1) instant medical information access, (2) clear health information, and (3) patient vigilance. Negative incident categories were (1) standardized content, (2) desire for direct communication, (3) website functionality, and (4) difficulty interpreting laboratory data. Thematic analysis of the portal’s immediacy resulted in high scores in the attributes enhances understanding (18/23, 78%), personalization (18/24, 75%), and motivates behavior (17/24, 71%), but low levels of interactivity (7/24, 29%) and engagement (2/24, 8%). Two overarching themes emerged to guide portal refinements: (1) communication can be improved with directness and interactivity and (2) perceived personalization must be greater to engage patients. Conclusions Results suggest that simple modifications, such as increased interactivity and personalized messages, can make portals customized, robust, easily accessible, and trusted information sources

  19. How do voice restoration methods affect the psychological status of patients after total laryngectomy?

    Science.gov (United States)

    Saltürk, Z; Arslanoğlu, A; Özdemir, E; Yıldırım, G; Aydoğdu, İ; Kumral, T L; Berkiten, G; Atar, Y; Uyar, Y

    2016-03-01

    This study investigated the relationship between psychological well-being and different voice rehabilitation methods in total laryngectomy patients. The study enrolled 96 patients who underwent total laryngectomy. The patients were divided into three groups according to the voice rehabilitation method used: esophageal speech (24 patients); a tracheoesophageal fistula and Provox 2 voice prosthesis (57 patients); or an electrolarynx (15 patients). The participants were asked to complete the Turkish version of the Voice Handicap Index-10 (VHI-10) to assess voice problems. They were also asked to complete the Turkish version of the Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). The test scores of the three groups were compared statistically. Patients who used esophageal speech had a mean VHI-10 score of 10.25 ± 3.22 versus 19.42 ± 5.56 and 17.60 ± 1.92 for the tracheoesophageal fistula and Provox 2 and electrolarynx groups respectively, reflecting better perception of their voice. They also had a PSS score of 11.38 ± 3.92, indicating that they felt less stressed in comparison with the tracheoesophageal fistula and Provox 2 and electrolarynx groups, which scored 18.84 ± 5.50 and 16.20 ± 3.49 respectively. The HADS scores of the groups were not different, indicating that the patients' anxiety and depression status did not vary. Patients who used esophageal speech perceived less stress and were less handicapped by their voice.

  20. Effectiveness of Different Pain Control Methods in Patients with Knee Osteoarthritis after Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Jin-Lain Ming

    2017-01-01

    Full Text Available The number of patients with knee osteoarthritis has increased in tandem with population aging. Consequently, the number of knee arthroplasties has also risen. The postoperative pain is the biggest challenge faced by patients soon after knee arthroplasty; therefore, this study is among different methods for post-knee arthroplasty pain control. A prospective longitudinal research design was employed; 177 adult patients who proposed for primary knee arthroplasty were enrolled and recruited. The patients were divided into conventional Group 1 (n=120 and patient-controlled analgesia (PCA Group 2 (n=57 according to the treatment methods they received. All patients experience the highest pain level on the day of their surgery; women complained of higher pain levels than men did, while the PCA group had lower postoperative pain. Meanwhile, patients with general anesthesia experienced more pain than those with spinal anesthesia in postoperative period. Patients with a higher postoperative pain index have a smaller optimal knee flexion angle. The PCA group had lower postoperative pain; all patients experienced the highest pain level on the day of their surgery. The results of this study could serve as a reference for nurses where PCA ensures a better postoperative pain control and therefore facilitates recovery and improves the quality of nursing.

  1. Educational needs in patients with spondyloarthritis in Sweden - a mixed-methods study.

    Science.gov (United States)

    Haglund, Emma; Bremander, Ann; Bergman, Stefan; Larsson, Ingrid

    2017-08-02

    There is a demand for a flexible and individually tailored patient education to meet patients' specific needs and priorities, but this area has seldom been studied in patients with spondyloarthritis (SpA), a family of inflammatory rheumatic diseases. The aim of the present study was to identify needs and priorities in patient education in patients with SpA. A second aim was to investigate patients' experiences and preferences of receiving patient education. Data collection included a questionnaire survey with the Educational Needs Assessment Tool (ENAT) and interviews, using a mixed-methods design. Patients were identified through a specialist clinic register. Descriptive data are presented as mean with standard deviation, or frequencies. Chi-square test and independent-samples t-test were used for group comparisons. A manifest qualitative conventional content analysis was conducted to explore patients' experiences and needs in patient education, based on two focus groups (n = 6) and five individual interviews. Almost half (43%) of the 183 SpA patients had educational needs, particularly regarding aspects of self-help, feelings, and the disease process. More educational needs were reported by women and in patients with higher disease activity, while duration of disease did not affect the needs. The qualitative analysis highlighted the importance of obtaining a guiding, reliable, and easily available patient education for management of SpA. Individual contacts with healthcare professionals were of importance, but newer media were also requested. There are considerable educational needs in patients with SpA, and education concerning self-help, feelings, and the diseases process were raised as important issues. Healthcare professionals need to consider the importance of presenting varied formats of education based on the experiences and preferences of patients with SpA.

  2. Effects of auditing patient safety in hospital care: design of a mixed-method evaluation

    Science.gov (United States)

    2013-01-01

    Background Auditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance. Audits are broadly conducted in hospitals, but little is known about their effects on the behaviour of healthcare professionals and patient safety outcomes. This study was initiated to evaluate the effects of patient safety auditing in hospital care and to explore the processes and mechanisms underlying these effects. Methods and design Our study aims to evaluate an audit system to monitor and improve patient safety in a hospital setting. We are using a mixed-method evaluation with a before-and-after study design in eight departments of one university hospital in the period October 2011–July 2014. We measure several outcomes 3 months before the audit and 15 months after the audit. The primary outcomes are adverse events and complications. The secondary outcomes are experiences of patients, the standardised mortality ratio, prolonged hospital stay, patient safety culture, and team climate. We use medical record reviews, questionnaires, hospital administrative data, and observations to assess the outcomes. A process evaluation will be used to find out which components of internal auditing determine the effects. Discussion We report a study protocol of an effect and process evaluation to determine whether auditing improves patient safety in hospital care. Because auditing is a complex intervention targeted on several levels, we are using a combination of methods to collect qualitative and quantitative data about patient safety at the patient, professional, and department levels. This study is relevant for hospitals that want to

  3. Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients.

    Science.gov (United States)

    Asadian, Simin; Khatony, Alireza; Moradi, Gholamreza; Abdi, Alireza; Rezaei, Mansour

    2016-01-01

    An accurate determination of body temperature in critically ill patients is a fundamental requirement for initiating the proper process of diagnosis, and also therapeutic actions; therefore, the aim of the study was to assess the accuracy and precision of four noninvasive peripheral methods of temperature measurement compared to the central nasopharyngeal measurement. In this observational prospective study, 237 patients were recruited from the intensive care unit of Imam Ali Hospital of Kermanshah. The patients' body temperatures were measured by four peripheral methods; oral, axillary, tympanic, and forehead along with a standard central nasopharyngeal measurement. After data collection, the results were analyzed by paired t-test, kappa coefficient, receiver operating characteristic curve, and using Statistical Package for the Social Sciences, version 19, software. There was a significant meaningful correlation between all the peripheral methods when compared with the central measurement (Ptemperatures of right and left tympanic membranes and the standard central nasopharyngeal measurement (88%). Paired t-test demonstrated an acceptable precision with forehead (P=0.132), left (P=0.18) and right (P=0.318) tympanic membranes, oral (P=1.00), and axillary (P=1.00) methods. Sensitivity and specificity of both the left and right tympanic membranes were more than for other methods. The tympanic and forehead methods had the highest and lowest accuracy for measuring body temperature, respectively. It is recommended to use the tympanic method (right and left) for assessing a patient's body temperature in the intensive care units because of high accuracy and acceptable precision.

  4. The Patient Centered Assessment Method (PCAM: integrating the social dimensions of health into primary care

    Directory of Open Access Journals (Sweden)

    Rebekah Pratt

    2015-07-01

    Full Text Available Background: Social dimensions of health are known to contribute to what is often termed “patient complexity”, which is particularly common among patients with multimorbidity. Health-care professionals require tools to help them identify and manage these aspects of patient needs. Objectives: To examine: (i the Patient Centered Assessment Method (PCAM, a tool for assessing patient complexity in ways that are sensitive to the biopsychosocial dimensions of health, in primary care settings in Scotland; (ii the impact of the PCAM on referral patterns and its perceived value; and (iii the PCAM’s perceived applicability for use in a complex patient population. Design: Two studies are described: (i a mixed-methods prospective cohort study of the implementation of the PCAM in primary care clinics; and (ii a qualitative exploratory study that evaluated the value of the PCAM in a complex patient population. Results: Use of the PCAM did not impact patient satisfaction or perception of practitioners’ empathy, but it did increase both the number of onward referrals per referred patient (9–12% and the proportion of referrals to non-medical services addressing psychological, social, and lifestyle needs. Nurses valued the PCAM, particularly its ability to help them address psychological and social domains of patients’ lives, and found it to be highly relevant for use in populations with known high complexity. Conclusions: The PCAM represents a feasible approach for assessing patient needs with consideration to the social dimensions of health, and allows practitioners to refer patients to a broader range of services to address patient complexity.

  5. Fifty Shades: ambivalence about birth control in an erotic bestseller and its cultural implications.

    Science.gov (United States)

    Maierhofer, Waltraud; Israel, Emanuella

    2017-04-01

    The Fifty Shades trilogy by E.L. James has taken the world by storm and become a cultural phenomenon. The lack of contraceptive use in the erotic fiction, first pointed out by bloggers, is analysed in this article and compared to medical information. James may be praised for sexualising condom use. However, her protagonist makes poor choices in terms of hormonal contraception and is negligent about its use, resulting in an unintended pregnancy and resolved in marital bliss and motherhood. What is of more interest here than a possible message about contraceptive use, is the outcome that the fiction's negligence in birth control and responsibility affirms an ideology in which female sexuality and sexual experimentation can only be tolerated within the context of procreation and affirmation of motherhood. Subsequently, the cultural significance of the trilogy's popularity and its tension between sexual exploration, birth control and fertility is explored. In a globally popular fantasy published more than five decades after the introduction of the pill, the protagonist's lack of attention to reliable birth control leads to a telling dichotomy that combines adventurous exploration of female sexuality and affirmation of the nuclear family.

  6. Laser applications for energy. Fifty years since advent of laser and next thirty years

    International Nuclear Information System (INIS)

    Nakai, Sadao

    2011-01-01

    The utilization of light has been changed since the advent of lasers about fifty years ago. Now in the twenty first century, laser science is being applied in every industry as the fundamental technology. In the recent years, remarkable progresses have been made in the semiconductor lasers of high power and wide wavelength region. The amazing developments of ceramics laser materials like YAG and nonlinear optics materials of organic crystals have been achieved as well as the big progress in the fiber lasers. It is also to be pointed out that very high power ultra short laser pulses have become available. In the field of power photonics, which is based on the power semiconductor lasers, fiber lasers and new laser materials, various industrial applications are expected to be constructed further in civil engineering, manufacturing technology, agricultural and biological applications, medical utilization and space sciences. It is expected, by the development of ultra short pulse and ultra high mean power lasers, that particle accelerations, ultra high density sciences, nuclear fusion neutron sources and laser fusion power reactors are to be advanced drastically. Recent development and future prospects of high power lasers are illustrated. Lasers are now regarded as one of the key technologies in line with the national policy toward the creation of innovative industries. Realization of the laser fusion reactor is the most challenging target in the coming thirty years. (S. Funahashi)

  7. Fifty years of herbicide research: comparing the discovery of trifluralin and halauxifen-methyl.

    Science.gov (United States)

    Epp, Jeffrey B; Schmitzer, Paul R; Crouse, Gary D

    2018-01-01

    Fifty years separate the commercialization of the herbicides trifluralin and halauxifen-methyl. Despite the vast degree of technological change that occurred over that time frame, some aspects of their discovery stories are remarkably similar. For example, both herbicides were prepared very early in the iterative discovery process and both were developed from known lead compound structures by hypothesis-driven research efforts without the use of in vitro assays or computer-aided molecular design. However, there are aspects of the halauxifen-methyl and trifluralin discovery stories that are substantially different. For example, the chemical technology required for the cost-effective production of halauxifen-methyl simply did not exist just two decades prior to its commercial launch. By contrast, the chemical technology required for the cost-effective production of trifluralin was reported in the chemical literature more than two decades prior to its commercial launch. In addition, changes in regulatory environment since the early 1960s ensured that their respective discovery to commercial launch stories would also differ in substantial ways. Ultimately, the time and cost required to develop and register halauxifen-methyl demanded a global initial business case while the lower registration hurdles that trifluralin cleared enabled a narrow initial business case mainly focused on the USA. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  8. Age-related changes in the macula. A histopathological study of fifty Indian donor eyes.

    Science.gov (United States)

    Biswas, Jyotirmay; Raman, Rajiv

    2002-09-01

    Age-related macular degeneration (ARMD) is clinically less common in India compared to the West. Therefore, clinicians are unfamiliar with histopathologic evidence of age-related macular changes in the Indian population. Fifty consecutive human donor eyes removed for corneal grafting were studied for gross, microscopic and histochemical features of age-related changes in the macula in the Indian population. A horizontal block was cut from the globe including the optic disc, and the macula. Six sections, 6 microns thick, were cut from three levels in the macula at a distance of 140 microns. These were stained with haemotoxylin-eosin, periodic acid-Schiff, Mallory, Masson trichrome, alcian blue and von Kossa stains. The presence of basal laminar deposits, drusen and thickening and calcification of Bruch's membrane in the macula were assessed at 400 x magnification using a modified version of Sark's classification. Twenty-four donor eyes (48%) had some form of age-related macular change. These included basal laminar deposits, hard drusen, soft drusen, extensive retinal pigment epithelium atrophy of the macula, and disciform degeneration of macula. A combination of changes was often seen. Age-related changes were more common in the seventh and eighth decade. Our study shows that histological changes characteristic of the early stages of age-related macular degeneration are fairly common in the Indian population. However, advanced macular changes are significantly rare.

  9. Community Energy Systems and the Law of Public Utilities. Volume Fifty-two. Wyoming

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.

    1981-01-01

    A detailed description is presented of the laws and programs of the State of Wyoming governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

  10. Community Energy Systems and the Law of Public Utilities. Volume Fifty-one. Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.

    1981-01-01

    A detailed description is presented of the laws and programs of the State of Wisconsin governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

  11. Community Energy Systems and the Law of Public Utilities. Volume Fifty. West Virginia

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.

    1981-01-01

    A detailed description is presented of the laws and programs of the State of West Virginia governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

  12. Comparative study of ultrasonographic, radiographic and after surgery signs in fifty bitches with pyometra

    International Nuclear Information System (INIS)

    Tello, L.; Martin, F; Valdes F, Alberto; Albala, A.

    1996-01-01

    Diagnoses of pyometra are specially based on clinical signs, clinicalpathology findings and radiography. Ultrasound has been a new, only recently available diagnostic tool. To establish some relation between radiography and ultrasonography scans, fifty female dogs with clinicalsigns of pyometra were scanned with ultrasound and radiography. Lateral and ventro-dorsal views were obtained, and scored from 0 to 3 according to presence of radiographical signs. On the other hand, this study tries to correlate uterine section measurements between ultrasound and measurements of the isolated organ in 3 anatomic points after surgery: a) Caudal to kidneys, b) Lateral to navel, c) Uterine body, caudalto horn bifurcation. Lateral radiographs were more succesfull in diagnosing raised uterine volume than ventro-dorsal radiographs. The radiograph technique was less efficient than ultrasound in distinguishing positive cases with pyometra. Ultrasound was able to detect 100% of thepyometra cases. Measurements of uterine sections larger than 900 mm(2) were correlated with higher values (2 or 3) in radiographic scores (p [es

  13. Nutritional assessment methods as predictors of postoperative mortality in gastric cancer patients submitted to gastrectomy

    Directory of Open Access Journals (Sweden)

    Aline Kirjner Poziomyck

    Full Text Available ABSTRACT Objectives: to determine the nutritional evaluation method that best predicts mortality in 90 days of patients submitted to gastrectomy for gastric cancer. Methods: we conducted a prospective study with 44 patients with gastric cancer, stages II to IIIa, of whom nine were submitted to partial gastrectomy, 34 to total gastrectomy, and one to esophago-gastrectomy. All patients were nutritionally evaluated through the same protocol, up to 72h after hospital admission. The parameters used were Patient-Generated Subjective Global Assessment (PGSGA, classical anthropometry, current weight and height, percentage of weight loss (%WL and body mass index (BMI. We also measured the thickness of the thumb adductor muscle (TAM in both hands, dominant hand (TAMD and non-dominant hand (TAMND, as well as the calculated the prognostic nutritional index (PNI. The laboratory profile included serum levels of albumin, erythrocytes, hemoglobin, hematocrit, leukocytes, and total lymphocytes count (TLC. Results: of the 44 patients studied, 29 (66% were malnourished by the subjective method, 15 being grade A, 18 grade B and 11 grade C. Cases with PGSGA grade B and TAMD 10.2±2.9 mm were significantly associated with higher mortality. The ROC curves (95% confidence interval of both PGSGA and TAMD thickness reliably predicted mortality at 30 and 90 days. No laboratory method allowed predicting mortality at 90 days. Conclusion: PGSGA and the TAMD thickness can be used as preoperative parameters for risk of death in patients undergoing gastrectomy for gastric cancer.

  14. Ultrasound surface probe as a screening method for evaluating the patients with blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Mohammad Nasr-Esfahani

    2014-01-01

    Full Text Available Background: Blunt abdominal trauma is one of the causes of mortality in emergency department. Free fluid in the abdomen due to intra-abdominal blunt trauma can be determined by the surface probe of ultrasound. Since the importance of this free fluid in hemodynamic stable patients with blunt trauma is associated with the unknown outcome for surgeons, this study was performed to evaluate the role of ultrasound surface probe as a screening method in evaluating the patients with blunt abdominal trauma. Materials and Methods: A descriptive-analytical study was done on 45 patients with blunt abdominal trauma and hemodynamic stability. The patients were evaluated twice during the three-hours, including repeated ultrasound surface probe and clinical examinations. Computerized tomography was also performed. The patients were divided based on the amount of the free fluid in the abdomen during the evaluations into two groups: Fixed or increased, and decreased free fluid. The results of the different evaluated methods were compared using the sensitivity and specificity. Results: From 17 patients with CT abnormalities, free fluid increased in 14 patients (82.4%. Free fluid was decreased in three patients who were discharged well from the surgery service without any complication. Surface probe in prognosis detection had a sensitivity of 82.4% and specificity of 92.9%. The percentage of false positive and negative ultrasound compared with CT scan was 7.1% and 17.6%. Also, positive and negative predictive value of the ultrasound with surface probe was 87.5% and 89.7% respectively. Conclusion: The use of the ultrasound with surface probe in the diagnosis of free fluid in blunt abdominal trauma in hemodynamic stable patients can be considered as a useful screening method.

  15. Enrichment methods to detect bone marrow micrometastases in breast carcinoma patients: clinical relevance

    International Nuclear Information System (INIS)

    Choesmel, Valérie; Pierga, Jean-Yves; Nos, Claude; Vincent-Salomon, Anne; Sigal-Zafrani, Brigitte; Thiery, Jean-Paul; Blin, Nathalie

    2004-01-01

    Improving technologies for the detection and purification of bone marrow (BM) micrometastatic cells in breast cancer patients should lead to earlier prognosis of the risk of relapse and should make it possible to design more appropriate therapies. The technique used has to overcome the challenges resulting from the small number of target cells (one per million hematopoietic cells) and the heterogeneous expression of micrometastatic cell markers. In the present study, we have assessed the clinical relevance of current methods aimed at detecting rare disseminated carcinoma cells. BM aspirates from 32 carcinoma patients were screened for the presence of micrometastatic cells positive for epithelial cell adhesion molecule and positive for cytokeratins, using optimized immunodetection methods. A comparison with data obtained for 46 control BM aspirates and a correlation with the clinical status of patients were performed. We developed a sensitive and efficient immunomagnetic protocol for the enrichment of BM micrometastases. This method was used to divide 32 breast carcinoma patients into three categories according to their epithelial cell adhesion molecule status. These categories were highly correlated with the recently revised American Joint Committee on Cancer staging system for breast cancer, demonstrating the clinical relevance of this simple and reliable immunomagnetic technique. We also evaluated immunocytochemical detection of cytokeratin-positive cells and cytomorphological parameters. Immunocytochemistry-based methods for the detection of BM micrometastases did not provide any information about the clinical status of patients, but helped to refine the immunomagnetic data by confirming the presence of micrometastases in some cases. We also tested a new density gradient centrifugation system, able to enrich the tumor fraction of BM specimens by twofold to threefold as compared with standard Ficoll methods. These improved methods for the detection of

  16. The Correlation between Body Mass Index and Routine Parameters in Men Over Fifty

    Directory of Open Access Journals (Sweden)

    Deok Ha Seo

    2017-12-01

    Full Text Available Purpose: This study aimed to investigate the relationships between body mass index (BMI and prostate-specific antigen (PSA levels, international prostate symptom score (IPSS, quality of life (QoL, and prostate volume (PV. Materials and Methods: Height, weight, PSA levels, PV, and IPSS were analyzed in 15,435 patients who underwent a prostate examination between 2001 and 2014. Patients aged <50 years or with a PSA level ≥10 ng/mL were excluded. The relationships between BMI and PSA, IPSS, QoL, and PV were analyzed by a scatter plot, one-way analysis of variance, and the Pearson correlation coefficient. Results: The mean age was 71.95±7.63 years, the mean BMI was 23.59±3.08 kg/m2, the mean PSA level was 1.45±1.45 ng/mL, the mean IPSS was 15.53±8.31, the mean QoL score was 3.48±1.25, and the mean PV was 29.72±14.02 mL. PSA, IPSS, and QoL showed a tendency to decrease with increasing BMI, and there were statistically significant differences for each parameter (p≤0.001. PV showed a significant tendency to increase with BMI (p<0.001. In the correlation analysis, BMI showed a statistically significant correlation (p<0.001 with PSA, IPSS, and QoL, although the correlations were very weak. In contrast, BMI showed a significant correlation with PV (p<0.001, with a meaningful Pearson correlation coefficient of 0.124. Conclusions: Higher BMI was associated with lower PSA levels and higher IPSS and QoL scores. Meanwhile, PV increased with BMI. Although obese individuals had a greater PV, obesity did not aggravate lower urinary tract symptoms.

  17. [A new method of gastric shunting for treatment of patients with morbid obesity].

    Science.gov (United States)

    Grubnik, V V; Golliak, V P; Kresiun, M S

    2013-01-01

    The gastric shunting (GSH) method, permitting to control the patients body mass more effectively and promoting complete remission of diabetes mellitus type II, was elaborated. In 2008 - 2009 yrs 29 patients (9 men, 20 women) were operated on for morbid obesity, using shunting interventions. In 21 patients (the first group) a standard GSH was performed, in 8 (second group)--a modified operation. In 18-24 mo the excessive patient's body mass in patients of the first group have reduced by 62.8%, of the second group--by 89.3%. Complete compensation of diabetes mellitus type II with rejection from insulin and other antidiabetic preparations was achieved in 4 patients of the first group and in all--in the second group. Resistence for insulin have had lowered in patients of both groups, including in the first group--in 1,4 times, in the second group--in 3.2 times. Thus, preliminary results accurately demonstrate, that application of a modified GSH method is more effective, concerning the patients body mass reduction and achievement of complete compensation of diabetes mellitus type II.

  18. Image/patient registration from (partial) projection data by the Fourier phase matching method

    International Nuclear Information System (INIS)

    Weiguo Lu; You, J.

    1999-01-01

    A technique for 2D or 3D image/patient registration, PFPM (projection based Fourier phase matching method), is proposed. This technique provides image/patient registration directly from sequential tomographic projection data. The method can also deal with image files by generating 2D Radon transforms slice by slice. The registration in projection space is done by calculating a Fourier invariant (FI) descriptor for each one-dimensional projection datum, and then registering the FI descriptor by the Fourier phase matching (FPM) method. The algorithm has been tested on both synthetic and experimental data. When dealing with translated, rotated and uniformly scaled 2D image registration, the performance of the PFPM method is comparable to that of the IFPM (image based Fourier phase matching) method in robustness, efficiency, insensitivity to the offset between images, and registration time. The advantages of the former are that subpixel resolution is feasible, and it is more insensitive to image noise due to the averaging effect of the projection acquisition. Furthermore, the PFPM method offers the ability to generalize to 3D image/patient registration and to register partial projection data. By applying patient registration directly from tomographic projection data, image reconstruction is not needed in the therapy set-up verification, thus reducing computational time and artefacts. In addition, real time registration is feasible. Registration from partial projection data meets the geometry and dose requirements in many application cases and makes dynamic set-up verification possible in tomotherapy. (author)

  19. Instant availability of patient records, but diminished availability of patient information: A multi-method study of GP's use of electronic patient records

    Directory of Open Access Journals (Sweden)

    Grimsmo Anders

    2008-03-01

    Full Text Available Abstract Background In spite of succesful adoption of electronic patient records (EPR by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship. Methods A combined qualitative and quantitative study that uses data collected from focus groups, observations of primary care encounters and a questionnaire survey of a random sample of general practitioners to describe their use of EPR in primary care. Results The overall availability of individual patient records had improved, but the availability of the information within each EPR was not satisfactory. GPs' use of EPRs were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians. We found no indications of disturbance of the clinician-patient relationship by use of computers in this study. Conclusion Although GPs are generally satisfied with their EPRs systems, there are still unmet needs and functionality to be covered. It is urgent to find methods that can make a better representation of information in large patient records as well as prevent EPRs from contributing to increased administrative workload of physicians.

  20. Effects of auditing patient safety in hospital care: design of a mixed-method evaluation.

    Science.gov (United States)

    Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Boeijen, Wilma; Westert, Gert P; van Gurp, Petra J; Wollersheim, Hub

    2013-06-22

    Auditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance. Audits are broadly conducted in hospitals, but little is known about their effects on the behaviour of healthcare professionals and patient safety outcomes. This study was initiated to evaluate the effects of patient safety auditing in hospital care and to explore the processes and mechanisms underlying these effects. Our study aims to evaluate an audit system to monitor and improve patient safety in a hospital setting. We are using a mixed-method evaluation with a before-and-after study design in eight departments of one university hospital in the period October 2011-July 2014. We measure several outcomes 3 months before the audit and 15 months after the audit. The primary outcomes are adverse events and complications. The secondary outcomes are experiences of patients, the standardised mortality ratio, prolonged hospital stay, patient safety culture, and team climate. We use medical record reviews, questionnaires, hospital administrative data, and observations to assess the outcomes. A process evaluation will be used to find out which components of internal auditing determine the effects. We report a study protocol of an effect and process evaluation to determine whether auditing improves patient safety in hospital care. Because auditing is a complex intervention targeted on several levels, we are using a combination of methods to collect qualitative and quantitative data about patient safety at the patient, professional, and department levels. This study is relevant for hospitals that want to early detect unsafe care and improve patient

  1. Individual radiation therapy patient whole-body phantoms for peripheral dose evaluations: method and specific software

    International Nuclear Information System (INIS)

    Alziar, I; Vicente, C; Giordana, G; Ben-Harrath, O; De Vathaire, F; Diallo, I; Bonniaud, G; Couanet, D; Chavaudra, J; Lefkopoulos, D; Ruaud, J B; Diaz, J C; Grandjean, P; Kafrouni, H

    2009-01-01

    This study presents a method aimed at creating radiotherapy (RT) patient-adjustable whole-body phantoms to permit retrospective and prospective peripheral dose evaluations for enhanced patient radioprotection. Our strategy involves virtual whole-body patient models (WBPM) in different RT treatment positions for both genders and for different age groups. It includes a software tool designed to match the anatomy of the phantoms with the anatomy of the actual patients, based on the quality of patient data available. The procedure for adjusting a WBPM to patient morphology includes typical dimensions available in basic auxological tables for the French population. Adjustment is semi-automatic. Because of the complexity of the human anatomy, skilled personnel are required to validate changes made in the phantom anatomy. This research is part of a global project aimed at proposing appropriate methods and software tools capable of reconstituting the anatomy and dose evaluations in the entire body of RT patients in an adapted treatment planning system (TPS). The graphic user interface is that of a TPS adapted to obtain a comfortable working process. Such WBPM have been used to supplement patient therapy planning images, usually restricted to regions involved in treatment. Here we report, as an example, the case of a patient treated for prostate cancer whose therapy planning images were complemented by an anatomy model. Although present results are preliminary and our research is ongoing, they appear encouraging, since such patient-adjusted phantoms are crucial in the optimization of radiation protection of patients and for follow-up studies. (note)

  2. Individual radiation therapy patient whole-body phantoms for peripheral dose evaluations: method and specific software.

    Science.gov (United States)

    Alziar, I; Bonniaud, G; Couanet, D; Ruaud, J B; Vicente, C; Giordana, G; Ben-Harrath, O; Diaz, J C; Grandjean, P; Kafrouni, H; Chavaudra, J; Lefkopoulos, D; de Vathaire, F; Diallo, I

    2009-09-07

    This study presents a method aimed at creating radiotherapy (RT) patient-adjustable whole-body phantoms to permit retrospective and prospective peripheral dose evaluations for enhanced patient radioprotection. Our strategy involves virtual whole-body patient models (WBPM) in different RT treatment positions for both genders and for different age groups. It includes a software tool designed to match the anatomy of the phantoms with the anatomy of the actual patients, based on the quality of patient data available. The procedure for adjusting a WBPM to patient morphology includes typical dimensions available in basic auxological tables for the French population. Adjustment is semi-automatic. Because of the complexity of the human anatomy, skilled personnel are required to validate changes made in the phantom anatomy. This research is part of a global project aimed at proposing appropriate methods and software tools capable of reconstituting the anatomy and dose evaluations in the entire body of RT patients in an adapted treatment planning system (TPS). The graphic user interface is that of a TPS adapted to obtain a comfortable working process. Such WBPM have been used to supplement patient therapy planning images, usually restricted to regions involved in treatment. Here we report, as an example, the case of a patient treated for prostate cancer whose therapy planning images were complemented by an anatomy model. Although present results are preliminary and our research is ongoing, they appear encouraging, since such patient-adjusted phantoms are crucial in the optimization of radiation protection of patients and for follow-up studies.

  3. Music as a method of coping with cancer: A qualitative study among cancer patients in Sweden

    Science.gov (United States)

    Ahmadi, Fereshteh

    2013-01-01

    Background: This study investigated patients’ understanding of the role of music in coping and in influencing their well-being. Methods: A qualitative study was conducted based on semi-structured interviews with 17 cancer patients. Participants were chosen from a group of patients who had listened to or played music as a means of coping with their illness. Results: The study shows the importance of considering the roles that different kinds of music play in coping with cancer. The music of nature, healing music, religious music and cheerful music each have different benefits for patients. Conclusions: A patient's situation and his or her individual characteristics determine the types of music that can act as a useful or harmful coping strategy. Therefore, it is essential to investigate the types of individual characteristics that can make listening to different kinds of music a helpful or harmful coping method. PMID:23805166

  4. Novel method for evaluation of eye movements in patients with narcolepsy

    DEFF Research Database (Denmark)

    Christensen, Julie A E; Kempfner, Lykke; Leonthin, Helle L

    2017-01-01

    BACKGROUND: Narcolepsy causes abnormalities in the control of wake-sleep, non-rapid-eye-movement (non-REM) sleep and REM sleep, which includes specific eye movements (EMs). In this study, we aim to evaluate EM characteristics in narcolepsy as compared to controls using an automated detector....... RESULTS: NT1 patients had significantly less EMs during wake, N1, and N2 sleep and more EMs during REM sleep compared to clinical controls, and significantly less EMs during wake and N1 sleep compared to NT2 patients. Furthermore, NT1 patients showed less EMs during NREM sleep in the first sleep cycle....... METHODS: We developed a data-driven method to detect EMs during sleep based on two EOG signals recorded as part of a polysomnography (PSG). The method was optimized using the manually scored hypnograms from 36 control subjects. The detector was applied on a clinical sample with subjects suspected...

  5. Timing, method and discontinuation of hydrocortisone administration for septic shock patients

    OpenAIRE

    Ibarra-Estrada, Miguel A; Ch?vez-Pe?a, Quetzalc?atl; Reynoso-Estrella, Claudia I; Rios-Zerme?o, Jorge; Aguilera-Gonz?lez, P?vel E; Garc?a-Soto, Miguel A; Aguirre-Avalos, Guadalupe

    2017-01-01

    AIM To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1st, 2015, to July 31st, 2016. Demographic data, comorbidities, medical management details, adverse effect...

  6. Following up patients with depression after hospital discharge: a mixed methods approach

    OpenAIRE

    Desplenter, Franciska A; Laekeman, Gert J; Simoens, Steven R

    2011-01-01

    Abstract Background A medication information intervention was delivered to patients with a major depressive episode prior to psychiatric hospital discharge. Methods The objective of this study was to explore how patients evolved after hospital discharge and to identify factors influencing this evolution. Using a quasi-experimental longitudinal design, the quantitative analysis measured clinical (using the Hospital Anxiety and Depression Scale, the somatic dimension of the Symptom Checklist 90...

  7. Unilateral versus bilateral irradiation in squamous cell head and neck cancer in relation to patient-rated xerostomia and sticky saliva

    NARCIS (Netherlands)

    Jellema, Anke Petra; Slotman, Ben J.; Doornaert, Patricia; Leemans, C. Rene; Langendijk, Johannes A.

    2007-01-01

    Background and purpose: To investigate the association between radiation technique with patient-rated moderate and severe xerostomia and sticky saliva. Materials and methods: One hundred and fifty patients treated with bilateral or unilateral irradiation for head and neck cancer were included. The

  8. An evidence-based patient-centered method makes the biopsychosocial model scientific.

    Science.gov (United States)

    Smith, Robert C; Fortin, Auguste H; Dwamena, Francesca; Frankel, Richard M

    2013-06-01

    To review the scientific status of the biopsychosocial (BPS) model and to propose a way to improve it. Engel's BPS model added patients' psychological and social health concerns to the highly successful biomedical model. He proposed that the BPS model could make medicine more scientific, but its use in education, clinical care, and, especially, research remains minimal. Many aver correctly that the present model cannot be defined in a consistent way for the individual patient, making it untestable and non-scientific. This stems from not obtaining relevant BPS data systematically, where one interviewer obtains the same information another would. Recent research by two of the authors has produced similar patient-centered interviewing methods that are repeatable and elicit just the relevant patient information needed to define the model at each visit. We propose that the field adopt these evidence-based methods as the standard for identifying the BPS model. Identifying a scientific BPS model in each patient with an agreed-upon, evidence-based patient-centered interviewing method can produce a quantum leap ahead in both research and teaching. A scientific BPS model can give us more confidence in being humanistic. In research, we can conduct more rigorous studies to inform better practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Efficiency estimation methods of chemical radiation treatment of patients with disseminated cervicalcancer

    International Nuclear Information System (INIS)

    Yivankova, V.S.; Nesterenko, T.M.; Khranovs'ka, N.M.; Baranovs'ka, L.M.; Khrulenko, T.V.; Shevchenko, G.M.

    2014-01-01

    The Department of Radiation Oncology, National Cancer Institute developed methods chemoradiotherapy (CRT) patients with locally advanced cancers of the cervix (cervical cancer MR). Before treatment patients underwent complex examination, including DNA index determination by laser DNA flow cytometry based on biopsies of the cervix. During concomitant radiotherapy were used cytotoxic drugs in radiomodifying doses. Conducted to investigate the possibility of monitoring the effectiveness of treatment at the subcellular level. The treatment and analysis of the clinical and instrumental monitoring data in 79 patients with MR of cervical cancer (63 patients studied and 16 - control group). Effectiveness of CRT was evaluated by the degree of tumor regression, the dynamics of indicators DNA status of cervical cells and severity of toxic effects. Analysis of the direct method results CRT showed that the dynamics of DNA clones of tumor status correlates with clinical data obtained in response to cytotoxic therapy MR cervical cancer. Positive response of tumors in patients with cervical cancer MR after a full course chemoradiation increased by 25,0 % in comparison with standard methods. Toxic effects of treatment on the number and severity of patients in the study group did not differ from the control group, did not exceed the second degree

  10. Ethylene and ammonia traces measurements from the patients' breath with renal failure via LPAS method

    Science.gov (United States)

    Popa, C.; Dutu, D. C. A.; Cernat, R.; Matei, C.; Bratu, A. M.; Banita, S.; Dumitras, D. C.

    2011-11-01

    The application of laser photoacoustic spectroscopy (LPAS) for fast and precise measurements of breath biomarkers has opened up new promises for monitoring and diagnostics in recent years, especially because breath test is a non-invasive method, safe, rapid and acceptable to patients. Our study involved assessment of breath ethylene and breath ammonia levels in patients with renal failure receiving haemodialysis (HD) treatment. Breath samples from healthy subjects and from patients with renal failure were collected using chemically inert aluminized bags and were subsequently analyzed using the LPAS technique. We have found out that the composition of exhaled breath in patients with renal failure contains not only ethylene, but also ammonia and gives valuable information for determining efficacy and endpoint of HD. Analysis of ethylene and ammonia traces from the human breath may provide insight into severity of oxidative stress and metabolic disturbances and may ensure optimal therapy and prevention of pathology at patients on continuous HD.

  11. On rational complex of investigation methods in prophylactic examination of patients with chronic kidney diseases

    International Nuclear Information System (INIS)

    Yazykov, A.S.; Telichko, F.F.

    1989-01-01

    A retrospective evaluation of the total quantity of X-ray procedures and the radiation degree in 310 patients with chronic kidney diseases is given. It is ascertained that only account of integral absorbed dose in the organ tissues, comprising the doses of X-ray examinations of other organs during the patient lifetime, can serve as the main condition for developing well-grounded recommendations concerning rational complex of examination methods during prophylactic examination of patients with chronic kidney disease. 9 refs.; 4 figs

  12. Measuring Patient Preferences: An Overview of Methods with a Focus on Discrete Choice Experiments.

    Science.gov (United States)

    Hazlewood, Glen S

    2018-05-01

    There is increasing recognition of the importance of patient preferences and methodologies to measure them. In this article, methods to quantify patient preferences are reviewed, with a focus on discrete choice experiments. In a discrete choice experiment, patients are asked to choose between 2 or more treatments. The results can be used to quantify the relative importance of treatment outcomes and/or other considerations relevant to medical decision making. Conducting and interpreting a discrete choice experiment requires multiple steps and an understanding of the potential biases that can arise, which we review in this article with examples in rheumatic diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. A novel method for measuring patients' adherence to insulin dosing guidelines: introducing indicators of adherence

    Directory of Open Access Journals (Sweden)

    Cahané Michel

    2008-12-01

    Full Text Available Abstract Background Diabetic type 1 patients are often advised to use dose adjustment guidelines to calculate their doses of insulin. Conventional methods of measuring patients' adherence are not applicable to these cases, because insulin doses are not determined in advance. We propose a method and a number of indicators to measure patients' conformance to these insulin dosing guidelines. Methods We used a database of logbooks of type 1 diabetic patients who participated in a summer camp. Patients used a guideline to calculate the doses of insulin lispro and glargine four times a day, and registered their injected doses in the database. We implemented the guideline in a computer system to calculate recommended doses. We then compared injected and recommended doses by using five indicators that we designed for this purpose: absolute agreement (AA: the two doses are the same; relative agreement (RA: there is a slight difference between them; extreme disagreement (ED: the administered and recommended doses are merely opposite; Under-treatment (UT and over-treatment (OT: the injected dose is not enough or too high, respectively. We used weighted linear regression model to study the evolution of these indicators over time. Results We analyzed 1656 insulin doses injected by 28 patients during a three weeks camp. Overall indicator rates were AA = 45%, RA = 30%, ED = 2%, UT = 26% and OT = 30%. The highest rate of absolute agreement is obtained for insulin glargine (AA = 70%. One patient with alarming behavior (AA = 29%, RA = 24% and ED = 8% was detected. The monitoring of these indicators over time revealed a crescendo curve of adherence rate which fitted well in a weighted linear model (slope = 0.85, significance = 0.002. This shows an improvement in the quality of therapeutic decision-making of patients during the camp. Conclusion Our method allowed the measurement of patients' adherence to their insulin adjustment guidelines. The indicators that we

  14. Methods of comprehensive geriatric assessment of older patients with rectal cancer

    Directory of Open Access Journals (Sweden)

    S. S. Gordeev

    2017-01-01

    Full Text Available The article presents a literature review on application of modern risk predictors of complications and morbidity necessary for selection of oncologically justified treatment methods for older patients with rectal cancer taking into account advancement of the disease and concomitant pathology. Use of modern scales, calculators, and questionnaires for evaluation of functional and physical status of this complex patient category by a multidisciplinary team allows to personalize therapy approach, minimize complications and morbidity after specific treatment. Application of the developed algorithms of assessment of older patients creates satisfactory conditions for their treatment based on oncological adequacy, functionality, and safety.  

  15. A Simple Method for Prosthodontic Rehabilitation of Edentulous Patient with Epidermolysis Bullosa: A Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Farhang Mahboub

    2011-06-01

    Full Text Available An abnormally small oral orifice is defined as microstomia. Microstomia may result from epidermolysis bullosa (EB, which consists of a group of disorders characterized by the presence of mechanical fragility of the skin with recurrent development of blisters and vesicles, resulting from minor mechanical friction or trauma. Since such patients have a small oral aperture, it may be impossible to take impression and fabricate dentures using conventional methods. In this article, a simple method for taking preliminary impressions from upper and lower edentulous ridges in one patient with limited mouth opening and then preparing the complete denture with custom denture teeth in a single unit was described.

  16. [NDT-Bobath method used in the rehabilitation of patients with a history of ischemic stroke].

    Science.gov (United States)

    Klimkiewicz, Paulina; Kubsik, Anna; Woldańska-Okońska, Marta

    2012-01-01

    Ischemic stroke is the third leading cause of death and disability in human. The vitally important problem after ischemic stroke is hemiparesis of the body. The most common methods used in improving the mobility of patients after ischemic stroke is a Bobath-NDT (Neuro-Developmental Treatment - Bobath), which initiated the Berta and Karel Bobath for children with cerebral palsy. It is a method designed to neurophysiological recovery of these vital functions that the patient was lost due to illness, and wants it back.

