Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study

Directory of Open Access Journals (Sweden)

Torisson G

2013-09-01

Full Text Available Gustav Torisson,1 Lennart Minthon,1 Lars Stavenow,2 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 2Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time. Results: After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann–Whitney U test, P = 0.02. For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009. Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002 and decreased from 75 to 58 in the intervention group (P = 0.25. From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann–Whitney test, P = 0.054. Conclusion: A multidisciplinary approach

Clinical Predictors of Hospital Admission in Children Aged 0-24 Months with Acute Bronchiolitis

Directory of Open Access Journals (Sweden)

Nucksheeba Aziz

2015-03-01

Full Text Available BACKGROUND Bronchiolitis is a significant cause of acute morbidity in children less than 2 years old and some children with bronchiolitis are admitted to the hospital. AIMS AND OBJECTIVES To identify clinical predictors of hospital admission in children aged 0-24 months with acute bronchiolitis.   METHODS: All children in the age group of 0-24 months presenting with acute bronchiolitis to a dedicated pediatric emergency department of GB pant cantonment children hospital, Govt Medical College Srinagar,   from April 2012-March 2013 were included in the study, provided they met the inclusion criteria. Non-parametric numerical variables were analyzed using Mann Whitney u test. Chi square was used to analyzecategorical variables, p value < 0.05 was considered significant. RESULTS: 763(552(72.3% male, mean age 8.52+/- 3.59 months children (0-24months presented with acute bronchiolitis during the study period. 435(313 (72% male, mean age 6.69+/-3.8 monthspatients were admitted to the hospital. The eight best predictors of admission (age, respiratory rate, heart rate, oxygen saturation, fever, grunt, dehydration and duration of symptoms were determined. CONCLUSION:This study has identified clinical predictors of admission in children aged 0-24 months with acute bronchiolitis. This information can be used as a guide in deciding whether to admit a child with bronchiolitis.

Real-time definition of non-randomness in the distribution of genomic events.

Directory of Open Access Journals (Sweden)

Ulrich Abel

Full Text Available Features such as mutations or structural characteristics can be non-randomly or non-uniformly distributed within a genome. So far, computer simulations were required for statistical inferences on the distribution of sequence motifs. Here, we show that these analyses are possible using an analytical, mathematical approach. For the assessment of non-randomness, our calculations only require information including genome size, number of (sampled sequence motifs and distance parameters. We have developed computer programs evaluating our analytical formulas for the real-time determination of expected values and p-values. This approach permits a flexible cluster definition that can be applied to most effectively identify non-random or non-uniform sequence motif distribution. As an example, we show the effectivity and reliability of our mathematical approach in clinical retroviral vector integration site distribution.

The Neuromuscular, Biochemical, and Endocrine Responses to a Single-Session Vs. Double-Session Training Day in Elite Athletes.

Science.gov (United States)

Johnston, Michael J; Cook, Christian J; Drake, David; Costley, Lisa; Johnston, Julie P; Kilduff, Liam P

2016-11-01

Johnston, MJ, Cook, CJ, Drake, D, Costley, L, Johnston, JP, and Kilduff, LP. The neuromuscular, biochemical, and endocrine responses to a single-session vs. double-session training day in elite athletes. J Strength Cond Res 30(11): 3098-3106, 2016-The aim of this study was to compare the acute neuromuscular, biochemical, and endocrine responses of a training day consisting of a speed session only with performing a speed-and-weights training session on the same day. Fifteen men who were academy-level rugby players completed 2 protocols in a randomized order. The speed-only protocol involved performing 6 maximal effort repetitions of 50-m running sprints with 5 minutes of recovery between each sprint, whereas the speed-and-weights protocol involved the same sprinting session but was followed 2 hours later by a lower-body weights session consisting of 4 sets of 5 backsquats and Romanian deadlift at 85% one repetition maximum. Testosterone, cortisol, creatine kinase, lactate, and perceived muscle soreness were determined immediately before, immediately after, 2 hours after, and 24 hours after both the protocols. Peak power, relative peak power, jump height, and average rate of force development were determined from a countermovement jump (CMJ) at the same time points. After 24-hours, muscle soreness was significantly higher after the speed-and-weights protocol compared with the speed-only protocol (effect size η = 0.253, F = 4.750, p ≤ 0.05). There was no significant difference between any of the CMJ variables at any of the posttraining time points. Likewise, creatine kinase, testosterone, and cortisol were unaffected by the addition of a weight-training session. These data indicate that the addition of a weight-training session 2 hours after a speed session, whereas increasing the perception of fatigue the next day does not result in a difference in endocrine response or in neuromuscular capability.