  17. Age-dependent salt hypertension in Dahl rats: fifty years of research.

    Science.gov (United States)

    Zicha, J; Dobešová, Z; Vokurková, M; Rauchová, H; Hojná, S; Kadlecová, M; Behuliak, M; Vaněčková, I; Kuneš, J

    2012-01-01

    Fifty years ago, Lewis K. Dahl has presented a new model of salt hypertension - salt-sensitive and salt-resistant Dahl rats. Twenty years later, John P. Rapp has published the first and so far the only comprehensive review on this rat model covering numerous aspects of pathophysiology and genetics of salt hypertension. When we summarized 25 years of our own research on Dahl/Rapp rats, we have realized the need to outline principal abnormalities of this model, to show their interactions at different levels of the organism and to highlight the ontogenetic aspects of salt hypertension development. Our attention was focused on some cellular aspects (cell membrane function, ion transport, cell calcium handling), intra- and extrarenal factors affecting renal function and/or renal injury, local and systemic effects of renin-angiotensin-aldosterone system, endothelial and smooth muscle changes responsible for abnormal vascular contraction or relaxation, altered balance between various vasoconstrictor and vasodilator systems in blood pressure maintenance as well as on the central nervous and peripheral mechanisms involved in the regulation of circulatory homeostasis. We also searched for the age-dependent impact of environmental and pharmacological interventions, which modify the development of high blood pressure and/or organ damage, if they influence the salt-sensitive organism in particular critical periods of development (developmental windows). Thus, severe self-sustaining salt hypertension in young Dahl rats is characterized by pronounced dysbalance between augmented sympathetic hyperactivity and relative nitric oxide deficiency, attenuated baroreflex as well as by a major increase of residual blood pressure indicating profound remodeling of resistance vessels. Salt hypertension development in young but not in adult Dahl rats can be attenuated by preventive increase of potassium or calcium intake. On the contrary, moderate salt hypertension in adult Dahl rats is

  18. Emerging frontiers of pharmacy education in Saudi Arabia: The metamorphosis in the last fifty years.

    Science.gov (United States)

    Asiri, Yousif A

    2011-01-01

    The trends in the quality of biomedical education in pharmacy schools have witnessed significant changes in the 21st century. With the advent of continuous revision and standardization processes of medical curricula throughout the world, the focus has been on imparting quality education. This pedagogic paradigm has shifted to pharmacy schools. In Saudi Arabia, the concept of "medical and pharmacy education" is relatively new as mainstream pharmacy curriculum and universities were established only half a century ago. This period has seen major changes in the dimension of "pharmacy education" to keep pace with the education systems in the United States and Europe. As our knowledge and perceptions about pharmaceuticals change with time, this motivates educators to search for better teaching alternatives to the ever increasing number of enthusiastic and budding pharmacists. Recently, the academic system in Saudi Arabian Pharmacy has adopted a more clinically-oriented Pharm. D. curriculum. This paper deals with the major changes from the inception of a small pharmacy faculty in 1959, the College of Pharmacy at the King Saud University, Riyadh, to the model of progress and a prototype of pharmacy colleges in Saudi Arabia. The fifty year chronological array can be regarded as an epitome of progress in pharmacy education in Saudi Arabia from its traditional curriculum to the modern day Pharm. D. curriculum with a high population growth and expanding health care sector, the demand for qualified pharmacists is growing and is projected to grow considerably in the future. The number of pharmacy graduates is increasing each year by many folds and to meet the needs the system lays stress upon a constant revising and updating of the current curriculum from a global perspective.

  19. Frailty, prefrailty and employment outcomes in Health and Employment After Fifty (HEAF) Study.

    Science.gov (United States)

    Palmer, Keith T; D'Angelo, Stefania; Harris, E Clare; Linaker, Cathy; Gale, Catharine R; Evandrou, Maria; Syddall, Holly; van Staa, Tjeerd; Cooper, Cyrus; Aihie Sayer, Avan; Coggon, David; Walker-Bone, Karen

    2017-07-01

    Demographic changes are requiring people to work longer. No previous studies, however, have focused on whether the 'frailty' phenotype (which predicts adverse events in the elderly) is associated with employment difficulties. To provide information, we assessed associations in the Health and Employment After Fifty Study, a population-based cohort of 50-65-year olds. Subjects, who were recruited from 24 English general practices, completed a baseline questionnaire on 'prefrailty' and 'frailty' (adapted Fried criteria) and several work outcomes, including health-related job loss (HRJL), prolonged sickness absence (>20 days vs less, past 12 months), having to cut down substantially at work and difficulty coping with work's demands. Associations were assessed using logistic regression and population attributable fractions (PAFs) were calculated. In all, 3.9% of 8095 respondents were classed as 'frail' and 31.6% as 'prefrail'. Three-quarters of the former were not in work, while 60% had left their last job on health grounds (OR for HRJL vs non-frail subjects, 30.0 (95% CI 23.0 to 39.2)). Among those in work, ORs for prolonged sickness absence, cutting down substantially at work and struggling with work's physical demands ranged from 10.7 to 17.2. The PAF for HRJL when any frailty marker was present was 51.8% and that for prolonged sickness absence was 32.5%. Associations were strongest with slow reported walking speed. Several associations were stronger in manual workers than in managers. Fried frailty symptoms are not uncommon in mid-life and are strongly linked with economically important adverse employment outcomes. Frailty could represent an important target for prevention. 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/.

  20. Detection method of flexion relaxation phenomenon based on wavelets for patients with low back pain

    Science.gov (United States)

    Nougarou, François; Massicotte, Daniel; Descarreaux, Martin

    2012-12-01

    The flexion relaxation phenomenon (FRP) can be defined as a reduction or silence of myoelectric activity of the lumbar erector spinae muscle during full trunk flexion. It is typically absent in patients with chronic low back pain (LBP). Before any broad clinical utilization of this neuromuscular response can be made, effective, standardized, and accurate methods of identifying FRP limits are needed. However, this phenomenon is clearly more difficult to detect for LBP patients than for healthy patients. The main goal of this study is to develop an automated method based on wavelet transformation that would improve time point limits detection of surface electromyography signals of the FRP in case of LBP patients. Conventional visual identification and proposed automated methods of time point limits detection of relaxation phase were compared on experimental data using criteria of accuracy and repeatability based on physiological properties. The evaluation demonstrates that the use of wavelet transform (WT) yields better results than methods without wavelet decomposition. Furthermore, methods based on wavelet per packet transform are more effective than algorithms employing discrete WT. Compared to visual detection, in addition to demonstrating an obvious saving of time, the use of wavelet per packet transform improves the accuracy and repeatability in the detection of the FRP limits. These results clearly highlight the value of the proposed technique in identifying onset and offset of the flexion relaxation response in LBP subjects.

  1. Methods for interpreting change over time in patient-reported outcome measures.

    Science.gov (United States)

    Wyrwich, K W; Norquist, J M; Lenderking, W R; Acaster, S

    2013-04-01

    Interpretation guidelines are needed for patient-reported outcome (PRO) measures' change scores to evaluate efficacy of an intervention and to communicate PRO results to regulators, patients, physicians, and providers. The 2009 Food and Drug Administration (FDA) Guidance for Industry Patient-Reported Outcomes (PRO) Measures: Use in Medical Product Development to Support Labeling Claims (hereafter referred to as the final FDA PRO Guidance) provides some recommendations for the interpretation of change in PRO scores as evidence of treatment efficacy. This article reviews the evolution of the methods and the terminology used to describe and aid in the communication of meaningful PRO change score thresholds. Anchor- and distribution-based methods have played important roles, and the FDA has recently stressed the importance of cross-sectional patient global assessments of concept as anchor-based methods for estimation of the responder definition, which describes an individual-level treatment benefit. The final FDA PRO Guidance proposes the cumulative distribution function (CDF) of responses as a useful method to depict the effect of treatments across the study population. While CDFs serve an important role, they should not be a replacement for the careful investigation of a PRO's relevant responder definition using anchor-based methods and providing stakeholders with a relevant threshold for the interpretation of change over time.

  2. Cost evaluation of two methods of post tooth extraction hemostasis in patients on anticoagulant therapy.

    Science.gov (United States)

    Zusman, S P; Lustig, J P; Bin Nun, G

    1993-06-01

    The classical management of patients on oral anticoagulant therapy included hospitalisation, cessation of the anticoagulant agent, and extraction of teeth when the prothrombine levels rise. This method was substituted in the High Risk Dental Clinic at Barzilai Medical Center in Ashkelon by use of a tissue sealant (Tisseel) which does not need hospitalisation nor cessation of the anticoagulant therapy. In comparing the last 23 sessions employing the former method to the first 23 sessions using the new method there were significant differences in the cost effectiveness for the health system, provider, insurer and patient. Despite the fact that from the health system point of view the new method is much more cost effective, there is no financial incentive for the provider (hospital) nor awareness on the part of the insurer (General Sick Fund) to embrace it and 'market' it.

  3. Responsiveness of observational and self-report methods for assessing disability in mobility in patients with osteoarthritis.

    NARCIS (Netherlands)

    Steultjens, M.P.M.; Roorda, L.D.; Dekker, J.; Bijlsma, J.W.J.

    2001-01-01

    Objective: To establish the responsiveness of observational and self-report methods for the assessment of disability in mobility in patients with osteoarthritis (OA). Methods: Data from 186 patients with hip OA of knee OA were used. Data from 1 observational method and 4 self-report methods for the

  4. New method of surgical treatment of patients with recurrent ingrown nail

    Directory of Open Access Journals (Sweden)

    Kondulukov A.N.

    2011-12-01

    Full Text Available The article discusses the surgical treatment of ingrown nail in patients with recurrent disease. The advantages of a new method of operation have been explained in the article. It gives a detailed description of the operation. The clinical and additional methods of research have confirmed the fact that a new operation reduces the wound healing period and the number of ingrown nail recurrences

  5. Evidence-Based Indicators of Neuropsychological Change in the Individual Patient: Relevant Concepts and Methods

    Science.gov (United States)

    Duff, Kevin

    2012-01-01

    Repeated assessments are a relatively common occurrence in clinical neuropsychology. The current paper will review some of the relevant concepts (e.g., reliability, practice effects, alternate forms) and methods (e.g., reliable change index, standardized based regression) that are used in repeated neuropsychological evaluations. The focus will be on the understanding and application of these concepts and methods in the evaluation of the individual patient through examples. Finally, some future directions for assessing change will be described. PMID:22382384

  6. The influence of process and patient factors on the recall of consent information in mentally competent patients undergoing surgery for neck of femur fractures

    OpenAIRE

    Khan, SK; Karuppaiah, K; Bajwa, AS

    2012-01-01

    INTRODUCTION Informed consent is an ethical and legal prerequisite for major surgical procedures. Recent literature has identified ‘poor consent’ as a major cause of litigation in trauma cases. We aimed to investigate the patient and process factors that influence consent information recall in mentally competent patients (abbreviated mental test score [AMTS] ≥6) presenting with neck of femur (NOF) fractures. METHODS A prospective study was conducted at a tertiary unit. Fifty NOF patients (cas...

  7. Effects of different blood purification methods on serum inflammatory cytokine in maintenance hemodialysis patients

    International Nuclear Information System (INIS)

    Zhang Yijing; Tian Jinsheng; Feng Xiaoyan

    2012-01-01

    Objective: To study the effects of low-flux hemodialysis (LFHD), high-flux hemodialysis (HFHD) and hemodiafiltration (HDF) on the serum inflammatory cytokine in maintenance hemodialysis (MHD) patients. Methods: Sixty MHD patients were randomly divided into LFHD group, HFHD group and HDF group. Results: The levels of serum CRP, IL-6, IL-8 and TNF-α were detected in three groups and control group. The results showed that levels of CRP, IL-6, IL-8 and TNF-α in patients with MHD before treatment were much higher than these in control group (P 0.05). The levels of CRP, IL-6, IL-8 and TNF-α did not significantly decrease in patients with HFHD after the first hemodialysis (P>0.05). The levels of CRP, IL-6, IL-8 and TNF-α decreased markedly in patients with HFHD after 6 months hemodialysis (P<0.05). The levels of CRP, IL-6, IL-8 and TNF-α decreased significantly in patients with HDF after the first hemodialysis and after 6 months (P<0.05). The levels of CRP, IL-6, IL-8 and TNF-α in HDF group were significantly lower than those in HFHD group after 6 months (P<0.05). Conclusion: There was microinflammatory state in MHD patients. The lowering of patients' serum CRP, IL-6, IL-8 and TNF-α levels and thus the recovery from microinflammatory state may be achieved by HDF, HFHD, and HFHD preferably by HDF. (authors)

  8. Clinical study of Atopic Dermatitis patient treated with Poison Extraction Method

    Directory of Open Access Journals (Sweden)

    Park Chi-young

    2007-06-01

    Full Text Available Objectives : This study is desinged in order to evaluate the Poison extraction method for the Atopic dermatitis. Methods : The authors observed the two cases of Atopic dermatitis patients who previously used steroid-based ointment. for treating the Poison Extraction Method. Conclusions : 1. In case 1, the patient with mild case of Atopic dermatitis in face is treated with the Poison extraction method. Rash symptoms intensed for first few days. As sweating appeared in the local area from the seventh day, all the symptoms was disappeared rapidly. No recurrence was found. 2. In case 2, the patient with severe case of Atopic dermatitis in whole body is treated with the Poison extraction method. The symptoms intensed after two months and all the symptoms of itchiness, rash, scaly letter dissapeared in the third and fourth months. No recurrence was found. 3. In both cases of mild and severe cases of Atopic dermatitis. all the symptoms were disappeared and no recurrence was found with the Poison Extraction Method.

  9. Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis

    Directory of Open Access Journals (Sweden)

    Fumio Omata

    2017-01-01

    Full Text Available Background. There are several diagnostic methods for Helicobacter pylori (H. pylori infection. A cost-effective analysis is needed to decide on the optimal diagnostic method. The aim of this study was to determine a cost-effective diagnostic method in patients with atrophic gastritis (AG. Methods. A decision-analysis model including seven diagnostic methods was constructed for patients with AG diagnosed by esophagogastroduodenoscopy. Expected values of cost and effectiveness were calculated for each test. Results. If the prevalence of H. pylori in the patients with AG is 85% and CAM-resistant H. pylori is 30%, histology, stool H. pylori antigen (SHPAg, bacterial culture (BC, and urine H. pylori antibody (UHPAb were dominated by serum H. pylori IgG antibody (SHPAb, rapid urease test (RUT, and urea breath test (UBT. Among three undominated methods, the incremental cost-effective ratios (ICER of RUT versus SHPAb and UBT versus RUT were $214 and $1914, respectively. If the prevalence of CAM-sensitive H. pylori was less than 55%, BC was not dominated, but its H. pylori eradication success rate was 0.86. Conclusions. RUT was the most cost-effective at the current prevalence of CAM-resistant H. pylori. BC could not be selected due to its poor effectiveness even if CAM-resistant H. pylori was more than 45%.

  10. Quantitative methods for evaluating the efficacy of thalamic deep brain stimulation in patients with essential tremor.

    Science.gov (United States)

    Wastensson, Gunilla; Holmberg, Björn; Johnels, Bo; Barregard, Lars

    2013-01-01

    Deep brain stimulation (DBS) of the thalamus is a safe and efficient method for treatment of disabling tremor in patient with essential tremor (ET). However, successful tremor suppression after surgery requires careful selection of stimulus parameters. Our aim was to examine the possible use of certain quantitative methods for evaluating the efficacy of thalamic DBS in ET patients in clinical practice, and to compare these methods with traditional clinical tests. We examined 22 patients using the Essential Tremor Rating Scale (ETRS) and quantitative assessment of tremor with the stimulator both activated and deactivated. We used an accelerometer (CATSYS tremor Pen) for quantitative measurement of postural tremor, and a eurythmokinesimeter (EKM) to evaluate kinetic tremor in a rapid pointing task. The efficacy of DBS on tremor suppression was prominent irrespective of the method used. The agreement between clinical rating of postural tremor and tremor intensity as measured by the CATSYS tremor pen was relatively high (rs = 0.74). The agreement between kinetic tremor as assessed by the ETRS and the main outcome variable from the EKM test was low (rs = 0.34). The lack of agreement indicates that the EKM test is not comparable with the clinical test. Quantitative methods, such as the CATSYS tremor pen, could be a useful complement to clinical tremor assessment in evaluating the efficacy of DBS in clinical practice. Future studies should evaluate the precision of these methods and long-term impact on tremor suppression, activities of daily living (ADL) function and quality of life.

  11. Selecting the patients for morning report sessions: case-based vs. conventional method.

    Science.gov (United States)

    Rabiei, Mehdi; Saeidi, Masumeh; Kiani, Mohammad Ali; Amin, Sakineh Mohebi; Ahanchian, Hamid; Jafari, Seyed Ali; Kianifar, Hamidreza

    2015-08-01

    One of the most important issues in morning report sessions is the number of patients. The aim of this study was to investigate and compare the number of cases reported in the morning report sessions in terms of case-based and conventional methods from the perspective of pediatric residents of Mashhad University of Medical Sciences. The present study was conducted on 24 pediatric residents of Mashhad University of Medical Sciences in the academic year 2014-2015. In this survey, the residents replied to a 20-question researcher-made questionnaire that had been designed to measure the views of residents regarding the number of patients in the morning report sessions using case-based and conventional methods. The validity of the questionnaire was confirmed by experts' views and its reliability by calculating Cronbach's alpha coefficients. Data were analyzed by t-test analysis. The mean age of the residents was 30.852 ± 2.506, and 66.6% of them were female. The results showed that there was no significant relationship among the variables of academic year, gender, and residents' perspective to choosing the number of patients in the morning report sessions (P > 0.05). T-test analysis showed a significant relationship among the average scores of residents in the selection of the case-based method in comparison to the conventional method (P case-based morning report was preferred compared to the conventional method. This method makes residents pay more attention to the details of patients' issues and therefore helps them to better plan how to address patient problems and improve their differential diagnosis skills.

  12. Clinical Correlates of Health Preference and Generic Health-Related Quality of Life in Patients with Colorectal Neoplasms

    OpenAIRE

    Wong, Carlos K. H.; Lam, Cindy L. K.; Poon, Jensen T. C.; Kwong, Dora L. W.

    2013-01-01

    BACKGROUND: The aims of the study were to assess the health preference and health-related quality of life (HRQOL) in patients with colorectal neoplasms (CRN), and to determine the clinical correlates that significantly influence the HRQOL of patients. METHODS: Five hundred and fifty-four CRN patients, inclusive of colorectal polyp or cancer, who attended the colorectal specialist outpatient clinic at Queen Mary Hospital in Hong Kong between October 2009 and July 2010, were included. Patients ...

  13. Changing practice: red blood cell typing by molecular methods for patients with sickle cell disease.

    Science.gov (United States)

    Casas, Jessica; Friedman, David F; Jackson, Tannoa; Vege, Sunitha; Westhoff, Connie M; Chou, Stella T

    2015-06-01

    Extended red blood cell (RBC) antigen matching is recommended to limit alloimmunization in patients with sickle cell disease (SCD). DNA-based testing to predict blood group phenotypes has enhanced availability of antigen-negative donor units and improved typing of transfused patients, but replacement of routine serologic typing for non-ABO antigens with molecular typing for patients has not been reported. This study compared the historical RBC antigen phenotypes obtained by hemagglutination methods with genotype predictions in 494 patients with SCD. For discrepant results, repeat serologic testing was performed and/or investigated by gene sequencing for silent or variant alleles. Seventy-one typing discrepancies were identified among 6360 antigen comparisons (1.1%). New specimens for repeat serologic testing were obtained for 66 discrepancies and retyping agreed with the genotype in 64 cases. One repeat Jk(b-) serologic phenotype, predicted Jk(b+) by genotype, was found by direct sequencing of JK to be a silenced allele, and one N typing discrepancy remains under investigation. Fifteen false-negative serologic results were associated with alleles encoding weak antigens or single-dose Fy(b) expression. DNA-based RBC typing provided improved accuracy and expanded information on RBC antigens compared to hemagglutination methods, leading to its implementation as the primary method for extended RBC typing for patients with SCD at our institution. © 2015 AABB.

  14. Recurrence rate and patient satisfaction of CO2 laser evaporation of lesions in patients with hidradenitis suppurativa

    DEFF Research Database (Denmark)

    Mikkelsen, Peter Riis; Dufour, Deirde Nathalie; Zarchi, Kian

    2015-01-01

    : To determine the recurrence rate, time to recurrence, and factors influencing disease recurrence in skin treated with CO2 laser evaporation, and healing by secondary intention; and patients' satisfaction with treatment. METHODS: Fifty-eight patients treated with CO2 laser evaporation were interviewed regarding...... recurrence and satisfaction after a mean of 25.7 months. RESULTS: Seventeen of 58 (29%) reported recurrence of HS lesions within the borders of the treated areas after a mean of 12.7 months. Obesity was a risk factor for recurrence with a hazard ratio of 4.53. Fifty-five patients (95%) reported some or great...... improvement, and 91% would recommend the CO2 laser surgery to other HS patients. CONCLUSION: This study supports the claim that CO2 laser treatment is an effective modality for recurrent HS lesions in a majority of patients. The authors identified obesity as a risk factor for recurrence. Self...

  15. Assessment of different quit smoking methods selected by patients in tobacco cessation centers in Iran

    Directory of Open Access Journals (Sweden)

    Gholamreza Heydari

    2015-01-01

    Full Text Available Background: Health systems play key roles in identifying tobacco users and providing evidence-based care to help them quit. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess different quit smoking methods selected by patients in tobacco cessation centers in Iran in order to identify those that are most appropriate for the country health system. Methods: In this cross-sectional and descriptive study, a random sample of all quit centers at the country level was used to obtain a representative sample. Patients completed the self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: A total of 1063 smokers returned completed survey questionnaires. The most frequently used methods were Nicotine Replacement Therapy (NRT and combination therapy (NRT and Counseling with 228 and 163 individuals reporting these respectively. The least used methods were hypnotism (n = 8 and the quit and win (n = 17. The methods which gained the maximum scores were respectively the combined method, personal and Champix with means of 21.4, 20.4 and 18.4. The minimum scores were for e-cigarettes, hypnotism and education with means of 12.8, 11 and 10.8, respectively. There were significant differences in mean scores based on different cities and different methods. Conclusions: According to smokers′ selection the combined therapy, personal methods and Champix are the most effective methods for quit smoking and these methods could be much more considered in the country health system.

  16. Design and fabrication of facial prostheses for cancer patient applying computer aided method and manufacturing (CADCAM)

    Science.gov (United States)

    Din, Tengku Noor Daimah Tengku; Jamayet, Nafij; Rajion, Zainul Ahmad; Luddin, Norhayati; Abdullah, Johari Yap; Abdullah, Abdul Manaf; Yahya, Suzana

    2016-12-01

    Facial defects are either congenital or caused by trauma or cancer where most of them affect the person appearance. The emotional pressure and low self-esteem are problems commonly related to patient with facial defect. To overcome this problem, silicone prosthesis was designed to cover the defect part. This study describes the techniques in designing and fabrication for facial prosthesis applying computer aided method and manufacturing (CADCAM). The steps of fabricating the facial prosthesis were based on a patient case. The patient was diagnosed for Gorlin Gotz syndrome and came to Hospital Universiti Sains Malaysia (HUSM) for prosthesis. The 3D image of the patient was reconstructed from CT data using MIMICS software. Based on the 3D image, the intercanthal and zygomatic measurements of the patient were compared with available data in the database to find the suitable nose shape. The normal nose shape for the patient was retrieved from the nasal digital library. Mirror imaging technique was used to mirror the facial part. The final design of facial prosthesis including eye, nose and cheek was superimposed to see the result virtually. After the final design was confirmed, the mould design was created. The mould of nasal prosthesis was printed using Objet 3D printer. Silicone casting was done using the 3D print mould. The final prosthesis produced from the computer aided method was acceptable to be used for facial rehabilitation to provide better quality of life.

  17. No-gold-standard evaluation of image-acquisition methods using patient data.

    Science.gov (United States)

    Jha, Abhinav K; Frey, Eric

    2017-02-11

    Several new and improved modalities, scanners, and protocols, together referred to as image-acquisition methods (IAMs), are being developed to provide reliable quantitative imaging. Objective evaluation of these IAMs on the clinically relevant quantitative tasks is highly desirable. Such evaluation is most reliable and clinically decisive when performed with patient data, but that requires the availability of a gold standard, which is often rare. While no-gold-standard (NGS) techniques have been developed to clinically evaluate quantitative imaging methods, these techniques require that each of the patients be scanned using all the IAMs, which is expensive, time consuming, and could lead to increased radiation dose. A more clinically practical scenario is where different set of patients are scanned using different IAMs. We have developed an NGS technique that uses patient data where different patient sets are imaged using different IAMs to compare the different IAMs. The technique posits a linear relationship, characterized by a slope, bias, and noise standard-deviation term, between the true and measured quantitative values. Under the assumption that the true quantitative values have been sampled from a unimodal distribution, a maximum-likelihood procedure was developed that estimates these linear relationship parameters for the different IAMs. Figures of merit can be estimated using these linear relationship parameters to evaluate the IAMs on the basis of accuracy, precision, and overall reliability. The proposed technique has several potential applications such as in protocol optimization, quantifying difference in system performance, and system harmonization using patient data.

  18. Video elicitation interviews: a qualitative research method for investigating physician-patient interactions.

    Science.gov (United States)

    Henry, Stephen G; Fetters, Michael D

    2012-01-01

    We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants' associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care.

  19. Methods of Suicide among Cancer Patients: A Nationwide Population-Based Study

    Science.gov (United States)

    Chung, Kuo-Hsuan; Lin, Herng-Ching

    2010-01-01

    A 3-year nationwide population-based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p…

  20. Video Elicitation Interviews: A Qualitative Research Method for Investigating Physician-Patient Interactions

    Science.gov (United States)

    Henry, Stephen G.; Fetters, Michael D.

    2012-01-01

    We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants’ associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care. PMID:22412003

  1. [The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia (VAP)].

    Science.gov (United States)

    Kowalczyk, Wojciech; Rybicki, Zbigniew; Tomaszewski, Dariusz; Truszczyński, Andrzej; Guzek, Aneta

    2011-01-01

    Although broncho-alveolar lavage (BAL) culture and protected specimen brush (PSB) are regarded as the most effective methods in the diagnosis of VAP, a simple endotracheal aspiration (EA) is frequently performed during routine care, because of its simplicity and low cost. We compared the effectiveness of EA with BAL and PSB in VAP patients. Sixty-one adult VAP patients, ventilated for longer than 48 h, were cultured with all three methods. Positive cultures were obtained from 63.9% of patients, with Acinetobacter baumannii being the most common pathogen. There was a high positive correlation between simple aspirates and BAL (k 0.817, CI 0.664-0.840, p aspirates and PSB (k 0.667, CI 0.483-0.871, p aspirate culturing, compared to BAL and PSB, it can be used successfully in most cases.

  2. Celebrating fifty years of research and applications in reminiscence and life review: State of the art and new directions

    NARCIS (Netherlands)

    Westerhof, Gerben Johan; Bohlmeijer, Ernst Thomas

    2014-01-01

    Fifty years ago, psychiatrist Robert Butler (1963) published an influential article on the recollection and evaluation of personal memories in later life. We discuss the major insights and applications in psychological gerontology that were inspired by Butler. Reminiscence and life review serve to

  3. 26 CFR 1.414(r)-4 - Qualified separate line of business-fifty-employee and notice requirements.

    Science.gov (United States)

    2010-04-01

    ...-employee and notice requirements. 1.414(r)-4 Section 1.414(r)-4 Internal Revenue INTERNAL REVENUE SERVICE... Bonus Plans, Etc. § 1.414(r)-4 Qualified separate line of business—fifty-employee and notice... business (as determined under § 1.414(r)-3) satisfies the 50-employee and notice requirements of § 1.414(r...

  4. Comparison of content in phenolic compounds, polyphenol oxidase and peroxidase in grains of fifty sorghum cultivars from Burkina Faso.

    NARCIS (Netherlands)

    Dicko, M.H.; Hilhorst, M.H.; Gruppen, H.; Traore, A.S.; Laane, N.C.M.; Berkel, van W.J.H.; Voragen, A.G.J.

    2002-01-01

    Analysis of fifty sorghum [Sorghum bicolor (L.) Moench] varieties used in Burkina Faso showed that they have different contents of phenolic compounds, peroxidase (POX), and polyphenol oxidase (PPO). Most of the varieties (82%) had a tannin content less than 0.25% (w/w). POX specific activity was

  5. Fifty Years of Safeguards under the EURATOM Treaty. A Regulatory Review

    International Nuclear Information System (INIS)

    Patel, B.; Chare, P.

    2007-01-01

    March 2007 marked the 50th anniversary of the signing of one of the founding treaties of the European Community. The EURATOM Treaty has its origins at a time when the stability of energy supplies in Europe was a major concern. Recently, much debate has centred on the possible reform or repeal of some parts of the treaty, given that its original aim was to promote and oversee the development of nuclear energy in Europe. This debate has focused attention on the future contribution of nuclear power to increasing energy demands in an enlarged Europe. However, despite these issues there is near universal agreement that the EURATOM Treaty has played a vital role in the protection of European citizens through the controls required for nuclear materials. Chapter 7 of the treaty (Safeguards) confers wide regulatory powers to the European Commission to ensure that civil nuclear materials are not diverted from their intended use as declared by the operators. This paper describes the early period of operation of the safeguards inspectorate, and gives statistics on the numbers and types of inspections carried out by the EURATOM inspectors, and discusses from an operational point of view the value of inspection activities. Further, a critical appraisal of Articles 77-85 within Chapter 7 is made. The paper also considers those safeguards requirements that are important to strengthen, in order to maintain a strong regulatory system to oversee future challenges, particularly in the context of increasing decommissioning activities within Europe. It is noteworthy that fifty-years after the founding of the treaty, many of the concerns about security of energy supply have re-emerged. It is a measure of the vision and forward thinking of its founders that the treaty has successfully overseen the safe and secure development of nuclear power in Europe (which currently provides a third of its electricity needs) and despite the many changes and developments that have occurred, that the

  6. BIOFEEDBACK: A NEW METHOD FOR CORRECTION OF MOTOR DISORDERS IN PATIENTS WITH MULTIPLE SCLEROSIS

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    Ya. S. Pekker

    2014-01-01

    Full Text Available Major disabling factors in multiple sclerosis is motor disorders. Rehabilitation of such violations is one of the most important medical and social problems. Currently, most of the role given to the development of methods for correction of motor disorders based on accessing natural resources of the human body. One of these methods is the adaptive control with biofeedback (BFB. The aim of our study was the correction of motor disorders in multiple sclerosis patients using biofeedback training. In the study, we have developed scenarios for training rehabilitation program computer EMG biofeedback aimed at correction of motor disorders in patients with multiple sclerosis (MS. The method was tested in the neurological clinic of SSMU. The study included 9 patients with definite diagnosis of MS with the presence of the clinical picture of combined pyramidal and cerebellar symptoms. Assessed the effectiveness of rehabilitation procedures biofeedback training using specialized scales (rating scale functional systems Kurtzke; questionnaire research quality of life – SF-36, evaluation of disease impact Profile – SIP and score on a scale fatigue – FSS. In the studied group of patients decreased score on a scale of fatigue (FSS, increased motor control (SIP2, the physical and mental components of health (SF-36. The tendency to reduce the amount of neurological deficit by reducing the points on the pyramidal Kurtske violations. Analysis of the exchange rate dynamics of biofeedback training on EMG for trained muscles indicates an increase in the recorded signal OEMG from session to session. Proved a tendency to increase strength and coordination trained muscles of patients studied.Positive results of biofeedback therapy in patients with MS can be recommended to use this method in the complex rehabilitation measures to correct motor and psycho-emotional disorders.

  7. Influence of different anesthesia methods on stress reaction and hemodynamics for elderly orthopedics patients during operations

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    Lin Li

    2017-07-01

    Full Text Available Objective: To study the influence of general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia method on stress reaction and hemodynamics for elderly orthopedics patients during operations. Methods: A total of 90 cases of elder patients who received orthopedic operations were randomly divided to group A, B and C, with 30 cases per group. Three groups of patients were separately given by general anesthesia, epidural anesthesia and combined spinal and epidural anesthesia for operations; The variations of adrenocorticotrophic hormone (ACTH, Cortisol (Cor, β-endorphin (β-EP, Angiotensin- Ⅱ(Ang-Ⅱ, heart rate (HR and blood pressure (SBP, DBP on patients in three groups before anesthesia (T0, during skin incision (T1, after skin incision (T2 and extubation after operation (T3 were compared and analyzed. Results: During T1, T2, ACTH, Cor, β-EP and Ang-Ⅱlevels in 3 groups of patients were significantly higher than those during T0; SBP and DBP were significantly lower than that during T0; HR during T2 was significantly lower than that during T0; During T3, every index in 3 groups were recovered to levels close to that during T0; During T1, T2, ACTH, Cor, β-EP, Ang-Ⅱ levels in group B and C were significantly lower than that in group A. And levels in C was lower than that in B; SBP and DBP in group B and C were significantly higher than A. No HR statistical significance appeared between each group. Conclusions: During clinical anesthesia, we should choose suitable anesthesia method combined with actual situations of patients. Combined spinal and epidural anesthesia had a slight influence on hemodynamics of elder orthopedics patients during operation, and it could effectively alleviate stress reaction during operation.

  8. Configural frequency analysis as a method of determining patients' preferred decision-making roles in dialysis

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    Loeffert Sabine

    2010-09-01

    Full Text Available Abstract Background Numerous studies examined factors in promoting a patient preference for active participation in treatment decision making with only modest success. The purpose of this study was to identify types of patients wishing to participate in treatment decisions as well as those wishing to play a completely active or passive role based on a Germany-wide survey of dialysis patients; using a prediction typal analysis method that defines types as configurations of categories belonging to different attributes and takes particularly higher order interactions between variables into account. Methods After randomly splitting the original patient sample into two halves, an exploratory prediction configural frequency analysis (CFA was performed on one-half of the sample (n = 1969 and the identified types were considered as hypotheses for an inferential prediction CFA for the second half (n = 1914. 144 possible prediction types were tested by using five predictor variables and control preferences as criterion. An α-adjustment (0.05 for multiple testing was performed by the Holm procedure. Results 21 possible prediction types were identified as hypotheses in the exploratory prediction CFA; four patient types were confirmed in the confirmatory prediction CFA: patients preferring a passive role show low information seeking preference, above average trust in their physician, perceive their physician's participatory decision-making (PDM-style positive, have a lower educational level, and are 56-75 years old (Type 1; p 76 years old (Type 2; p p p Conclusions The method prediction configural frequency analysis was newly introduced to the research field of patient participation and could demonstrate how a particular control preference role is determined by an association of five variables.

  9. Improving diet recipe and cooking methods attenuates hyperphosphatemia in patients undergoing peritoneal dialysis.

    Science.gov (United States)

    Jiang, N; Fang, W; Gu, A P; Yuan, J Z; Yang, X X; Lin, A W; Ni, Z H; Qian, J Q

    2015-09-01

    Hyperphosphatemia is an independent predictor for cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis (PD). The study aimed to investigate the effect of dietary intervention on reducing serum phosphate concentration in hyperphosphatemic PD patients. In this single-center clinical trial, 97 prevalent PD patients with serum phosphate concentration ≥ 1.6 mmol/l were allocated to the intervention (n = 48) or control (n = 49) group and followed up for 1 year. In addition to phosphate binder (calcium carbonate) therapy, patients in the intervention group were intensively educated to reduce phosphate-rich food intake and improve cooking methods. While stable in the control group (1.97 ± 0.20 to 1.94 ± 0.35 mmol/l, p > 0.05), the serum phosphate concentration decreased significantly in the intervention group (1.98 ± 0.28 to 1.65 ± 0.33 mmol/l, p = 0.015) concurrently with the drop in dietary phosphate intake (13.03 ± 3.39 to 10.82 ± 3.00 mg/kg ideal body weight/day, p = 0.001). Moreover, after 6 months of intervention, fewer patients needed to use calcium carbonate (from 64.6% to 41.5%, p = 0.029) and the medicine dose reduced significantly (from 2.25 (0, 3.94) to 0 (0, 1.50) g/day, p cooking methods attenuated hyperphosphatemia in PD patients. It suggests that regular assessment of dietary phosphate intake and modification of diet recipe and cooking methods are essential for hyperphosphatemia treatment in PD patients in addition to phosphate binder therapy. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Scale Space Methods for Analysis of Type 2 Diabetes Patients' Blood Glucose Values

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    Stein Olav Skrøvseth

    2011-01-01

    Full Text Available We describe how scale space methods can be used for quantitative analysis of blood glucose concentrations from type 2 diabetes patients. Blood glucose values were recorded voluntarily by the patients over one full year as part of a self-management process, where the time and frequency of the recordings are decided by the patients. This makes a unique dataset in its extent, though with a large variation in reliability of the recordings. Scale space and frequency space techniques are suited to reveal important features of unevenly sampled data, and useful for identifying medically relevant features for use both by patients as part of their self-management process, and provide useful information for physicians.

  11. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing

    International Nuclear Information System (INIS)

    Ramamurthy, Senthil; D’Orsi, Carl J; Sechopoulos, Ioannis

    2016-01-01

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360° with a perforated tungsten plate in the path of the x-ray beam. To make patient testing feasible, a wirelessly controlled electronic positioner for the tungsten plate was designed and added to a breast CT system. Other improvements to the algorithm were implemented, including automated exclusion of non-valid primary estimate points and the use of a different approximation method to estimate the full scatter signal. To evaluate the effectiveness of the algorithm, evaluation of the resulting image quality was performed with a breast phantom and with nine patient images. The improvements in the algorithm resulted in the avoidance of introduction of artifacts, especially at the object borders, which was an issue in the previous implementation in some cases. Both contrast, in terms of signal difference and signal difference-to-noise ratio were improved with the proposed method, as opposed to with the correction algorithm incorporated in the system, which does not recover contrast. Patient image evaluation also showed enhanced contrast, better cupping correction, and more consistent voxel values for the different tissues. The algorithm also reduces artifacts present in reconstructions of non-regularly shaped breasts. With the implemented hardware and software improvements, the proposed method can be reliably used during patient breast CT imaging, resulting in improvement of image quality, no introduction of artifacts, and in some cases reduction of artifacts already present. The impact of the algorithm on actual clinical performance for detection, diagnosis and other clinical tasks in breast imaging remains to be evaluated. (paper)

  12. A NEW METHOD FOR PREDICTING SURVIVAL AND ESTIMATING UNCERTAINTY IN TRAUMA PATIENTS

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    V. G. Schetinin

    2017-01-01

    Full Text Available The Trauma and Injury Severity Score (TRISS is the current “gold” standard of screening patient’s condition for purposes of predicting survival probability. More than 40 years of TRISS practice revealed a number of problems, particularly, 1 unexplained fluctuation of predicted values caused by aggregation of screening tests, and 2 low accuracy of uncertainty intervals estimations. We developed a new method made it available for practitioners as a web calculator to reduce negative effect of factors given above. The method involves Bayesian methodology of statistical inference which, being computationally expensive, in theory provides most accurate predictions. We implemented and tested this approach on a data set including 571,148 patients registered in the US National Trauma Data Bank (NTDB with 1–20 injuries. These patients were distributed over the following categories: (1 174,647 with 1 injury, (2 381,137 with 2–10 injuries, and (3 15,364 with 11–20 injuries. Survival rates in each category were 0.977, 0.953, and 0.831, respectively. The proposed method has improved prediction accuracy by 0.04%, 0.36%, and 3.64% (p-value <0.05 in the categories 1, 2, and 3, respectively. Hosmer-Lemeshow statistics showed a significant improvement of the new model calibration. The uncertainty 2σ intervals were reduced from 0.628 to 0.569 for patients of the second category and from 1.227 to 0.930 for patients of the third category, both with p-value <0.005. The new method shows the statistically significant improvement (p-value <0.05 in accuracy of predicting survival and estimating the uncertainty intervals. The largest improvement has been achieved for patients with 11–20 injuries. The method is available for practitioners as a web calculator http://www.traumacalc.org.

  13. Accuracy of Platelet Counting by Optical and Impedance Methods in Patients with Thrombocytopaenia and Microcytosis

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    Mohamed-Rachid Boulassel

    2015-11-01

    Full Text Available Objectives: Obtaining accurate platelet counts in microcytic blood samples is challenging, even with the most reliable automated haematology analysers. The CELL-DYN™ Sapphire (Abbott Laboratories, Chicago, Illinois, USA analyser uses both optical density and electronic impedance methods for platelet counting. This study aimed to evaluate the accuracy of optical density and electrical impedance methods in determining true platelet counts in thrombocytopaenic samples with microcytosis as defined by low mean corpuscular volume (MCV of red blood cells. Additionally, the impact of microcytosis on platelet count accuracy was evaluated. Methods: This study was carried out between February and December 2014 at the Haematology Laboratory of the Sultan Qaboos University Hospital in Muscat, Oman. Blood samples were collected and analysed from 189 patients with thrombocytopaenia and MCV values of <76 femtolitres. Platelet counts were tested using both optical and impedance methods. Stained peripheral blood films for each sample were then reviewed as a reference method to confirm platelet counts. Results: The platelet counts estimated by the impedance method were on average 30% higher than those estimated by the optical method (P <0.001. The estimated intraclass correlation coefficient was 0.52 (95% confidence interval: 0.41–0.62, indicating moderate reliability between the methods. The degree of agreement between methods ranged from -85.5 to 24.3 with an estimated bias of -30, suggesting that these methods generate different platelet results. Conclusion: The impedance method significantly overestimated platelet counts in microcytic and thrombocytopaenic blood samples. Further attention is therefore needed to improve the accuracy of platelet counts, particularly for patients with conditions associated with microcytosis.

  14. New Methods of Treatment for Trophic Lesions of the Lower Extremities in Patients with Diabetes Mellitus

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    S.V. Bolgarska

    2016-08-01

    Full Text Available Introduction. Complications in the form of trophic ulcers of the lower extremities are one of the serious consequences of diabetes mellitus (DM, as they often lead to severe health and social problems, up to high amputations. The aim of the study was the development and clinical testing of diagnostic and therapeutic algorithm for the comprehensive treatment of trophic ulcers of the lower extremities in patients with DM. Materials and methods. Here are presented the results of treatment of 63 patients (42 women and 21 men with neuropathic type of trophic lesions of the lower limbs or postoperative defects at the stage of granulation. Of them, 32 patients (study group received local intradermal injections of hyaluronic acid preparations and sodium succinate (Lacerta into the extracellular matrix. Patients of the comparison group were treated with hydrocolloid materials (hydrocoll, granuflex. The level of glycated hemoglobin, the degree of circulatory disorders (using ankle brachial index, before and after the test with a load and neuropathic disorders (on a scale for the evaluation of neurologic dysfunctions — NDS were assessed in patients. Results. The results of treatment were assessed by the rate of defect healing during 2 or more months. In the study group, 24 patients showed complete healing of the defect (75 %, while in the control group the healing was observed in 16 patients (51.6 %. During the year, relapses occurred in 22.2 % of cases in the study group, and in 46.9 % — in the control one (p < 0.05. Conclusion. The developed method of treatment using Lacerta allowed to increase the effectiveness of therapy, to speed recovery, to decrease a number of complications in patients with DM and trophic ulcers of the lower extremities.

  15. Low-Cost Method to Monitor Patient Adherence to HIV Antiretroviral Therapy Using Multiplex Cathepsin Zymography.

    Science.gov (United States)

    Platt, Manu O; Evans, Denise; Keegan, Philip M; McNamara, Lynne; Parker, Ivana K; Roberts, LaDeidra M; Caulk, Alexander W; Gleason, Rudolph L; Seifu, Daniel; Amogne, Wondwossen; Penny, Clement

    2016-01-01

    Monitoring patient adherence to HIV antiretroviral therapy (ART) by patient survey is inherently error prone, justifying a need for objective, biological measures affordable in low-resource settings where HIV/AIDS epidemic is highest. In preliminary studies conducted in Ethiopia and South Africa, we observed loss of cysteine cathepsin activity in peripheral blood mononuclear cells of HIV-positive patients on ART. We optimized a rapid protocol for multiplex cathepsin zymography to quantify cysteine cathepsins, and prospectively enrolled 350 HIV-positive, ART-naïve adults attending the Themba Lethu Clinic, Johannesburg, South Africa, to test if suppressed cathepsin activity could be a biomarker of ART adherence (103 patients were included in final analysis). Poor adherence was defined as detectable viral load (>400 copies/ml) or simplified medication adherence questionnaire, 4-6 months after ART initiation. 86 % of patients with undetectable viral loads after 6 months were cathepsin negative, and cathepsin-positive patients were twice as likely to have detectable viral loads (RR 2.32 95 % CI 1.26-4.29). Together, this demonstrates proof of concept that multiplex cathepsin zymography may be an inexpensive, objective method to monitor patient adherence to ART. Low cost of this electrophoresis-based assay makes it a prime candidate for implementation in resource-limited settings.

  16. Low cost method to monitor patient adherence to HIV antiretroviral therapy using multiplex cathepsin zymography

    Science.gov (United States)

    Platt, Manu O.; Evans, Denise; Keegan, Philip M.; McNamara, Lynne; Parker, Ivana K.; Roberts, LaDeidra M.; Caulk, Alexander W.; Gleason, Rudolph L.; Seifu, Daniel; Amogne, Wondwossen; Penny, Clement

    2015-01-01

    Monitoring patient adherence to HIV antiretroviral therapy (ART) by patient survey is inherently error-prone, justifying a need for objective, biological measures affordable in low resource settings where HIV/AIDS epidemic is highest. In preliminary studies conducted in Ethiopia and South Africa, we observed loss of cysteine cathepsin activity in peripheral blood mononuclear cells (PBMCs) of HIV-positive patients on ART. We optimized a rapid protocol for multiplex cathepsin zymography to quantify cysteine cathepsins, and prospectively enrolled 350 HIV-positive, ART naïve adults attending the Themba Lethu Clinic, Johannesburg, South Africa, to test if suppressed cathepsin activity could be a biomarker of ART adherence (103 patients were included in final analysis). Poor adherence was defined as detectable viral load (>400 copies/ml) or simplified medication adherence questionnaire (SMAQ), 4–6 months after ART initiation. 86% of patients with undetectable viral loads after 6 months were cathepsin negative, and cathepsin positive patients were twice as likely to have detectable viral loads (RR 2.32 95% CI 1.26–4.29). Together, this demonstrates proof of concept that multiplex cathepsin zymography may be an inexpensive, objective method to monitor patient adherence to ART. Low cost of this electrophoresis based assay makes it a prime candidate for implementation in resource limited settings. PMID:26589706

  17. A cephalometric method to diagnosis the craniovertebral junction abnormalities in osteogenesis imperfecta patients

    Science.gov (United States)

    Ríos-Rodenas, Mercedes; Gutiérrez-Díez, María-Pilar; Feijóo, Gonzalo; Mourelle, Maria-Rosa; Garcilazo, Mario; Ortega-Aranegui, Ricardo

    2015-01-01

    Osteogenesis imperfecta (OI) is a hereditary bone fragility disorder that in most patients is caused by mutations affecting collagen type I. Their typical oral and craneofacial characteristics (Dentinogenesis imperfecta type I and class III malocclusion), involve the dentist in the multidisciplinary team that treat these patients. It is usual to perform lateral skull radiographs for the orthodontic diagnosis. In addition, this radiograph is useful to analyse the junctional area between skull base and spine, that could be damaged in OI. Pathology in the craneovertebral junction (CVJ) is a serious complication of OI with a prevalence ranging from rare to 37%. To diagnosis early skull base anomalies in these patients, previously the neurological symptoms have been appear, we make a simple cephalometric analysis of the CVJ. This method has four measurements and one angle. Once we calculate the values of the OI patient, we compare the result with the mean and the standard deviations of an age-appropriate average in healthy controls. If the patient has a result more than 2,5 SDs above the age-appropriate average in healthy controls, we should to refer the patient to his/her pediatrician or neurologist. These doctors have to consider acquiring another diagnostic images to be used to determine cranial base measurements with more reliability. Thereby, dentists who treat these patients, must be aware of the normal radiological anatomy of the cervical spine on the lateral cephalogram. Key words:Osteogenesis imperfecta, craniovertebral junction, cephalometric. PMID:25810828

  18. New patient-controlled abdominal compression method in radiography: radiation dose and image quality.

    Science.gov (United States)

    Piippo-Huotari, Oili; Norrman, Eva; Anderzén-Carlsson, Agneta; Geijer, Håkan

    2018-05-01

    The radiation dose for patients can be reduced with many methods and one way is to use abdominal compression. In this study, the radiation dose and image quality for a new patient-controlled compression device were compared with conventional compression and compression in the prone position . To compare radiation dose and image quality of patient-controlled compression compared with conventional and prone compression in general radiography. An experimental design with quantitative approach. After obtaining the approval of the ethics committee, a consecutive sample of 48 patients was examined with the standard clinical urography protocol. The radiation doses were measured as dose-area product and analyzed with a paired t-test. The image quality was evaluated by visual grading analysis. Four radiologists evaluated each image individually by scoring nine criteria modified from the European quality criteria for diagnostic radiographic images. There was no significant difference in radiation dose or image quality between conventional and patient-controlled compression. Prone position resulted in both higher dose and inferior image quality. Patient-controlled compression gave similar dose levels as conventional compression and lower than prone compression. Image quality was similar with both patient-controlled and conventional compression and was judged to be better than in the prone position.

  19. Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study.

    Science.gov (United States)

    Tannor, Elliot K; Archer, Elize; Kapembwa, Kenneth; van Schalkwyk, Susan C; Davids, M Razeen

    2017-01-05

    The increasing prevalence of treated end-stage renal disease and low transplant rates in Africa leads to longer durations on dialysis. Dialysis should not only be aimed at prolonging lives but also improve quality of life (QOL). Using mixed methods, we investigated the QOL of patients on chronic haemodialysis (HD) and peritoneal dialysis (PD). We conducted a cross-sectional study at Tygerberg Hospital in Cape Town, South Africa. All the PD patients were being treated with continuous ambulatory peritoneal dialysis. The KDQOL-SF 1.3 questionnaire was used for the quantitative phase of the study. Thereafter, focus-group interviews were conducted by an experienced facilitator in groups of HD and PD patients. Electronic recordings were transcribed verbatim and analysed manually to identify emerging themes. A total of 106 patients completed questionnaires and 36 of them participated in the focus group interviews. There was no difference between PD and HD patients in the overall KDQOL-SF scores. PD patients scored lower with regard to symptoms (P = 0.005), energy/fatigue (P = 0.025) and sleep (P = 0.023) but scored higher for work status (P = 0.005) and dialysis staff encouragement (P = 0.019) than those on HD. Symptoms and complications were verbalised more in the PD patients, with fear of peritonitis keeping some housebound. PD patients were more limited by their treatment modality which impacted on body image, sexual function and social interaction but there were less dietary and occupational limitations. Patients on each modality acknowledged the support received from family and dialysis staff but highlighted the lack of support from government. PD patients had little opportunity for interaction with one another and therefore enjoyed less support from fellow patients. PD patients experienced a heavier symptom burden and greater limitations related to their dialysis modality, especially with regards to social functioning. The mixed-methods approach

  20. Language barriers and patient safety risks in hospital care. A mixed methods study.

    Science.gov (United States)

    van Rosse, Floor; de Bruijne, Martine; Suurmond, Jeanine; Essink-Bot, Marie-Louise; Wagner, Cordula

    2016-02-01

    A language barrier has been shown to be a threat for quality of hospital care. International studies highlighted a lack of adequate noticing, reporting, and bridging of a language barrier. However, studies on the link between language proficiency and patient safety are scarce, especially in Europe. The present study investigates patient safety risks due to language barriers during hospitalization, and the way language barriers are detected, reported, and bridged in Dutch hospital care. We combined quantitative and qualitative methods in a sample of 576 ethnic minority patients who were hospitalized on 30 wards within four urban hospitals. The nursing and medical records of 17 hospital admissions of patients with language barriers were qualitatively analyzed, and complemented by 12 in-depth interviews with care providers and patients and/or their relatives to identify patient safety risks during hospitalization. The medical records of all 576 patients were screened for language barrier reports. The results were compared to patients' self-reported Dutch language proficiency. The policies of wards regarding bridging language barriers were compared with the reported use of interpreters in the medical records. Situations in hospital care where a language barrier threatened patient safety included daily nursing tasks (i.e. medication administration, pain management, fluid balance management) and patient-physician interaction concerning diagnosis, risk communication and acute situations. In 30% of the patients that reported a low Dutch proficiency, no language barrier was documented in the patient record. Relatives of patients often functioned as interpreter for them and professional interpreters were hardly used. The present study showed a wide variety of risky situations in hospital care for patients with language barriers. These risks can be reduced by adequately bridging the language barrier, which, in the first place, demands adequate detecting and reporting of a

  1. Systemic assessment of patients undergoing dental implant surgeries: A trans- and post-operative analysis

    OpenAIRE

    Sanjay Byakodi; Sachin Kumar; Rajesh Kumar Reddy; Vipin Kumar; Shipra Sepolia; Shivangi Gupta; Harkanwal Preet Singh

    2017-01-01

    Background: Procedure-related and patient-related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Materials and Methods: Fifty-one patients were included in the study, in which a total of 110 dental implants were placed. Complete examination of the subjects was done before and after placement of dental implants. Implant surgery was planned, and osseointegrated dental i...

  2. Computerized method for arm movement assessment in Parkinson's disease and cerebellar syndrome patients

    Directory of Open Access Journals (Sweden)

    Đorđević Olivera

    2005-01-01

    Full Text Available In clinical setting, the symptoms of the impaired motor behavior in patients with different neurological diseases are identified by classical tests incorporated in clinical neurological examination. New computerized methods for objective motor assessment have been recently suggested in the literature. We developed computerized method for assessment and evaluation of arm movement in patients with Parkinson's disease (PD in early phase and in patients with cerebellar syndrome. Method is based on automatic acquisition of hand coordinates during drawing of line and circle, and offline analysis of kinematic parameters (time duration, path length, mean and maximal velocity, velocity profile, and precision. Clinical application is in recognition and follow-up of the impaired kinematic parameters, specific for these two groups of patients. AIM We propose computerized method that consists of two motor tasks: Task 1- drawing a line defined with end points; and Task 2 - drawing a circle defined by referential model. The first task was rather simple with defined direction, and the second included continuous change of the direction that required permanent adjustment. The aim was to detect which kinematic parameters were particularly different in PD and in patients with cerebellar syndrome in relation to healthy controls, and then to apply this method as an additional instrument in clinical evaluation. METHODS Hand trajectories were assessed during simple self-paced 1 point-to-point movement-Task 1; and 2 circle-Task 2, by cordless magnetic mouse in a hand on digitizing board (Drawing board III, 305x457 mm, GTCO Cal Comp Inc. The subjects were seated in a relaxed manner on the chair adjusted to the table height, and instructed not to correct drawn line during performance of a task. The first session was for practicing the tests only, and in the next session, the subjects repeated 5 times each task. All sessions were videotaped with CCD camera. Testing

  3. Methods of measurement of myocardial blood flow in patients: a critical review

    International Nuclear Information System (INIS)

    Marcus, M.L.; Wilson, R.F.; White, C.W.

    1987-01-01

    During the past decade, major progress has been made in the evolution of technology directed toward the accurate measurement of regional myocardial perfusion in patients. The deficiencies of some of the older methods (thermodilution and gas clearance) are better appreciated and improved approaches (Doppler catheters, positron-emission tomography, and digital subtraction angiography) have been developed. The new approaches should play a major role in research and for most applications the older methods will gradually be replaced. Efforts to bring these new methods to community hospitals and practicing cardiologists should be stimulated. Doppler catheters, positron-emission tomography, and digital-subtraction angiography are commercially available and Doppler catheters and digital-subtraction angiography could be easily incorporated into routine cardiac catheterization procedures. The Doppler catheter is the most inexpensive and probably the simplest to apply. In our opinion, routine measurements of coronary flow reserve will significantly improve the care of patients with coronary obstructive disease and other diseases that impair myocardial perfusion. If coronary reserve measurements are used frequently, patient selection for coronary angioplasty and bypass surgery will no longer depend entirely on visual assessment of percent diameter stenosis, a very poor criterion in many situations. Also, patients with chest pain syndromes, normal coronary vessels, and impaired coronary reserve will be identified and perhaps some effective treatment for this condition will be devised. 77 references

  4. Assessment guidance of carbohydrate counting method in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Martins, Michelle R; Ambrosio, Ana Cristina T; Nery, Marcia; Aquino, Rita de Cássia; Queiroz, Marcia S

    2014-04-01

    We evaluated the application of the method of carbohydrate counting performed by 21 patients with type 2 diabetes, 1 year later attending a guidance course. Participants answered a questionnaire to assess patients' adhesion to carbohydrate counting as well as to identify habit changes and the method's applicability, and values of glycated hemoglobin were also analyzed. Most participants (76%) were females, and 25% of them had obesity degree III. There was a statistically significant decrease in glycated hemoglobin from 8.42±0.02% to 7.66±0.01% comparing values before and after counseling. We observed that although patients stated that the method was difficult they understood that carbohydrate counting could allow them make choices and have more freedom in their meals; we also verified if they understood accurately how to replace some foods used regularly in their diets and most patients correctly chose replacements for the groups of bread (76%), beans (67%) and noodles (67%). We concluded that participation in the course led to improved blood glucose control with a significant reduction of glycated hemoglobin, better understanding of food groups and the adoption of healthier eating habits. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  5. Comparison of different methods of helicobacter pylori detection in symptomatic gastroduodenal patients of Karachi

    International Nuclear Information System (INIS)

    Hanif, M.; Zaidi, P.; Hameed, A.; Rasool, A.

    2009-01-01

    Helicobacter pylori is a principal cause of chronic gastritis (CG), gastric and duodenal ulcers and a major risk factor for gastric cancer in humans. The objective of this study was to determine and compare the prevalence of H. pylori by different detection methods in symptomatic patients of Karachi. A total of 227 biopsy samples were collected from patients having complaints of peptic ulcer disease (PUD), chronic gastritis and/or abdominal discomfort (AD) from three different health providing institutions of Karachi during 2004- 2006 and analyzed for the presence of H. pylori. Comparative evaluation of three different conventional diagnostic techniques with that of a highly specific PCR amplification of ureC gene were carried out and found H. pylori in 62.5%, 64.7%. 68.7% and 59% by PCR, histology, rapid urease test and culture respectively. Out of 227 biopsy samples collected, 120 (52.8%) were H. pylori positive by all methods comprising 62 male patients and 58 female patients. A significant association between H. pylori infection and gastro duodenal diseases was observed. Among 120 H. pylori infected patients 56 were comprised of PUD, 37 with CG, 19 with AD and 8 with Gastric cancer (GCa). The epidemiology of H. p)1/ori infection is also discussed. (author)

  6. Method of Detection of Well-Differentiated Thyroid Cancers in Obese and Non-Obese Patients.

    Directory of Open Access Journals (Sweden)

    Jonathan Zagzag

    Full Text Available The incidence of well-differentiated thyroid cancer (WDTC is increasing rapidly. Many authors feel that this increase is due to over-diagnosis and that one of the contributing factors is the increasing use of various imaging studies. The rate of obesity has also been increasing in the United States. It has been suggested that patients with an increased body mass index (BMI kg/m2 have a higher incidence of WDTC than patients with normal BMI. One might hypothesize that thyroid nodules are more difficult to palpate in obese patients and that as more cancers are detected by imaging the apparent rate of increase in WDTC in obese patients would appear to be greater than in non-obese patients. This study was undertaken to evaluate this hypothesis by determining if there is any difference in the way thyroid cancers are initially detected in obese and non-obese patients.The medical records of all 519 patients with a postoperative diagnosis of WDTC who underwent thyroidectomy at NYU Langone Medical Center from January 1, 2007 through August 31, 2010 by the three members of NYU Endocrine Surgery Associates were reviewed. Patients were divided into Non-obese (BMI<30 kg/m2 and Obese (BMI≥30 kg/m2 groups. Patients were also divided by the initial method of detection of their tumor into Palpation, Imaging, and Incidental groups.The final study group contained 270 patients, 181(67% of whom were in the Non-obese Group and 89(33% were in the Obese Group. In the Non-obese group, 81(45% of tumors were found by palpation, 72(40% were found by imaging, and 28(16% were found incidentally. In the Obese group, 40(45% were found by palpation, 38(43% were found by imaging, and 11(12% were found incidentally. These differences were not statistically significant (p-value 0.769.We show that BMI does not play a role in the method of initial detection in patients with WDTC. This suggests that the prevalence of WDTC detected by imaging is not an artifact caused by an

  7. Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery

    Directory of Open Access Journals (Sweden)

    Soeteman M

    2015-03-01

    Full Text Available Marijn Soeteman,1 Vera Peters,2 Jamiu O Busari1,3 1Department of Pediatrics, Atrium Medical Center, Heerlen, 2Faculty of Health, Medicine and Life Sciences, 3Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands Objective: In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic’s waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1 accessibility to caregivers and 2 quality of service and available amenities. Design: We conducted a multi-method survey using 1 a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2 specially designed questionnaires to investigate patients’ perceptions of our wait time and how to improve our services. Results: The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55% felt that 10–20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%. Finally, a large number of patients (97% were satisfied with the quality of service and with the accessibility to caregivers (94%. Conclusion: The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of

  8. A new simple three-dimensional method to characterize upper airway in orthognathic surgery patient

    DEFF Research Database (Denmark)

    Di Carlo, Gabriele; Fernandez Gurani, Sirwan; Pinholt, Else Marie

    2017-01-01

    .2% for cross-sectional measurements, and 0.3 to 2.5% for linear measurements. No systematic errors were detected. CONCLUSIONS: This new proposed definition of upper airway boundaries was shown to be technical feasible and tested to be reliable in measuring upper airway in patients undergoing orthognathic......OBJECTIVES: To develop and validate a new reproducible 3D upper airway analysis based on skeletal structures not involved in the modification, which occur during orthognathic surgery. METHODS: From retrospective cohort of orthognathic surgically treated patients, pre- and postsurgical CBCT...

  9. Quantitative analysis of patients with celiac disease by video capsule endoscopy: A deep learning method.

    Science.gov (United States)

    Zhou, Teng; Han, Guoqiang; Li, Bing Nan; Lin, Zhizhe; Ciaccio, Edward J; Green, Peter H; Qin, Jing

    2017-06-01

    Celiac disease is one of the most common diseases in the world. Capsule endoscopy is an alternative way to visualize the entire small intestine without invasiveness to the patient. It is useful to characterize celiac disease, but hours are need to manually analyze the retrospective data of a single patient. Computer-aided quantitative analysis by a deep learning method helps in alleviating the workload during analysis of the retrospective videos. Capsule endoscopy clips from 6 celiac disease patients and 5 controls were preprocessed for training. The frames with a large field of opaque extraluminal fluid or air bubbles were removed automatically by using a pre-selection algorithm. Then the frames were cropped and the intensity was corrected prior to frame rotation in the proposed new method. The GoogLeNet is trained with these frames. Then, the clips of capsule endoscopy from 5 additional celiac disease patients and 5 additional control patients are used for testing. The trained GoogLeNet was able to distinguish the frames from capsule endoscopy clips of celiac disease patients vs controls. Quantitative measurement with evaluation of the confidence was developed to assess the severity level of pathology in the subjects. Relying on the evaluation confidence, the GoogLeNet achieved 100% sensitivity and specificity for the testing set. The t-test confirmed the evaluation confidence is significant to distinguish celiac disease patients from controls. Furthermore, it is found that the evaluation confidence may also relate to the severity level of small bowel mucosal lesions. A deep convolutional neural network was established for quantitative measurement of the existence and degree of pathology throughout the small intestine, which may improve computer-aided clinical techniques to assess mucosal atrophy and other etiologies in real-time with videocapsule endoscopy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis.

    NARCIS (Netherlands)

    Steultjens, M.P.M.; Dekker, J.; Baar, M.E. van; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    1999-01-01

    Objective: To establish the internal consistency of validity of an observational method for assessing diasbility in mobility in patients with osteoarthritis (OA), Methods: Data were obtained from 198 patients with OA of the hip or knee. Results of the observational method were compared with results

  11. Responsiveness of observational and self-report methods for assessing disability in mobility in patients with osteoarthritis

    NARCIS (Netherlands)

    Steultjens, M. P.; Roorda, L. D.; Dekker, J.; Bijlsma, J. W.

    2001-01-01

    To establish the responsiveness of observational and self-report methods for the assessment of disability in mobility in patients with osteoarthritis (OA). Data from 186 patients with hip OA or knee OA were used. Data from 1 observational method and 4 self-report methods for the assessment of

  12. Physically consistent data assimilation method based on feedback control for patient-specific blood flow analysis.

    Science.gov (United States)

    Ii, Satoshi; Adib, Mohd Azrul Hisham Mohd; Watanabe, Yoshiyuki; Wada, Shigeo

    2018-01-01

    This paper presents a novel data assimilation method for patient-specific blood flow analysis based on feedback control theory called the physically consistent feedback control-based data assimilation (PFC-DA) method. In the PFC-DA method, the signal, which is the residual error term of the velocity when comparing the numerical and reference measurement data, is cast as a source term in a Poisson equation for the scalar potential field that induces flow in a closed system. The pressure values at the inlet and outlet boundaries are recursively calculated by this scalar potential field. Hence, the flow field is physically consistent because it is driven by the calculated inlet and outlet pressures, without any artificial body forces. As compared with existing variational approaches, although this PFC-DA method does not guarantee the optimal solution, only one additional Poisson equation for the scalar potential field is required, providing a remarkable improvement for such a small additional computational cost at every iteration. Through numerical examples for 2D and 3D exact flow fields, with both noise-free and noisy reference data as well as a blood flow analysis on a cerebral aneurysm using actual patient data, the robustness and accuracy of this approach is shown. Moreover, the feasibility of a patient-specific practical blood flow analysis is demonstrated. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Improving patient care trajectories: an innovative quasi-experimental research method for health services.

    Science.gov (United States)

    Campos, Eneida Rached; Moreira-Filho, Djalma de Carvalho; Silva, Marcos Tadeu Nolasco da

    2018-05-01

    Scores to predict treatment outcomes have earned a well-deserved place in healthcare practice. However, when used to help achieve excellence in the care of a given disease, scores should also take into account organizational and social aspects. This article aims to create scores to obtain key variables and its application in the management of care of a given disease. We present a method called Epidemiological Planning for Patient Care Trajectory (PELC) and its application in a research of HIV pediatric patients. This case study is presented by means of two studies. The first study deals with the development of the method PELC. The second is HIV Pediatric case-control study based on PELC method. HIV pediatric research - the first practical PELC application - found these four key variables to the individual quality level care trajectories: adherence to ART, attending at least one appointment with the otolaryngologist, attending at least one appointment with social services, and having missed one or more routine appointments. We believe PELC method can be used in researches about any kind of care trajectories, contributing to quality level advancements in health services, with emphasis on patient safety and equity in healthcare.

  14. [Trends in the mortality of liver cancer in Qidong, China: an analysis of fifty years].

    Science.gov (United States)

    Chen, Jian-guo; Zhu, Jian; Zhang, Yong-hui; Chen, Yong-sheng; Ding, Lu-lu; Lu, Jian-hua; Zhu, Yuan-rong

    2012-07-01

    To describe and analyze the charecteristics and trends of liver cancer mortality during the past fifty years in Qidong, China. Retrospective mortality survey was conducted to get the data on liver cancer death in the period of 1958-1971, and the data from 1972 to 2007 were obtained from the records of cancer registration in Qidong. The crude mortality rate (CR) of liver cancer, and age-standardized rate by Chinese population (CASR) and by world population (WASR) were calculated and analyzed. The total percent changes (PC) and annual percent changes (APC) were used for evaluating the increasing trends of the mortality. The sex-specific rate, age-specific rate, truncated rate of the age group 35 - 64, cumulative rate of the age group 0-74, cumulative risk, period-rate, and the rate for age-birth cohort were compared. The natural death rate in Qidong residents for the past five-decade period experienced a wave interval of 8.62‰ in 1958 down to 5.37‰ in 1979, and up to 7.75‰ in 2007. The mortality rate for all-site cancers was increased from 56.69 per 100, 000 to 234.97 per 100, 000. The mortality rate of liver cancer, being 20.45 per 100, 100 in 1958 was increased to 49.04 per 100, 000 in 1972, and up to 69.29 per 100, 000 in 2007. According to the registration data of 1972 - 2007, the death from liver cancer was accounted for 34.88% of all deaths due to cancers, with a CR of 58.86 per 100, 000, CASR of 38.36 per 100, 000, and WASR, 49.37 Per 100, 000 in Qidong. The truncated rate for the age group 35 - 64 was 117.08 per 100, 000, and the cumulative rate for the age group 0-74 and the cumulative risk were 5.15% and 5.02%, respectively. The CRs for males was 90.52 per 100, 000 and for females was 27.93 per 100, 000, with a sex ratio of 3.24:1. For the period of 1972 - 2007, the PC for CR was 49.71%, and APC was +1.41%, showing an increasing variation tendency. The APCs for CASR and WASR, however, were decreasing, with a percentage of -1.11%, and -0

  15. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids : A critical analysis

    NARCIS (Netherlands)

    Pieterse, A.H.; de Vries, M.

    2013-01-01

    Background  Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that

  16. Medical students volunteering in hospital: a novel method of exploring and recording the patient experience

    Directory of Open Access Journals (Sweden)

    Monica Lorraina Hytiris

    2017-05-01

    Full Text Available Background: Patient experience is increasingly recognised as an important feature of healthcare quality improvement. However, many of the methods implemented for its collection have significant limitations and reliability issues. This article describes how a UK healthcare organisation worked with medical student volunteers to build capacity for the collection of patient feedback in evidence-informed ways, and summarises student reflections on this process. Aims: To improve the quantity and quality of inpatient feedback, and in doing so provide new learning opportunities for medical students. Conclusions: Patient feedback gathered by volunteers is beneficial to the service and to medical student volunteers. As the feedback gathered is ward-specific, opportunities are created for practice improvements to be identified and acted on. It is feasible for medical students to be trained effectively as volunteers in gathering patient care experiences with adequate support mechanisms in place. Implications for practice: •\tHealthcare services should consider the use of personnel independent of the care team for the collection of patient feedback •\tPatient feedback needs to be shared with practitioners in a timely manner •\tMedical schools should consider this type of volunteering as a unique opportunity for medical students to improve understanding of patients’ experiences of healthcare, and of how care can be person-centred

  17. NDT-Bobath method in normalization of muscle tone in post-stroke patients.

    Science.gov (United States)

    Mikołajewska, Emilia

    2012-01-01

    Ischaemic stroke is responsible for 80-85% of strokes. There is great interest in finding effective methods of rehabilitation for post-stroke patients. The aim of this study was to assess the results of rehabilitation carried out in the normalization of upper limb muscle tonus in patients, estimated on the Ashworth Scale for Grading Spasticity. The examined group consisted of 60 patients after ischaemic stroke. 10 sessions of NDT-Bobath therapy were provided within 2 weeks (ten days of therapy). Patient examinations using the Ashworth Scale for Grading Spasticity were done twice: the first time on admission and the second after the last session of the therapy to assess rehabilitation effects. Among the patients involved in the study, the results measured on the Ashworth Scale (where possible) were as follows: recovery in 16 cases (26.67%), relapse in 1 case (1.67%), no measurable changes (or change within the same grade of the scale) in 8 cases (13.33%). Statistically significant changes were observed in the health status of the patients. These changes, in the area of muscle tone, were favorable and reflected in the outcomes of the assessment using the Ashworth Scale for Grading Spasticity.

  18. Review of a single contemporary femoral neck fracture fixation method in young patients.

    LENUS (Irish Health Repository)

    Henari, Shwan

    2011-03-01

    An intracapsular femoral neck fracture in a young patient is a rare and difficult injury to manage. The occurrence of complications following fixation is multifactorial. Initial displacement and timing and accuracy of reduction are the key factors affecting outcome. The severities of the trauma to the hip and the impact of the intracapsular hematoma also play a role, the importance of which remains poorly understood. The purpose of this study was to evaluate the high incidence of femoral neck fractures treated in our institution over a 7-month period, to record the long-term outcome of these patients, all of whom were treated with contemporary methods of internal fixation, and to highlight the reasons for this injury being termed an "orthopedic emergency" and its differences from the same injury in the elderly population. We performed a retrospective analysis of 12 cases of intracapsular femur neck fracture in patients younger than 50 years treated over 7 months in a regional trauma center. All patients underwent satisfactory reduction and fixation. Nine of the 12 patients had a good outcome at a mean follow-up of 29 months. One patient developed a nonunion of the femoral head requiring total hip arthroplasty, one developed avascular necrosis of the femoral head, and one developed partial avascular necrosis. This compares favorably with other studies.

  19. Fire forbids fifty-fifty forest

    Science.gov (United States)

    Staal, Arie; Hantson, Stijn; Holmgren, Milena; Pueyo, Salvador; Bernardi, Rafael E.; Flores, Bernardo M.; Xu, Chi; Scheffer, Marten

    2018-01-01

    Recent studies have interpreted patterns of remotely sensed tree cover as evidence that forest with intermediate tree cover might be unstable in the tropics, as it will tip into either a closed forest or a more open savanna state. Here we show that across all continents the frequency of wildfires rises sharply as tree cover falls below ~40%. Using a simple empirical model, we hypothesize that the steepness of this pattern causes intermediate tree cover (30‒60%) to be unstable for a broad range of assumptions on tree growth and fire-driven mortality. We show that across all continents, observed frequency distributions of tropical tree cover are consistent with this hypothesis. We argue that percolation of fire through an open landscape may explain the remarkably universal rise of fire frequency around a critical tree cover, but we show that simple percolation models cannot predict the actual threshold quantitatively. The fire-driven instability of intermediate states implies that tree cover will not change smoothly with climate or other stressors and shifts between closed forest and a state of low tree cover will likely tend to be relatively sharp and difficult to reverse. PMID:29351323

  20. Beginning Typewriting: A Fifty-Fifty Proposition

    Science.gov (United States)

    Ivarie, Ted

    1976-01-01

    Beginning typewriting should be a 50-50 proposition with equal time devoted to machine operation and skill development and to language arts instruction in elementary and secondary education. (Author/LH)

  1. Fire forbids fifty-fifty forest.

    Science.gov (United States)

    van Nes, Egbert H; Staal, Arie; Hantson, Stijn; Holmgren, Milena; Pueyo, Salvador; Bernardi, Rafael E; Flores, Bernardo M; Xu, Chi; Scheffer, Marten

    2018-01-01

    Recent studies have interpreted patterns of remotely sensed tree cover as evidence that forest with intermediate tree cover might be unstable in the tropics, as it will tip into either a closed forest or a more open savanna state. Here we show that across all continents the frequency of wildfires rises sharply as tree cover falls below ~40%. Using a simple empirical model, we hypothesize that the steepness of this pattern causes intermediate tree cover (30‒60%) to be unstable for a broad range of assumptions on tree growth and fire-driven mortality. We show that across all continents, observed frequency distributions of tropical tree cover are consistent with this hypothesis. We argue that percolation of fire through an open landscape may explain the remarkably universal rise of fire frequency around a critical tree cover, but we show that simple percolation models cannot predict the actual threshold quantitatively. The fire-driven instability of intermediate states implies that tree cover will not change smoothly with climate or other stressors and shifts between closed forest and a state of low tree cover will likely tend to be relatively sharp and difficult to reverse.

  2. A sensitive immunoblotting method for screening of microalbuminuria in diabetic patient's urine

    International Nuclear Information System (INIS)

    Abdolkhaleg, D.; Behrooz, S.

    2005-01-01

    Urinary albumin excretion is a useful marker in the prognosis of diabetic nephropathy and microvascular diseases. Methods such as enzyme linked immunosorbent assay (ELISA), radio immunoassay(RIA), radial immunodiffusion, albu screen, micro bumin and micral test are usually used for detection and screening of microalbuminuria in these patients. With consideration to the cost of an assay, methods such as ELISA and RIA are not suitable methods for screening purpose. Therefore, the aim of this work is to set a dot immunoblotting method for the measurement and screening of microalbumin in urine samples. The study was conducted during the period August 2001 to June 2003 at the National Research Center for Genetic Engineering and Biotechnology (NRCGEB) and Pars Hospital Laboratory of Tehran, Iran on 96 diabetic patients urine samples. First, anti human albumin antibodies (Abs) were produced in rabbit and immunoglobulin G (IgG) fraction was purified by protein-A affinity chromatography. Titer of Abs and optimum incubation conditions were tested by direct ELISA. Then different concentration of human albumin (0-300 mg/l) was loaded to nitrocellulose membranes and was assayed by dot immunoblotting method. The specificity and cross reactivity of Abs was tested by SDS-PAGE electrophoresis and western immunoblotting. The sensitivity of the method was calculated from human albumin calibration curve and compared with commercial immunoturbidimetric assays. Our results indicates that in using IgG with the concentrations 0.5-1 ug/ml (2 x 10-5 to 10-4 dilutions) the intensity of color directly increased with the increase of human albumin standards in blots. Western immunoblotting of urine samples did not show any cross reactivity with other urine proteins. Comparison of results of this method by commercial immunoturbidimetric methods indicates the correlation regression of approximately 0.979. The sensitivity of the method was approximately 5 mg/L of human albumin. This simple

  3. Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study.

    Science.gov (United States)

    Lee, Wei Wei; Alkureishi, Maria A; Ukabiala, Obioma; Venable, Laura Ruth; Ngooi, Samantha S; Staisiunas, Daina D; Wroblewski, Kristen E; Arora, Vineet M

    2016-11-01

    While concerns remain regarding Electronic Medical Records (EMR) use impeding doctor-patient communication, resident and faculty patient perspectives post-widespread EMR adoption remain largely unexplored. We aimed to describe patient perspectives of outpatient resident and faculty EMR use and identify positive and negative EMR use examples to promote optimal utilization. This was a prospective mixed-methods study. Internal medicine faculty and resident patients at the University of Chicago's primary care clinic participated in the study. In 2013, one year after EMR implementation, telephone interviews were conducted with patients using open-ended and Likert style questions to elicit positive and negative perceptions of EMR use by physicians. Interview transcripts were analyzed qualitatively to develop a coding classification. Satisfaction with physician EMR use was examined using bivariate statistics. In total, 108 interviews were completed and analyzed. Two major themes were noted: (1) Clinical Functions of EMR and (2) Communication Functions of EMR; as well as six subthemes: (1a) Clinical Care (i.e., clinical efficiency), (1b) Documentation (i.e., proper record keeping and access), (1c) Information Access, (1d) Educational Resource, (2a) Patient Engagement and (2b) Physical Focus (i.e., body positioning). Overall, 85 % (979/1154) of patient perceptions of EMR use were positive, with the majority within the "Clinical Care" subtheme (n = 218). Of negative perceptions, 66 % (115/175) related to the "Communication Functions" theme, and the majority of those related to the "Physical Focus" subtheme (n = 71). The majority of patients (90 %, 95/106) were satisfied with physician EMR use: 59 % (63/107) reported the computer had a positive effect on their relationship and only 7 % (8/108) reported the EMR made it harder to talk with their doctors. Despite concerns regarding EMRs impeding doctor-patient communication, patients reported largely positive

  4. CHANGES IN TUMOR NECROSIS FACTOR ALFA DURING TREATMENT OF PATIENTS WITH MULTIPLE SCLEROSIS BY TRANSIMMUNIZATION METHOD

    Directory of Open Access Journals (Sweden)

    A. V. Kil'dyushevskiy

    2016-01-01

    Full Text Available Background: Despite the availability of a  large number of treatments for multiple sclerosis with various targets, these treatments are not always effective. According to the literature, experimental studies have shown a  significant decrease in tumor necrosis factor alfa (TNF-α with the use of extracorporeal photochemotherapy. Aim: To assess changes in TNF-α in patients with multiple sclerosis during treatment with transimmunization. Materials and methods: The study recruited 13 adult patients with multiple sclerosis. Serum TNF-α was measured by immunochemiluminescence analysis (IMMULITE 1000, Siemens. The patients were treated by transimmunization, i.e. a  modified photopheresis. Two hours before the procedure, Ammifurin (8-methoxypsoralene was administered to all the patients, then their mononuclear cells were isolated under PBSC protocol with Haemonetics MCS+ cell separator. Thereafter, mononuclear cells were irradiated with ultraviolet for 90  minutes and incubated for 20 hours at 37 °С. The next day the cells were re-infused to the patients. The procedure was performed 2  times per week for 6  months, then once per 4  months. Results: Before transimmunization, mean TNF-α level in adult patients with multiple sclerosis was 9.958±0.812  pg/mL (normal, below 8.1 pg/mL. After transimmunization, its level was 6.992±0.367  pg/mL (р<0.05. Conclusion: Ultraviolet irradiation of peripheral blood monocytes with their subsequent incubation (transimmunization led to a 30% decrease of serum TNF-α in patients with multiple sclerosis. This indicates a suppressive effect of transimmunization on TNF-α. Hence, in patients with multiple sclerosis transimmunization exerts an anti-inflammatory effect.

  5. Following up patients with depression after hospital discharge: a mixed methods approach

    Directory of Open Access Journals (Sweden)

    Desplenter Franciska A

    2011-11-01

    Full Text Available Abstract Background A medication information intervention was delivered to patients with a major depressive episode prior to psychiatric hospital discharge. Methods The objective of this study was to explore how patients evolved after hospital discharge and to identify factors influencing this evolution. Using a quasi-experimental longitudinal design, the quantitative analysis measured clinical (using the Hospital Anxiety and Depression Scale, the somatic dimension of the Symptom Checklist 90 and recording the number of readmissions and humanistic (using the Quality of Life Enjoyment and Satisfaction Questionnaire outcomes of patients via telephone contacts up to one year following discharge. The qualitative analysis was based on the researcher diary, consisting of reports on the telephone outcome assessment of patients with major depression (n = 99. All reports were analyzed using the thematic framework approach. Results The change in the participants' health status was as diverse as it was at hospital discharge. Participants reported on remissions; changes in mood; relapses; and re-admissions (one third of patients. Quantitative data on group level showed low anxiety, depression and somatic scores over time. Three groups of contributing factors were identified: process, individual and environmental factors. Process factors included self caring process, medical care after discharge, resumption of work and managing daily life. Individual factors were symptom control, medication and personality. Environmental factors were material and social environment. Each of them could ameliorate, deteriorate or be neutral to the patient's health state. A mix of factors was observed in individual patients. Conclusions After hospital discharge, participants with a major depressive episode evolved in many different ways. Process, individual and environmental factors may influence the participant's health status following hospital discharge. Each of the factors

  6. Validation of non-invasive haemodynamic methods in patients with liver disease

    DEFF Research Database (Denmark)

    Brittain, Jane M; Busk, Troels M; Møller, Søren

    2018-01-01

    Patients with advanced cirrhosis often present a hyperdynamic circulation characterized by a decrease in systolic and diastolic blood pressure (SBP and DBP), and an increase in heart rate (HR) and cardiac output (CO). Accurate assessment of the altered circulation can be performed invasively......; however, due to the disadvantages of this approach, non-invasive methods are warranted. The purpose of this study was to compare continuous non-invasive measurements of haemodynamic variables by the Finometer and the Task Force Monitor with simultaneous invasive measurements. In 25 patients with cirrhosis......, respectively; and CO: 0·1 ± 1·6 and -1·0 ± 2·0 L min(-1) , respectively. The study demonstrates that the overall performances of the Finometer and the Task Force Monitor in estimating absolute values of SBP, DBP, HR and CO in patients with cirrhosis are not equivalent to the gold standard, but may have...

  7. Nonpharmacological methods in managing patients with dementia in a tertiary care hospital.

    Science.gov (United States)

    Pandey, Nisha Mani; Tripathi, Shailendra Mohan; Singh, Bhupendra; Tiwari, Sarvada Chandra

    2018-01-01

    Management of dementia is very crucial. Nonpharmacological methods (NPM) are well appreciated and encouraged to be used as first-line treatment for managing elderly patients with dementia (PwD). The present case reports aimed to share the strategies of NPM for managing PwD. NPM requires a structured blueprint to record, follow-up, and monitor the outcomes. A structured proforma has been developed in the department. After getting all the basic information from the patient, needed assessments are being done by the concerned team member to identify and rate the level of severity of the problem, and specific NPM strategies are being provided. Concerted efforts give positive results; knowledge and understanding about the illness help the caregiver in managing the patient. No negative impact has been reported; NPM is a cost-effective approach and therefore should be studied on a larger level to provide evidence from India and prove its efficacy.

  8. [Effect of different anesthetic methods on postoperative outcomes in elderly patients undergoing hip fracture surgery].

    Science.gov (United States)

    Wei, B; Zhang, H; Xu, M; Li, M; Wang, J; Zhang, L P; Guo, X Y; Zhao, Y M; Zhou, F

    2017-12-18

    To investigate the effect of general or regional anesthesia on postoperative cardiopulmonary complications and inpatient mortality after hip fracture surgery in elderly patients. A retrospective analysis was conducted according to the medical records of 572 elderly patients with hip fractures admitted to our hospital from January 1, 2005 to December 31, 2014. The age, gender, preoperative comorbidities, length of preoperative bedridden time, mechanism of injury, surgical types, anesthetic methods, major postoperative complications and inpatient mortality were recorded. Multivariate Logistic regression analysis was applied to analyze the impact of different anesthetic methods on inpatient mortality in these patients. Of the 572 patients, 392 (68.5%) received regional anesthesia. Inpatient death occurred in 8 (8/572, mortality: 1.4%), including 5 cases of RA group (5/392, mortality: 1.3%) and 3 cases of GA group (3/180, mortality: 1.7%). There was no statistically significant difference between the two groups in inpatient mortality (P>0.05). Multiple Logistic regression analysis showed that gender (odds ratio: 0.18, 95% CI: 0.03-1.05, P=0.057), age (odds ratio: 1.22, 95% CI: 1.07-1.38, P=0.002), preoperative pulmonary comorbidities (odds ratio: 12.09, 95% CI: 2.28-64.12, P=0.003) and surgical types (odds ratio: 9.36, 95% CI: 1.34-64.26, P=0.024) were risk factors for inpatient mortality. Postoperative cardiovascular complications occurred in 36 patients (36/572, morbidity: 6.3%), with 19 patients in RA group (19/392, morbidity: 4.8%),and 17 patients in GA group (17/180, morbidity: 9.4%). Multiple Logistic regression analysis showed that age (odds ratio: 1.13, 95% CI: 1.07-1.19, Pbedridden time (odds ratio: 1.11, 95% CI: 1.04-1.18, P=0.003) and anesthetic methods (odds ratio: 5.86, 95% CI: 2.98-11.53, Pelderly patients. Regional anesthesia is associated with a lower risk of pulmonary complications after surgical procedure compared with general anesthesia.