Per-Oral Endoscopic Myotomy Versus Laparoscopic Heller Myotomy for Achalasia: A Meta-Analysis of Nonrandomized Comparative Studies.

Science.gov (United States)

Zhang, Yuan; Wang, Hongjuan; Chen, Xingdong; Liu, Lan; Wang, Hongbo; Liu, Bin; Guo, Jianqiang; Jia, Hongying

2016-02-01

We aimed to assess the short-term outcomes of per-oral endoscopic myotomy (POEM) compared with laparoscopic Heller myotomy (LHM) for achalasia through a meta-analysis of nonrandomized comparative studies.We searched PubMed, Embase, Medline, Cochrane Library, and Google Scholar for studies that compared POEM and LHM for achalasia and were published between January 1, 2008 and December 31, 2014. The Methodological Index for Nonrandomized Studies (MINORS) was used to evaluate the quality of the studies. Random- and fixed-effects meta-analytical models were used, and between-study heterogeneity was assessed.Four nonrandomized comparative studies that included 317 patients (125 in the POEM group and 192 in the LHM group) met our research criteria and were assessed. There were no differences between the POEM and LHM groups in terms of sex, preoperative Eckhart score, length of myotomy, operation time, length of hospital stay, and complications. The patients in the POEM group were older than those in the LHM group (MD =2.81, 95% CI 0.27-5.35; P = 0.03) with high between-study homogeneity (χ = 1.96, df = 2, I = 0%; P = 0.38). The patients in the POEM group had a lower Eckardt score after surgery compared with those in the LHM group (MD = -0.30, 95% CI -0.42 to -0.18; P < 0.001) with high between-study homogeneity (χ = 0.00, df = 1, I = 0%; P = 1.00).The efficacy and safety of POEM appear to be comparable to those of LHM. Multicenter and randomized trials with larger sample size are needed to further compare the efficacy and safety of POEM and LHM for the treatment of achalasia.

Evaluation of the Structure of Morning Report Sessions of the Wards of Type One Educational Hospitals and Comparison with Announced Standards of the Ministry of Health and Medical Education

Directory of Open Access Journals (Sweden)

Shahram Yazdani

2013-07-01

Full Text Available Background and Objectives: Morning report is a long-standing method that its promotion has an important role in medical education. The present research was done with the aim of studying the structure of morning report sessions of the wards of type one educational hospitals and comparison with announced standards of the Ministry of Health and Medical Education.Methods: This study was performed in five main educational hospitals included wards of Obstetrics and Gynecology, Internal Medicine, Pediatrics, Surgery, Psychiatry, Neurology, Emergency Medicine, Orthopedic Surgery, Infectious Disease, and Intensive Care Unit wards were evaluated 8 approved standards 3 times for each one, and totally 73 cases. The studied standards consisted of the time of patient introduction, number of patients, duration of session, appropriateness of the session place, the venue, near ward place, Availability of teaching aids, number of sessions per week and a simple reception during the session.Results: Mean time for introduction of each patient was 4.4 minutes, mean number of introduced patients was 3.2 cases, mean duration of the session was 47.4 minutes, presentation in the ward (61.6%, appropriateness of place capacity 95.9%, and mean number of sessions per week was 4.2. No simple reception was seen in any sessions. Abundance of teaching aids was 79.5% for physical examination bed Negatoscope 89%, white board 93.2%, computer 87.7%, printer 19.2%, internet 17.8%, and video projector 83.6%.Conclusion: The results of this study showed that the general structure of morning report in the studied university was appropriate and fulfilled 6 out of 8 Standards. Also, the simple reception was not standard, and the standard of teaching aids was appropriate for 5 out of 7, and printer and internet were inappropriate.

Intra-session and inter-session variability of nitric oxide pulmonary diffusing capacity in adults with cystic fibrosis.