  9. Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients

    Directory of Open Access Journals (Sweden)

    Asadian S

    2016-09-01

    Full Text Available Simin Asadian,1 Alireza Khatony,1 Gholamreza Moradi,2 Alireza Abdi,1 Mansour Rezaei,3 1Nursing and Midwifery School, Kermanshah University of Medical Sciences, 2Department of Anesthesiology, 3Biostatistics & Epidemiology Department, Kermanshah University of Medical Sciences, Kermanshah, Iran Introduction: An accurate determination of body temperature in critically ill patients is a fundamental requirement for initiating the proper process of diagnosis, and also therapeutic actions; therefore, the aim of the study was to assess the accuracy and precision of four noninvasive peripheral methods of temperature measurement compared to the central nasopharyngeal measurement. Methods: In this observational prospective study, 237 patients were recruited from the intensive care unit of Imam Ali Hospital of Kermanshah. The patients’ body temperatures were measured by four peripheral methods; oral, axillary, tympanic, and forehead along with a standard central nasopharyngeal measurement. After data collection, the results were analyzed by paired t-test, kappa coefficient, receiver operating characteristic curve, and using Statistical Package for the Social Sciences, version 19, software. Results: There was a significant meaningful correlation between all the peripheral methods when compared with the central measurement (P<0.001. Kappa coefficients showed good agreement between the temperatures of right and left tympanic membranes and the standard central nasopharyngeal measurement (88%. Paired t-test demonstrated an acceptable precision with forehead (P=0.132, left (P=0.18 and right (P=0.318 tympanic membranes, oral (P=1.00, and axillary (P=1.00 methods. Sensitivity and specificity of both the left and right tympanic membranes were more than for other methods. Conclusion: The tympanic and forehead methods had the highest and lowest accuracy for measuring body temperature, respectively. It is recommended to use the tympanic method (right and left for

  10. Evaluation of radiation dose to patients in intraoral dental radiography using Monte Carlo Method

    International Nuclear Information System (INIS)

    Park, Il; Kim, Kyeong Ho; Oh, Seung Chul; Song, Ji Young

    2016-01-01

    The use of dental radiographic examinations is common although radiation dose resulting from the dental radiography is relatively small. Therefore, it is required to evaluate radiation dose from the dental radiography for radiation safety purpose. The objectives of the present study were to develop dosimetry method for intraoral dental radiography using a Monte Carlo method based radiation transport code and to calculate organ doses and effective doses of patients from different types of intraoral radiographies. Radiological properties of dental radiography equipment were characterized for the evaluation of patient radiation dose. The properties including x-ray energy spectrum were simulated using MCNP code. Organ doses and effective doses to patients were calculated by MCNP simulation with computational adult phantoms. At the typical equipment settings (60 kVp, 7 mA, and 0.12 sec), the entrance air kerma was 1.79 mGy and the measured half value layer was 1.82 mm. The half value layer calculated by MCNP simulation was well agreed with the measurement values. Effective doses from intraoral radiographies ranged from 1 μSv for maxilla premolar to 3 μSv for maxilla incisor. Oral cavity layer (23⁓82 μSv) and salivary glands (10⁓68 μSv) received relatively high radiation dose. Thyroid also received high radiation dose (3⁓47 μSv) for examinations. The developed dosimetry method and evaluated radiation doses in this study can be utilized for policy making, patient dose management, and development of low-dose equipment. In addition, this study can ultimately contribute to decrease radiation dose to patients for radiation safety

  11. Evaluation of Different Methods for Removing Oral Biofilm in Patients Admitted to the Intensive Care Unit

    Science.gov (United States)

    Oliveira, Maria Sonia; Borges, Alvaro Henrique; Mattos, Fernanda Zanol; Semenoff, Tereza Aparecida Della Vedove; Segundo, Alex Semenoff; Tonetto, Mateus Rodrigues; Bandeca, Matheus Coêlho; Porto, Alessandra Nogueira

    2014-01-01

    Background: The present study aimed to evaluate the different methods for removing oral biofilm in combination with 0.12% chlorhexidine, in patients admitted to the intensive care unit (ICU) of the General University Hospital. Materials and Methods: Initially, the patients were included in the study and underwent periodontal evaluation by means of the visible plaque index (VPI) and gingival bleeding index (GBI). The removal of visible biofilm, by a professional, was carried out using a toothbrush and dental floss, followed by the application of a 0.12% chlorhexidine solution. The patients were included in this randomized and controlled study into four groups (total n = 48), as follows: Chlorhexidine and gauze 12/12 h; chlorhexidine and gauze 24/24 h; chlorhexidine and brushing 12/12 h; chlorhexidine and brushing 24/24 h. The patients underwent the biofilm removal protocol for 7 days and then were subjected to a new clinical evaluation as to VPI and GBI. Data analysis was performed through stratification and arrangement of the records, in order to carry out the associations with health indicators used in the study, and the statistical tests used were Kappa and t-test for independent and paired samples. Results: A decrease in the VPI and GBI values when comparing baseline to the final evaluation for all groups was observed. Conclusion: Based on the methodology, it was possible to concluded that chlorhexidine associated with the mechanical action of the toothbrush or gauze in the times 12 h and 24 h in the ICU environment presented the same results as regards amount of visible biofilm. How to cite the article: Oliveira MS, Borges AH, Mattos FZ, Semenoff TA, Segundo AS, Tonetto MR, Bandeca MC, Porto AN. Evaluation of different methods for removing oral biofilm in patients admitted to the intensive care unit. J Int Oral Health 2014;6(3):61-4. PMID:25083034

  12. Evaluation of radiation dose to patients in intraoral dental radiography using Monte Carlo Method

    Energy Technology Data Exchange (ETDEWEB)

    Park, Il; Kim, Kyeong Ho; Oh, Seung Chul; Song, Ji Young [Dept. of Nuclear Engineering, Kyung Hee University, Yongin (Korea, Republic of)

    2016-11-15

    The use of dental radiographic examinations is common although radiation dose resulting from the dental radiography is relatively small. Therefore, it is required to evaluate radiation dose from the dental radiography for radiation safety purpose. The objectives of the present study were to develop dosimetry method for intraoral dental radiography using a Monte Carlo method based radiation transport code and to calculate organ doses and effective doses of patients from different types of intraoral radiographies. Radiological properties of dental radiography equipment were characterized for the evaluation of patient radiation dose. The properties including x-ray energy spectrum were simulated using MCNP code. Organ doses and effective doses to patients were calculated by MCNP simulation with computational adult phantoms. At the typical equipment settings (60 kVp, 7 mA, and 0.12 sec), the entrance air kerma was 1.79 mGy and the measured half value layer was 1.82 mm. The half value layer calculated by MCNP simulation was well agreed with the measurement values. Effective doses from intraoral radiographies ranged from 1 μSv for maxilla premolar to 3 μSv for maxilla incisor. Oral cavity layer (23⁓82 μSv) and salivary glands (10⁓68 μSv) received relatively high radiation dose. Thyroid also received high radiation dose (3⁓47 μSv) for examinations. The developed dosimetry method and evaluated radiation doses in this study can be utilized for policy making, patient dose management, and development of low-dose equipment. In addition, this study can ultimately contribute to decrease radiation dose to patients for radiation safety.

  13. Integration of PET/CT in Current Diagnostic and Response Evaluation Methods in Patients with Tuberculosis

    International Nuclear Information System (INIS)

    Oezmen, Oelem; Goekcek, Atila; Tatci, Ebru; Biner, Inci; Akkalyoncu, Behiye

    2014-01-01

    Tuberculosis is a systemic disease that still affects many people. While pleural involvement is frequently observed in extrapulmonary tuberculosis, multiple skeletal system and articular involvements are quite rare. FDG PET imaging could be a promising diagnostic and treatment monitoring method, especially in complicated cases and if the other methods are inadequate. In this case study, we report a patient who was admitted with suspected malignancy and then diagnosed with tuberculosis pleuritis, lymphadenitis, spondylodiscitis, and sacroiliitis with specific symptoms; the response to anti-tuberculosis therapy was shown using FDG PET/CT

  14. An effective method of surgical treatment of refractory glaucoma patients using Ex-PRESSTM filtering device

    Directory of Open Access Journals (Sweden)

    Sergey Yuryevich Astakhov

    2013-03-01

    Full Text Available Based on data obtained from examination and subsequent follow-up of 47 patients (50 eyes with refractory glaucoma, an efficacy estimation of a new method of the Ex-PRESSTM filtering device implantation was performed. The data analysis showed that the proposed surgical procedure has a low level of intra- and post-operative complications, is characterized by technical ease, and provides a long term stabilization of the glaucomatous process. Therefore it is possible to draw a conclusion that the Ex-PRESSTM filtering device implantation is an effective method for the treatment of refractory glaucoma.

  15. Integration of PET/CT in Current Diagnostic and Response Evaluation Methods in Patients with Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Oezmen, Oelem; Goekcek, Atila; Tatci, Ebru; Biner, Inci; Akkalyoncu, Behiye [Atatuerk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara (Turkmenistan)

    2014-03-15

    Tuberculosis is a systemic disease that still affects many people. While pleural involvement is frequently observed in extrapulmonary tuberculosis, multiple skeletal system and articular involvements are quite rare. FDG PET imaging could be a promising diagnostic and treatment monitoring method, especially in complicated cases and if the other methods are inadequate. In this case study, we report a patient who was admitted with suspected malignancy and then diagnosed with tuberculosis pleuritis, lymphadenitis, spondylodiscitis, and sacroiliitis with specific symptoms; the response to anti-tuberculosis therapy was shown using FDG PET/CT.

  16. Randomized controlled trial of internal and external targeted temperature management methods in post- cardiac arrest patients.

    Science.gov (United States)

    Look, Xinqi; Li, Huihua; Ng, Mingwei; Lim, Eric Tien Siang; Pothiawala, Sohil; Tan, Kenneth Boon Kiat; Sewa, Duu Wen; Shahidah, Nur; Pek, Pin Pin; Ong, Marcus Eng Hock

    2018-01-01

    Targeted temperature management post-cardiac arrest is currently implemented using various methods, broadly categorized as internal and external. This study aimed to evaluate survival-to-hospital discharge and neurological outcomes (Glasgow-Pittsburgh Score) of post-cardiac arrest patients undergoing internal cooling verses external cooling. A randomized controlled trial of post-resuscitation cardiac arrest patients was conducted from October 2008-September 2014. Patients were randomized to either internal or external cooling methods. Historical controls were selected matched by age and gender. Analysis using SPSS version 21.0 presented descriptive statistics and frequencies while univariate logistic regression was done using R 3.1.3. 23 patients were randomized to internal cooling and 22 patients to external cooling and 42 matched controls were selected. No significant difference was seen between internal and external cooling in terms of survival, neurological outcomes and complications. However in the internal cooling arm, there was lower risk of developing overcooling (p=0.01) and rebound hyperthermia (p=0.02). Compared to normothermia, internal cooling had higher survival (OR=3.36, 95% CI=(1.130, 10.412), and lower risk of developing cardiac arrhythmias (OR=0.18, 95% CI=(0.04, 0.63)). Subgroup analysis showed those with cardiac cause of arrest (OR=4.29, 95% CI=(1.26, 15.80)) and sustained ROSC (OR=5.50, 95% CI=(1.64, 20.39)) had better survival with internal cooling compared to normothermia. Cooling curves showed tighter temperature control for internal compared to external cooling. Internal cooling showed tighter temperature control compared to external cooling. Internal cooling can potentially provide better survival-to-hospital discharge outcomes and reduce cardiac arrhythmia complications in carefully selected patients as compared to normothermia. Copyright © 2017. Published by Elsevier Inc.

  17. Mobile Diabetes Intervention Study of Patient Engagement and Impact on Blood Glucose: Mixed Methods Analysis.

    Science.gov (United States)

    Quinn, Charlene Connolly; Butler, Erin C; Swasey, Krystal K; Shardell, Michelle D; Terrin, Michael D; Barr, Erik A; Gruber-Baldini, Ann L

    2018-02-02

    Successful treatment of diabetes includes patient self-management behaviors to prevent or delay complications and comorbid diseases. On the basis of findings from large clinical trials and professional guidelines, diabetes education programs and health providers prescribe daily regimens of glucose monitoring, healthy eating, stress management, medication adherence, and physical activity. Consistent, long-term commitment to regimens is challenging. Mobile health is increasingly being used to assist patients with lifestyle changes and self-management behaviors between provider visits. The effectiveness of mobile health to improve diabetes outcomes depends on patient engagement with a technology, content, or interactions with providers. In the current analysis, we aimed to identify patient engagement themes in diabetes messaging with diabetes providers and determine if differences in engagement in the Mobile Diabetes Intervention Study (MDIS) influenced changes in glycated hemoglobin A 1c (HbA 1c ) over a 1-year treatment period (1.9% absolute decrease in the parent study). In the primary MDIS study, 163 patients were enrolled into 1 of 3 mobile intervention groups or a usual care control group based on their physician cluster randomization assignment. The control group received care from their physicians as usual. Participants in each intervention group had access to a patient portal where they could record monitoring values for blood glucose, blood pressure, medication changes, or other self-management information while also assigned to varying levels of physician access to patient data. Intervention participants could choose to send and receive messages to assigned certified diabetes educators with questions or updates through the secure Web portal. For this secondary analysis, patient engagement was measured using qualitative methods to identify self-care themes in 4109 patient messages. Mixed methods were used to determine the impact of patient engagement on

  18. Nurses`knowledge of and attitude towards exercise as a treatment method for hypertensive patients

    Directory of Open Access Journals (Sweden)

    L. Grobler

    2005-01-01

    Full Text Available Aerobic exercise is used in treating hypertension. Eventhough physiotherapists are the first choice in presenting exercise treatment, few are available to do so in primary health clinics. Nurses arepatients’ first contact and may be able to fulfil this role. Nurses’knowledge and attitude towards exercise as a treatment method for hypertensive patients was determined. This descriptive study included all nurses (n=67 working in 23 Bloemfontein clinics. Forty-three nursescompleted structured questionnaires that determined their knowledge of exercise as a treatment method. All nurses prescribed medication forhypertensive patients. Most nurses prescribed weight control (72.1%, diet control (76.7%, patient education (74.4%, and life-style modification (72.1%. Most (83.7% nurses were aware of exercise as a treatment method for hypertension. Only seven nurses, prescribing a brisk walk, recommended the correct type of exercise. The nurses’attitude towards exercise as a treatment method was determined using focus group interviews (n=16. Nurses reflected a positive attitude towards exercise with 198 positive responses. Nurses could express more than one opinion, all of which were recorded. Twenty responses reflected little or no knowledge, and four responses reflected an unsure/neutral attitude towards exercise. Ten responses reflected disinterest in prescribing exercise. Nurses do not have adequate knowledge to enable them to confidently prescribe exercise to patients. The need for more information was mentioned and some nurses were willing to present exercise classes. A training program, containing pertinent information, so that nurses can prescribe exercise for hypertension, needs to be developed.

  19. Nurses`knowledge of and attitude towards exercise as a treatment method for hypertensive patients

    OpenAIRE

    L. Grobler; L. Roets

    2005-01-01

    Aerobic exercise is used in treating hypertension. Eventhough physiotherapists are the first choice in presenting exercise treatment, few are available to do so in primary health clinics. Nurses arepatients’ first contact and may be able to fulfil this role. Nurses’knowledge and attitude towards exercise as a treatment method for hypertensive patients was determined. This descriptive study included all nurses (n=67) working in 23 Bloemfontein clinics. Forty-three nursescompleted structured qu...

  20. The method of edge anxiety-depressive disorder correction in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    A. Kozhanova

    2015-11-01

    4.    Kazimierz Wielki University, Bydgoszcz, Poland Abstract   The article presents the results of research on the effectiveness of the method developed by the authors for correcting the anxiety and depressive edge disorders in patients with type 2 diabetes through the use of magnetic-therapy.   Tags: anxiety-depressive disorder, hidden depression, diabetes, medical rehabilitation, singlet-oxygen therapy.

  1. [Physiotherapy methods in the rehabilitation of patients with cerebral vascular diseases].

    Science.gov (United States)

    Ezhov, V V

    1996-01-01

    The author has examined 650 patients aged 30-65 years with prestroke forms of cerebrovascular diseases. Basing on clinico-neurological, electrophysiological and biochemical data, five new variants of physiotherapy are proposed: transcerebral and segmental dalargin electrophoresis combined with magnetotherapy and manual therapy. Relevant practical recommendations are provided. The author's findings extend the knowledge of curative potential of physical methods and on their mechanism of action in cerebrovascular insufficiency.

  2. Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding

    International Nuclear Information System (INIS)

    Ryu, Jeong Ah; Kim, Bo Hyun; Lee, Jong Mee; Kim, Soo Ah; Lee, Sang Hoon

    2004-01-01

    To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding

  3. Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jeong Ah; Kim, Bo Hyun; Lee, Jong Mee; Kim, Soo Ah [Sungkyunkwan University, Seoul (Korea, Republic of); Lee, Sang Hoon [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2004-03-15

    To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.

  4. A mixed method thematic review: the importance of hope to the dying patient.

    Science.gov (United States)

    Broadhurst, Kathleen; Harrington, Ann

    2016-01-01

    To review the literature and investigate the meaning of hope to patients receiving palliative care and to examine the themes that foster hope in those patients. Hope is often linked to the future and is a significant factor for patients dealing with adversity, such as a terminal illness. The concept of hope is underreported in the literature. Mixed method thematic review. CINAHL, Scopus, PsychINFO, Informit, PubMed, Science Direct, ProQuest, Web of Science and Google Scholar online databases were searched using keywords and inclusion and exclusion criteria published between 2003-2013. Twelve qualitative articles were thematically analysed using Braun and Clarke's (2006) steps to ascertain major themes and sub-themes. On analysis, the remaining three mixed method studies were found to reflect the themes generated by the qualitative studies. Seven key themes that increased hope were found: disease status; positive personal relationships; positive character traits; quality of life; setting and achieving goals; spirituality/religion; and hope after death. The importance of hope to dying patients was established. Hope is a very complex and personal phenomena requiring hope-enhancing strategies to be individualized. More research is needed with groups whose culture, youth or type of illness may affect their ability to foster and maintain hope. © 2015 John Wiley & Sons Ltd.

  5. The role of simulation in mixed-methods research: a framework & application to patient safety.

    Science.gov (United States)

    Guise, Jeanne-Marie; Hansen, Matthew; Lambert, William; O'Brien, Kerth

    2017-05-04

    Research in patient safety is an important area of health services research and is a national priority. It is challenging to investigate rare occurrences, explore potential causes, and account for the complex, dynamic context of healthcare - yet all are required in patient safety research. Simulation technologies have become widely accepted as education and clinical tools, but have yet to become a standard tool for research. We developed a framework for research that integrates accepted patient safety models with mixed-methods research approaches and describe the performance of the framework in a working example of a large National Institutes of Health (NIH)-funded R01 investigation. This worked example of a framework in action, identifies the strengths and limitations of qualitative and quantitative research approaches commonly used in health services research. Each approach builds essential layers of knowledge. We describe how the use of simulation ties these layers of knowledge together and adds new and unique dimensions of knowledge. A mixed-methods research approach that includes simulation provides a broad multi-dimensional approach to health services and patient safety research.

  6. A Pilot Project to Develop and Assess a Health Education Programme for Type 2 Diabetes Mellitus Patients

    Science.gov (United States)

    Atak, Nazli; Arslan, Umit

    2005-01-01

    Objective: The current research was designed to develop a health education programme for type 2 diabetes mellitus based on the Taba-Tyler model and to evaluate its effect. Design: The study was quasi-experimental in design. Setting: Fifty-five patients from the Endocrinology and Metabolism Unit, University Hospital of Ankara. Method: An education…

  7. Right ventricular load and function during exercise in patients with open and closed atrial septal defect type secundum

    NARCIS (Netherlands)

    Pieter De Meester; Roselien Buys; Werner Budts; Marion Delcroix; Prof. Dr. Luc L.E.M.J. Vanhees; Jens-Uwe Voigt; Alexander Van de Bruaene

    2013-01-01

    Abstract Purpose: This study aimed at evaluating (1) right ventricular (RV) mean power during exercise, (2) the contribution of flow and pressure to RV mean power, and (3) the impact of pulmonary artery pressure on RV function during exercise. Methods: Fifty patients with atrial septal defect (ASD)

  8. Nonlinear Methods to Assess Changes in Heart Rate Variability in Type 2 Diabetic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Bhaskar, Roy, E-mail: imbhaskarall@gmail.com [Indian Institute of Technology (India); University of Connecticut, Farmington, CT (United States); Ghatak, Sobhendu [Indian Institute of Technology (India)

    2013-10-15

    Heart rate variability (HRV) is an important indicator of autonomic modulation of cardiovascular function. Diabetes can alter cardiac autonomic modulation by damaging afferent inputs, thereby increasing the risk of cardiovascular disease. We applied nonlinear analytical methods to identify parameters associated with HRV that are indicative of changes in autonomic modulation of heart function in diabetic patients. We analyzed differences in HRV patterns between diabetic and age-matched healthy control subjects using nonlinear methods. Lagged Poincaré plot, autocorrelation, and detrended fluctuation analysis were applied to analyze HRV in electrocardiography (ECG) recordings. Lagged Poincare plot analysis revealed significant changes in some parameters, suggestive of decreased parasympathetic modulation. The detrended fluctuation exponent derived from long-term fitting was higher than the short-term one in the diabetic population, which was also consistent with decreased parasympathetic input. The autocorrelation function of the deviation of inter-beat intervals exhibited a highly correlated pattern in the diabetic group compared with the control group. The HRV pattern significantly differs between diabetic patients and healthy subjects. All three statistical methods employed in the study may prove useful to detect the onset and extent of autonomic neuropathy in diabetic patients.

  9. Nonlinear Methods to Assess Changes in Heart Rate Variability in Type 2 Diabetic Patients

    International Nuclear Information System (INIS)

    Bhaskar, Roy; Ghatak, Sobhendu

    2013-01-01

    Heart rate variability (HRV) is an important indicator of autonomic modulation of cardiovascular function. Diabetes can alter cardiac autonomic modulation by damaging afferent inputs, thereby increasing the risk of cardiovascular disease. We applied nonlinear analytical methods to identify parameters associated with HRV that are indicative of changes in autonomic modulation of heart function in diabetic patients. We analyzed differences in HRV patterns between diabetic and age-matched healthy control subjects using nonlinear methods. Lagged Poincaré plot, autocorrelation, and detrended fluctuation analysis were applied to analyze HRV in electrocardiography (ECG) recordings. Lagged Poincare plot analysis revealed significant changes in some parameters, suggestive of decreased parasympathetic modulation. The detrended fluctuation exponent derived from long-term fitting was higher than the short-term one in the diabetic population, which was also consistent with decreased parasympathetic input. The autocorrelation function of the deviation of inter-beat intervals exhibited a highly correlated pattern in the diabetic group compared with the control group. The HRV pattern significantly differs between diabetic patients and healthy subjects. All three statistical methods employed in the study may prove useful to detect the onset and extent of autonomic neuropathy in diabetic patients

  10. Learning outcomes associated with patient simulation method in pharmacotherapy education: an integrative review.

    Science.gov (United States)

    Aura, Suvi M; Sormunen, Marjorita S T; Jordan, Sue E; Tossavainen, Kerttu A; Turunen, Hannele E

    2015-06-01

    The aims of this systematic integrative review were to identify evidence for the use of patient simulation teaching methods in pharmacotherapy education and to explore related learning outcomes. A systematic literature search was conducted using 6 databases as follows: CINAHL, PubMed, SCOPUS, ERIC, MEDIC, and the Cochrane Library, using the key words relating to patient simulation and pharmacotherapy. The methodological quality of each study was evaluated. Eighteen articles met the inclusion criteria. The earliest article was published in 2005. The selected research articles were subjected to qualitative content analysis. Patient simulation has been used in pharmacotherapy education for preregistration nursing, dental, medical, and pharmacy students and for the continuing education of nurses. Learning outcomes reported were summarized as follows: (1) commitment to pharmacotherapy learning, (2) development of pharmacotherapy evaluation skills, (3) improvement in pharmacotherapy application skills, and (4) knowledge and understanding of pharmacotherapy. To develop effective teaching methods and ensure health care professionals' competence in medication management, further research is needed to determine the educational and clinical effectiveness of simulation teaching methods.

  11. Study of regional cerebral blood flow in obsessive compulsive disorder patients with SPM and ROI method

    International Nuclear Information System (INIS)

    Li Peiyong; Jiang Xufeng; Zhang Liying; Guo Wanhua; Zhu Chengmo

    2002-01-01

    Objective: To investigate the alternations in regional cerebral blood flow (rCBF) in obsessive compulsive disorder (OCD) patients using statistical parametric mapping (SPM). Methods: rCBF measurements using 99 Tc m -ethyl cysteinate dimer (ECD) SPECT was performed on 14 OCD patients and 23 age-matched healthy volunteers. The rCBF distribution was compared between these two groups with SPM under the conditions of increased and decreased perfusion, and with regions of interest (ROIs) using cerebral template. P value was set at 0.01 level. Results: SPM analysis showed that rCBF decreased in cerebral areas including bilateral putamen, superior temporal gyrus and precuneus, and right orbital gyrus, superior and middle frontal gyrus, and left temporo-occipital lobule and superior parietal gyrus, and vermis. rCBF was also increased in left inferior frontal gyrus and posterior cingulate gyrus. With ROIs method, rCBF was decreased in right anterior frontal, temporo-parietal lobule and left temporo-occipital lobule. Conclusions: The study supports the viewpoint that rCBF abnormality of fronto-striatal circuits is involved in OCD patients. SPM method is a forceful tool in analyzing cerebral regional characters

  12. A method for patient set-up guidance in radiotherapy using augmented reality

    International Nuclear Information System (INIS)

    Talbot, J.; Meyer, J.; Watts, R.; Grasset, R.

    2009-01-01

    Full text: A system for patient set-up in external beam radiotherapy was developed using Augmented Reality (AR). Live images of the linac treatment couch and patient were obtained with video cameras and displayed on a nearby monitor. A 3D model of the patient's external contour was obtained from planning CT data, and AR tracking software was used to superimpose the model onto the video images in the correct position for treatment. Throughout set-up and treatment, the user can view the monitor and visually confirm that the patient is positioned correctly. To ensure that the virtual contour was displayed in the correct position, a process was devised to register the coordinates of the linac with the camera images. A cube with AR tracking markers attached to its faces was constructed for alignment with the isocentre using room lasers or cone-beam CT. The performance of the system was investigated in a clinical environment by using it to position an anthropomorphic phantom without the aid of additional set-up methods. The positioning errors were determined by means of CBCT and image registration. The translational set-up errors were found to be less than 2.4 mm and the rotational errors less than 0.3 0 . This proof-of-principle study has demonstrated the feasibility of using AR for patient position and pose guidance.

  13. Outcomes in Patients Treated with a Novel, Simple Method for Hemostasis of Dermal Avulsion Injuries.

    Science.gov (United States)

    Dowling, Sean Taylor; Lin, Brian Wai

    2017-10-01

    A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication. Emergency department of Kaiser Permanente Medical Center, San Francisco, California. Six patients were treated in the emergency department for fingertip dermal avulsion injuries using a tourniquet and tissue adhesive glue (Dermabond by Ethicon, Somerville, New Jersey). Patients were subsequently contacted to assess healing and satisfaction with cosmetic outcome through interview and photographs of their wounds at 9 months following the date of injury. All 6 patients were satisfied with the cosmetic outcome of treatment, and none received a diagnosis of serious complications. This series demonstrates cosmetic outcomes for injuries treated with the technique, highlights potential problems that may be perceived by patients during their clinical course, and creates the groundwork for a larger clinical study examining the use of the technique.

  14. Assessing Critical Thinking Outcomes of Dental Hygiene Students Utilizing Virtual Patient Simulation: A Mixed Methods Study.

    Science.gov (United States)

    Allaire, Joanna L

    2015-09-01

    Dental hygiene educators must determine which educational practices best promote critical thinking, a quality necessary to translate knowledge into sound clinical decision making. The aim of this small pilot study was to determine whether virtual patient simulation had an effect on the critical thinking of dental hygiene students. A pretest-posttest design using the Health Science Reasoning Test was used to evaluate the critical thinking skills of senior dental hygiene students at The University of Texas School of Dentistry at Houston Dental Hygiene Program before and after their experience with computer-based patient simulation cases. Additional survey questions sought to identify the students' perceptions of whether the experience had helped develop their critical thinking skills and improved their ability to provide competent patient care. A convenience sample of 31 senior dental hygiene students completed both the pretest and posttest (81.5% of total students in that class); 30 senior dental hygiene students completed the survey on perceptions of the simulation (78.9% response rate). Although the results did not show a significant increase in mean scores, the students reported feeling that the use of virtual patients was an effective teaching method to promote critical thinking, problem-solving, and confidence in the clinical realm. The results of this pilot study may have implications to support the use of virtual patient simulations in dental hygiene education. Future research could include a larger controlled study to validate findings from this study.

  15. Use of text messaging in general practice: a mixed methods investigation on GPs' and patients' views.

    Science.gov (United States)

    Leahy, Dorothy; Lyons, Aoife; Dahm, Matthias; Quinlan, Diarmuid; Bradley, Colin

    2017-11-01

    Text messaging has become more prevalent in general practice as a tool with which to communicate with patients. The main objectives were to assess the extent, growth, and perceived risks and benefits of text messaging by GPs to communicate with patients, and assess patients' attitudes towards receiving text messages from their GP. A mixed methods study, using surveys, a review, and a focus group, was conducted in both urban and rural practices in the south-west of Ireland. A telephone survey of 389 GPs was conducted to ascertain the prevalence of text messaging. Subsequently, the following were also carried out: additional telephone surveys with 25 GPs who use text messaging and 26 GPs who do not, a written satisfaction survey given to 78 patients, a review of the electronic information systems of five practices, and a focus group with six GPs to ascertain attitudes towards text messaging. In total, 38% ( n = 148) of the surveyed GPs used text messaging to communicate with patients and 62% ( n = 241) did not. Time management was identified as the key advantage of text messaging among GPs who used it (80%; n = 20) and those who did not (50%; n = 13). Confidentiality was reported as the principal concern among both groups, at 32% ( n = 8) and 69% ( n = 18) respectively. Most patients (99%; n = 77) were happy to receive text messages from their GP. The GP focus group identified similar issues and benefits in terms of confidentiality and time management. Data were extracted from the IT systems of five consenting practices and the number of text messages sent during the period from January 2013 to March 2016 was generated. This increased by 40% per annum. Collaborative efforts are required from relevant policymakers to address data protection and text messaging issues so that GPs can be provided with clear guidelines to protect patient confidentiality. © British Journal of General Practice 2017.

  16. Analysis of pharmacist-patient communication using the Roter Method of Interaction Process Analysis System.

    Science.gov (United States)

    Nakayama, Chika; Kimata, Shiori; Oshima, Taeyuki; Kato, Ayako; Nitta, Atsumi

    2016-01-01

    Effective communication between pharmacists and patients is a crucial factor in ensuring that medications are used properly. However, few studies have examined the contents of actual on-site communications between pharmacists and patients. To identify the characteristics of and problems with routine communications between pharmacists and patients using the Roter Method of Interaction Process Analysis System (RIAS). Conversations between pharmacists and simulated patients (SPs) were recorded and transcribed. Using the RIAS technique, their utterances were classified into 42 categories, and these were further divided into 11 clusters, such as open- and closed-ended questions, and analyzed. Furthermore, the influence that the different scenarios performed by the pharmacists may have had on the structure of their communication was investigated. All of the transcripts were double-coded by two certified coders. A total of 57 pharmacists took part in the study. The mean ratio of utterances made by SPs and pharmacists were 44% and 56%, respectively. The percentage of pharmacists' questions was more than double that of SPs' for both open- and closed-ended questions. In the influence that the different scenarios, the scenarios for patients with cancer was significantly higher ratio of utterances by the pharmacists. Pharmacists' communications tended to focus more on information-gathering activities that concentrated on closed-ended questions and frequent counseling, or directing utterances about the medication than on considering the patient's background. On the other hand, the pharmacists did communicate in ways that matched each patient's disease. This study identified the structure of pharmacists' on-site communications, and revealed the associated characteristics and problems. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A new method to evaluate patient characteristic response to ultrafiltration during hemodialysis.

    Science.gov (United States)

    Casagrande, G; Teatini, U; Romei Longhena, G; Miglietta, F; Fumero, R; Costantino, M L

    2007-05-01

    Several factors are involved in the pathogenesis of dialysis discomfort interfering with optimal fluid removal and reducing the efficacy of the treatment; the most important one is a decrease in blood volume caused by an imbalance between ultrafiltration (UF) and plasmarefilling (PR) rates. This study is aimed at devising a method to tailor the dialysis therapy to each individual patient, by analyzing the relationship between PR and UF during the sessions in stable patients and widening the knowledge of fluid exchanges during the treatment. Thirty stable patients undergoing maintenance hemodialysis were enrolled. Three dialysis sessions were monitored for each patient; systemic pressure, blood composition, blood volume % variation, weight loss and conductivity were recorded repeatedly. A Plasma Refilling Index (PRI), defined and calculated by means of parameters measured throughout the dialysis, was introduced as a novel instrument to study plasma refilling phenomena. Results. The PRI provides understanding of patient response (in terms of plasma refilling) to the set UF. In the monitored sessions, the PRI trend is found to be characteristic of each patient; a PRI course that is at variance with the characteristic trend is a signal of inadequate or unusual dialysis scheduling. Moreover, statistical analysis highlights two different PRI trends during the first hour and during the rest of the treatment, suggesting the presence of different treatment phases. The main advantage of the PRI index is that it is non-invasive peculiar to each patient and easy to compute in a dialysis routine based on online data recorded by the monitor. A deviation from the characteristic trend may be a warning for the clinician. The analysis of the PRI trend also suggests how to modulate UF as a function of interstitial to intravascular fluid removal balance during dialysis.

  18. Individualising Chronic Care Management by Analysing Patients' Needs - A Mixed Method Approach.

    Science.gov (United States)

    Timpel, P; Lang, C; Wens, J; Contel, J C; Gilis-Januszewska, A; Kemple, K; Schwarz, P E

    2017-11-13

    Modern health systems are increasingly faced with the challenge to provide effective, affordable and accessible health care for people with chronic conditions. As evidence on the specific unmet needs and their impact on health outcomes is limited, practical research is needed to tailor chronic care to individual needs of patients with diabetes. Qualitative approaches to describe professional and informal caregiving will support understanding the complexity of chronic care. Results are intended to provide practical recommendations to be used for systematic implementation of sustainable chronic care models. A mixed method study was conducted. A standardised survey (n = 92) of experts in chronic care using mail responses to open-ended questions was conducted to analyse existing chronic care programs focusing on effective, problematic and missing components. An expert workshop (n = 22) of professionals and scientists of a European funded research project MANAGE CARE was used to define a limited number of unmet needs and priorities of elderly patients with type 2 diabetes mellitus and comorbidities. This list was validated and ranked using a multilingual online survey (n = 650). Participants of the online survey included patients, health care professionals and other stakeholders from 56 countries. The survey indicated that current care models need to be improved in terms of financial support, case management and the consideration of social care. The expert workshop identified 150 patient needs which were summarised in 13 needs dimensions. The online survey of these pre-defined dimensions revealed that financial issues, education of both patients and professionals, availability of services as well as health promotion are the most important unmet needs for both patients and professionals. The study uncovered competing demands which are not limited to medical conditions. The findings emphasise that future care models need to focus stronger on individual patient needs and

  19. Patient preferences for the allocation of deceased donor kidneys for transplantation: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Tong Allison

    2012-04-01

    Full Text Available Abstract Background Deceased donor kidneys are a scarce health resource, yet patient preferences for organ allocation are largely unknown. The aim of this study was to determine patient preferences for how kidneys should be allocated for transplantation. Methods Patients on dialysis and kidney transplant recipients were purposively selected from two centres in Australia to participate in nominal/focus groups in March 2011. Participants identified and ranked criteria they considered important for deceased donor kidney allocation. Transcripts were thematically analysed to identify reasons for their rankings. Results From six groups involving 37 participants, 23 criteria emerged. Most agreed that matching, wait-list time, medical urgency, likelihood of surviving surgery, age, comorbidities, duration of illness, quality of life, number of organs needed and impact on the recipient's life circumstances were important considerations. Underpinning their rankings were four main themes: enhancing life, medical priority, recipient valuation, and deservingness. These were predominantly expressed as achieving equity for all patients, or priority for specific sub-groups of potential recipients regarded as more "deserving". Conclusions Patients believed any wait-listed individual who would gain life expectancy and quality of life compared with dialysis should have access to transplantation. Equity of access to transplantation for all patients and justice for those who would look after their transplant were considered important. A utilitarian rationale based on maximizing health gains from the allocation of a scarce resource to avoid "wastage," were rarely expressed. Organ allocation organisations need to seek input from patients who can articulate preferences for allocation and advocate for equity and justice in organ allocation.

  20. Carbon footprint of patient journeys through primary care: a mixed methods approach.

    Science.gov (United States)

    Andrews, Elizabeth; Pearson, David; Kelly, Charlotte; Stroud, Laura; Rivas Perez, Martin

    2013-09-01

    The NHS has a target of cutting its carbon dioxide (CO2) emissions by 80% below 1990 levels by 2050. Travel comprises 17% of the NHS carbon footprint. This carbon footprint represents the total CO2 emissions caused directly or indirectly by the NHS. Patient journeys have previously been planned largely without regard to the environmental impact. The potential contribution of 'avoidable' journeys in primary care is significant. To investigate the carbon footprint of patients travelling to and from a general practice surgery, the issues involved, and potential solutions for reducing patient travel. A mixed methods study in a medium-sized practice in Yorkshire. During March 2012, 306 patients completed a travel survey. GIS maps of patients' travel (modes and distances) were produced. Two focus groups (12 clinical and 13 non-clinical staff) were recorded, transcribed, and analysed using a thematic framework approach. The majority (61%) of patient journeys to and from the surgery were made by car or taxi; main reasons cited were 'convenience', 'time saving', and 'no alternative' for accessing the surgery. Using distances calculated via ArcGIS, the annual estimated CO2 equivalent carbon emissions for the practice totalled approximately 63 tonnes. Predominant themes from interviews related to issues with systems for booking appointments and repeat prescriptions; alternative travel modes; delivering health care; and solutions to reducing travel. The modes and distances of patient travel can be accurately determined and allow appropriate carbon emission calculations for GP practices. Although challenging, there is scope for identifying potential solutions (for example, modifying administration systems and promoting walking) to reduce 'avoidable' journeys and cut carbon emissions while maintaining access to health care.

  1. Pharmacokinetic-pharmacodynamic correlation of imipenem in pediatric burn patients using a bioanalytical liquid chromatographic method

    Directory of Open Access Journals (Sweden)

    Silvia Regina Cavani Jorge Santos

    2015-06-01

    Full Text Available A bioanalytical method was developed and applied to quantify the free imipenem concentrations for pharmacokinetics and PK/PD correlation studies of the dose adjustments required to maintain antimicrobial effectiveness in pediatric burn patients. A reverse-phase Supelcosil LC18 column (250 x 4.6 mm 5 micra, binary mobile phase consisting of 0.01 M, pH 7.0 phosphate buffer and acetonitrile (99:1, v/v, flow rate of 0.8 mL/min, was applied. The method showed good absolute recovery (above 90%, good linearity (0.25-100.0 µg/mL, r2=0.999, good sensitivity (LLOQ: 0.25 µg/mL; LLOD: 0.12 µg/mL and acceptable stability. Inter/intraday precision values were 7.3/5.9%, and mean accuracy was 92.9%. A bioanalytical method was applied to quantify free drug concentrations in children with burns. Six pediatric burn patients (median 7.0 years old, 27.5 kg, normal renal function, and 33% total burn surface area were prospectively investigated; inhalation injuries were present in 4/6 (67% of the patients. Plasma monitoring and PK assessments were performed using a serial blood sample collection for each set, totaling 10 sets. The PK/PD target attained (40%T>MIC for each minimum inhibitory concentration (MIC: 0.5, 1.0, 2.0, 4.0 mg/L occurred at a percentage higher than 80% of the sets investigated and 100% after dose adjustment. In conclusion, the purification of plasma samples using an ultrafiltration technique followed by quantification of imipenem plasma measurements using the LC method is quite simple, useful, and requires small volumes for blood sampling. In addition, a small amount of plasma (0.25 mL is needed to guarantee drug effectiveness in pediatric burn patients. There is also a low risk of neurotoxicity, which is important because pharmacokinetics are unpredictable in these critical patients with severe hospital infection. Finally, the PK/PD target was attained for imipenem in the control of sepsis in pediatric patients with burns.

  2. How often do patients in primary care use the methods of traditional medicine

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    Petrov-Kiurski Miloranka

    2014-01-01

    Full Text Available Introduction: Traditional medicine is a comprehensive system of theory and practice, implemented in the prevention, diagnostics and treatment of diseases, which utilizes preparations of vegetable, animal and mineral origin, as well as methods of spiritual therapy Objective: 1. To estimate how many patients in primary care use traditional medicine for diagnostics, treatment and prevention of diseases, and to establish possible differences regarding gender, age and urban or rural location. 2. What methods of traditional medicine are the most often used, and for which diseases and conditions? 3. Why did the subjects opted for this type of treatment, and what was the effect of the therapy? Method: Multicentric research based on interviewing patients in five outpatient health centers in Serbia. As a survey instrument was used a questionnaire with 10 questions. Results: The study included 1157 subjects, 683 women and 474 men, mean age 60.22±14.54, The traditional medicine was used by 83.66% (79.96% males and 86.245% females. Information about the methods of traditional medicine subjects usually received from their friends and acquaintances (54.9% and the media (39.3%. There is no significant difference in the way of obtaining information in relation to gender. Information on the internet was obtained more often in subjects younger than 65 (p=0.000 and in urban population (p=0.000. The same is true for information obtained from doctor or pharmacist (p=0.003. They opted for this method because in their opinion it is less harmful and have less adverse effects (72.8%. This type of treatment patients used for treatment of muscles, bone and joint diseases - 28.5%, diseases of the heart and blood vessels -21,1 %, and for the treatment of pain 19.7%. Patients from rural areas more often used traditional medicine for treatment of cardiovascular diseases (p=0.000. Outcome of treatment was good or satisfactory in 45.3%, moderate in 32%, and in 15.8% effect was

  3. Effect of the carbohydrate counting method on glycemic control in patients with type 1 diabetes

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    Dias Viviane M

    2010-08-01

    Full Text Available Abstract Background The importance of achieving and maintaining an appropriate metabolic control in patients with type 1 diabetes mellitus (DM1 has been established in many studies aiming to prevent the development of chronic complications. The carbohydrate counting method can be recommended as an additional tool in the nutritional treatment of diabetes, allowing patients with DM1 to have more flexible food choices. This study aimed to evaluate the influence of nutrition intervention and the use of multiple short-acting insulin according to the carbohydrate counting method on clinical and metabolic control in patients with DM1. Methods Our sample consisted of 51 patients with DM1, 32 females, aged 25.3 ± 1.55 years. A protocol of nutritional status evaluation was applied and laboratory analysis was performed at baseline and after a three-month intervention. After the analysis of the food records, a balanced diet was prescribed using the carbohydrate counting method, and short-acting insulin was prescribed based on the total amount of carbohydrate per meal (1 unit per 15 g of carbohydrate. Results A significant decrease in A1c levels was observed from baseline to the three-month evaluation after the intervention (10.40 ± 0.33% and 9.52 ± 0.32%, respectively, p = 0.000. It was observed an increase in daily insulin dose after the intervention (0.99 ± 0.65 IU/Kg and 1.05 ± 0.05 IU/Kg, respectively, p = 0.003. No significant differences were found regarding anthropometric evaluation (BMI, waist, hip or abdominal circumferences and waist to hip ratio after the intervention period. Conclusions The use of short-acting insulin based on the carbohydrate counting method after a short period of time resulted in a significant improvement of the glycemic control in patients with DM1 with no changes in body weight despite increases in the total daily insulin doses.

  4. Communicating patient-reported outcome scores using graphic formats: results from a mixed-methods evaluation.

    Science.gov (United States)

    Brundage, Michael D; Smith, Katherine C; Little, Emily A; Bantug, Elissa T; Snyder, Claire F

    2015-10-01

    Patient-reported outcomes (PROs) promote patient-centered care by using PRO research results ("group-level data") to inform decision making and by monitoring individual patient's PROs ("individual-level data") to inform care. We investigated the interpretability of current PRO data presentation formats. This cross-sectional mixed-methods study randomized purposively sampled cancer patients and clinicians to evaluate six group-data or four individual-data formats. A self-directed exercise assessed participants' interpretation accuracy and ratings of ease-of-understanding and usefulness (0 = least to 10 = most) of each format. Semi-structured qualitative interviews explored helpful and confusing format attributes. We reached thematic saturation with 50 patients (44 % < college graduate) and 20 clinicians. For group-level data, patients rated simple line graphs highest for ease-of-understanding and usefulness (median 8.0; 33 % selected for easiest to understand/most useful) and clinicians rated simple line graphs highest for ease-of-understanding and usefulness (median 9.0, 8.5) but most often selected line graphs with confidence limits or norms (30 % for each format for easiest to understand/most useful). Qualitative results support that clinicians value confidence intervals, norms, and p values, but patients find them confusing. For individual-level data, both patients and clinicians rated line graphs highest for ease-of-understanding (median 8.0 patients, 8.5 clinicians) and usefulness (median 8.0, 9.0) and selected them as easiest to understand (50, 70 %) and most useful (62, 80 %). The qualitative interviews supported highlighting scores requiring clinical attention and providing reference values. This study has identified preferences and opportunities for improving on current formats for PRO presentation and will inform development of best practices for PRO presentation. Both patients and clinicians prefer line graphs across group-level data and individual

  5. Comparison of diagnostic methods to detect Histoplasma capsulatum in serum and blood samples from AIDS patients

    Science.gov (United States)

    da Silva, Marcos Vinicius; Criado, Paulo Ricardo; Luiz, Olinda do Carmo; Vicentini, Adriana Pardini

    2018-01-01

    Background Although early and rapid detection of histoplasmosis is essential to prevent morbidity and mortality, few diagnostic tools are available in resource-limited areas, especially where it is endemic and HIV/AIDS is also epidemic. Thus, we compared conventional and molecular methods to detect Histoplasma capsulatum in sera and blood from HIV/AIDS patients. Methodology We collected a total of 40 samples from control volunteers and patients suspected of histoplasmosis, some of whom were also infected with other pathogens. Samples were then analyzed by mycological, serological, and molecular methods, and stratified as histoplasmostic with (group I) or without AIDS (group II), uninfected (group III), and infected with HIV and other pathogens only (group IV). All patients were receiving treatment for histoplasmosis and other infections at the time of sample collection. Results Comparison of conventional methods with nested PCR using primers against H. capsulatum 18S rRNA (HC18S), 5.8S rRNA ITS (HC5.8S-ITS), and a 100 kDa protein (HC100) revealed that sensitivity against sera was highest for PCR with HC5.8S-ITS, followed by immunoblotting, double immunodiffusion, PCR with HC18S, and PCR with HC100. Specificity was equally high for double immunodiffusion, immunoblotting and PCR with HC100, followed for PCR with HC18S and HC5.8-ITS. Against blood, sensitivity was highest for PCR with HC5.8S-ITS, followed by PCR with HC18S, Giemsa staining, and PCR with HC100. Specificity was highest for Giemsa staining and PCR with HC100, followed by PCR with HC18S and HC5.8S-ITS. PCR was less efficient in patients with immunodeficiency due to HIV/AIDS and/or related diseases. Conclusion Molecular techniques may detect histoplasmosis even in cases with negative serology and mycology, potentially enabling early diagnosis. PMID:29342162

  6. Comparison of diagnostic methods to detect Histoplasma capsulatum in serum and blood samples from AIDS patients.

    Directory of Open Access Journals (Sweden)

    Katia Cristina Dantas

    Full Text Available Although early and rapid detection of histoplasmosis is essential to prevent morbidity and mortality, few diagnostic tools are available in resource-limited areas, especially where it is endemic and HIV/AIDS is also epidemic. Thus, we compared conventional and molecular methods to detect Histoplasma capsulatum in sera and blood from HIV/AIDS patients.We collected a total of 40 samples from control volunteers and patients suspected of histoplasmosis, some of whom were also infected with other pathogens. Samples were then analyzed by mycological, serological, and molecular methods, and stratified as histoplasmostic with (group I or without AIDS (group II, uninfected (group III, and infected with HIV and other pathogens only (group IV. All patients were receiving treatment for histoplasmosis and other infections at the time of sample collection.Comparison of conventional methods with nested PCR using primers against H. capsulatum 18S rRNA (HC18S, 5.8S rRNA ITS (HC5.8S-ITS, and a 100 kDa protein (HC100 revealed that sensitivity against sera was highest for PCR with HC5.8S-ITS, followed by immunoblotting, double immunodiffusion, PCR with HC18S, and PCR with HC100. Specificity was equally high for double immunodiffusion, immunoblotting and PCR with HC100, followed for PCR with HC18S and HC5.8-ITS. Against blood, sensitivity was highest for PCR with HC5.8S-ITS, followed by PCR with HC18S, Giemsa staining, and PCR with HC100. Specificity was highest for Giemsa staining and PCR with HC100, followed by PCR with HC18S and HC5.8S-ITS. PCR was less efficient in patients with immunodeficiency due to HIV/AIDS and/or related diseases.Molecular techniques may detect histoplasmosis even in cases with negative serology and mycology, potentially enabling early diagnosis.

  7. Black patients with binge-eating disorder: Comparison of different assessment methods.

    Science.gov (United States)

    Lydecker, Janet A; White, Marney A; Grilo, Carlos M

    2016-10-01

    The Eating Disorder Examination (EDE) is a well-established assessment instrument, but requires substantial training and administration time. The Eating Disorder Examination Questionnaire (EDE-Q) is the corresponding self-report survey, which does not have these demands. Research has shown concordance between these 2 assessment methods, but samples have lacked racial diversity. The current study examined the concordance of the EDE-Q and EDE in a sample of Black patients with binge-eating disorder (BED) and a matched sample of White patients. Participants were 238 (Black n = 119, White n = 119) treatment-seeking adults with DSM-IV-TR-defined BED. Participants completed the EDE-Q, and trained doctoral-level clinicians assessed participants for BED and eating-disorder psychopathology using the Structured Clinical Interview for DSM-IV Disorders and the Eating Disorder Examination (EDE) interview. The EDE-Q and EDE yielded significantly correlated frequencies of binge eating and eating-disorder psychopathology subscales. The EDE-Q yielded significantly lower frequencies of binge eating and higher scores on 3 of 4 subscales (not dietary restraint). Similar patterns of concordance between the EDE-Q and EDE were found for an alternative brief version of the instruments. Patterns of convergence and divergence between the EDE-Q and EDE observed in Black patients with BED are generally consistent with findings derived from the matched White sample: overall, scores are correlated but higher on the self-report compared with interview assessment methods. Clinicians assessing patients with BED should be aware of this overall pattern, and be aware that this pattern is similar in Black patients with BED with the notable exception of dietary restraint. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. The Armed Forces Epidemiological Board: Its First Fifty Years, 1940-1990

    Science.gov (United States)

    1990-02-01

    measles; (9 mumps; (g) diphtheria and tetanus toxoids; (I) enteric infections such as bacillary dysentery, Shigella, Sahnonella typhosa, Vibrio cholerae ...pestis that followed the kissing of the dead. Once he remarked that a patient in New Mexico did not die of plague but of "too many antibiotics." Another...interests shifted to hog cholera and the f’eld of virology. This interest continued for the next thirty-eight y’ears. A key obs,’.%ation (with Dr. Paul

  9. A Novel Classification Method for Syndrome Differentiation of Patients with AIDS

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    Yufeng Zhao

    2015-01-01

    Full Text Available We consider the analysis of an AIDS dataset where each patient is characterized by a list of symptoms and is labeled with one or more TCM syndromes. The task is to build a classifier that maps symptoms to TCM syndromes. We use the minimum reference set-based multiple instance learning (MRS-MIL method. The method identifies a list of representative symptoms for each syndrome and builds a Gaussian mixture model based on them. The models for all syndromes are then used for classification via Bayes rule. By relying on a subset of key symptoms for classification, MRS-MIL can produce reliable and high quality classification rules even on datasets with small sample size. On the AIDS dataset, it achieves average precision and recall 0.7736 and 0.7111, respectively. Those are superior to results achieved by alternative methods.

  10. Research methods to change clinical practice for patients with rare cancers.

    Science.gov (United States)

    Billingham, Lucinda; Malottki, Kinga; Steven, Neil

    2016-02-01

    Rare cancers are a growing group as a result of reclassification of common cancers by molecular markers. There is therefore an increasing need to identify methods to assess interventions that are sufficiently robust to potentially affect clinical practice in this setting. Methods advocated for clinical trials in rare diseases are not necessarily applicable in rare cancers. This Series paper describes research methods that are relevant for rare cancers in relation to the range of incidence levels. Strategies that maximise recruitment, minimise sample size, or maximise the usefulness of the evidence could enable the application of conventional clinical trial design to rare cancer populations. Alternative designs that address specific challenges for rare cancers with the aim of potentially changing clinical practice include Bayesian designs, uncontrolled n-of-1 trials, and umbrella and basket trials. Pragmatic solutions must be sought to enable some level of evidence-based health care for patients with rare cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Acute Pain Perception During Different Sampling Methods for Respiratory Culture in Cystic Fibrosis Patients.

    Science.gov (United States)

    Eyns, Hanneke; De Wachter, Elke; Malfroot, Anne; Vaes, Peter

    2018-03-01

    Reliable identification of lower respiratory tract pathogens is crucial in the management of cystic fibrosis (CF). The multitude of treatments and clinical procedures are a considerable burden and are potentially provoking pain. As part of another study (NCT02363764), investigating the bacterial yield of three sampling methods, nasal swabs (NSs), cough swabs (CSs), and (induced) sputum samples ([I]SSs), in both expectorating patients (EPs) and non-expectorating patients (NEPs) with CF, the present study aimed to explore the prevalence of respiratory culture sampling-related pain as assessed by self-report within a cohort of children and adults. Literate patients with CF (aged six years or older) completed a questionnaire on pain perception related to the three aforementioned sampling methods (No/Yes; visual analogue scale for pain [VAS-Pain] [0-10 cm]). In addition, patients were asked to rank these methods by their own preference without taking into account the presumed bacterial yield. In total, 119 questionnaires were returned. In the EPs-group, CS was most frequently (n%; mean VAS-Pain if pain [range]) reported as painful method: overall (n = 101; 12.9%; 1.8 [0.2-4.8]), children (n = 41; 22.0%; 1.4 [0.2-2.7]), and adults (n = 60; 6.7%; 2.5 [0.5-4.8]). Highest pain intensity scores were observed with NS overall (3.0%; 2.4 [0.3-6.2]) and in children (4.9%; 3.3 [0.3-6.2]), but not in adults (1.7%; 0.6 [-]).NEPs-children (n = 17) reported ISS most frequently and as most painful sampling method (17.6%; 2.0 [1.0-4.0]). The only NEP-adult did not perceive pain. NEPs preferred NS > CS > ISS (61.1%, 33.3%, 5.6%, respectively [P = 0.001]) as primary sampling method, whereas EPs preferred SS > NS > CS (65.7%, 26.3%, 8.1%, respectively [P method inversely correlated to pain perception and intensity in EPs (φ = -0.155 [P = 0.007] and ρ = -0.926 [P = 0.008], respectively), but not in NEPs (φ = -0.226 [P = 0.097] and ρ = -0.135 [P = 0

  12. Comparison between MRI-based attenuation correction methods for brain PET in dementia patients

    International Nuclear Information System (INIS)

    Cabello, Jorge; Lukas, Mathias; Pyka, Thomas; Nekolla, Stephan G.; Ziegler, Sibylle I.; Rota Kops, Elena; Shah, N. Jon; Ribeiro, Andre; Yakushev, Igor

    2016-01-01

    The combination of Positron Emission Tomography (PET) with magnetic resonance imaging (MRI) in hybrid PET/MRI scanners offers a number of advantages in investigating brain structure and function. A critical step of PET data reconstruction is attenuation correction (AC). Accounting for bone in attenuation maps (μ-map) was shown to be important in brain PET studies. While there are a number of MRI-based AC methods, no systematic comparison between them has been performed so far. The aim of this work was to study the different performance obtained by some of the recent methods presented in the literature. To perform such a comparison, we focused on [ 18 F]-Fluorodeoxyglucose-PET/MRI neurodegenerative dementing disorders, which are known to exhibit reduced levels of glucose metabolism in certain brain regions. Four novel methods were used to calculate μ-maps from MRI data of 15 patients with Alzheimer's dementia (AD). The methods cover two atlas-based methods, a segmentation method, and a hybrid template/segmentation method. Additionally, the Dixon-based and a UTE-based method, offered by a vendor, were included in the comparison. Performance was assessed at three levels: tissue identification accuracy in the μ-map, quantitative accuracy of reconstructed PET data in specific brain regions, and precision in diagnostic images at identifying hypometabolic areas. Quantitative regional errors of -20-10 % were obtained using the vendor's AC methods, whereas the novel methods produced errors in a margin of ±5 %. The obtained precision at identifying areas with abnormally low levels of glucose uptake, potentially regions affected by AD, were 62.9 and 79.5 % for the two vendor AC methods, the former ignoring bone and the latter including bone information. The precision increased to 87.5-93.3 % in average for the four new methods, exhibiting similar performances. We confirm that the AC methods based on the Dixon and UTE sequences provided by the vendor are inferior

  13. Comparison between MRI-based attenuation correction methods for brain PET in dementia patients

    Energy Technology Data Exchange (ETDEWEB)

    Cabello, Jorge; Lukas, Mathias; Pyka, Thomas; Nekolla, Stephan G.; Ziegler, Sibylle I. [Technische Universitaet Muenchen, Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Munich (Germany); Rota Kops, Elena; Shah, N. Jon [Forschungszentrum Juelich GmbH, Institute of Neuroscience and Medicine 4, Medical Imaging Physics, Juelich (Germany); Ribeiro, Andre [Forschungszentrum Juelich GmbH, Institute of Neuroscience and Medicine 4, Medical Imaging Physics, Juelich (Germany); Institute of Biophysics and Biomedical Engineering, Lisbon (Portugal); Yakushev, Igor [Technische Universitaet Muenchen, Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Munich (Germany); Institute TUM Neuroimaging Center (TUM-NIC), Munich (Germany)

    2016-11-15

    The combination of Positron Emission Tomography (PET) with magnetic resonance imaging (MRI) in hybrid PET/MRI scanners offers a number of advantages in investigating brain structure and function. A critical step of PET data reconstruction is attenuation correction (AC). Accounting for bone in attenuation maps (μ-map) was shown to be important in brain PET studies. While there are a number of MRI-based AC methods, no systematic comparison between them has been performed so far. The aim of this work was to study the different performance obtained by some of the recent methods presented in the literature. To perform such a comparison, we focused on [{sup 18}F]-Fluorodeoxyglucose-PET/MRI neurodegenerative dementing disorders, which are known to exhibit reduced levels of glucose metabolism in certain brain regions. Four novel methods were used to calculate μ-maps from MRI data of 15 patients with Alzheimer's dementia (AD). The methods cover two atlas-based methods, a segmentation method, and a hybrid template/segmentation method. Additionally, the Dixon-based and a UTE-based method, offered by a vendor, were included in the comparison. Performance was assessed at three levels: tissue identification accuracy in the μ-map, quantitative accuracy of reconstructed PET data in specific brain regions, and precision in diagnostic images at identifying hypometabolic areas. Quantitative regional errors of -20-10 % were obtained using the vendor's AC methods, whereas the novel methods produced errors in a margin of ±5 %. The obtained precision at identifying areas with abnormally low levels of glucose uptake, potentially regions affected by AD, were 62.9 and 79.5 % for the two vendor AC methods, the former ignoring bone and the latter including bone information. The precision increased to 87.5-93.3 % in average for the four new methods, exhibiting similar performances. We confirm that the AC methods based on the Dixon and UTE sequences provided by the vendor are

  14. Effectiveness of pelvic floor muscle training on symptoms and uroflowmetry parameters in female patients with overactive bladder

    OpenAIRE

    KULAKSIZOĞLU, HALUK; AKAND, MURAT; ÇAKMAKÇI, EVRİM; GÜL, MURAT; SEÇKİN, BEDREDDİN

    2015-01-01

    Background/aim: To evaluate the effects of pelvic floor muscle training (PFMT) on symptoms of overactive bladder (OAB) as well as uroflowmetry parameters and functional bladder capacity. Materials and methods: Fifty-nine female patients with OAB symptoms were included. Patients were assessed by SEAPI-QMM, uroflowmetry, and abdominal ultrasound. A specially designed PFMT program using a Pilates ball was generated for patients. The training period was 1-h sessions twice a week for 6 weeks and ...

  15. Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study

    OpenAIRE

    Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

    2014-01-01

    Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty...

  16. Effects of the bilateral isokinetic strengthening training on functional parameters, gait, and the quality of life in patients with stroke

    OpenAIRE

    Büyükvural Şen, Sıdıka; Özbudak Demir, Sibel; Ekiz, Timur; Özgirgin, Neşe

    2015-01-01

    Objective: To evaluate the effects of the bilateral isokinetic strengthening training applied to knee and ankle muscles on balance, functional parameters, gait, and the quality of in stroke patients. Methods: Fifty patients (33 M, 17 F) with subacute-chronic stroke and 30 healthy subjects were included. Stroke patients were allocated into isokinetic and control groups. Conventional rehabilitation program was applied to all cases; additionally maximal concentric isokinetic strengthening traini...

  17. Comparative study of patient doses calculated with two methods for breast digital tomosynthesis

    International Nuclear Information System (INIS)

    Castillo, M.; Chevalier, M.; Calzado, A.; Garayo, J.; Valverde, J.

    2015-01-01

    In this study, the average glandular doses (DG) delivered in breast tomosynthesis examinations were estimated over a sample of 150 patients using two different methods. In method 1, the conversion factors air-kerma to DG used were those tabulated by Dance et al. and in method 2 were the ones from Feng et al. The protocol for the examination followed in the unit of this study consists in two views per breast, each view composed by a 2D acquisition and a tomosynthesis scan (3D). The resulting DG values from both methods present statistically significant differences (p=0.02) for the 2D modality and were similar for the 3D scan (p=0.22). The estimated median value of DG for the most frequent breasts (thicknesses between 50 and 60 mm) delivered in a single 3D acquisition is 1.7 mGy (36% and 17% higher than the value for the 2D mode estimated with each method) which lies far below the tolerances established by the Spanish Protocol Quality Control in Radiodiagnostic (2011). The total DG for a tomosynthesis examination (6.0 mGy) is a factor 2.4 higher than the dose delivered in a 2D examination with two views (method 1). (Author)

  18. Prevalence of periodontopathogenic bacteria in patients suffering from periodontitis using culture and PCR methods

    Directory of Open Access Journals (Sweden)

    Amir Aliramezani

    2012-01-01

    Full Text Available Background and Aims: Periodontitis is one of the most common oral diseases with the various incidence rates in different populations. A number of bacteria are considered as the major etiologic agents of periodontitis. The aim of the present study was to determine the prevalence of periodontopathogen bacteria in patients using both PCR and culture techniques.Materials and Methods: In this study, one-hundred patients (including 62 females and 38 males with an average age of 49±11.5 years with adult periodontitis referred to periodontics department of School of Dentistry/Tehran University of Medical Sciences were investigated. The samples were taken and sent immediately to the laboratory for culture and molecular evaluation. The PCR was performed using specific primers and the statistical analysis of data was performed using SPSS statistic software and McNemar test.Results: The results demonstrated that the total detection rate in culture method was 64%. The rate of Aggregatibacter actinomycetemcomitans (Aa was 28% which was significantly higher than that of Porphyromonas gingivalis (Pg (6% and Prevotella intermedia (Pi (3%. 27% of cases showed mixed bacterial growth. 65% of patients were positive using molecular method. The rate of Aa (30% was significantly higher than that of Pg (7% and Pi (5%. The mixed PCR positive rate containing of Aa, Pg and Pi was (23%.Conclusion: In this study, it was found that most of the bacteria isolated using culture and molecular methods were Aa, Pg and Pi, respectively. Although the detection frequencies of both techniques were similar, the specificity, sensitivity and bacterial detection speed of the PCR technique is obviously higher. Therefore, the use of molecular techniques is strongly recommended. However, both techniques seem to be suitable for microbiological diagnostics.

  19. Fifty years of Fanger's equation: Is there anything to discover yet?

    DEFF Research Database (Denmark)

    d'Ambrosio Alfano, Francesca Romana; Palella, Boris Igor; Riccio, Giuseppe

    2018-01-01

    This short communication to the Editor is completely devoted to a recent paper published by Broday et al. (2017) in which a comparative analysis of methods for determining the clothing surface temperature is reported. Contrarily to what our colleagues have found, we will demonstrate that the algo......This short communication to the Editor is completely devoted to a recent paper published by Broday et al. (2017) in which a comparative analysis of methods for determining the clothing surface temperature is reported. Contrarily to what our colleagues have found, we will demonstrate...

  20. Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications

    Directory of Open Access Journals (Sweden)

    Ana Cláudia Soncini Sanches

    Full Text Available Summary Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC, various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight. Currently, IC is considered the gold standard.

  1. A novel method to correct for pitch and yaw patient setup errors in helical tomotherapy

    International Nuclear Information System (INIS)

    Boswell, Sarah A.; Jeraj, Robert; Ruchala, Kenneth J.; Olivera, Gustavo H.; Jaradat, Hazim A.; James, Joshua A.; Gutierrez, Alonso; Pearson, Dave; Frank, Gary; Mackie, T. Rock

    2005-01-01

    An accurate means of determining and correcting for daily patient setup errors is important to the cancer outcome in radiotherapy. While many tools have been developed to detect setup errors, difficulty may arise in accurately adjusting the patient to account for the rotational error components. A novel, automated method to correct for rotational patient setup errors in helical tomotherapy is proposed for a treatment couch that is restricted to motion along translational axes. In tomotherapy, only a narrow superior/inferior section of the target receives a dose at any instant, thus rotations in the sagittal and coronal planes may be approximately corrected for by very slow continuous couch motion in a direction perpendicular to the scanning direction. Results from proof-of-principle tests indicate that the method improves the accuracy of treatment delivery, especially for long and narrow targets. Rotational corrections about an axis perpendicular to the transverse plane continue to be implemented easily in tomotherapy by adjustment of the initial gantry angle

  2. Religiousness, religious coping methods and distress level among psychiatric patients in Malaysia.

    Science.gov (United States)

    Nurasikin, M S; Khatijah, L A; Aini, A; Ramli, M; Aida, S A; Zainal, N Z; Ng, C G

    2013-06-01

    Patients having psychiatric diagnoses often experience high level of distress. Religiousness is often used by them as part of their coping mechanism and problem-solving strategies. To determine the level of religious commitment and coping methods in psychiatric patients and its relationship with distress level. Religious commitment and coping patterns were measured with the Duke University Religious Index (DUREL) and Brief RCOPE, respectively. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS) and distress level was assessed with the Depressive, Anxiety and Stress Scale (DASS). Social support and experiences of recent threatening events were measured with the Multidimensional Scale of Perceived Social Support (MSPSS) and Life Threatening Events (LTE). A total of 228 patients were included in this study with a mean age of 40.2 years. The majority were male, Malay, Muslim, single and with psychotic disorder. The subjects had a high level of religious commitment and had used more positive coping methods. Negative religious coping, psychiatric symptoms and diagnosis of anxiety disorder or major depression were significantly associated with high distress level. Higher religious commitment was significantly associated with lower distress (p depression were associated with higher distress.

  3. Patients' views on changes in doctor-patient communication between 1982 and 2001 : a mixed-methods study

    NARCIS (Netherlands)

    Butalid, Ligaya; Verhaak, Peter F. M.; Boeije, Hennie R.; Bensing, Jozien M.

    2012-01-01

    Background: Doctor-patient communication has been influenced over time by factors such as the rise of evidence-based medicine and a growing emphasis on patient-centred care. Despite disputes in the literature on the tension between evidence-based medicine and patient-centered medicine, patients'

  4. How do patients come to be seen as 'difficult'?: a mixed-methods study in community mental health care

    NARCIS (Netherlands)

    Koekkoek, B.; Hutschemaekers, G.; van Meijel, B.; Schene, A.

    2011-01-01

    Across all health care settings, certain patients are perceived as 'difficult' by clinicians. This paper's aim is to understand how certain patients come to be perceived and labelled as 'difficult' patients in community mental health care, through mixed-methods research in The Netherlands between

  5. Theory-informed design of values clarification methods : A cognitive psychological perspective on patient health-related decision making

    NARCIS (Netherlands)

    Pieterse, A.H.; de Vries, M.; Kunneman, M.; Stiggelbout, A.M.; Feldman-Stewart, D.

    2013-01-01

    Healthcare decisions, particularly those involving weighing benefits and harms that may significantly affect quality and/or length of life, should reflect patients' preferences. To support patients in making choices, patient decision aids and values clarification methods (VCM) in particular have

  6. Development of generic quality indicators for patient-centered cancer care by using a RAND modified Delphi method

    NARCIS (Netherlands)

    Uphoff, Eleonora P. M. M.; Wennekes, Lianne; Punt, Cornelis J. A.; Grol, Richard P. T. M.; Wollersheim, Hub C. H.; Hermens, Rosella P. M. G.; Ottevanger, Petronella B.

    2012-01-01

    Despite growing attention to patient-centered care, the needs of cancer patients are not always met. Using a RAND modified Delphi method, this study aimed to systematically develop evidence-based indicators, to be used to measure the quality of patient-centered cancer care as a first step toward

  7. An improved method for sacro-iliac joint imaging: a study of normal subjects, patients with sacro-iliitis and patients with low back pain

    International Nuclear Information System (INIS)

    Ayres, J.; Hilson, A.J.W.; Maisey, M.N.; Laurent, R.; Panayi, G.S.; Saunders, A.J.

    1981-01-01

    A new method is described for quantitative measurement of the uptake of sup(99m)Tc-methylene diphosphonate (MDP) by the sacro-iliac joints. The method uses 'regions of interest' providing advantages over the previously described 'slice' method; the two methods are compared in normal subjects, patients with known sacro-iliitis and patients with low back pain. Sacro-iliac activity, as calculated by the sacro-iliac index (SII) in normal patients, was shown to decrease with age in females but not in males. The SII was compared with radiographs of the sacro-iliac joints in the patients with known sacro-iliac joint disease and in those with low back pain. The method is useful for the exclusion of sacro-iliitis as a specific cause of back pain. (author)

  8. Internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis

    NARCIS (Netherlands)

    Steultjens, M. P.; Dekker, J.; van Baar, M. E.; Oostendorp, R. A.; Bijlsma, J. W.

    1999-01-01

    To establish the internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis (OA). Data were obtained from 198 patients with OA of the hip or knee. Results of the observational method were compared with results of self-report

  9. A Pictorial History of the Drury College Student: The First Fifty Years

    Science.gov (United States)

    Maddux, Mindy

    2011-01-01

    Established in 1873, Drury College in Springfield, Missouri, provided a unique experience for their undergraduate students. A limited amount of research has been conducted on the institution but no work has been done to specifically look at the undergraduate student experience. Using archival research methods and information from literature on…

  10. Modeling of tube current modulation methods in computed tomography dose calculations for adult and pregnant patients

    International Nuclear Information System (INIS)

    Caracappa, Peter F.; Xu, X. George; Gu, Jianwei

    2011-01-01

    The comparatively high dose and increasing frequency of computed tomography (CT) examinations have spurred the development of techniques for reducing radiation dose to imaging patients. Among these is the application of tube current modulation (TCM), which can be applied either longitudinally along the body or rotationally along the body, or both. Existing computational models for calculating dose from CT examinations do not include TCM techniques. Dose calculations using Monte Carlo methods have been previously prepared for constant-current rotational exposures at various positions along the body and for the principle exposure projections for several sets of computational phantoms, including adult male and female and pregnant patients. Dose calculations from CT scans with TCM are prepared by appropriately weighting the existing dose data. Longitudinal TCM doses can be obtained by weighting the dose at the z-axis scan position by the relative tube current at that position. Rotational TCM doses are weighted using the relative organ doses from the principle projections as a function of the current at the rotational angle. Significant dose reductions of 15% to 25% to fetal tissues are found from simulations of longitudinal TCM schemes to pregnant patients of different gestational ages. Weighting factors for each organ in rotational TCM schemes applied to adult male and female patients have also been found. As the application of TCM techniques becomes more prevalent, the need for including TCM in CT dose estimates will necessarily increase. (author)

  11. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients.

    Science.gov (United States)

    Ciesla, Nancy; Dinglas, Victor; Fan, Eddy; Kho, Michelle; Kuramoto, Jill; Needham, Dale

    2011-04-12

    Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, and persistent nerve and muscle impairments after hospital discharge. Using an explicit protocol with a structured approach to training and quality assurance of research staff, manual muscle testing (MMT) is a highly reliable method for assessing strength, using a standardized clinical examination, for patients following ARDS, and can be completed with mechanically ventilated patients who can tolerate sitting upright in bed and are able to follow two-step commands. (7, 8) This video demonstrates a protocol for MMT, which has been taught to ≥ 43 research staff who have performed >800 assessments on >280 ARDS survivors. Modifications for the bedridden patient are included. Each muscle is tested with specific techniques for positioning, stabilization, resistance, and palpation for each score of the 6-point ordinal Medical Research Council scale. Three upper and three lower extremity muscles are graded in this protocol: shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion. These muscles were chosen based on the standard approach for evaluating patients for ICU-acquired weakness used in prior publications. (1,2).

  12. Development of diagnostic RI test method for antiglutamic acid decarboxylase (GAD) in SMS and IDDM patients

    International Nuclear Information System (INIS)

    Ota, Mitsuhiro; Ota, Kiyoe; Nishimura, Masataka; Ma Jie; Obayashi, Hiroshi; Saida, Takahiko

    2000-01-01

    Western blotting with antigens purified using its specific antibody bound column has demonstrated that patients with Stiff-man syndrome (SMS) and insulin-dependent diabetic mellitus (IDDM) were both positive for anti-GAD antibody. Further, anti-GAD antibodies from various animal brains were characterized using GAD 65 and GAD 67 peptide antibody. The antibody against the anti-N-terminal peptide inhibited the enzyme activity of GAD, suggesting that the active site of GAD might exist in the N-terminal region. Development of a new detection method for anti-GAD antibody was attempted and the amount of GAD protein bound to protein G resin was determined based on the activity to release 14 CO 2 from 14 C glutamic acid. In addition, solid-phase RIA method was developed using GAD purified by the anti-peptide antibody affinity column. The positive detection rate for GAD antibody was 39% for the enzymatic method and 56% for the solid-phase RIA method. To develop a further sensitive detection method for GAD antibody, construction of recombinant GAD was attempted and two GAD65s different in molecular size were constructed using pMal-c vector. Thus obtained antibodies against anti-N-terminal peptides were separately responded to GAD65 and GAD67 isoforms in the rat, mouse and bovine brains, whereas the carboxy-terminal antibodies were reactive to both isoforms together. Therefore, it became possible to make purification of GAD65 and GAD67 by the use of the two N-terminal peptide antibodies. Further, it became possible to purify GAD as a mixture of both isoforms. However, the yield of purification using anti-affinity column was still unsatisfactory ( several percent) and the GAD preparation obtained had little activity. The positive detection by the solid-phase RIA method was 50% for SMS patients and 56% for IDDM ones, indicating that this method was superior to the previous enzyme method. The protein A method in which labeled human recombinant GAD65 was used to precipitate 125 -I

  13. Development of diagnostic RI test method for antiglutamic acid decarboxylase (GAD) in SMS and IDDM patients

    Energy Technology Data Exchange (ETDEWEB)

    Ota, Mitsuhiro; Ota, Kiyoe; Nishimura, Masataka; Ma Jie; Obayashi, Hiroshi; Saida, Takahiko [Utano National Hospital, Kyoto (Japan)

    2000-02-01

    Western blotting with antigens purified using its specific antibody bound column has demonstrated that patients with Stiff-man syndrome (SMS) and insulin-dependent diabetic mellitus (IDDM) were both positive for anti-GAD antibody. Further, anti-GAD antibodies from various animal brains were characterized using GAD 65 and GAD 67 peptide antibody. The antibody against the anti-N-terminal peptide inhibited the enzyme activity of GAD, suggesting that the active site of GAD might exist in the N-terminal region. Development of a new detection method for anti-GAD antibody was attempted and the amount of GAD protein bound to protein G resin was determined based on the activity to release {sup 14}CO{sub 2} from {sup 14}C glutamic acid. In addition, solid-phase RIA method was developed using GAD purified by the anti-peptide antibody affinity column. The positive detection rate for GAD antibody was 39% for the enzymatic method and 56% for the solid-phase RIA method. To develop a further sensitive detection method for GAD antibody, construction of recombinant GAD was attempted and two GAD65s different in molecular size were constructed using pMal-c vector. Thus obtained antibodies against anti-N-terminal peptides were separately responded to GAD65 and GAD67 isoforms in the rat, mouse and bovine brains, whereas the carboxy-terminal antibodies were reactive to both isoforms together. Therefore, it became possible to make purification of GAD65 and GAD67 by the use of the two N-terminal peptide antibodies. Further, it became possible to purify GAD as a mixture of both isoforms. However, the yield of purification using anti-affinity column was still unsatisfactory ( several percent) and the GAD preparation obtained had little activity. The positive detection by the solid-phase RIA method was 50% for SMS patients and 56% for IDDM ones, indicating that this method was superior to the previous enzyme method. The protein A method in which labeled human recombinant GAD65 was used to

  14. Review Article. Electrophysiological Methods for Study of Changes in Visual Analyzer in Patients with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Elena Mermeklieva

    2017-03-01

    Full Text Available The electrophysiological (EF methods are objective methods for studying the visual analyzer function. These include electroretinography (ERG, electrooculography (EOG and visual evoked potentials (VEPs. ERG and EOG are used for diagnosis and monitoring of a number of diseases of the retina. VEPs depend on the functional integrity of the entire optical path from the retina through the optic nerve, optic tract, the optical radiation to the visual cortex. The electrophysiological methods are widely used in studying the function of the visual analyzer in the ophthalmic and neurological practice, for objectively measuring the visual acuity and the visual field in non-cooperative patients, small children and in simulation. Diabetes mellitus (DM is a group of metabolic diseases characterized by hyperglycemia. One of the late complications of DM is diabetic retinopathy (DR. It is one of the most serious complications of diabetes, often leading to blindness. Nowadays, DR includes retinal neurodegeneration and microvascular complications. By EF studies can evaluate the function of the retina in diabetic patients in an objective manner using ERG, that reflects the EF activity of the neurons in the retina and VEPs, which indicate the electrical conductivity across the optic tract to the visual cortex.

  15. PHYSICAL METHODS OF REHABILITATION IN CANCER PATIENTS AFTER COMBINED MODALITY TREATMENT FOR BREAST CANCER

    Directory of Open Access Journals (Sweden)

    V. E. Tishakova

    2017-01-01

    Full Text Available According to worldwide statistics breast cancer is the most common cancer in women. Despite the success in current methods of treatment post-operative period in major of patients is characterized by post-mastectomy syndrome which leads to impairment in daily activities, difficulties in social adaptation and consequently to dicrease of the quality of life. The specific causes, risk factors, characteristics of clinical and pathogenetic manifestations of post-mastectomy syndrome are described in detail in this review. Different approaches to post-mastectomy syndrome classification, its clinical and instrumental diagnosis are defined. Based on more than 40 publications of Russian and foreign authors, the issue of selection of appropriate treatment tactics for the syndrome is investigated and discussed in detail. A considerable part of the review is focused on the use of physical methods of treating the post-mastectomy syndrome. It is observed that an increasing number of specialists gives preference to methods of conservative treatment special of which are medical gymnastics, complex decongestive therapy and compression therapy. On the other hand, the absence of the unified treatment algorithms is challenging for clinicians. Therefore, its development with the focus on patient-specific approach is a crucial task for modern rehabilitology in breast cancer surgery.

  16. A rapid method of detecting motor blocks in patients with Parkinson's disease during volitional hand movements

    Directory of Open Access Journals (Sweden)

    Popović Mirjana B.

    2002-01-01

    Full Text Available INTRODUCTION An algorithm to study hand movements in patients with Parkinson's disease (PD who experience temporary, involuntary inability to move a hand have been developed. In literature, this rather enigmatic phenomenon has been described in gait, speech, handwriting and tapping, and noted as motor blocks (MB or freezing episodes. Freezing refers to transient periods in which the voluntary motor activity being attempted by an individual is paused. It is a sudden, unplanned state of immobility that appears to arise from deficits in initiating or simultaneously and sequentially executing movements, in correcting inappropriate movements or in planning movements. The clinical evaluation of motor blocks is difficult because of a variability both within and between individuals and relationship of blocks to time of drug ingestion. In literature the terms freezing, motor block or motor freezing are used in parallel. AIM In clinical settings classical manifestations of Parkinson's Disease (akinesia bradykinesia, rigidity, tremor, axial motor performance and postural instability are typically evaluated. Recently, in literature, new computerized methods are suggested for their objective assessment. We propose monitoring of motor blocks during hand movements to be integrated. For this purpose we have developed a simple method that comprises PC computer, digitizing board and custom made software. Movement analysis is "off line", and the result is the data that describe the number, duration and onset of motor blocks. METHOD Hand trajectories are assessed during simple volitional self paced point-to-point planar hand movement by cordless magnetic mouse on a digitizing board (Drawing board III, 305 x 457 mm, GTCO Cal Comp Inc, Fig. 1. Testing included 8 Parkinsonian patients and 8 normal healthy controls, age matched, with unknown neurologic motor or sensory disorders, Table 1. Three kinematic indicators of motor blocks: 1 duration (MBTJ; 2 onset (t%; and 3

  17. Methods and Models for Capacity and Patient Flow Analysis in Hospital Sector

    DEFF Research Database (Denmark)

    Kozlowski, Dawid

    at a private hospital in Denmark or at a hospital abroad if the public healthcare system is unable to provide treatment within the stated maximum waiting time guarantee. A queue modelling approach is used to analyse the potential negative consequences of the policy on the utilization of public hospital......This thesis is concerned about the novel applications of operations research methods for capacity and flow analysis within hospital sector. The first part of the thesis presents a detailed Discrete-Event Simulation (DES) model that has been developed as an analytical tool designed to facilitate...... by an improved patient flow. The specially developed structure of the model facilitates its reuse at different units, with no advanced modelling skills required in day-to-day use. This feature amplifies the usefulness of DES in conducting comprehensive patient flow analyses at any department with emergency...

  18. Evaluation of Patient Radiation Dose during Cardiac Interventional Procedures: What Is the Most Effective Method?

    International Nuclear Information System (INIS)

    Chida, K.; Saito, H.; Ishibashi, T.; Zuguchi, M.; Kagaya, Y.; Takahashi, S.

    2009-01-01

    Cardiac interventional radiology has lower risks than surgical procedures. This is despite the fact that radiation doses from cardiac intervention procedures are the highest of any commonly performed general X-ray examination. Maximum radiation skin doses (MSDs) should be determined to avoid radiation-associated skin injuries in patients undergoing cardiac intervention procedures. However, real-time evaluation of MSD is unavailable for many cardiac intervention procedures. This review describes methods of determining MSD during cardiac intervention procedures. Currently, in most cardiac intervention procedures, real-time measuring of MSD is not feasible. Thus, we recommend that physicians record the patient's total entrance skin dose, such as the dose at the interventional reference point when it can be monitored, in order to estimate MSD in intervention procedures

  19. Pressure pain sensitivity: A new method of stress measurement in patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Holmager, Pernille

    2013-01-01

    to induce hyperalgesia.The aim of the present study was to evaluate hyperalgesia by pressure pain sensitivity (PPS) in patients with IHD, and compare PPS to questionnaires measuring depressive symptoms, reduced psychological wellbeing, and QOL as markers of stress. Design. A cross-sectional study of 361......Abstract Background. Chronic stress is prevalent in patients with ischemic heart disease (IHD) and worsens the long-term prognosis. Chronic stress is vaguely defined, but is associated with depressive symptoms, reduced psychological wellbeing, and reduced quality of life (QOL). Stress seems...... subjects with IHD. Methods. PPS was measured on the sternum, and compared to the questionnaires: Clinical stress symptoms score (CSS), Major Depression Inventory (MDI), WHO-5 Wellbeing Index, and SF-36 QOL score. Results. PPS correlated to CSS (r = 0.20, p

  20. Iodine metabolism in leprosy patients (examination with a method of whole-body radiometry)

    International Nuclear Information System (INIS)

    Balybin, E.S.

    1986-01-01

    A method of whole-body radiometry was used to study iodine metabolism in 47 patients with lepromatous leprosy. Disorders were found in 1/3 of the cases. The level of organic iodine in the body was the most informative of all iodine metabolism indices. In the active stage of leprosy it was twice as low, on an average, as the normal one, in the stage of incomplete and stable regression it rose not reaching, however, the values of healthy persons. The content of iodine in the thyroid of leprosy patients showed a tendency to a rise starting from the active stage, however it was only in the stages of incomplete and stable regression that it significantly exceeded the normal level. The data obtained should be considered during therapy of lepers to predict and control an unfavorable complication like specific polyneuritis

  1. Comparison the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination or ultrasound methods

    OpenAIRE

    Hadi Karimzadeh; Zahra Seyedbonakdar; Maryam Mousavi; Mehdi Karami

    2016-01-01

    Background: This study aimed to compare the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination and ultrasound methods. Materials and Methods: This study is a cross-sectional study which was conducted in Al-Zahra Hospital (Isfahan, Iran) during 2014?2015. In our study, ninety patients were selected based on the American College of Rheumatology 2010 criteria. All patients were examined by a rheumatologist to find the existence of effusion, ...

  2. A Study of Effectiveness of Rational, Emotive, Behavior Therapy (REBT) with Group Method on Decrease of Stress among Diabetic Patients

    OpenAIRE

    Kianoush Zahrakar

    2012-01-01

    Introduction: The purpose of the present research was studying the effectiveness of Rational Emotive Behavior Therapy (REBT) with Group method in decreasing stress of diabetic patients. Methods: The population of research consisted of all diabetic patients that are member of diabetic patient’s association 0f karaj city. The sample consisted of 30 diabetic patients (experimental group 15 persons and control group 15 persons) that selected through random sampling. Research design was experiment...

  3. Oral rinse as a potential method to culture Candida isolate from AIDS patients

    Directory of Open Access Journals (Sweden)

    Desiana Radithia

    2011-12-01

    Full Text Available Background: Candida isolate is easily sampled from oral cavity by swabbing directly on the candidiasis lesion, to be smeared onto slides for direct examination or cultured in a growth medium. This method is by far the gold standard for defining candidiasis diagnosis. However it is difficult to apply on sensitive patients and almost impossible on patients showing no clinical appearance of oral candidiasis. AIDS patients are very prone to candida infection and have a tendency of repetitive infection involving mixed species. As many candida species show different susceptibility to anti-fungal agents, it is necessary to identify the species causing the infection in the management of oral candidiasis. Oral rinse is a suggested method to obtain candida isolate to be cultured for further analysis such as species identification. This method is simple and less risky on infection transmission as less tools are required in the procedure. Purpose: This study aimed to assess the application of oral rinse as an alternative method to culture Candida isolate from AIDS patients. Methods: A cross-sectional observative study was conducted in HIV/AIDS in-Patient Facility of Intermediate Care Unit for Infection Disease, Dr. Soetomo Hospital Surabaya. Fourteen stadium 4 AIDS patients matching criteria were swabbed on 1/3-posterior of the tongue, and then given 10 ml phosphate buffer saline to rinse vigorously for 15 seconds. Both specimens were cultured on Sabouraud’s dextrose agar and colony growth was observed. Results: Candida colonies were able to grow from all 14 isolates (100% by both methods. Qualitatively, cultures from oral rinse specimens were more populated than cultures from swab specimens. Conclusion: Oral rinse is an applicable technique to obtain Candida species isolate. This technique is safe, easy, non-invasive, and needs less tools therefore less risky for HIV transmission.Latar belakang: Isolat Candida mudah diambil dengan cara mengusap lesi

  4. Computer-Based Oral Hygiene Instruction versus Verbal Method in Fixed Orthodontic Patients

    Science.gov (United States)

    Moshkelgosha, V.; Mehrvarz, Sh.; Saki, M.; Golkari, A.

    2017-01-01

    Statement of Problem: Fixed orthodontic appliances in the oral cavity make tooth cleaning procedures more complicated. Objectives: This study aimed to compare the efficacy of computerized oral hygiene instruction with verbal technique among fixed orthodontic patients referred to the evening clinic of Orthodontics of Shiraz Dental School. Materials and Methods: A single-blind study was performed in Orthodontic Department of Shiraz, Islamic Republic of Iran, from January to May 2015 following the demonstrated exclusion and inclusion criteria. The sample size was considered 60 patients with 30 subjects in each group. Bleeding on probing and plaque indices and dental knowledge were assessed in the subjects to determine pre-intervention status. A questionnaire was designed for dental knowledge evaluation. The patients were randomly assigned into the computerized and verbal groups. Three weeks after the oral hygiene instruction, indices of bleeding on probing and plaque index and the dental knowledge were evaluated to investigate post-intervention outcome. The two groups were compared by chi-square and student t tests. The pre- and post-intervention scores in each group were compared using paired t-test. Results: In the computerized group, the mean score for plaque index and bleeding on probing index was significantly decreased while dental health knowledge was significantly increased after oral hygiene instruction, in contrast to the verbal group. Conclusions: Within the limitations of the current study, computerized oral hygiene instruction is proposed to be more effective in providing optimal oral health status compared to the conventional method in fixed orthodontic patients. PMID:28959765

  5. Application of the polymerase chain reaction in determination of recombinant retrovirus titers as fifty percent endpoints

    DEFF Research Database (Denmark)

    Husemoen, L L; Gram, G J; Hansen, J E

    2000-01-01

    -based protocols that would significantly simplify and shorten this procedure. Using PCR and primers specific for the Neoregion of the MLV-derived vector LeGSN, we determined 1. the proviral integration in target cells, and 2. the viral nucleic acid (RNA or DNA) content of the vector stock. Results were compared......, determination of virus titer involves the testing of culture medium from individual packaging cell lines for the ability to transfer drug resistance to susceptible cells - a process that can easily take up to 14 days. It is generally agreed that this method is cumbersome. We sought to develop PCR...... with those using the conventional method. We found that these specific PCR-based procedures were indeed useful for rapid determination of viral titers as well as for quick screening for high-titer vector-producing cell clones and successful transduction of target cells....

  6. Self-image of the Patients with Head and Neck Cancer: A Mixed Method Research

    Science.gov (United States)

    Nayak, Shalini G; Pai, Mamatha Shivananda; George, Linu Sara

    2016-01-01

    Aim: The aim of the study was to assess the self-image of the patients with head and neck cancers (HNCs) by using a mixed method research. Subjects and Methods: A mixed method approach and triangulation design was used with the aim of assessing the self-image of the patients with HNCs. Data was gathered by using self-administered self-image scale and structured interview. Nested sampling technique was adopted. Sample size for quantitative approach was 54 and data saturation was achieved with seven subjects for qualitative approach. Institutional Ethical Committee clearance was obtained. Results: The results of the study showed that 30 (56%) subjects had positive self-image and 24 (44%) had negative self-image. There was a moderate positive correlation between body image and integrity (r = 0.430, P = 0.001), weak positive correlation between body image and self-esteem (r = 0.270, P = 0.049), and no correlation between self-esteem and integrity (r = 0.203, P = 0.141). The participants also scored maximum (24/24) in the areas of body image and self-esteem. Similar findings were also observed in the phenomenological approach. The themes evolved were immaterial of outer appearance and desire of good health to all. Conclusion: The illness is long-term and impacts the individual 24 h a day. Understanding patients’ self-concept and living experiences of patients with HNC is important for the health care professionals to improve the care. PMID:27559264

  7. Self-image of the patients with head and neck cancer: A mixed method research

    Directory of Open Access Journals (Sweden)

    Shalini G Nayak

    2016-01-01

    Full Text Available Aim: The aim of the study was to assess the self-image of the patients with head and neck cancers (HNCs by using a mixed method research. Subjects and Methods: A mixed method approach and triangulation design was used with the aim of assessing the self-image of the patients with HNCs. Data was gathered by using self-administered self-image scale and structured interview. Nested sampling technique was adopted. Sample size for quantitative approach was 54 and data saturation was achieved with seven subjects for qualitative approach. Institutional Ethical Committee clearance was obtained. Results: The results of the study showed that 30 (56% subjects had positive self-image and 24 (44% had negative self-image. There was a moderate positive correlation between body image and integrity (r = 0.430, P = 0.001, weak positive correlation between body image and self-esteem (r = 0.270, P = 0.049, and no correlation between self-esteem and integrity (r = 0.203, P = 0.141. The participants also scored maximum (24/24 in the areas of body image and self-esteem. Similar findings were also observed in the phenomenological approach. The themes evolved were "immaterial of outer appearance" and "desire of good health to all." Conclusion: The illness is long-term and impacts the individual 24 h a day. Understanding patients′ self-concept and living experiences of patients with HNC is important for the health care professionals to improve the care.

  8. Comparing deep learning and concept extraction based methods for patient phenotyping from clinical narratives.

    Science.gov (United States)

    Gehrmann, Sebastian; Dernoncourt, Franck; Li, Yeran; Carlson, Eric T; Wu, Joy T; Welt, Jonathan; Foote, John; Moseley, Edward T; Grant, David W; Tyler, Patrick D; Celi, Leo A

    2018-01-01

    In secondary analysis of electronic health records, a crucial task consists in correctly identifying the patient cohort under investigation. In many cases, the most valuable and relevant information for an accurate classification of medical conditions exist only in clinical narratives. Therefore, it is necessary to use natural language processing (NLP) techniques to extract and evaluate these narratives. The most commonly used approach to this problem relies on extracting a number of clinician-defined medical concepts from text and using machine learning techniques to identify whether a particular patient has a certain condition. However, recent advances in deep learning and NLP enable models to learn a rich representation of (medical) language. Convolutional neural networks (CNN) for text classification can augment the existing techniques by leveraging the representation of language to learn which phrases in a text are relevant for a given medical condition. In this work, we compare concept extraction based methods with CNNs and other commonly used models in NLP in ten phenotyping tasks using 1,610 discharge summaries from the MIMIC-III database. We show that CNNs outperform concept extraction based methods in almost all of the tasks, with an improvement in F1-score of up to 26 and up to 7 percentage points in area under the ROC curve (AUC). We additionally assess the interpretability of both approaches by presenting and evaluating methods that calculate and extract the most salient phrases for a prediction. The results indicate that CNNs are a valid alternative to existing approaches in patient phenotyping and cohort identification, and should be further investigated. Moreover, the deep learning approach presented in this paper can be used to assist clinicians during chart review or support the extraction of billing codes from text by identifying and highlighting relevant phrases for various medical conditions.

  9. Cognitive function fifty-six years after surgical treatment of temporal lobe epilepsy: A case study

    Directory of Open Access Journals (Sweden)

    Sarah Jane Banks

    2014-01-01

    Our investigation at 56 postoperative years focused on cognitive skills, with some emphasis on learning and memory; a clinical examination was also performed, and the anatomical extent of the resection was determined on 3-Tesla magnetic resonance imaging. Four age- and IQ-appropriate women were tested as healthy control subjects. The patient showed material-specific impairments in language and verbal memory compared with the control subjects and also compared with her own earlier performance, but her performance on other cognitive tasks did not differ from that of the control subjects. Thus, her specific deficits had worsened over time, and she was also impaired compared with healthy individuals of her age, but her deficits remained confined to the verbal sphere, consistent with her temporal lobe seizure focus and surgery.

  10. Fifty Years of Research in ARDS. Gas Exchange in Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Radermacher, Peter; Maggiore, Salvatore Maurizio; Mercat, Alain

    2017-10-15

    Acute respiratory distress syndrome (ARDS) is characterized by severe impairment of gas exchange. Hypoxemia is mainly due to intrapulmonary shunt, whereas increased alveolar dead space explains the alteration of CO 2 clearance. Assessment of the severity of gas exchange impairment is a requisite for the characterization of the syndrome and the evaluation of its severity. Confounding factors linked to hemodynamic status can greatly influence the relationship between the severity of lung injury and the degree of hypoxemia and/or the effects of ventilator settings on gas exchange. Apart from situations of rescue treatment, targeting optimal gas exchange in ARDS has become less of a priority compared with prevention of injury. A complex question for clinicians is to understand when improvement in oxygenation and alveolar ventilation is related to a lower degree or risk of injury for the lungs. In this regard, a full understanding of gas exchange mechanism in ARDS is imperative for individualized symptomatic support of patients with ARDS.

  11. [Fifty years of psychiatry at the interface between psyche and soma: a SWOT analysis].

    Science.gov (United States)

    van Houdenhove, B; Luyten, P

    2008-01-01

    During the past 50 years the border area between psychiatry and somatic medicine has undergone remarkable changes. Theories have become better-founded, both psychologically and neurobiologically, research has become more sophisticated, and liaison-psychiatrists and health psychiatrist/behavioural medicine psychologists have played an increasingly active role in this domain. At the beginning of the 21st century modern psychosomatic medicine is facing new challenges; these include how to create a workable diagnostic classification system, how to instruct and educate both health professionals and lay-persons to an adequate level, how to utilize innovative research paradigms without having recourse to reductionism and how to implement in medical practice treatments that are geared to the needs of the individual patient.

  12. Bladder management methods and urological complications in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Roop Singh

    2011-01-01

    Full Text Available Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI and other urological complications in spinal cord injury patients (SCI, and to compare the incidence of these complications with different bladder management subgroups. Materials and Methods: 545 patients (386 males and 159 females of traumatic spinal cord injury with the mean age of 35.4±16.2 years (range, 18 - 73 years were included in the study. The data regarding demography, bladder type, method of bladder management, and urological complications, were recorded. Bladder management methods included indwelling catheterization in 224 cases, clean intermittent catheterization (CIC in 180 cases, condom drainage in 45 cases, suprapubic cystostomy in 24 cases, reflex voiding in 32 cases, and normal voiding in 40 cases. We assessed the incidence of UTI and bacteriuria as the number of episodes per hundred person-days, and other urological complications as percentages. Results: The overall incidence of bacteriuria was 1.70 / hundred person-days. The overall incidenceof urinary tract infection was 0.64 / hundered person-days. The incidence of UTI per 100 person-days was 2.68 for indwelling catheterization, 0.34 for CIC, 0.34 for condom drainage, 0.56 for suprapubic cystostomy, 0.34 for reflex voiding, and 0.32 for normal voiding. Other urological complications recorded were urethral stricture (n=66, 12.1%, urethritis (n=78, 14.3%, periurethral abscess (n=45, 8.2%, epididymorchitis (n=44, 8.07%, urethral false passage (n=22, 4.03%, urethral fistula (n=11, 2%, lithiasis (n=23, 4.2%, hematuria (n=44, 8.07%, stress incontinence (n=60, 11%, and pyelonephritis (n=6, 1.1%. Clean intermittent catheterization was associated with lower incidence of urological complications, in comparison to indwelling catheterization. Conclusions

  13. Theory-informed design of values clarification methods: A cognitive psychological perspective on patient health-related decision making

    OpenAIRE

    Pieterse, A.H.; de Vries, M.; Kunneman, M.; Stiggelbout, A.M.; Feldman-Stewart, D.

    2013-01-01

    Healthcare decisions, particularly those involving weighing benefits and harms that may significantly affect quality and/or length of life, should reflect patients' preferences. To support patients in making choices, patient decision aids and values clarification methods (VCM) in particular have been developed. VCM intend to help patients to determine the aspects of the choices that are important to their selection of a preferred option. Several types of VCM exist. However, they are often des...

  14. Functional Assessment of the Stomatognathic System, after the Treatment of Edentulous Patients, with Different Methods of Establishing the Centric Relation.

    Science.gov (United States)

    Nitecka-Buchta, Aleksandra; Proba, Thomas; Proba, Paulina; Stefański, Kamil; Baron, Stefan

    2018-01-01

    The study compares subjective experiences of patients, wearing complete dentures. Two different methods of determining a centric relation were performed: the traditional method using wax occlusal rims and the Gerber method, based on gothic arch tracings. The success rate of establishing a centric relation in both methods was evaluated (rentgenodiagnostics). The influence of the method used to obtain the centric relation on patients' stomatognathic system (condyle centralization, pain) was also evaluated. Better results were achieved in gothic arch tracing method. Before every prosthetic treatment of edentulous patients, a functional analysis of the TMJ is necessary. The lack of centric relation, in a long term adaptation patients, does not lead to TMD symptoms. This trial is registered with NCT03343015.

  15. Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton

    DEFF Research Database (Denmark)

    Bech, P; Bech, P

    2009-01-01

    as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first...... placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without...

  16. Pre-validation methods for developing a patient reported outcome instrument

    Directory of Open Access Journals (Sweden)

    Castillo Mayret M

    2011-08-01

    Full Text Available Abstract Background Measures that reflect patients' assessment of their health are of increasing importance as outcome measures in randomised controlled trials. The methodological approach used in the pre-validation development of new instruments (item generation, item reduction and question formatting should be robust and transparent. The totality of the content of existing PRO instruments for a specific condition provides a valuable resource (pool of items that can be utilised to develop new instruments. Such 'top down' approaches are common, but the explicit pre-validation methods are often poorly reported. This paper presents a systematic and generalisable 5-step pre-validation PRO instrument methodology. Methods The method is illustrated using the example of the Aberdeen Glaucoma Questionnaire (AGQ. The five steps are: 1 Generation of a pool of items; 2 Item de-duplication (three phases; 3 Item reduction (two phases; 4 Assessment of the remaining items' content coverage against a pre-existing theoretical framework appropriate to the objectives of the instrument and the target population (e.g. ICF; and 5 qualitative exploration of the target populations' views of the new instrument and the items it contains. Results The AGQ 'item pool' contained 725 items. Three de-duplication phases resulted in reduction of 91, 225 and 48 items respectively. The item reduction phases discarded 70 items and 208 items respectively. The draft AGQ contained 83 items with good content coverage. The qualitative exploration ('think aloud' study resulted in removal of a further 15 items and refinement to the wording of others. The resultant draft AGQ contained 68 items. Conclusions This study presents a novel methodology for developing a PRO instrument, based on three sources: literature reporting what is important to patient; theoretically coherent framework; and patients' experience of completing the instrument. By systematically accounting for all items dropped

  17. Perspective: Fifty years of density-functional theory in chemical physics

    Energy Technology Data Exchange (ETDEWEB)

    Becke, Axel D., E-mail: axel.becke@dal.ca [Department of Chemistry, Dalhousie University, 6274 Coburg Rd., P.O. Box 15000, Halifax, Nova Scotia B3H 4R2 (Canada)

    2014-05-14

    Since its formal inception in 1964–1965, Kohn-Sham density-functional theory (KS-DFT) has become the most popular electronic structure method in computational physics and chemistry. Its popularity stems from its beautifully simple conceptual framework and computational elegance. The rise of KS-DFT in chemical physics began in earnest in the mid 1980s, when crucial developments in its exchange-correlation term gave the theory predictive power competitive with well-developed wave-function methods. Today KS-DFT finds itself under increasing pressure to deliver higher and higher accuracy and to adapt to ever more challenging problems. If we are not mindful, however, these pressures may submerge the theory in the wave-function sea. KS-DFT might be lost. I am hopeful the Kohn-Sham philosophical, theoretical, and computational framework can be preserved. This Perspective outlines the history, basic concepts, and present status of KS-DFT in chemical physics, and offers suggestions for its future development.

  18. Perspective: Fifty years of density-functional theory in chemical physics

    International Nuclear Information System (INIS)

    Becke, Axel D.

    2014-01-01

    Since its formal inception in 1964–1965, Kohn-Sham density-functional theory (KS-DFT) has become the most popular electronic structure method in computational physics and chemistry. Its popularity stems from its beautifully simple conceptual framework and computational elegance. The rise of KS-DFT in chemical physics began in earnest in the mid 1980s, when crucial developments in its exchange-correlation term gave the theory predictive power competitive with well-developed wave-function methods. Today KS-DFT finds itself under increasing pressure to deliver higher and higher accuracy and to adapt to ever more challenging problems. If we are not mindful, however, these pressures may submerge the theory in the wave-function sea. KS-DFT might be lost. I am hopeful the Kohn-Sham philosophical, theoretical, and computational framework can be preserved. This Perspective outlines the history, basic concepts, and present status of KS-DFT in chemical physics, and offers suggestions for its future development

  19. Science that connects the past and the future. Fifty years of 14C dating

    International Nuclear Information System (INIS)

    Imamura, M.

    2006-01-01

    Major contribution of radiochemistry in archaeological sciences is the dating which provides the most essential information in studies of prehistory. In particular the method of 14 C dating revolutionized the theory of civilization in the world. In this talk I will review 50 years of 14 C dating, techniques and applications, and then the possibilities in contemporary world. The technical developments are featured by ultra-sensitive method of accelerator mass spectrometry in 1977 and its developments, and an introduction of international calibration datasets for 14 C dates started in 1986. Both contributed greatly to improvements in versatility and precision for dating. As for the applications, several interesting topics are reviewed such as the origin of agriculture and its propagation in the western world, the oldest pottery production in Japanese archipelago and its relation to world climate, paddy-rice agriculture and its propagation in Japanese archipelago. Since 14 C studies in nature is also well known as key information on carbon dynamics in earth's surface, it may be said that 14 C play an extraordinary role in understanding our past, present and the future. (author)

  20. Incidence of peri-implant mucositis and peri-implantitis in edentulous patients with an implant-retained mandibular overdenture during a 10-year follow-up period

    NARCIS (Netherlands)

    Meijer, Henny J. A.; Raghoebar, Gerry M.; de Waal, Yvonne C. M.; Vissink, Arjan

    2014-01-01

    Objectives: The aim of this sub-analysis of two prospective studies was to assess the incidence of peri-implant mucositis and peri-implantitis in fully edentulous patients with an implant-retained mandibular overdenture during a 10-year follow-up period. Material and Methods: One hundred and fifty

  1. Addition of Liposome Bupivacaine to Bupivacaine HCl Versus Bupivacaine HCl Alone for Interscalene Brachial Plexus Block in Patients Having Major Shoulder Surgery

    NARCIS (Netherlands)

    Vandepitte, C.; Kuroda, M.; Witvrouw, R.; Anne, L.; Bellemans, J.; Corten, K.; Vanelderen, P.J.; Mesotten, D.; Leunen, I.; Heylen, M.; Boxstael, S. Van; Golebiewski, M.; Velde, M. van de; Knezevic, N.N.; Hadzic, A.

    2017-01-01

    BACKGROUND AND OBJECTIVES: We examined whether liposome bupivacaine (Exparel) given in the interscalene brachial plexus block lowers pain in the setting of multimodal postoperative pain management for major shoulder surgery. METHODS: Fifty-two adult patients were randomized to receive either 5 mL of

  2. Relationship between CT visual score and lung volume which is measured by helium dilution method and body plethysmographic method in patients with pulmonary emphysema

    International Nuclear Information System (INIS)

    Toyoshima, Hideo; Ishibashi, Masayoshi; Senju, Syoji; Tanaka, Hideki; Aritomi, Takamichi; Watanabe, Kentaro; Yoshida, Minoru

    1997-01-01

    We examined the relationship between CT visual score and pulmonary function studies in patients with pulmonary emphysema. Lung volume was measured using helium dilution method and body plethysmographic method. Although airflow obstruction and overinflation measured by helium dilution method did not correlate with CT visual score, CO diffusing capacity per alveolar volume (DL CO /V A ) showed significant negative correlation with CT visual score (r=-0.49, p CO /V A reflect pathologic change in pulmonary emphysema. Further, both helium dilution method and body plethysmographic method are required to evaluate lung volume of pulmonary emphysema because of its ventilatory unevenness. (author)

  3. The Roche Immunoturbidimetric Albumin Method on Cobas c 501 Gives Higher Values Than the Abbott and Roche BCP Methods When Analyzing Patient Plasma Samples.

    Science.gov (United States)

    Helmersson-Karlqvist, Johanna; Flodin, Mats; Havelka, Aleksandra Mandic; Xu, Xiao Yan; Larsson, Anders

    2016-09-01

    Serum/plasma albumin is an important and widely used laboratory marker and it is important that we measure albumin correctly without bias. We had indications that the immunoturbidimetric method on Cobas c 501 and the bromocresol purple (BCP) method on Architect 16000 differed, so we decided to study these methods more closely. A total of 1,951 patient requests with albumin measured with both the Architect BCP and Cobas immunoturbidimetric methods were extracted from the laboratory system. A comparison with fresh plasma samples was also performed that included immunoturbidimetric and BCP methods on Cobas c 501 and analysis of the international protein calibrator ERM-DA470k/IFCC. The median difference between the Abbott BCP and Roche immunoturbidimetric methods was 3.3 g/l and the Roche method overestimated ERM-DA470k/IFCC by 2.2 g/l. The Roche immunoturbidimetric method gave higher values than the Roche BCP method: y = 1.111x - 0.739, R² = 0.971. The Roche immunoturbidimetric albumin method gives clearly higher values than the Abbott and Roche BCP methods when analyzing fresh patient samples. The differences between the two methods were similar at normal and low albumin levels. © 2016 Wiley Periodicals, Inc.

  4. Colonic transit time in patient with slow-transit constipation: Comparison of radiopaque markers and barium suspension method

    Energy Technology Data Exchange (ETDEWEB)

    Xu Huimin [Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongtina Lu, Chaoyang District, Beijing 100020 (China); Department of General Surgery, Weifang People' s Hospital, ShanDong Province 261041 (China); Han Jiagang [Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongtina Lu, Chaoyang District, Beijing 100020 (China); Na Ying [Department of Medical Imaging, Weifang People' s Hospital, ShanDong Province 261041 (China); Zhao Bo; Ma Huachong [Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongtina Lu, Chaoyang District, Beijing 100020 (China); Wang Zhenjun, E-mail: wang3zj@sohu.com [Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongtina Lu, Chaoyang District, Beijing 100020 (China)

    2011-08-15

    Background: Colonic transit study provides valuable information before surgical treatment is considered for patient with constipation. The radiopaque markers method is the most common way for evaluating colon transit time. The aim of this study is to compare the barium suspension with the radiopaque makers to assess the colonic mobility in patient with constipation. Methods: Colonic transit time was measured in 11 female patients with slow-transit constipation using both radiopaque markers and barium suspension method. In radiopaque markers method, the patient ingested 20 markers on the first day, and an abdominal radiograph was performed every 24 h until 80% markers were excreted. In barium suspension method, the patient swallowed up to 50 ml of 200% (w/v) barium meal. The abdominal radiographs were taken at the same time point as the former. Results: The total or segmental colonic transit time were obviously prolonged in all patients. Segmental transits time spent in the right colon, left colon and rectosigmoid for radiopaque markers and barium suspension method was, respectively, 30 {+-} 6 h and 34 {+-} 7 h; 38 {+-} 9 h and 32 {+-} 6 h; 40 {+-} 8 h and 38 {+-} 10 h. In the radiopaque markers method, total colonic transit time was 108 {+-} 14 h and it was 103 {+-} 13 h in the barium suspension method (P > 0.05). Conclusion: The barium suspension and radiopaque markers gave the similar results for colonic transit time. The barium suspension was a simple and cheap method for evaluating the colonic mobility.

  5. Colonic transit time in patient with slow-transit constipation: Comparison of radiopaque markers and barium suspension method

    International Nuclear Information System (INIS)

    Xu Huimin; Han Jiagang; Na Ying; Zhao Bo; Ma Huachong; Wang Zhenjun

    2011-01-01

    Background: Colonic transit study provides valuable information before surgical treatment is considered for patient with constipation. The radiopaque markers method is the most common way for evaluating colon transit time. The aim of this study is to compare the barium suspension with the radiopaque makers to assess the colonic mobility in patient with constipation. Methods: Colonic transit time was measured in 11 female patients with slow-transit constipation using both radiopaque markers and barium suspension method. In radiopaque markers method, the patient ingested 20 markers on the first day, and an abdominal radiograph was performed every 24 h until 80% markers were excreted. In barium suspension method, the patient swallowed up to 50 ml of 200% (w/v) barium meal. The abdominal radiographs were taken at the same time point as the former. Results: The total or segmental colonic transit time were obviously prolonged in all patients. Segmental transits time spent in the right colon, left colon and rectosigmoid for radiopaque markers and barium suspension method was, respectively, 30 ± 6 h and 34 ± 7 h; 38 ± 9 h and 32 ± 6 h; 40 ± 8 h and 38 ± 10 h. In the radiopaque markers method, total colonic transit time was 108 ± 14 h and it was 103 ± 13 h in the barium suspension method (P > 0.05). Conclusion: The barium suspension and radiopaque markers gave the similar results for colonic transit time. The barium suspension was a simple and cheap method for evaluating the colonic mobility.

  6. Fifty Years of Burn Care at Shriners Hospitals for Children, Galveston.

    Science.gov (United States)

    Čapek, Karel D; Culnan, Derek M; Desai, Manubhai H; Herndon, David N

    2018-03-01

    More than 50 years ago, Shriners Hospitals for Children expanded their philanthropy to include care for burned children. In so doing, the effects of their work weightily expanded from rehabilitation and quality of life outcomes to include survival proper. As the first facility dedicated to the care of burned children, originally designated the Shriners Burn Institute, the Galveston hospital remains the cornerstone of this endeavor. Shriners maintains charitable pediatric hospitals, provide care irrespective of the patient's or the family's ability to pay, and promote research. The sole criterion for admission at Shriners Hospitals for Children is the determination by a surgeon at a Shriners hospital that "the child's trouble may be corrected or improved." This philanthropic effort to provide medical care for children is one expression of the human commonality recognized by Shriners. In this article, we provide some background information on how this hospital came into existence as well as a global summary of its interventions toward greater survival and more complete rehabilitation of burned children. Based on the findings presented herein, we assert that there is less suffering and less loss of life due to childhood burns today than in previous years. We attribute much of this improvement to the simple voluntary collective decision by Shriners to provide alms for burned children.

  7. Fifty years of advances in sarcoma treatment: moving the needle from conventional chemotherapy to targeted therapy.

    Science.gov (United States)

    Patel, Shreyaskumar R

    2014-01-01

    Much of the progress in systemic therapy for sarcomas was accomplished in the first half of the last 5 decades. Various chemotherapeutic agents were tested in the 70s through the 80s and became part of the standard of care for this patient population. During the decade of the 90s, dose intensification became feasible as a result of improved supportive care and the availability of growth factors, thus maximizing the therapeutic potential of this class of agents. However, response rates and survival plateaued and it became obvious that newer and mechanistically different agents were needed to improve the therapeutic index and gain further enhancement of outcomes. Since early 2000, primarily inspired by the experience with imatinib in gastrointestinal stromal tumors (GISTs), several targeted therapies have been tested in sarcomas with modest success. The major limitations encountered include the lack of drivers and actionable targets for bone and soft tissue sarcomas with complex genomic profiles. Continued investigations and sequencing of larger numbers of these rare and heterogeneous malignancies could shed some light on a path toward improved outcomes.

  8. The Effect of a Program Using Some Therapeutic Methods to Rehabilitate Patients Suffering from Neck Pain

    Directory of Open Access Journals (Sweden)

    Ayad O MAR

    2015-09-01

    Full Text Available Neck pain is one of the common physical problems of the adults which needs to be taken seriously in order to prevent further health problems. As the daily life of the modern people leads physical in activity, and the use of electronic devices causes imprope r effect on certain parts of the body, specials programs have to be developed as preventive treatment. Therapeutic methods can also be listed through such preventive methods. The purpose of this study was to i dentify the impact of the proposed program usin g some natural methods of treatment for the rehabilitation of people with neck pain , to i dentify the improved range of motion in all directions to the neck area , and also t o identify the extent of improvement in muscle strength for the neck and back. Twelv e patients in Ain Zara Physiotherapy Center and Tripoli Clinic (in Tripoli city were chosen as voluntarily whose age ranged from 30 to 50 years, and the subjects were divided into two groups , as experimental and control groups. This study proved that pro posed therapeutic methods help the treatment of neck pain.

  9. Interobserver Reliability of Four Diagnostic Methods Using Traditional Korean Medicine for Stroke Patients

    Directory of Open Access Journals (Sweden)

    Ju Ah Lee

    2014-01-01

    Full Text Available Objective. The aim of this study is to evaluate the consistency of pattern identification (PI, a set of diagnostic indicators used by traditional Korean medicine (TKM clinicians. Methods. A total of 168 stroke patients who were admitted into oriental medical university hospitals from June 2012 through January 2013 were included in the study. Using the PI indicators, each patient was independently diagnosed by two experts from the same department. Interobserver consistency was assessed by simple percentage agreement as well as by kappa and AC1 statistics. Results. Interobserver agreement on the PI indicators (for all patients was generally high: pulse diagnosis signs (AC1=0.66–0.89; inspection signs (AC1=0.66–0.95; listening/smelling signs (AC1=0.67–0.88; and inquiry signs (AC1=0.62–0.94. Conclusion. In four examinations, there was moderate agreement between the clinicians on the PI indicators. To improve clinician consistency (e.g., in the diagnostic criteria used, it is necessary to analyze the reasons for inconsistency and to improve clinician training.

  10. Reduced exposure to coughed air by a novel ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Brand, Marek

    2012-01-01

    A novel hospital bed integrated ventilation and cleaning unit (HBIVCU) for local airflow control and cleansing, limiting the airborne spread of contagious air coughed from a sick patient in a hospital room, was developed. The performance efficiency of the unit, to successfully reduce occupants......’ exposure to coughed air, was studied in a full-scale, two-bed hospital room mock-up, 4.65 m x 4.65 m x 2.60 m (W x L x H), with two patients and a doctor. Four units were placed along the two sides of both beds close to the head. The room was ventilated by overhead mixing air distribution at 22 °C room air...... of the novel unit, at background ventilation rates of 3 h-1and 6 h-1, was evaluated by measuring the excess CO2 concentration at the mouth of both the doctor and the exposed patient. When the novel method was not used, the CO2 concentration (exposure) measured in the air “inhaled” by the doctor exceeded 20...

  11. [Effects of two different methods for airway humidification for patients with tracheostomy: a Meta-analysis].

    Science.gov (United States)

    Wang, Jing; Pi, Hongying

    2016-01-01

    To evaluate the effects of two different kinds of airway humidification for tracheostomy patients, and to provide their relevant clinical effect and suggestions for their use. Online databases, including PubMed, EMBASE, JBI evidence-based nursing center library, the Cochrane Library, and Chinese databases (CNKI, Wanfang database, VIP, CBM) were searched systematically up to March 2015. Randomized controlled trials (RCTs) were considered eligible for inclusion if the following criteria were met: no history of respiratory tract infection; satisfactory nutritional status; tracheotomy performed; 18 years older. Two different humidification methods were used. Continuous airway humidification was used in the experiment group, while intermittent airway humidification was used in the control group. Two qualified reviewers reviewed the original articles, evaluating the quality of articles, and data were extracted independently. The enrolled RCTs were analyzed by Meta-analysis. A total of nine RCTs were included, containing 631 cases, among them 316 cases in expertment group, and 315 cases in control group. Continuous airway humidification was shown to be able to reduce the incidence of irritable cough [odds ratio (OR) = 0.20, 95% confidence interval (95%CI) = 0.12-0.34, P humidification for tracheostomy patients. Because the number of including articles was relative small, and the quality of some articles was poor, it is impossible to draw a reliable conclusion that continuous airway humidification could lower the incidence of complications for patients undergone tracheostomy.

  12. Effectiveness of Anonymization Methods in Preserving Patients' Privacy: A Systematic Literature Review.

    Science.gov (United States)

    Langarizadeh, Mostafa; Orooji, Azam; Sheikhtaheri, Abbas

    2018-01-01

    An ever growing for application of electronic health records (EHRs) has improved healthcare providers' communications, access to data for secondary use and promoted the quality of services. Patient's privacy has been changed to a great issue today since there are large loads of critical information in EHRs. Therefore, many privacy preservation techniques have been proposed and anonymization is a common one. This study aimed to investigate the effectiveness of anonymization in preserving patients' privacy. The articles published in the 2005-2016 were included. Pubmed, Cochrane, IEEE and ScienceDirect were searched with a variety of related keywords. Finally, 18 articles were included. In the present study, the relevant anonymization issues were investigated in four categories: secondary use of anonymized data, re-identification risk, anonymization effect on information extraction and inadequacy of current methods for different document types. The results revealed that though anonymization cannot reduce the risk of re-identification to zero, if implemented correctly, can manage to help preserve patient's privacy.

  13. A Delphi Method Analysis to Create an Emergency Medicine Educational Patient Satisfaction Survey

    Directory of Open Access Journals (Sweden)

    Kory S. London

    2015-12-01

    Full Text Available Introduction: Feedback on patient satisfaction (PS as a means to monitor and improve performance in patient communication is lacking in residency training. A physician’s promotion, compensation and job satisfaction may be impacted by his individual PS scores, once he is in practice. Many communication and satisfaction surveys exist but none focus on the emergency department setting for educational purposes. The goal of this project was to create an emergency medicine-based educational PS survey with strong evidence for content validity. Methods: We used the Delphi Method (DM to obtain expert opinion via an iterative process of surveying. Questions were mined from four PS surveys as well as from group suggestion. The DM analysis determined the structure, content and appropriate use of the tool. The group used four-point Likert-type scales and Lynn’s criteria for content validity to determine relevant questions from the stated goals. Results: Twelve recruited experts participated in a series of seven surveys to achieve consensus. A 10-question, single-page survey with an additional page of qualitative questions and demographic questions was selected. Thirty one questions were judged to be relevant from an original 48-question list. Of these, the final 10 questions were chosen. Response rates for individual survey items was 99.5%. Conclusion: The DM produced a consensus survey with content validity evidence. Future work will be needed to obtain evidence for response process, internal structure and construct validity.

  14. Methods to measure target site penetration of antibiotics in critically ill patients.

    Science.gov (United States)

    Schwameis, Richard; Zeitlinger, Markus

    2013-02-01

    While several tools are necessary to repair a car, the engineer knows exactly which instrument he has to utilize at different parts of the broken machine. Likewise, depending on the information we are interested in, we have to choose different tools to investigate and consecutively understand the multiple aspects that are involved in pharmacokinetics of antimicrobial agents in critically ill patients. Some techniques, like blood sampling, microdialysis or positrons emission tomography (PET) will allow for obtaining continues concentration time profiles while others like bronchoalveolar lavage (BAL), biopsy or surgical tissue samples can only be used a limited number of times per subject. PET and methods based on tissue homogenization will deliver an average of the actual concentrations in intra - and extracellular compartments while investigations in isolated blood cells or microdialysis allow for more distinguished allocation of a concentration to a defined compartment. The present review aims at discussing the advantages and disadvantages of the various methods used for assessing pharmacokinetics in critically ill patients with regard to specific aspects of pharmacokinetic research and further reviews data of selected antibiotics as examples for applications of the individual techniques.

  15. Fifty years of solid-phase extraction in water analysis--historical development and overview.

    Science.gov (United States)

    Liska, I

    2000-07-14

    The use of an appropriate sample handling technique is a must in an analysis of organic micropollutants in water. The efforts to use a solid phase for the recovery of analytes from a water matrix prior to their detection have a long history. Since the first experimental trials using activated carbon filters that were performed 50 years ago, solid-phase extraction (SPE) has become an established sample preparation technique. The initial experimental applications of SPE resulted in widespread use of this technique in current water analysis and also to adoption of SPE into standardized analytical methods. During the decades of its evolution, chromatographers became aware of the advantages of SPE and, despite many innovations that appeared in the last decade, new SPE developments are still expected in the future. A brief overview of 50 years of the history of the use of SPE in organic trace analysis of water is given in presented paper.

  16. Introduction to the focus issue: fifty years of chaos: applied and theoretical.

    Science.gov (United States)

    Hikihara, Takashi; Holmes, Philip; Kambe, Tsutomu; Rega, Giuseppe

    2012-12-01

    The discovery of deterministic chaos in the late nineteenth century, its subsequent study, and the development of mathematical and computational methods for its analysis have substantially influenced the sciences. Chaos is, however, only one phenomenon in the larger area of dynamical systems theory. This Focus Issue collects 13 papers, from authors and research groups representing the mathematical, physical, and biological sciences, that were presented at a symposium held at Kyoto University from November 28 to December 2, 2011. The symposium, sponsored by the International Union of Theoretical and Applied Mechanics, was called 50 Years of Chaos: Applied and Theoretical. Following some historical remarks to provide a background for the last 50 years, and for chaos, this Introduction surveys the papers and identifies some common themes that appear in them and in the theory of dynamical systems.

  17. Inferring genome-wide patterns of admixture in Qataris using fifty-five ancestral populations

    Directory of Open Access Journals (Sweden)

    Omberg Larsson

    2012-06-01

    Full Text Available Abstract Background Populations of the Arabian Peninsula have a complex genetic structure that reflects waves of migrations including the earliest human migrations from Africa and eastern Asia, migrations along ancient civilization trading routes and colonization history of recent centuries. Results Here, we present a study of genome-wide admixture in this region, using 156 genotyped individuals from Qatar, a country located at the crossroads of these migration patterns. Since haplotypes of these individuals could have originated from many different populations across the world, we have developed a machine learning method "SupportMix" to infer loci-specific genomic ancestry when simultaneously analyzing many possible ancestral populations. Simulations show that SupportMix is not only more accurate than other popular admixture discovery tools but is the first admixture inference method that can efficiently scale for simultaneous analysis of 50-100 putative ancestral populations while being independent of prior demographic information. Conclusions By simultaneously using the 55 world populations from the Human Genome Diversity Panel, SupportMix was able to extract the fine-scale ancestry of the Qatar population, providing many new observations concerning the ancestry of the region. For example, as well as recapitulating the three major sub-populations in Qatar, composed of mainly Arabic, Persian, and African ancestry, SupportMix additionally identifies the specific ancestry of the Persian group to populations sampled in Greater Persia rather than from China and the ancestry of the African group to sub-Saharan origin and not Southern African Bantu origin as previously thought.

  18. Evaluation of four methods for separation of lymphocytes from normal individuals and patients with cancer and tuberculosis.

    Science.gov (United States)

    Patrick, C C; Graber, C D; Loadholt, C B

    1976-01-01

    An optimal technique was sought for lymphocyte recovery from normal and chronic diseased individuals. Lymphocytes were separated by four techniques: Plasmagel, Ficoll--Hypaque, a commercial semiautomatic method, and simple centrifugation using blood drawn from ten normal individuals, ten cancer patients, and ten tuberculosis patients. The lymphocyte mixture obtained after using each method was analyzed for percent recovery, amount if contamination by erythrocytes and neutrophils, and percent viability. The results show that the semiautomatic method yielded the best percent recovery of lymphocytes for normal individuals, while the simple centrifugation method contributed the highest percent recovery for cancer and tuberculosis patients. The Ficoll-Hypaque method gave the lowest erythrocyte contamination for all three types of individuals tested, while the Plasmagel method gave the lowest neutrophil contamination for all three types of individuals. The simple centrifugation method yielded all viable lymphocytes and thus gave the highest percent viability.

  19. Comparison of three radiographic methods in screening of temporomandibular joint involvement in patients with psoriatic arthritis

    International Nuclear Information System (INIS)

    Koenoenen, M.; Kilpinen, E.

    1990-01-01

    Fifty-three randomly selected subjects with psoriatic arthritis (PA) were examined radiographically by means of orthopantomography, transcranial radiography, and transmaxillary radiography. Two examiners graded the radiographic signs of flattening, osteophytes, erosion, and sclerosis. The findings obtained were then compared to determine the best technique for screening of temporomandibular joint (TMJ) bone changes. Together the techniques showed definite (24%) and possible (6%) changes, suggesting TMJ involvement in 31 of 106 joints. In all projections, radiographic signs suggesting TMJ involvement were most frequent in the condyle. Erosion in the condyle was the most frequent finding. Agreement with regard to definite changes in the condyle was found in only one-third to half of the cases. It is concluded that in radiography of the TMJ in subjects with PA, a combination of radiographic techniques should be used to obtain maximum information. However, orthopantomography is well suited for screening of TMJ involvement in subjects with PA. 30 refs., 2 figs., 3 tabs

  20. The development of a patient-specific method for physiotherapy goal setting: a user-centered design.

    Science.gov (United States)

    Stevens, Anita; Köke, Albère; van der Weijden, Trudy; Beurskens, Anna

    2018-08-01

    To deliver client-centered care, physiotherapists need to identify the patients' individual treatment goals. However, practical tools for involving patients in goal setting are lacking. The purpose of this study was to improve the frequently used Patient-Specific Complaints instrument in Dutch physiotherapy, and to develop it into a feasible method to improve physiotherapy goal setting. An iterative user-centered design was conducted in co-creation with the physiotherapists and patients, in three phases. Their needs and preferences were identified by means of group meetings and questionnaires. The new method was tested in several field tests in physiotherapy practices. Four main objectives for improvement were formulated: clear instructions for the administration procedure, targeted use across the physiotherapy process, client-activating communication skills, and a client-centered attitude of the physiotherapist. A theoretical goal-setting framework and elements of shared decision making were integrated into the new-called, Patient-Specific Goal-setting method, together with a practical training course. The user-centered approach resulted in a goal-setting method that is fully integrated in the physiotherapy process. The new goal-setting method contributes to a more structured approach to goal setting and enables patient participation and goal-oriented physiotherapy. Before large-scale implementation, its feasibility in physiotherapy practice needs to be investigated. Implications for rehabilitation Involving patients and physiotherapists in the development and testing of a goal-setting method, increases the likelihood of its feasibility in practice. The integration of a goal-setting method into the physiotherapy process offers the opportunity to focus more fully on the patient's goals. Patients should be informed about the aim of every step of the goal-setting process in order to increase their awareness and involvement. Training physiotherapists to use a patient

  1. Developing a Healthy Web-Based Cookbook for Pediatric Cancer Patients and Survivors: Rationale and Methods

    Science.gov (United States)

    Raber, Margaret

    2015-01-01

    Background Obesity has been a growing problem among children and adolescents in the United States for a number of decades. Childhood cancer survivors (CCS) are more susceptible to the downstream health consequences of obesity such as cardiovascular disease, endocrine issues, and risk of cancer recurrence due to late effects of treatment and suboptimal dietary and physical activity habits. Objective The objective of this study was to document the development of a Web-based cookbook of healthy recipes and nutrition resources to help enable pediatric cancer patients and survivors to lead healthier lifestyles. Methods The Web-based cookbook, named “@TheTable”, was created by a committee of researchers, a registered dietitian, patients and family members, a hospital chef, and community advisors and donors. Recipes were collected from several sources including recipe contests and social media. We incorporated advice from current patients, parents, and CCS. Results Over 400 recipes, searchable by several categories and with accompanying nutritional information, are currently available on the website. In addition to healthy recipes, social media functionality and cooking videos are integrated into the website. The website also features nutrition information resources including nutrition and cooking tip sheets available on several subjects. Conclusions The “@TheTable” website is a unique resource for promoting healthy lifestyles spanning pediatric oncology prevention, treatment, and survivorship. Through evaluations of the website’s current and future use, as well as incorporation into interventions designed to promote energy balance, we will continue to adapt and build this unique resource to serve cancer patients, survivors, and the general public. PMID:25840596

  2. Clinical course teaching in transport of critically ill patients: Small group methods

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Beigmohammadi

    2016-10-01

    Full Text Available Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160 and other group the lecture base learning (n=160. In the clinical course, each participant under observation of an anesthesiologist in the operation room and ICU was acquainted with mask ventilation, intubation and learned to work with a defibrillator, infusion pump, portable ventilator and pulse oximeter. In lecture group, the anesthesiologist explained the topics by video and dummy. At the end of education course, the interns’ abilities were evaluated based on checklist method and scored by the project colleague in all educational items. Three hundred twenty interns, 122 males, and 198 females; were enrolled, two groups. The clinical course training caused improvements in the interns’ knowledge and abilities in intubation and use of the defibrillator and portable ventilator vs.lecture group significantly (P<0.005. The males were better than females in laryngoscopy, but the progress of the females was significantly better than males (P=0.003. The rate of adverse events was reduced significantly after clinical course teaching (P=0.041 Clinical course teaching could promote interns' clinical competencies in the transport of critically ill patients.

  3. Fifty years dynamics of Russian forests: Impacts on the earth system

    Science.gov (United States)

    Shvidenko, Anatoly; Schepaschenko, Dmitry; Kraxner, Florian

    2015-04-01

    The paper presents a succinct history of Russian forests during the time period of 1960-2010 and reanalysis of their impacts on global carbon and nitrogen cycles. We present dynamics of land cover change (including major categories of forest land) and biometric characteristics of forests (species composition, age structure, growing stock volume etc.) based on reconciling all relevant information (data of forest and land inventories, official forest management statistics, multi-sensor remote sensing products, data of forest pathological monitoring etc.). Completeness and reliability of background information was different during the period of the study. Forest inventory data and official statistics were partially modified based on relevant auxiliary information and used for 1960-2000. The analysis for 2001-2010 was provided with a crucial use of multi-sensor remote sensing data. For this last period a hybrid forest mask was developed at resolution of 230m by integration of 8 remote sensing products and using geographical weighted regression and data of crowdsourcing. During the considered 50 years forested areas of Russia substantially increased by middle of 1990s and slightly declined (at about 5%) after. Indicators needed for assessment of carbon and nitrogen cycles of forest ecosystems were defined for the entire period (aggregated estimates by decades for 1960-2000 and yearly for 2001-2010) based on unified methodology with some peculiarities following from availability of information. Major results were obtained by landscape-ecosystem method that uses as comprehensive as possible empirical and semi-empirical information on ecosystems and landscapes in form of an Integrated Land Information System and complimentary combines pool- and flux-based methods. We discuss and quantify major drivers of forest cover change (socio-economic, environmental and climatic) including forest management (harvest, reforestation and afforestation), impacts of seasonal weather on

  4. Patient safety initiatives in Central and Eastern Europe: A mixed methods approach by the LINNEAUS collaboration on patient safety in primary care

    Science.gov (United States)

    Godycki-Cwirko, Maciek; Esmail, Aneez; Dovey, Susan; Wensing, Michel; Parker, Dianne; Kowalczyk, Anna; Błaszczyk, Honorata; Kosiek, Katarzyna

    2015-01-01

    ABSTRACT Background: Despite patient safety being recognized as an important healthcare issue in the European Union, there has been variable implementation of patient safety initiatives in Central and Eastern Europe (CEE). Objective: To assess the status of patient safety initiatives in countries in CEE; to describe a process of engagement in Poland, which can serve as a template for the implementation of patient safety initiatives in primary care. Methods: A mixed methods design was used. We conducted a review of literature focusing on publications from CEE, an inventory of patient safety initiatives in CEE countries, interviews with key informants, international survey, review of national reporting systems, and pilot demonstrator project in Poland with implementation of patient safety toolkits assessment. Results: There was no published patient safety research from Albania, Belarus, Greece, Latvia, Lithuania, Romania, or Russia. Nine papers were found from Bulgaria, Croatia, the Czech Republic, Poland, Serbia, and Slovenia. In most of the CEE countries, patient safety had been addressed at the policy level although the focus was mainly in hospital care. There was a dearth of activity in primary care. The use of patient improvement strategies was low. Conclusion: International cooperation as exemplified in the demonstrator project can help in the development and implementation of patient safety initiatives in primary care in changing the emphasis away from a blame culture to one where greater emphasis is placed on improvement and learning. PMID:26339839

  5. Fifty top-cited spine articles from mainland China: A citation analysis.

    Science.gov (United States)

    Wu, Yaohong; Zhao, Yachao; Lin, Linghan; Lu, Zhijun; Guo, Zhaoyang; Li, Xiaoming; Chen, Rongchun; Ma, Huasong

    2018-02-01

    Objective To identify the 50 top-cited spine articles from mainland China and to analyze their main characteristics. Methods Web of Science was used to identify the 50 top-cited spine articles from mainland China in 27 spine-related journals. The title, year of publication, number of citations, journal, anatomic focus, subspecialty, evidence level, city, institution and author were recorded. Results The top 50 articles had 29-122 citations and were published in 11 English-language journals; most (32) were published in the 2000s. The journal Spine had the largest number of articles and The Lancet had the highest impact factor. The lumber spine was the most discussed anatomic area (18). Degenerative spine disease was the most common subspecialty topic (22). Most articles were clinical studies (29); the others were basic research (21). Level IV was the most common evidence level (17). Conclusions This list indicates the most influential articles from mainland China in the global spine research community. Identification of these articles provides insights into the trends in spine care in mainland China and the historical contributions of researchers from mainland China to the international spine research field.

  6. Fifty-year trends in a box turtle population in Maryland

    Science.gov (United States)

    Hall, R.J.; Henry, P.F.P.; Bunck, C.M.

    1999-01-01

    A survey conducted in 1995 investigated long term declines reported in a population of box turtles Terrapene Carolina monitored each decade since 1945 in bottomland hardwood forest at the Patuxent Wildlife Research Center, Maryland. Methods duplicated past surveys in most respects, but were supplemented by radiotelemetry and a survey of dominant vegetation. Seventy different turtles were found on the 11.8 ha study area, a decline of >75% since peak populations were recorded in 1955. Searchers were less efficient in 1995 than in 1945-1975 for a variety of possible reasons. Among turtles recorded, approximately equal numbers persisted from each of the past five decades, with some individuals surviving >70 years. A sex ratio strongly favoring males was first recorded in 1975 and continued in 1995, but juveniles and subadults were found in greater proportion in 1995 than in any other survey. Six of nine radio-marked turtles left the bottomland study area and migrated to the adjoining bluffs to hibernate, suggesting more extensive movements and perhaps less stable home ranges than formerly thought. Age structure of trees indicated a gradual change to more shade-tolerant species. Examination of rates of change from survey data suggested that major losses probably resulted from changes in hydrology that exacerbated flooding in 1972, with recovery only beginning in 1995 and perhaps limited both by repeated flood events and successional changes in the forest. Slow recovery from losses may indicate that populations of the species would respond poorly to exploitation.

  7. [IMPROVEMENT AND CHOICE OF COLOSTOMY METHOD IN THE TREATMENT OF PATIENTS, SUFFERING AN ACUTE OBTURATIVE IMPASSABILITY OF LARGE BOWEL].

    Science.gov (United States)

    Kustryo, V I; Langazo, O V

    2015-11-01

    Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times.

  8. Fifty-Four Durand Lines: The Importance of Persistent Security Assistance in Africa

    Directory of Open Access Journals (Sweden)

    Whitney Grespin

    2013-07-01

    Full Text Available The US has long faced criticism about being a ‘fair weather friend’ to foreign states only as it suits current policy interests. Such inconsistent engagement results in opportunity costs that are both fiscally draining and damaging to US social and political capital. US defense, development, and diplomatic establishments can more easily realize progress and encourage positive forward movement with African states by initiating and maintaining more consistent collaboration with foreign nation representatives. An increased commitment to persistent engagement will be especially important for the Department of Defense, which has been sharply criticized for its heavy-handedness when partnering with foreign security forces over the past decade. As the international community has observed through recent events across the African continent, it is important that the US government conduct policy planning and operations with a mind to building long-term relationships rather than dabbling in flings and ill-suited one night stands. This is particularly important with programs that involve potentially sensitive knowledge and skills transfers, such as the military reform and security force capacity building that the US has favored more heavily as of late. As the US continues to shift from heavy presence, high-visibility interventions to more subtle and nuanced capacity enhancement initiatives, government representatives will need to rely less on muscle and more on craft. The type of work that is required to truly effect change and build durable institutional relationships is hard, slow, and methodical work that does not lend itself to a quick fix.

  9. Fifty years of HgCdTe at Texas Instruments and beyond

    Science.gov (United States)

    Kinch, Michael A.

    2009-05-01

    Work on HgCdTe began at Texas Instruments in the early 1960s, and continued through 1997 when TI's defense business was sold first to Raytheon, and subsequently in 1998 to DRS Technologies. This presentation traces the history of HgCdTe's evolution throughout this timeframe to the present day, as viewed through the eyes of the author and several of his TI contemporaries who have survived the experience. The materials technology will be traced from the early days of bulk growth by the solid state recrystalization technique, through the traveling heater method of growth, to liquid phase epitaxy from large Te-rich melts, to vapor phase growth by molecular beam epitaxy and metal organic chemical vapor deposition. The evolution of detector device architectures at TI over the years will be discussed, from the early, successful days of photoconductors and the Common Module System, through the somewhat problematic and relatively unsuccessful foray into charge coupled and charge injection devices for 2nd generation FPAs for the Javelin program, to the outstandingly successful development of the vertically integrated photodiode (VIP) and high density VIP FPA architectures for mono-color and multi-color 3rd generation systems. The versatile, and unique nature of this infrared semiconductor materials system will be highlighted by reference to current work at DRS Technologies into electron avalanche photodiodes (EAPDs), for use in active/passive IR systems, and high operating temperature (HOT) detectors, which threaten to eventually offer BLIP photon detection at uncooled operating temperatures, over the whole IR spectrum from 1 to 12um.

  10. A survey on psychiatric patients' use of non-medical alternative practitioners: incidence, methods, estimation, and satisfaction.

    Science.gov (United States)

    Demling, J H; Neubauer, S; Luderer, H-J; Wörthmüller, M

    2002-12-01

    We investigated to what extent psychiatric inpatients consult Heilpraktiker, i.e. non-academically trained providers of complementary and alternative medicine (CAM), which diagnostic and therapeutic methods Heilpraktiker employ, how patients assess Heilpraictikers' professional competence, CAM in general and issues of satisfaction for those who have had experience with Heilpraktiker. Four hundred and seventy three patients admitted to a psychiatric university department during a 9-month period filled out a questionnaire developed for this investigation. About one third of the patients had consulted a Heilpraktiker, a quarter of these for their current psychiatric illness. Women were in the majority. Patients with the highest secondary school education consulted Heilpraktiker less often. There was considerable 'customer loyalty' towards Heilpraktiker. Largely the same diagnostic and treatment methods were employed for mental illness as for somatic complaints. Except for iridology, exotic or dangerous methods played a secondary role. Patients generally revealed a very positive attitude toward Heilpraktiker and CAM, although methods were rated differently. CAM enjoyed greater appreciation among women and patients who had consulted Heilpraktiker. Patients with personal experience were, on the whole, very satisfied with the professional competence, with the atmosphere in the practice and staff concern for the patient's well-being. Degree of satisfaction correlated closely with frequency of consultation. More patients with neurotic disorders considered the cost unreasonable than others, despite comparatively frequent visits. Psychiatric patients seek out Heilpraktiker to a considerable degree. Especially those who have relevant experience rank Heilpraktiker highly, in particular due to their 'psychotherapeutic' attitude, but professional competence is also valued. Methods of CAM received mixed reviews from patients but are generally seen in a positive light. It is

  11. SU-E-J-11: A New Optical Method to Register Patient External Motion

    International Nuclear Information System (INIS)

    Barbes, B; Azcona, J; Moreno, M; Prieto, E; Foronda, J; Burguete, J

    2014-01-01

    Purpose: To devise and implement a new system to measure and register the patient motion during radiotherapy treatments. Methods: The system can obtain the position of several points in the 3D-space, through their projections in the 2D-images recorded by two cameras. The algorithm needs a series of constants, that are obtained using the images of a calibrated phantom.To test the system, some adhesive labels were placed on the surface of an object. Two cameras recorded the moving object over time. An in-house developed software localized the labels in each image. In the first pair of images, the program used a first approximation given by the user. In the subsequent images, it used the last position as an approximate location. The final exact coordinates of the point were obtained in a two-step process using the contrast of the images. From the 2D-positions of the point in each frame, the 3D-trajectories of each of these marks were obtained.The system was tested with linear displacements, oscillations of a mechanical oscillator, circular trajectories of a rotating disk, and with respiratory motion of a volunteer. Results: Trajectories of several points were reproduced with sub-millimeter accuracy in the three directions of the space. The system was able to follow periodic motion with amplitudes lower than 0.5mm; and trajectories of rotating points at speeds up to 200mm/s. The software could also track accurately the respiration motion of a person. Conclusion: A new, inexpensive optical tracking system for patient motion has been demonstrated. The system detects motion with high accuracy. Installation and calibration of the system is simple and quick. Data collection is not expected to involve any discomfort for the patient, nor any delay for the treatment. The system could be also used as a method of warning for patient movements, and for gating. We acknowledge financial support from Fundacion Mutua Madrilena, Madrid, Spain

  12. SU-E-J-11: A New Optical Method to Register Patient External Motion

    Energy Technology Data Exchange (ETDEWEB)

    Barbes, B; Azcona, J; Moreno, M; Prieto, E [Clinica Universidad de Navarra, Pamplona, Navarra (Spain); Foronda, J [Tecnun Universidad de Navarra, San Sabastian (Spain); Burguete, J [Universidad de Navarra, Pamplona, Navarra (Spain)

    2014-06-01

    Purpose: To devise and implement a new system to measure and register the patient motion during radiotherapy treatments. Methods: The system can obtain the position of several points in the 3D-space, through their projections in the 2D-images recorded by two cameras. The algorithm needs a series of constants, that are obtained using the images of a calibrated phantom.To test the system, some adhesive labels were placed on the surface of an object. Two cameras recorded the moving object over time. An in-house developed software localized the labels in each image. In the first pair of images, the program used a first approximation given by the user. In the subsequent images, it used the last position as an approximate location. The final exact coordinates of the point were obtained in a two-step process using the contrast of the images. From the 2D-positions of the point in each frame, the 3D-trajectories of each of these marks were obtained.The system was tested with linear displacements, oscillations of a mechanical oscillator, circular trajectories of a rotating disk, and with respiratory motion of a volunteer. Results: Trajectories of several points were reproduced with sub-millimeter accuracy in the three directions of the space. The system was able to follow periodic motion with amplitudes lower than 0.5mm; and trajectories of rotating points at speeds up to 200mm/s. The software could also track accurately the respiration motion of a person. Conclusion: A new, inexpensive optical tracking system for patient motion has been demonstrated. The system detects motion with high accuracy. Installation and calibration of the system is simple and quick. Data collection is not expected to involve any discomfort for the patient, nor any delay for the treatment. The system could be also used as a method of warning for patient movements, and for gating. We acknowledge financial support from Fundacion Mutua Madrilena, Madrid, Spain.

  13. Understanding the patient experience through the power of film: A mixed method qualitative research study.

    Science.gov (United States)

    Ogston-Tuck, Sherri; Baume, Kath; Clarke, Chris; Heng, Simon

    2016-11-01

    For decades film has proved to be a powerful form of communication. Whether produced as entertainment, art or documentary, films have the capacity to inform and move us. Films are a highly attractive teaching instrument and an appropriate teaching method in health education. It is a valuable tool for studying situations most transcendental to human beings such as pain, disease and death. The objectives were to determine how this helps students engage with their role as health care professionals; to determine how they view the personal experience of illness, disease, disability or death; and to determine how this may impact upon their provision of patient care. The project was underpinned by the film selection determined by considerate review, intensive scrutiny, contemplation and discourse by the research team. 7 films were selected, ranging from animation; foreign, documentary, biopic and Hollywood drama. Each film was shown discretely, in an acoustic lecture theatre projected onto a large screen to pre-registration student nurses (adult, child and mental health) across each year of study from different cohorts (n=49). A mixed qualitative method approach consisted of audio-recorded 5-minute reactions post film screening; coded questionnaires; and focus group. Findings were drawn from the impact of the films through thematic analysis of data sets and subjective text condensation categorised as: new insights looking through patient eyes; evoking emotion in student nurses; spiritual care; going to the moves to learn about the patient experience; self discovery through films; using films to link theory to practice. Deeper learning through film as a powerful medium was identified in meeting the objectives of the study. Integration of film into pre registration curriculum, pedagogy, teaching and learning is recommended. The teaching potential of film stems from the visual process linked to human emotion and experience. Its impact has the power to not only help in

  14. Empathy and the wounded healer: a mixed-method study of patients and doctors views on empathy.

    Science.gov (United States)

    Brady, C; Bambury, R M; O'Reilly, S

    2015-04-01

    Empathy is increasingly being recognized as a crucial component for an effective doctor-patient relationship. Using a mixed method approach, we surveyed 125 patients and 361 medical practitioners (doctors and medical students) views of the doctor-patient relationship. We qualitatively assessed patients' views of what constituted a good doctor and qualitatively measured empathy using a validated scale in medical practitioners. Patients desire a doctor that is both clinically proficient 66 (55%) and caring 32 (27%). Doctors who have a personal experience of illness have a statistically higher empathy score. These doctors may be well placed to help develop and foster empathy in our profession.

  15. Functional Assessment of the Stomatognathic System, after the Treatment of Edentulous Patients, with Different Methods of Establishing the Centric Relation

    Directory of Open Access Journals (Sweden)

    Aleksandra Nitecka-Buchta

    2018-01-01

    Full Text Available The study compares subjective experiences of patients, wearing complete dentures. Two different methods of determining a centric relation were performed: the traditional method using wax occlusal rims and the Gerber method, based on gothic arch tracings. The success rate of establishing a centric relation in both methods was evaluated (rentgenodiagnostics. The influence of the method used to obtain the centric relation on patients’ stomatognathic system (condyle centralization, pain was also evaluated. Better results were achieved in gothic arch tracing method. Before every prosthetic treatment of edentulous patients, a functional analysis of the TMJ is necessary. The lack of centric relation, in a long term adaptation patients, does not lead to TMD symptoms. This trial is registered with NCT03343015.

  16. Current imaging methods for evaluation of metabolic risk in pediatric patients

    International Nuclear Information System (INIS)

    Balev, B.; Lateva, M.; Popova, R.; Teneva, Ts.; Iotova, V.

    2013-01-01

    Full text: Introduction: The incidence of cardio - metabolic diseases increase in an increasingly early age is one of the challenges of the 21st century. This phenomenon is attributed largely of the obesity epidemic, it is particularly significant when the obesity occurs in childhood - obese children have a greater probability of developing cardiovascular disease and diabetes earlier. What you will learn: The significance of the obesity epidemic in childhood and metabolic risk increase; The compartment of adipose tissue and their role in maintaining metabolic balance and its breach; The importance of imaging methods in recent studies related to obesity and cardio - metabolic diseases in children; New imaging methods for proofing of pathological fat accumulation in other tissues and organs and their role in the study of metabolic disorders. Discussion: Various studies of pathology at obesity prove that obesity indicators are not sufficient for individualized assessment of cardio - metabolic risk. Only by imaging methods, information about the accumulated fat in metabolically more active visceral and ectopic adipose tissue depots has been obtained. The most common imaging techniques for analysis of body composition and adiposity in children - dual-energy X-ray absorptiometry (DXA), ultrasound , computed tomography ( CT) scan , magnetic resonance imaging ( MRI), magnetic resonance spectroscopy (MRS) will be presented. Conclusion: The imaging methods are widely used in the obesity and metabolic risk studies, as the trend is to be applied increasingly into practice. The results from Imaging studies affect not only to therapeutic approach, but also to the motivation of parents and patients to comply prescribed measures

  17. GPU-accelerated Lattice Boltzmann method for anatomical extraction in patient-specific computational hemodynamics

    Science.gov (United States)

    Yu, H.; Wang, Z.; Zhang, C.; Chen, N.; Zhao, Y.; Sawchuk, A. P.; Dalsing, M. C.; Teague, S. D.; Cheng, Y.

    2014-11-01

    Existing research of patient-specific computational hemodynamics (PSCH) heavily relies on software for anatomical extraction of blood arteries. Data reconstruction and mesh generation have to be done using existing commercial software due to the gap between medical image processing and CFD, which increases computation burden and introduces inaccuracy during data transformation thus limits the medical applications of PSCH. We use lattice Boltzmann method (LBM) to solve the level-set equation over an Eulerian distance field and implicitly and dynamically segment the artery surfaces from radiological CT/MRI imaging data. The segments seamlessly feed to the LBM based CFD computation of PSCH thus explicit mesh construction and extra data management are avoided. The LBM is ideally suited for GPU (graphic processing unit)-based parallel computing. The parallel acceleration over GPU achieves excellent performance in PSCH computation. An application study will be presented which segments an aortic artery from a chest CT dataset and models PSCH of the segmented artery.

  18. The modern methods of treatment of patients with radiation syndrome in a specialized hospital (analytical review)

    International Nuclear Information System (INIS)

    Selidovkin, G.D.

    1995-01-01

    Modern methods of treatment of patients with various symptoms of acute radiation disease in a specialized hospital are reviewed. The treatment starts from prophylactic prescription of antibacterial antibiotics of latest generations (imipinem, cephalosporin of 3-rd generation), antifungal and antiviral remedies, immunoglobulin G, selective decontamination of intestines should be carried out. Transfusion of donor thrombocytes and erythrocytes in the quantities adequate to the degree of explicit cytopenia should be provided. Full parenteral feeding should be prescribed, desintoxication and adjustment therapy is be administered. Transplantation of HLA-identical bone marrow may be recommended only over the range from 10 to 15 Gy close to uniform irradiation. The most promising in the therapy of acute radiation disease - 3, 4 are hemopoietic growth factors. 76 refs.; 2 tabs

  19. Measurement of methionine level with the LC-ESI-MS/MS method in schizophrenic patients.

    Science.gov (United States)

    Kulaksizoglu, S; Kulaksizoglu, B; Ellidag, H Y; Eren, E; Yilmaz, N; Baykal, A

    2016-01-01

    The purpose of this study was to evaluate plasma methionine levels by using liquid chromatography electrospray ionization-tandem mass spectroscopy (LC-ESI-MS/MS) in schizophrenic patients. A twelve-point standard graph was drawn, and the recovery rate, the intra-day and inter-day coefficients of variation (CV), the limit of detection (LOD), and the limit of quantification (LOQ) were evaluated. The y and R2 values of the standard graph equation were determined as 0.011x + 0.0179 and 0.9989, respectively, and the graph remained linear until the 200 µmol/l level. The intra-day coefficients of variation of the samples (n = 10) containing 8, 28, and 58 µmol/l methionine were determined as 2.68, 3.10, and 3.79%, respectively; while their inter-day coefficients of variation were determined as 2.98, 3.19, and 3.84%. The LOD and LOQ values were determined as 0.04 and 0.1 µmol/l, respectively, while the mean recovery rates were determined as 101.7 and 99.3%. Plasma methionine values were measured as 21.5 (19.5-24,6) µmol/l for the patient group, 17.8 (16.3-20.1) µmol/l for the control group, and the difference between the two groups was statistically significant (p = 0.03). LC-ESI-MS/MS method represents a fairly sensitive, economic, and rapid analysis that requires very little sample and is suitable for measuring methionine levels in schizophrenic patients.

  20. Comparative study of three methods of estimation of creatinine clearance in critically ill patients.

    Science.gov (United States)

    Blasco, V; Antonini, F; Zieleskiewicz, L; Hammad, E; Albanèse, J; Martin, C; Leone, M

    2014-05-01

    At the bedside, the reference method for creatinine clearance determination is based on the measurement of creatinine concentrations in urine and serum (mCrCl). Several models are available to calculate the creatinine clearance from the serum creatinine concentration. This observational survey aimed at testing the hypothesis that the proposed equations are unreliable to determine accurate creatinine clearance in patients admitted to intensive care unit (ICU). Creatinine clearance was determined by the use of mCrCl. Then, we compared three equations: Cockcroft-Gault (CG), Simplified Modification of Diet in Renal Disease (MDRDs), and Chronic Kidney Disease Epidemiology (CKD-EPI) in 156 consecutive patients within the first 24hours after ICU admission. We tested the hypothesis that the three equations were equivalent. The agreement between the three equations was evaluated by linear regression and Bland and Altman analysis. Bland and Altman analysis showed similar agreement between the three equations. The biases and precisions were -4.8±51, -1.3±50, and 8.2±44 for CG, MDRDs, and CKD-EPI equations, respectively (P>0.05). The precisions were similar for the three equations (P>0.05). The percentages of outliers at ±30% were 44%, 45%, and 49% for CG, MDRDs, and CKD-EPI, respectively (P>0.05). Regarding the high percentage of outliers, the use of these equations cannot be recommended in ICU patients. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  1. Cow's Milk Desensitization in Anaphylactic Patients: A New Personalized-dose Method.

    Science.gov (United States)

    Babaie, Delara; Nabavi, Mohammad; Arshi, Saba; Mesdaghi, Mehrnaz; Chavoshzadeh, Zahra; Bemanian, Mohammad Hasan; Tafakori, Mitra; Amirmoini, Mehrdad; Esmailzadeh, Hosein; Molatefi, Rasoul; Rekabi, Mahsa; Akbarpour, Nadieh; Masoumi, Farimah; Fallahpour, Morteza

    2017-02-01

    Cow's milk allergy (CMA) is the most frequent food allergy in children and oral immunotherapy (OIT) is a promising approach for treatment of patients. The most challenging cases are anaphylactic with coexisting asthma and proposing safe protocols is crucial especially in high risk groups. Considering that CMA varies among patients, an individualized OIT protocol would be beneficial to achieve a safer and more efficient method of desensitization. 18 children more than 3 years of age with IgE-mediated CMA were enrolled. CMA was confirmed by positive skin prick test (SPT) and positive oral food challenge (OFC) and 60% of individuals had a convincing history of persistent asthma. SPT with milk extracts, whole fresh milk and serially diluted milk concentrations were performed.  The dilution of milk that induced 3-5 mm of wheal in each individual was selected as the starting dilution for OIT. Desensitization began by 1 drop of the defined dilution and continued increasingly. Overall, 16 out of 18 children (88.8%) achieved the daily intake of 120 mL of milk. Four out of these 16 children accomplished the protocol without any adverse allergic reactions. 12 patients experienced mild to severe reactions. Wheal and erythema in SPT (p≤0.001), and sIgE (p≤0.003) to most milk allergens were significantly decreased following desensitization. We successfully desensitized 16 of 18 children with IgE-mediated CMA by individualized desensitization protocol. Individualizing the OIT protocol would be helpful to save time and perhaps to relieve the allergic symptoms after ingesting cow's milk intake.

  2. A Reliable Method to Measure Lip Height Using Photogrammetry in Unilateral Cleft Lip Patients.

    Science.gov (United States)

    van der Zeeuw, Frederique; Murabit, Amera; Volcano, Johnny; Torensma, Bart; Patel, Brijesh; Hay, Norman; Thorburn, Guy; Morris, Paul; Sommerlad, Brian; Gnarra, Maria; van der Horst, Chantal; Kangesu, Loshan

    2015-09-01

    There is still no reliable tool to determine the outcome of the repaired unilateral cleft lip (UCL). The aim of this study was therefore to develop an accurate, reliable tool to measure vertical lip height from photographs. The authors measured the vertical height of the cutaneous and vermilion parts of the lip in 72 anterior-posterior view photographs of 17 patients with repairs to a UCL. Points on the lip's white roll and vermillion were marked on both the cleft and the noncleft sides on each image. Two new concepts were tested. First, photographs were standardized using the horizontal (medial to lateral) eye fissure width (EFW) for calibration. Second, the authors tested the interpupillary line (IPL) and the alar base line (ABL) for their reliability as horizontal lines of reference. Measurements were taken by 2 independent researchers, at 2 different time points each. Overall 2304 data points were obtained and analyzed. Results showed that the method was very effective in measuring the height of the lip on the cleft side with the noncleft side. When using the IPL, inter- and intra-rater reliability was 0.99 to 1.0, with the ABL it varied from 0.91 to 0.99 with one exception at 0.84. The IPL was easier to define because in some subjects the overhanging nasal tip obscured the alar base and gave more consistent measurements possibly because the reconstructed alar base was sometimes indistinct. However, measurements from the IPL can only give the percentage difference between the left and right sides of the lip, whereas those from the ABL can also give exact measurements. Patient examples were given that show how the measurements correlate with clinical assessment. The authors propose this method of photogrammetry with the innovative use of the IPL as a reliable horizontal plane and use of the EFW for calibration as a useful and reliable tool to assess the outcome of UCL repair.

  3. A mixed methods study to understand patient expectations for antibiotics for an upper respiratory tract infection

    Directory of Open Access Journals (Sweden)

    Christina Gaarslev

    2016-10-01

    Full Text Available Abstract Background Antimicrobial resistance is a public health challenge supplemented by inappropriate prescribing, especially for an upper respiratory tract infection in primary care. Patient/carer expectations have been identified as one of the main drivers for inappropriate antibiotics prescribing by primary care physicians. The aim of this study was to understand who is more likely to expect an antibiotic for an upper respiratory tract infection from their doctor and the reasons underlying it. Methods This study used a sequential mixed methods approach: a nationally representative cross sectional survey (n = 1509 and four focus groups. The outcome of interest was expectation and demand for an antibiotic from a doctor when presenting with a cold or flu. Results The study found 19.5 % of survey respondents reported that they would expect the doctor to prescribe antibiotics for a cold or flu. People younger than 65 years of age, those who never attended university and those speaking a language other than English at home were more likely to expect or demand antibiotics for a cold or flu. People who knew that ‘antibiotics don’t kill viruses’ and agreed that ‘taking an antibiotic when one is not needed means they won’t work in the future’ were less likely to expect or demand antibiotics. The main reasons for expecting antibiotics were believing that antibiotics are an effective treatment for a cold or flu and that they shortened the duration and potential deterioration of their illness. The secondary reason centered around the value or return on investment for visiting a doctor when feeling unwell. Conclusion Our study found that patients do not appear to feel they have a sufficiently strong incentive to consider the impact of their immediate use of antibiotics on antimicrobial resistance. The issue of antibiotic resistance needs to be explained and reframed as a more immediate health issue with dire consequences to ensure the

  4. A Novel Rapid MALDI-TOF-MS-Based Method for Measuring Urinary Globotriaosylceramide in Fabry Patients

    Science.gov (United States)

    Alharbi, Fahad J.; Geberhiwot, Tarekegn; Hughes, Derralynn A.; Ward, Douglas G.

    2016-04-01

    Fabry disease is an X-linked lysosomal storage disorder caused by deficiency of α-galactosidase A, resulting in the accumulation of glycosphingolipids in various organs. Globotriaosylceramide (Gb3) and its isoforms and analogues have been identified and quantified as biomarkers of disease severity and treatment efficacy. The current study aimed to establish rapid methods for urinary Gb3 extraction and quantitation. Urine samples from 15 Fabry patients and 21 healthy control subjects were processed to extract Gb3 by mixing equal volumes of urine, methanol containing an internal standard, and chloroform followed by sonication and centrifugation. Thereafter, the lower phase was analyzed by MALDI-TOF MS and the relative peak areas of the internal standard and four major species of Gb3 determined. The results showed high reproducibility with intra- and inter-assay coefficients variation of 9.9% and 13.7%, respectively. The limit of detection was 0.15 ng/μL and the limit of quantitation was 0.30 ng/μL. Total urinary Gb3 levels in both genders of classic Fabry patients were significantly higher than in healthy controls (p < 0.0001). Gb3 levels in Fabry males were higher than in Fabry females (p = 0.08). We have established a novel assay for urinary total Gb3 that takes less than 15 min from start to finish.

  5. Effect of different blood purification methods on adipokines and flammatory factor in patients with diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Chun Zhong

    2016-02-01

    Full Text Available Objective: To investigate the effect of in different type hemopurification techniques on adipokine and flammatory factor in diabetic nephropathy with maintenance hemodialysis (MHD. Methods: A total of 81 diabetic nephropathy patients were randomly divided into on hemodialysis group (HD, n=27, hemodialysis with hemoperfusion group (HD+HP, n=27, online hemodiafiltration group (OL-HDF, n=27. Levels of adiponectin, resistin, interleukin-6 (IL-6, and tumor necrosis factor (TNF-α were tested and compared before and after treatment. Results: Indicators of HD group have no statistical significance before and after treatment. HD+HP and OL-HDF group adiponectin level increased significantly, resistin, IL-6 and TNF-α level decreased significantly before and after treatment; OL-HDF group resistin, IL-6 and TNF-α level decreased more significantly than HD+HP group after treatment. Conclusion: HD+HP and OL-HDF treatments have reliable curative effect on diabetic nephropathy patients, which can regulate adiponectin, resistin, IL-6 and TNF-α level. Effect of OL-HDF treatment eliminates resistin, IL-6 and TNF-α more markedly than HD+HP treatment.

  6. Simple and effective method to lower body core temperatures of hyperthermic patients.

    Science.gov (United States)

    O'Connor, John P

    2017-06-01

    Hyperthermia is a potentially life threatening scenario that may occur in patients due to accompanying morbidities, exertion, or exposure to dry and arid environmental conditions. In particular, heat stroke may result from environmental exposure combined with a lack of thermoregulation. Key clinical findings in the diagnosis of heatstroke are (1) a history of heat stress or exposure, (2) a rectal temperature greater than 40 °C, and (3) central nervous system dysfunction (altered mental state, disorientation, stupor, seizures, or coma) (Prendergast and Erickson, 2014 [1]). In these patients, it is important to bring the body's core temperature down to acceptable levels in a short period of time to avoid tissue/organ injury or death (Yoder, 2001; Casa et al., 2007 [2,3]). A number of potential approaches, both non-invasive and invasive, may be used to lower the temperature of these individuals. Non-invasive techniques generally include: evaporative cooling, ice water immersion, whole-body ice packing, strategic ice packing, and convective cooling. Invasive approaches may include gastric lavage or peritoneal lavage (Schraga and Kates [4]). The efficacy of these methods vary and select treatment approaches may be unsuitable for specific individuals (Schraga and Kates [4]). In this work, the effectiveness of radiation cooling of individuals as a stand-alone treatment and comparisons with existing noninvasive techniques are presented. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Survey of methods used to determine if a patient has a deep vein thrombosis: An exploratory research report.

    Science.gov (United States)

    Heick, John D; Farris, James W

    2017-09-01

    The use of evidence-based practice (EBP) is encouraged in the physical therapy profession, but integrating evidence into practice can be difficult for clinicians because of lack of time and other constraints. To survey physical therapy clinical instructors and determine the methods they use for screening for deep vein thrombosis (DVT), a type of venous thromboembolism (VTE) in the lower extremities. Exploratory survey. Twelve survey questions written specifically for this study were sent to a convenience sample of clinical instructors associated with seven universities across 43 states. Eight hundred fifty clinical instructors (22.4% response rate) completed the survey. Of those who responded, 80.5% were taught to use Homans sign to screen for a possible DVT in their entry-level education and 67.9% continued to use Homans sign in clinical practice. Regardless of post-graduate education, respondents were more likely to choose Homans sign than a clinical decision rule (CDR) to screen for a suspected DVT. Additionally, nearly two-thirds of respondents failed to correctly identify one or more of the major risk factors for developing a DVT/VTE. The response rate was 22.4% and therefore may not fully represent the population of physical therapy clinical instructors in the United States. Results from this exploratory survey indicated that approximately two-thirds of physical therapy clinical instructors used outdated DVT/VTE screening methods that they were taught in their entry-level education and nearly two-thirds did not identify the major risk factors associated with DVT/VTE. These results suggest that change is necessary in physical therapy education, clinical practice, and continuing professional development to ensure a more evidenced-based identification of DVT and VTE.

  8. Agreement between fasting and postprandial LDL cholesterol measured with 3 methods in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Lund, Søren S.; Petersen, Martin; Frandsen, Merete

    2011-01-01

    LDL cholesterol (LDL-C) is a modifiable cardiovascular disease risk factor. We used 3 LDL-C methods to study the agreement between fasting and postprandial LDL-C in type 2 diabetes (T2DM) patients.......LDL cholesterol (LDL-C) is a modifiable cardiovascular disease risk factor. We used 3 LDL-C methods to study the agreement between fasting and postprandial LDL-C in type 2 diabetes (T2DM) patients....

  9. The Effect of Medicine Knowledge on the Methods Applied for Lowering Blood Pressure in Patients with Hypertension

    OpenAIRE

    Belguzar Kara; Senay Uzun; Mehmet Yokusoglu; Mehmet Uzun

    2009-01-01

    AIM: The aim of this study was to determine the effect of medicine knowledge on the methods applied for lowering blood pressure among patients with hypertension. METHODS: This cross-sectional study was conducted between February 1 and April 30, 2006. The sample of the study was constituted by 77 patients who had admitted to Gulhane Military Medical Academy Cardiology Outpatient Clinic with the diagnosis of hypertension. The data were collected by using a questionnaire designed by the investig...

  10. Using method triangulation to validate a new instrument (CPWQ-com) assessing cancer patients' satisfaction with communication

    DEFF Research Database (Denmark)

    Ross, Lone; Lundstrøm, Louise Hyldborg; Petersen, Morten Aagaard

    2012-01-01

    Patients' perceptions of care including the communication with health care staff is recognized as an important aspect of the quality of cancer care. Using mixed methods, we developed and validated a short instrument assessing this communication.......Patients' perceptions of care including the communication with health care staff is recognized as an important aspect of the quality of cancer care. Using mixed methods, we developed and validated a short instrument assessing this communication....

  11. Surgical management of pilonidal sinus patients by primary and secondary repair methods: a comparative study

    Directory of Open Access Journals (Sweden)

    Haji Barati B

    2010-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Gross difference in return to work exists in pilonidal sinus patients operated by primary and secondary repair. This survey was to evaluate the results of surgical management of pilonidal sinus with primary or secondary closure."n"nMethods: In a randomized clinical trial, patients with pilonidal sinus referring to the surgical clinic of Shariati Hospital in Tehran, Iran between March 2007 and March 2009 were underwent either excision with midline closure (primary, n=40, or excision without closure (secondary, n=40. The recorded outcomes were hospital stay, healing time, time off work, postoperative pain, patient's satisfaction and the recurrence rate."n"nResults: Majority of the patients were male (87.50%. There was no significant difference in the hospital stay. Time off work (8.65±1.73 Vs. 11.53±2.33 days, p=0.001 and healing time (3.43±0.92 Vs. 5.3±0.79 days, p=0.001 were shorter in primary group; but, there were no significant differences in hospital stay and number of visits. Intensity of postoperative pain in the 1st (37.75±6.5 Vs. 43.63±5.06, p=0.001, 2nd (26.75±6.66 Vs. 34.63±5.48, p=0.001, 3rd (18.25±6.05 Vs. 27.88±6.88, p=0.001, and 7th (8.45±3.85 Vs. 17.88±6.19, p=0.001 days were

  12. AN EMPIRICAL METHOD FOR MATERIALITY: WOULD CONFLICT OF INTEREST DISCLOSURES CHANGE PATIENT DECISIONS?

    Science.gov (United States)

    Spece, Roy; Yokum, David; Okoro, Andrea-Gale; Robertson Christopher

    2014-01-01

    The law has long been concerned with the agency problems that arise when advisors, such as attorneys or physicians, put themselves in financial relationships that create conflicts of interest. If the financial relationship is "material" to the transactions proposed by the advisor, then non-disclosure of the relationship may be pertinent to claims of malpractice, informed consent, and even fraud, as well as to professional discipline. In these sorts of cases, materiality is closely related to the question of causation, roughly turning on whether the withheld information might have changed the decision of a reasonable advisee (i.e., a patient). The injured plaintiff will predictably testify that the information would have impacted his or her choice, but that self-serving testimony may be unreliable. The fact finder is left to speculate about the counterfactual world in which the information was disclosed. This Article shows how randomized vignette-based experimentation may create a valuable form of evidence to address these questions, for both litigation and policymaking. To demonstrate this method and investigate conflicts of interest in healthcare in particular, we recruited 691 human subjects and asked them to imagine themselves as patients facing a choice about whether to undergo a cardiac stenting procedure recommended by a cardiologist. We manipulated the vignettes in a 2 x 3 between-subjects design, where we systematically varied the appropriateness of the proposed treatment, which was described in terms of patient risk without the procedure (low or high), and manipulated the type of disclosure provided by the physician (none, standard, or enhanced). We used physician ownership of the specialty hospital where the surgery would be performed as the conflict of interest, disclosed or not, and the "enhanced" disclosure included notice that such relationships have been associated with biases in prescribing behavior. We found that the mock patients were

  13. Prevalence and correlates of suicide ideation in patients with COPD: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Fleehart S

    2014-12-01

    Full Text Available Sara Fleehart,1,* Vincent S Fan,2,3,* Huong Q Nguyen,4 Jungeun Lee,1 Ruth Kohen,3 Jerald R Herting,5 Gustavo Matute-Bello,2,3 Sandra G Adams,6,7 Genevieve Pagalilauan,3 Soo Borson3 1School of Nursing, University of Washington, Seattle, WA, USA; 2VAPuget Sound Health Care Center, Seattle, WA, USA; 3School of Medicine, University of Washington, Seattle, WA, USA; 4Reseach and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; 5Department of Sociology, University of Washington, Seattle, WA, USA; 6School of Medicine, University of Texas Health Science Center; 7South Texas Veterans Health Care System, San Antonio, TX, USA *These authors contributed equally to this paper Purpose: The purpose of this study was to examine the prevalence and correlates of suicidal ideation (SI in patients with stable moderate to very severe chronic obstructive pulmonary disease (COPD. Patients and methods: We conducted an exploratory mixed methods analysis of data from participants in a longitudinal observational study of depression in COPD. We measured depression with the Patient Health Questionnaire-9 (PHQ-9, which includes an item on SI. We compared participants with and without SI in relation to sociodemographics, symptoms, anxiety, and healthcare resource use with independent t-tests and chi-square tests. Content analysis was performed on qualitative data gathered during a structured SI safety assessment. Results: Of 202 participants, 121 (60% had depressive symptoms (PHQ ≥6; 51 (25% had a PHQ-9 ≥10, indicating a high likelihood of current major depression; and 22 (11% reported SI. Compared to the 99 depressed participants without SI, those with SI were more likely to be female (59% vs 27%, P=0.004; had worse dyspnea (P=0.009, depression (P<0.001, and anxiety (P=0.003; and were also more likely to have received treatment for depression and/or anxiety (82% vs 40%, P<0.001 and more hospitalizations for COPD exacerbations (P=0.03 but had similar

  14. Ready for goal setting? Process evaluation of a patient-specific goal-setting method in physiotherapy.

    Science.gov (United States)

    Stevens, Anita; Köke, Albère; van der Weijden, Trudy; Beurskens, Anna

    2017-08-31

    Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method. We conducted a process evaluation within a non-controlled intervention study. Community-based physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals, planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by recording consultations and assessing patient files, questionnaires and written reflection reports. Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files were analysed. The PSG steps were performed as intended, but the 'setting goals' and 'planning treatment' steps were not performed in detail. The patients and physiotherapists were positive about the method, and the physiotherapists perceived increased patient participation. They became aware of the importance of engaging patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e. informing and involving patients, and client-centred competences had improved, this was not completely confirmed by the objectively observed behaviour. The PSG is a feasible method and tends to have impact on increasing patient participation in the goal

  15. Follow-up of cardiac parameters by isotope diagnostic methods in patients after in-patient post-infarction rehabilitation

    International Nuclear Information System (INIS)

    Mester, Janos; Szasz, Karoly; Pavics, Laszlo; Rajtar, Maria; Csernay, Laszlo

    1989-01-01

    The size and the extent of the myocardial infarction was determined by 74 MBq 201 Tl imaging at rest using 201 TlCl intravenous injection. ECG-gated equilibrium radionuclide studies were performed in each case on the first day of rehabilitation, then 3 and 9 weeks after the first examination, finally 6 months after the patient finished the three-week in-patient rehabilitation. No significant changes were observed in the average value of the endodiastolic volume of the left ventricle and in the number of ventricular segments with wall motion abnormality, though the physical performance of the patients increased. (author) 33 refs.; 6 tabs

  16. A Comparison of the impact of family-centered and patient-centered education methods on attitude toward and adherence to diet and fluid restriction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Asgari P

    2015-02-01

    Full Text Available Background and Objective: One of the major issues in hemodialysis patients is adherence to diet and fluid restriction. In order to reduce the adverse consequences of the disease and improve quality of life, educating these patients is of great importance. Therefore, the present study was conducted in order to compare the impact of two methods of education (patient-centered and family–centered on attitude toward and adherence to diet and fluid restriction in hemodialysis patients. Materials and Method: This clinical trial was performed on patients referred to the hemodialysis ward of hospitals affiliated with Tehran University of Medical Sciences, Iran, during May to October 2012. Through purposive sampling method, 60 patients were selected and randomly assigned to two groups patient-centered (n = 30 and family-centered (n = 30. Patients’ attitude toward and adherence to diet regime and fluid restriction were assessed using a researcher-made self-report questionnaire in 3 stages (before the intervention, and 2 and 4 weeks after the intervention. The reliability and validity of the questionnaire were approved. Data analysis was performed using SPSS software version 16 and independent t-test, chi-square, Fisher’s exact test, and repeated measures ANOVA. Results: Before the intervention, the findings showed no significant difference between the 2 groups in terms of adherence to diet and fluid restriction. In the second week after the intervention, mean adherence to diet in the family-centered group was significantly higher than the patient-centered group (P = 0.010. Moreover, at the end of the second (P = 0.001 and fourth weeks (P = 0.002, the attitude toward adherence to diet and fluid restriction was more positive in the family-centered group, in comparison to the patient-centered group. Conclusion: Family-centered education is more effective on patient adherence to the treatment regimen. Thus, it is recommended that family

  17. Opioid Usage During Admission in Hip Fracture Patients-The Effect of the Continuous Femoral Nerve Block

    DEFF Research Database (Denmark)

    Helsø, Ida; Jantzen, Christopher; Lauritzen, Jes Bruun

    2016-01-01

    INTRODUCTION: The aim of this study was to investigate whether there was a difference in opioid usage during admission for hip fracture patients with continuous femoral nerve block (cFNB) when compared to patients nonfemoral nerve block (nFNB). METHODS AND MATERIALS: Patients were identified from...... the local database on all hip fracture patients admitted to Bispebjerg University Hospital, Denmark. Four hundred fifty-six hip fracture patients were included during the period September 2008 to October 2010. RESULTS: Three hundred sixty-six hip fracture patients had cFNB. The mean time with cFNB was 3...

  18. Usefulness of transrectal ultrasound-guided 12 core biopsy method in patients with clinically suspected prostate cancer

    International Nuclear Information System (INIS)

    Kwon, Se Hwan; Lim, Joo Won; Park, Seong Jin; Ko, Young Tae; Kim, Yoon Wha

    2000-01-01

    To evaluate the improvement of prostate cancer detection provided by transrectal ultrasound (TRUS)-guided 12 core biopsy method compared with sextant biopsy method. Between June 1997 and February 1999, 29 patients with pathologically proven prostate cancer in 124 patients who underwent TRUS-guided 12 core biopsy method were evaluated. They had abnormal findings in prostate specific antigen (PSA), digital rectal examination (DRE) or TRUS findings. The prostate was diffusely enlarged in all patients on DRE findings and in 15 cases (15/29, 52%), hard nodule was palpated. The average of PSA and prostate specific antigen density (PSAD) is 229.33 ng/ml (1-2280) and 9.14 ng/ml/cm 3 (0.048-142.5), respectively, 12 transrectal biopsy, including 2 transition zones, was performed in both lobe, 6 biopsies were located in both base, middle and apex. Then 2 biopsies were inserted between 3 biopsies in both peripheral zone and 2 biopsies were performed in both transition zone. Each specimen was pathologically examined. The results of pathology were compared with method 1 and 2, respectively. We defined the method 1 and 2 as different sextant biopsy method. The method 1 is that cores are taken from both base, middle and apex and method 2 is that cores are taken from both base, apex and transition zone. TRUS findings were analyzed by two radiologists. Of the 29 patients with prostate cancer, 3 (10%) had carcinomas only in the additional regions as compared with method. When compared with method 2,2 (7.0%) had carcinomas only in the additional regions. 2 patients were same in both cases. TRUS findings were abnormal in 21 cases in all patients whose 12 biopsy method was not helpful. 12 biopsy method was helpful in 2/8 (25%) whose TRUS findings were non-specific and 1/21 (4.8%) whose TRUS findings were abnormal. Small low echoic lesion was seen in one patients whose 12 biopsy method was helpful, but cancer was found in other area. TRUS-guided 12 core biopsy method may be superior to

  19. Method

    Directory of Open Access Journals (Sweden)

    Ling Fiona W.M.

    2017-01-01

    Full Text Available Rapid prototyping of microchannel gain lots of attention from researchers along with the rapid development of microfluidic technology. The conventional methods carried few disadvantages such as high cost, time consuming, required high operating pressure and temperature and involve expertise in operating the equipment. In this work, new method adapting xurography method is introduced to replace the conventional method of fabrication of microchannels. The novelty in this study is replacing the adhesion film with clear plastic film which was used to cut the design of the microchannel as the material is more suitable for fabricating more complex microchannel design. The microchannel was then mold using polymethyldisiloxane (PDMS and bonded with a clean glass to produce a close microchannel. The microchannel produced had a clean edge indicating good master mold was produced using the cutting plotter and the bonding between the PDMS and glass was good where no leakage was observed. The materials used in this method is cheap and the total time consumed is less than 5 hours where this method is suitable for rapid prototyping of microchannel.

  20. Statement to the fifty-third session of the United Nations General Assembly, New York, 2 November 1998

    International Nuclear Information System (INIS)

    ElBaradei, M.

    1998-01-01

    The document reproduces the statement of the Director General of the IAEA at the fifty-third session of the United Nations General Assembly in New York, USA, on 2 November 1998. The statement focuses on the priority work of the Agency under the following main headings: contribution to peace and security (including the IAEA's strengthened safeguards system, inspections in Iraq, safeguards verifications in the Democratic People's Republic of Korea, future prospects of verification, illicit trafficking in nuclear material), co-operation for development (the Agency's technical co-operation programme), and meeting global challenges in the field of energy, the environment and nuclear safety. The statement concludes with a description of the process of management review and reform initiated by the Director General to ensure that the Agency is responding efficiently and effectively to the needs of its Member States

  1. Fifty Years of Insulin

    African Journals Online (AJOL)

    has since saved millions of lives throughout the world. The year 197I is the 50th anniversary of Banting's historic discovery. The story of insulin ... He found no evidence of injury. An impaired ... Prize in medicine for his discovery of insulin.

  2. Normalization Fifty Years Beyond

    DEFF Research Database (Denmark)

    Bonfils, Inge Storgaard; Tøssebro, Jan; Teittinen, Antti

    2012-01-01

    toward larger group homes and congregations, inequality across municipalities, marketization, and new public management, but also an increasing emphasis on consumer rights and the use of the personal assistance scheme in services for people with ID. The authors conclude that diverging trends coexist...

  3. Fifty years of ILO

    International Nuclear Information System (INIS)

    1969-01-01

    'Poverty anywhere constitutes a danger to prosperity everywhere. This is the motto of the International Labour Organisation (ILO) which in June this year was celebrating the 50th anniversary of its foundation. It was initiated to advance the cause of social justice as a way of contributing to peace. (author)

  4. PAs: Fifty years young.

    Science.gov (United States)

    Mandel, Ellen D; North, Shannon

    2017-10-01

    The PA profession is 50 years young. Practicing PAs and current students hail from several generational categories ranging from Builders to Generation Z. This article reviews how different generations may have experienced PA program expansion, professional identity, state licensing, and prescription delegation. The authors sampled a cohort of PA program applicants about their views on what evokes optimism and concern for the PA profession. These themes mirror the recently paved professional road, while posing the all-important question: What construction lies on the horizon?

  5. Fifty years of ILO

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1969-07-01

    'Poverty anywhere constitutes a danger to prosperity everywhere. This is the motto of the International Labour Organisation (ILO) which in June this year was celebrating the 50th anniversary of its foundation. It was initiated to advance the cause of social justice as a way of contributing to peace. (author)

  6. Needs and preferences among patients with high-grade glioma and their caregivers - A longitudinal mixed methods study

    DEFF Research Database (Denmark)

    Piil, K; Jakobsen, J; Christensen, K B

    2018-01-01

    Previous reports on the patient perspective of daily life during a 1-year high-grade glioma (HGG) trajectory from the time of diagnosis are sparse. The aim of this longitudinal mixed methods study is to identify the specific needs and preferences for rehabilitation and supportive care and how...... it links with physical activity, psychological measures and health quality longitudinally over the first year after diagnosis among patients with HGG and their caregivers by integrating qualitative and quantitative findings. Using a longitudinal mixed methods design, patients with malignant glioma (n = 30...

  7. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation

    Science.gov (United States)

    Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna

    2011-01-01

    Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (Porganisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296

  8. Cardiac Patients' Experiences and Perceptions of Social Media: Mixed-Methods Study.

    Science.gov (United States)

    Partridge, Stephanie R; Grunseit, Anne C; Gallagher, Patrick; Freeman, Becky; O'Hara, Blythe J; Neubeck, Lis; Due, Sarah; Paull, Glenn; Ding, Ding; Bauman, Adrian; Phongsavan, Philayrath; Roach, Kellie; Sadler, Leonie; Glinatsis, Helen; Gallagher, Robyn

    2017-09-15

    Traditional in-person cardiac rehabilitation has substantial benefits for cardiac patients, which are offset by poor attendance. The rapid increase in social media use in older adults provides an opportunity to reach patients who are eligible for cardiac rehabilitation but unable to attend traditional face-to-face groups. However, there is a paucity of research on cardiac patients' experiences and perspectives on using social media to support their health. The aim of this study was to describe cardiac rehabilitation patients' experiences in using social media in general and their perspective on using social media, particularly Facebook, to support their cardiac health and secondary prevention efforts. A mixed-methods study was undertaken among cardiac rehabilitation patients in both urban and rural areas. First, this study included a survey (n=284) on social media use and capability. Second, six focus group interviews were conducted with current Facebook users (n=18) to elucidate Facebook experience and perspectives. Social media use was low (28.0%, 79/282) but more common in participants who were under 70 years of age, employed, and had completed high school. Social media users accessed Web-based information on general health issues (65%, 51/79), medications (56%, 44/79), and heart health (43%, 34/79). Participants were motivated to invest time in using Facebook for "keeping in touch" with family and friends and to be informed by expert cardiac health professionals and fellow cardiac participants if given the opportunity. It appeared that participants who had a higher level of Facebook capability (understanding of features and the consequences of their use and efficiency in use) spent more time on Facebook and reported higher levels of "liking," commenting, or sharing posts. Furthermore, higher Facebook capability appeared to increase a participants' willingness to participate in a cardiac Facebook support group. More capable users were more receptive to the use

  9. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation.

    Science.gov (United States)

    Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna; Lilford, Richard

    2011-02-03

    To conduct an independent evaluation of the first phase of the Health Foundation's Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Mixed method evaluation involving five substudies, before and after design. NHS hospitals in the United Kingdom. Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration--monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)--there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for "difference in difference" 2

  10. Fifty shades of gradients: does the pressure gradient in venous sinus stenting for idiopathic intracranial hypertension matter? A systematic review.

    Science.gov (United States)

    McDougall, Cameron M; Ban, Vin Shen; Beecher, Jeffrey; Pride, Lee; Welch, Babu G

    2018-03-02

    OBJECTIVE The role of venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) is not well understood. The aim of this systematic review is to attempt to identify subsets of patients with IIH who will benefit from VSS based on the pressure gradients of their venous sinus stenosis. METHODS MEDLINE/PubMed was searched for studies reporting venous pressure gradients across the stenotic segment of the venous sinus, pre- and post-stent pressure gradients, and clinical outcomes after VSS. Findings are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS From 32 eligible studies, a total of 186 patients were included in the analysis. Patients who had favorable outcomes had higher mean pressure gradients (22.8 ± 11.5 mm Hg vs 17.4 ± 8.0 mm Hg, p = 0.033) and higher changes in pressure gradients after stent placement (19.4 ± 10.0 mm Hg vs 12.0 ± 6.0 mm Hg, p = 0.006) compared with those with unfavorable outcomes. The post-stent pressure gradients between the 2 groups were not significantly different (2.8 ± 4.0 mm Hg vs 2.7 ± 2.0 mm Hg, p = 0.934). In a multivariate stepwise logistic regression controlling for age, sex, body mass index, CSF opening pressure, pre-stent pressure gradient, and post-stent pressure gradient, the change in pressure gradient with stent placement was found to be an independent predictor of favorable outcome (p = 0.028). Using a pressure gradient of 21 as a cutoff, 81/86 (94.2%) of patients with a gradient > 21 achieved favorable outcomes, compared with 82/100 (82.0%) of patients with a gradient ≤ 21 (p = 0.022). CONCLUSIONS There appears to be a relationship between the pressure gradient of venous sinus stenosis and the success of VSS in IIH. A randomized controlled trial would help elucidate this relationship and potentially guide patient selection.

  11. Comparison of standard fibrinogen measurement methods with fibrin clot firmness assessed by thromboelastometry in patients with cirrhosis.

    Science.gov (United States)

    Vucelic, Dragica; Jesic, Rada; Jovicic, Snezana; Zivotic, Maja; Grubor, Nikica; Trajkovic, Goran; Canic, Ivana; Elezovic, Ivo; Antovic, Aleksandra

    2015-06-01

    The Clauss fibrinogen method and thrombin clotting time (TCT) are still routinely used in patients with cirrhosis to define fibrinogen concentration and clotting potential. The thromboelastometric functional fibrinogen FIBTEM assay evaluates the strength of fibrin-based clots in whole blood, providing information on both quantitative deficit and fibrin polymerization disorders. To compare these three methods of assessing fibrinogen in patients with cirrhosis of different aetiologies, characterized by impairment in fibrinogen concentration as well as functional aberrance. Sixty patients with alcoholic and 24 patients with cholestatic cirrhosis were included (Child-Pugh score (CPs)A, n=24; B, n=32; C, n=28). All parameters were compared with those from a control group. Maximum clot firmness (MCF) in the FIBTEM test was assessed in regard to its relevance in detection of qualitative fibrinogen disorders in comparison with results obtained by standard measurement methods, i.e. the Clauss fibrinogen method and TCT. With increased cirrhosis severity, fibrinogen and FIBTEM-MCF levels significantly declined (p=0.002), while TCT was significantly prolonged (p=0.002). In all CPs groups, fibrinogen strongly correlated with FIBTEM-MCF (r=0.77, r=0.72, r=0.74; pmeasurement in cirrhotic patients, especially in evaluating fibrin polymerization disorders in these patients. Further studies are needed to evaluate the usefulness of this assay in predicting bleeding complications in cirrhotic patients as well as monitoring replacement treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Comparison of two methods of tonometry in glaucoma patients: Goldmann applanation tonometer and non-contact tonometer

    Directory of Open Access Journals (Sweden)

    Hong-Feng Li

    2015-01-01

    Full Text Available AIM: To compare the two methods for the measurement of glaucoma patients' intraocular pressure(IOPbetween Goldmann applanation tonometer(GATand non-contact tonometer(NCTand find the laws of the two methods.METHODS: The IOP of 108 glaucoma patients(206 eyeswere measured by GAT and NCT respectively. RESULTS: In 108 glaucoma patients, the average IOP of 206 eyes was 29.77±10.27mmHg by GAT and 24.59±8.58mmHg by NCT. There was significant difference between GAT and NCT(PCONCLUSION: The measurement results with NCT were lower than that of GAT. The higher of IOP, the difference between GAT and NCT was greater. It's better to measure IOP by GAT for the glaucoma patients, in order to avoid the misdiagnosis and mistreatment of glaucoma.

  13. What are the decision-making preferences of patients in vascular surgery? A mixed-methods study.

    Science.gov (United States)

    Santema, T B Katrien; Stoffer, E Anniek; Kunneman, Marleen; Koelemay, Mark J W; Ubbink, Dirk T

    2017-02-10

    Shared decision-making (SDM) has been advocated as the preferred method of choosing a suitable treatment option. However, patient involvement in treatment decision-making is not yet common practice in the field of vascular surgery. The aim of this mixed-methods study was to explore patients' decision-making preferences and to investigate which facilitators and barriers patients perceive as important for the application of SDM in vascular surgery. Patients were invited to participate after visiting the vascular surgical outpatient clinic of an Academic Medical Center in the Netherlands. A treatment decision was made during the consultation for an abdominal aortic aneurysm or peripheral arterial occlusive disease. Patients filled in a number of questionnaires (quantitative part) and a random subgroup of patients participated in an in-depth interview (qualitative part). A total of 67 patients participated in this study. 58 per cent of them (n=39) indicated that they preferred a shared role in decision-making. In more than half of the patients (55%; n=37) their preferred role was in disagreement with what they had experienced. 31 per cent of the patients (n=21) preferred a more active role in the decision-making process than they had experienced. Patients indicated a good patient-doctor relationship as an important facilitator for the application of SDM. The vast majority of vascular surgical patients preferred, but did not experience a shared role in the decision-making process, although the concept of SDM was insufficiently clear to some patients. This emphasises the importance of explaining the concept of SDM and implementing it in the clinical encounter. 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/.

  14. Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

    Science.gov (United States)

    Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

    2011-04-01

    The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The

  15. A mixed methods study to understand patient expectations for antibiotics for an upper respiratory tract infection.

    Science.gov (United States)

    Gaarslev, Christina; Yee, Melissa; Chan, Georgi; Fletcher-Lartey, Stephanie; Khan, Rabia

    2016-01-01

    Antimicrobial resistance is a public health challenge supplemented by inappropriate prescribing, especially for an upper respiratory tract infection in primary care. Patient/carer expectations have been identified as one of the main drivers for inappropriate antibiotics prescribing by primary care physicians. The aim of this study was to understand who is more likely to expect an antibiotic for an upper respiratory tract infection from their doctor and the reasons underlying it. This study used a sequential mixed methods approach: a nationally representative cross sectional survey ( n  = 1509) and four focus groups. The outcome of interest was expectation and demand for an antibiotic from a doctor when presenting with a cold or flu. The study found 19.5 % of survey respondents reported that they would expect the doctor to prescribe antibiotics for a cold or flu. People younger than 65 years of age, those who never attended university and those speaking a language other than English at home were more likely to expect or demand antibiotics for a cold or flu. People who knew that 'antibiotics don't kill viruses' and agreed that 'taking an antibiotic when one is not needed means they won't work in the future' were less likely to expect or demand antibiotics. The main reasons for expecting antibiotics were believing that antibiotics are an effective treatment for a cold or flu and that they shortened the duration and potential deterioration of their illness. The secondary reason centered around the value or return on investment for visiting a doctor when feeling unwell. Our study found that patients do not appear to feel they have a sufficiently strong incentive to consider the impact of their immediate use of antibiotics on antimicrobial resistance. The issue of antibiotic resistance needs to be explained and reframed as a more immediate health issue with dire consequences to ensure the success of future health campaigns.

  16. method

    Directory of Open Access Journals (Sweden)

    L. M. Kimball

    2002-01-01

    Full Text Available This paper presents an interior point algorithm to solve the multiperiod hydrothermal economic dispatch (HTED. The multiperiod HTED is a large scale nonlinear programming problem. Various optimization methods have been applied to the multiperiod HTED, but most neglect important network characteristics or require decomposition into thermal and hydro subproblems. The algorithm described here exploits the special bordered block diagonal structure and sparsity of the Newton system for the first order necessary conditions to result in a fast efficient algorithm that can account for all network aspects. Applying this new algorithm challenges a conventional method for the use of available hydro resources known as the peak shaving heuristic.

  17. Discrete choice as a method for exploring education preferences in a Danish population of patients with type 2 diabetes.

    Science.gov (United States)

    Schiøtz, Michaela; Bøgelund, Mette; Almdal, Thomas; Willaing, Ingrid

    2012-05-01

    To determine preferences among patients with type 2 diabetes for content and format of patient education. Using discrete choice methods, we surveyed patients about their preferences for patient education. We investigated preferred content and format regarding education on living well with diabetes, preventing complications, healthy eating, exercising, and psychosocial issues related to diabetes. We obtained usable responses from 2187 patients with type 2 diabetes. Acquiring competencies to live a fulfilling life with diabetes, adjust diet and exercise habits, and prevent complications was significantly more highly valued than was simply being informed about these topics. Patients preferred to be involved in the planning of their diabetes care and valued individually tailored content higher than prescheduled content. Women and younger patients found diet and exercise significantly more important than did men, and patients with poorly controlled diabetes valued all education and support more highly than did patients in better control. Patients with type 2 diabetes prefer to be actively involved in educational activities, to develop competencies to prevent and manage complications, and to involve their social network in supporting them. Future patient education should enhance participation and competence development and include relatives. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Physical methods for the treatment of fever in critically ill patients: a randomized controlled trial.

    Science.gov (United States)

    Salgado, Patrícia de Oliveira; Silva, Ludmila Christiane Rosa da; Silva, Priscila Marinho Aleixo; Chianca, Tânia Couto Machado

    2016-01-01

    To evaluate the effects of physical methods of reducing body temperature (ice pack and warm compression) in critically ill patients with fever. A randomized clinical trial involving 102 adult patients with tympanic temperature ≥ 38.3°C of an infectious focus, and randomized into three groups: Intervention I - ice pack associated with antipyretic; Intervention II - warm compress associated with antipyretic; and Control - antipyretic. Tympanic temperature was measured at 15 minute intervals for 3 hours. The effect of the interventions was evaluated through the Mann-Whitney test and Survival Analysis. "Effect size" calculation was carried out. Patients in the intervention groups I and II presented greater reduction in body temperature. The group of patients receiving intervention I presented tympanic temperature below 38.3°C at 45 minutes of monitoring, while the value for control group was lower than 38.3°C starting at 60 minutes, and those who received intervention II had values lower than 38.3°C at 75 minutes of monitoring. No statistically significant difference was found between the interventions, but with the intervention group I patients showed greater reduction in tympanic temperature compared to the other groups. Brazilian Registry of Clinical Trials: RBR-2k3kbq. Avaliar o efeito de métodos físicos (bolsa de gelo e compressa morna) na redução da temperatura corporal de pacientes críticos com febre. Ensaio clínico randomizado com 102 pacientes adultos e temperatura timpânica ≥ 38,3°C de foco infeccioso, aleatorizados em três grupos: Intervenção I ‒ bolsa de gelo associada a antitérmico; Intervenção II ‒ compressa morna associada a antitérmico; e Controle ‒ antitérmico. A temperatura timpânica foi mensurada em intervalos de 15 minutos durante 3 horas. O efeito das intervenções foi avaliado pelo teste Mann-Whitney e Análise de Sobrevivência. Cálculo do "Effect size" foi procedido. Os pacientes dos grupos Intervenção I e II

  19. Development and content validation of the information assessment method for patients and consumers.

    Science.gov (United States)

    Pluye, Pierre; Granikov, Vera; Bartlett, Gillian; Grad, Roland M; Tang, David L; Johnson-Lafleur, Janique; Shulha, Michael; Barbosa Galvão, Maria Cristiane; Ricarte, Ivan Lm; Stephenson, Randolph; Shohet, Linda; Hutsul, Jo-Anne; Repchinsky, Carol A; Rosenberg, Ellen; Burnand, Bernard; Légaré, France; Dunikowski, Lynn; Murray, Susan; Boruff, Jill; Frati, Francesca; Kloda, Lorie; Macaulay, Ann; Lagarde, François; Doray, Geneviève

    2014-02-18

    Online consumer health information addresses health problems, self-care, disease prevention, and health care services and is intended for the general public. Using this information, people can improve their knowledge, participation in health decision-making, and health. However, there are no comprehensive instruments to evaluate the value of health information from a consumer perspective. We collaborated with information providers to develop and validate the Information Assessment Method for all (IAM4all) that can be used to collect feedback from information consumers (including patients), and to enable a two-way knowledge translation between information providers and consumers. Content validation steps were followed to develop the IAM4all questionnaire. The first version was based on a theoretical framework from information science, a critical literature review and prior work. Then, 16 laypersons were interviewed on their experience with online health information and specifically their impression of the IAM4all questionnaire. Based on the summaries and interpretations of interviews, questionnaire items were revised, added, and excluded, thus creating the second version of the questionnaire. Subsequently, a panel of 12 information specialists and 8 health researchers participated in an online survey to rate each questionnaire item for relevance, clarity, representativeness, and specificity. The result of this expert panel contributed to the third, current, version of the questionnaire. The current version of the IAM4all questionnaire is structured by four levels of outcomes of information seeking/receiving: situational relevance, cognitive impact, information use, and health benefits. Following the interviews and the expert panel survey, 9 questionnaire items were confirmed as relevant, clear, representative, and specific. To improve readability and accessibility for users with a lower level of literacy, 19 items were reworded and all inconsistencies in using a

  20. INTRAPERITONEAL AEROSOL CHEMOTHERAPY UNDER PRESSURE (IACUP – AN INNOVATIVE METHOD OF TREATMENT OF PATIENTS WITH PERITONEAL CARCINOMATOSIS

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2016-01-01

    Full Text Available Widespread peritoneal carcinomatosis in gastric cancer, in fact, is the end-stage of the disease. The survival median of patients is no more than 3–6 months. Development of various methods of intraperitoneal chemotherapy can improve the prognosis of this category of patients.Objective. To evaluate the efficacy and safety of intraperitoneal aerosol chemotherapy under pressure (IACUP in patients with gastric cancer with peritoneal carcinomatosis.Materials and methods. The treatment Protocol consisted of a laparotomy or laparoscopy for the staging of the tumor process, 3–4 courses of systemic chemotherapy scheme XELOX followed by conducting at least 3 sessions of intraperitoneal aerosol chemotherapy under pressure (IACUP with an interval of 6 weeks on the background of chemotherapy. In the case of progression the patient was excluded from the study. Currently, the study included 27 patients with disseminated gastric cancer who underwent 46 procedures of IACUP. There were 8 men and 19 women. The average age of patients was 50.6 years.Results. In the framework of the safety assessment of IACUP there were 3 cases of adverse effects. Two patients (7,4% noted nausea for the first 2 days after running the session of IACUP. In one patient the iatrogenic perforation of the diaphragm during biopsy of the peritoneum with the development of carbonetworks occurred. The survival median was 11 months. One-year survival rate (by KaplanMeier was 50.7%. 14 patients are alive and continue to participate in the study during the first year of observation.Conclusion. Intraperitoneal aerosol chemotherapy under pressure (IACUP is a simple, minimally invasive and safe method for the palliative treatment of patients with disseminated carcinomatosis of gastric cancer. We developed the treatment Protocol that allows us to achieve one-year survival of more than half of patients.

  1. Effect of modified surgical method on subcutaneous hydrops of patients with breast cancer after modified radical mastectomy

    OpenAIRE

    Yan Li; Hua-Feng Pan; Gui-Lan Sun

    2016-01-01

    Objective: Through prospective randomized clinical study,to observe the preventive effect of improved surgical method to subcutaneous hydrops after modified radical mastec tomy. Method: A total of 80 cases of patients who have done modified radical mastectomy were selected, and randomly divided them into study group (40 cases) and control group (40 cases), then adopted different surgical methods as followed respectively, to observe the daily drainage volume at the first 3 d after ...

  2. Radioimmunoassay for human myoglobin: methods and results in patients with skeletal muscle or myocardial disorders

    International Nuclear Information System (INIS)

    Miyoshi, K.; Saito, S.; Kawai, H.; Kondo, A.; Iwasa, M.; Hayashi, T.; Yagita, M.

    1978-01-01

    A sensitive and specific radioimmunoassay has been developed for the measurement of serum Mb. Immunization of rabbit with human Mb yielded anti-Mb antibody which was purified by affinity chromatography. Human hemoglobin, CK, and the component of serum per se did not appear to cross-react with the antibody. Mb was radiolabeled by the chloramine T method. The radioimmunoassay method could detect as little as 0.3 ng of Mb and was not affected by hemolysis. Information is also given on precision, recovery, and specimen preservation. Mb levels could be detected in all of 120 normal adults, and the values ranged between 1 and 28 ng/ml (mean, 13.1 +- 6.1). No sex difference was observed. Levels were markedly elevated in all the patients with progressive muscular dystrophy, especially in the Duchenne type at the level of 40 to 1700 ng/ml. It was also noticed that about 70% of female gene carriers of Duchenne type had a slightly increased Mb level. An elevated serum Mb was also noted in polymyositis. In every case of acute myocardial infarction, serum Mb levels were increased, peak values ranging from 175 to 4400 ng/ml and averaging 1162 +- 287.9 Mb levels were elevated faster and peaked earlier (within 6 to 12 hr after the attack) than serum CK activity and returned to nearly normal range within 3 to 4 days. The increase in serum Mb was also noticed in shock and surgery. These data indicate that radioimmunoassay of Mb is a useful test for judging the myolytic state of myogenic myopathies and for early detection of myocardial infarction

  3. Evaluating Service Quality from Patients' Perceptions: Application of Importance-performance Analysis Method.

    Science.gov (United States)

    Mohebifar, Rafat; Hasani, Hana; Barikani, Ameneh; Rafiei, Sima

    2016-08-01

    Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance-performance analysis matrix. A descriptive-analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling technique was stratified random sampling. Required data were collected based on a standard questionnaire (SERVQUAL). Data analysis was done through SPSS version 18 statistical software and importance-performance analysis matrix. The results showed a significant gap between importance and performance in all five dimensions of service quality (p quality gap and "responsiveness" had the lowest gap (1.97). Also, according to findings, reliability and assurance were in Quadrant (I), empathy was in Quadrant (II), and tangibles and responsiveness were in Quadrant (IV) of the importance-performance matrix. The negative gap in all dimensions of quality shows that quality improvement is necessary in all dimensions. Using quality and diagnosis measurement instruments such as importance-performance analysis will help hospital managers with planning of service quality improvement and achieving long-term goals.

  4. Internal jugular vein patency and treatment methods after neck dissection in patients with oral cancer

    International Nuclear Information System (INIS)

    Makiguchi, Takaya; Yokoo, Satoshi; Miyazaki, Hidetaka; Ogawa, Masaru; Takayama, Yu; Negishi, Akihide

    2014-01-01

    Stenosis and obstruction of the internal jugular vein (IJV) sometimes occur following modified radical neck dissection or selective neck dissection, in which the IJV is preserved. The objective of this study was to assess risk factors for stenosis or obstruction of the IJV following neck dissection. A total of 58 neck dissections performed in 51 patients by the same surgeon at Gunma University Hospital were retrospectively reviewed. The relationships of the patency of the IJV with gender, side of dissection, number of lymph node metastases, invasion out of the lymph node, radiotherapy, and reconstructive method were examined. The patency of the IJV was evaluated postoperatively using enhanced computed tomography. All cases with obstruction of the IJV received postoperative radiotherapy and neck dissection on the left side. Postoperative radiotherapy was a significant risk factor for obstruction of the IJV. Free flap reconstruction was not a risk factor for stenosis and obstruction. The rate of obstruction of the IJV was significantly decreased in cases with pectoral major musculocutaneous flap reconstruction or extended supraomohyoid neck dissection in which the muscle extensively covered the IJV. (author)

  5. 3D MRI of the colon: methods and first results of 5 patients

    International Nuclear Information System (INIS)

    Luboldt, W.; Bauerfeind, P.; Pelkonen, P.; Steiner, P.; Krestin, G.P.; Debatin, J.F.

    1997-01-01

    Purpose: 'Exoscopic' and endoscopic identification of colorectal pathologies via MRI. Methods: 5 patients (36-88 years), two normal and three with different colorectal pathologies (diverticular disease, polyps and carcinoma of the colon), were examined by MRI after colonoscopy. Subsequent to filling of the colon with a gadolinium-water mixture under MRI-monitoring, 3D-data sets of the colon were acquired in prone and supine positions over a 28 sec breathold interval. Subsequently multiplanar T 1 -weighted 2D-sequences were acquired before and following i.v. administration of Gd-DTPA (0.1 mmol/kg BW). All imaging was performed in the coronal orientation. The 3D-data were interactively analysed based on various displays: Maximum intensity projection (MIP), surface shadowed display (SSD), multiplanar reconstruction (MPR), virtual colonoscopy (VC). Results: All of the colorectal pathologies could be interactively diagnosed by MPR. On MIP images some pathologies were missed. VC presented the morphology of colon haustra as well as of all endoluminally growing lesions in a manner similar to endoscopy. The colon masses showed uptake of contrast media and could thus be differentiated from air or faeces. (orig./AJ) [de

  6. A SWIFT Method for Handing Off Obstetrical Patients on the Labor Floor.

    Science.gov (United States)

    Sheen, Jean-Ju; Reimers, Laura; Govindappagari, Shravya; Ngai, Ivan M; Garretto, Diana; Donepudi, Roopali; Tropper, Pamela; Goffman, Dena; Dayal, Ashlesha K; Bernstein, Peter S

    2017-07-06

    The aim of this study was to improve patient handoffs on the labor floor. A prospective cohort study of obstetrics residents at Montefiore Medical Center was performed between 2012 and 2014. Labor-floor handoffs were recorded before and after didactic sessions as well as after installation of whiteboards formatted with the mnemonic SWIFT (Subject, Why?, Issues, Fetus, Tasks). Handoff transcripts were evaluated by obstetricians blinded to timing and speaker identity. An intraclass correlation coefficient accounted for evaluator differences. Data analysis was by ordinal logistic regression, the generalized estimating equations method (correlated data), and Bonferroni adjustment (multiple comparisons). Forty-five handoffs were evaluated (15 each predidactics, postdidactics, and postwhiteboard revision). Higher completeness scores over time were noted for admission reason, labor concerns, and task list (not statistically significant). Comprehensive score increases prelecture to postwhiteboard were seen in handoff clarity (2.81 versus 2.91) and overall quality (2.77 versus 2.81) (not statistically significant). A subanalysis of four residents who gave multiple handoffs over different periods revealed few significant changes over time. Greater interevaluator consistency was noted with more objective elements. The mnemonic SWIFT, with formalized curricula for obstetrical resident training focusing on new learners and increased faculty involvement and reinforcement, may result in improvement of handoffs on the labor floor.

  7. Application of adjusted subpixel method (ASM) in HRCT measurements of the bronchi in bronchial asthma patients and healthy individuals

    International Nuclear Information System (INIS)

    Mincewicz, Grzegorz; Rumiński, Jacek; Krzykowski, Grzegorz

    2012-01-01

    Background: Recently, we described a model system which included corrections of high-resolution computed tomography (HRCT) bronchial measurements based on the adjusted subpixel method (ASM). Objective: To verify the clinical application of ASM by comparing bronchial measurements obtained by means of the traditional eye-driven method, subpixel method alone and ASM in a group comprised of bronchial asthma patients and healthy individuals. Methods: The study included 30 bronchial asthma patients and the control group comprised of 20 volunteers with no symptoms of asthma. The lowest internal and external diameters of the bronchial cross-sections (ID and ED) and their derivative parameters were determined in HRCT scans using: (1) traditional eye-driven method, (2) subpixel technique, and (3) ASM. Results: In the case of the eye-driven method, lower ID values along with lower bronchial lumen area and its percentage ratio to total bronchial area were basic parameters that differed between asthma patients and healthy controls. In the case of the subpixel method and ASM, both groups were not significantly different in terms of ID. Significant differences were observed in values of ED and total bronchial area with both parameters being significantly higher in asthma patients. Compared to ASM, the eye-driven method overstated the values of ID and ED by about 30% and 10% respectively, while understating bronchial wall thickness by about 18%. Conclusions: Results obtained in this study suggest that the traditional eye-driven method of HRCT-based measurement of bronchial tree components probably overstates the degree of bronchial patency in asthma patients.

  8. Validation and Clinical Evaluation of a Novel Method To Measure Miltefosine in Leishmaniasis Patients Using Dried Blood Spot Sample Collection

    Science.gov (United States)

    Rosing, H.; Hillebrand, M. J. X.; Blesson, S.; Mengesha, B.; Diro, E.; Hailu, A.; Schellens, J. H. M.; Beijnen, J. H.

    2016-01-01

    To facilitate future pharmacokinetic studies of combination treatments against leishmaniasis in remote regions in which the disease is endemic, a simple cheap sampling method is required for miltefosine quantification. The aims of this study were to validate a liquid chromatography-tandem mass spectrometry method to quantify miltefosine in dried blood spot (DBS) samples and to validate its use with Ethiopian patients with visceral leishmaniasis (VL). Since hematocrit (Ht) levels are typically severely decreased in VL patients, returning to normal during treatment, the method was evaluated over a range of clinically relevant Ht values. Miltefosine was extracted from DBS samples using a simple method of pretreatment with methanol, resulting in >97% recovery. The method was validated over a calibration range of 10 to 2,000 ng/ml, and accuracy and precision were within ±11.2% and ≤7.0% (≤19.1% at the lower limit of quantification), respectively. The method was accurate and precise for blood spot volumes between 10 and 30 μl and for Ht levels of 20 to 35%, although a linear effect of Ht levels on miltefosine quantification was observed in the bioanalytical validation. DBS samples were stable for at least 162 days at 37°C. Clinical validation of the method using paired DBS and plasma samples from 16 VL patients showed a median observed DBS/plasma miltefosine concentration ratio of 0.99, with good correlation (Pearson's r = 0.946). Correcting for patient-specific Ht levels did not further improve the concordance between the sampling methods. This successfully validated method to quantify miltefosine in DBS samples was demonstrated to be a valid and practical alternative to venous blood sampling that can be applied in future miltefosine pharmacokinetic studies with leishmaniasis patients, without Ht correction. PMID:26787691

  9. Assessment of Bone Status in Inhaled Corticosteroid User Asthmatic Patients with an Ultrasound Measurement Method

    Directory of Open Access Journals (Sweden)

    Mayumi Sasagawa

    2011-01-01

    Conclusions: The 6 month manegement of asthma in the actual clinical setting, including regular ICS use, might have a harmful influence on the bone status of female asthmatic patients. It may be necessary to manage and treat female patients for potent corticosteroid-induced osteoporosis, although further analyses of bone status in asthma <