Science.gov (United States)

Radtke, Thomas; Benden, Christian; Maggi-Beba, Marion; Kriemler, Susi; van der Lee, Ivo; Dressel, Holger

2017-12-01

We evaluated the intra-session and inter-session variability of the diffusing capacity of nitric oxide (DLNO), carbon monoxide (DLCO), alveolar-capillary membrane diffusing capacity for carbon monoxide (DMCO) and pulmonary capillary blood volume (Vc) in patients with cystic fibrosis (CF). Patients performed single-breath diffusing capacity measurements during all of 3 consecutive study visits. Precision of gas diffusing parameters was quantified by within-subject standard deviation (SD ws ) and coefficient of variation (CV). Intra-session and inter-session reproducibility was determined by SD ws *2.77. 15 clinically stable patients were included. The intra-session precision of gas diffusing parameters improved over the study visits. The inter-session SD ws for DLNO, DLCO, DMCO, and Vc was 4.8, 1.3, 2.4, and 4.3, respectively. Reproducibility was 13.3, 3.8, 6.7 and 12.0mLmin -1 mmHg -1 ; CV was 4.4, 4.7, 4.4 and 5.8%, respectively. The intra-session variability of DLNO, DLCO, DMCO and Vc improves with breath-hold maneuver training in test-naïve patients with CF, indicating a learning effect. Inter-session reproducibility data are lower than those previously reported in healthy subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

Repetition Performance And Blood Lactate Responses Adopting Different Recovery Periods Between Training Sessions In Trained Men.

Science.gov (United States)

Miranda, Humberto; de Freitas Maia, Marianna; Paz, Gabriel Andrade; de Souza, João A A A; Simão, Roberto; de Araújo Farias, Déborah; Willardson, Jeffrey M

2017-02-08

The purpose of this study was to examine the effect of different recovery periods (24h, 48h, and 72h) between repeated resistance training (RT) sessions for the upper body muscles on repetition performance and blood lactate responses in trained men. Sixteen recreationally trained men (age: 26.1 ± 3.1 years; height: 179 ± 4.5 cm; body mass: 82.6 ± 4.0 kg, 4.5 ± 2.2 years of RT experience) participated in this study. Eight-repetition maximum (8-RM) loads were determined for the bench press (BP), 30° incline bench press (BP30), and 45° incline bench press (BP45) exercises. To assess the effects of different recovery periods between repeated training sessions, three protocols were performed in randomized order, including: 24 hours (P24); 48 hours (P48); and 72 hours (P72). Each RT session consisted of performing four repetition maximum sets of BP, BP30, and BP45 with 8-RM loads and 2-minute rest intervals between sets. Blood lactate levels were measured pre-session (PRE), immediately post-session (POST), 3 minutes post-session (P3), and 5 minutes post-session (P5). For the P24 protocol, significant decreases in repetition performance were found between sessions for the BP, BP30, and BP45 exercises, respectively. When considering session 2 only, the total work (repetition x sets) was significantly higher in P48 and P72 versus P24 for the BP30 and BP45 exercises. Blood lactate levels (i.e. POST, P3, and P5) significantly increased for session 2 under the P24 compared to the P48 and P72 protocols, respectively. Therefore, coaches and practitioners who need to accomplish a higher training volume for the upper body muscles should adopt recovery periods longer than 24 hours between sessions that train the same or similar muscle groups.

Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers: A Nonrandomized Clinical Trial.

Science.gov (United States)

Kattakuzhy, Sarah; Gross, Chloe; Emmanuel, Benjamin; Teferi, Gebeyehu; Jenkins, Veronica; Silk, Rachel; Akoth, Elizabeth; Thomas, Aurielle; Ahmed, Charisse; Espinosa, Michelle; Price, Angie; Rosenthal, Elana; Tang, Lydia; Wilson, Eleanor; Bentzen, Soren; Masur, Henry; Kottilil, Shyam

2017-09-05

Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has resulted in high rates of disease cure; however, not enough specialists currently are available to provide care. To determine the efficacy of HCV treatment independently provided by nurse practitioners (NPs), primary care physicians (PCPs), or specialist physicians using DAA therapy. Nonrandomized, open-label clinical trial initiated in 2015. (ClinicalTrials.gov: NCT02339038). 13 urban, federally qualified health centers (FQHCs) in the District of Columbia. A referred sample of 600 patients, of whom 96% were black, 69% were male, 82% were treatment naive, and 20% had cirrhosis. Seventy-two percent of the patients had HCV genotype 1a infection. The baseline characteristics of patients seen by each provider type were similar. Patients were assigned in a nonrandomized but specified manner to receive treatment from 1 of 5 NPs, 5 PCPs, or 6 specialists. All providers underwent an identical 3-hour training session based on guidelines. Patients received treatment with ledipasvir-sofosbuvir, which was provided on site, according to U.S. Food and Drug Administration labeling requirements. Sustained virologic response (SVR). 516 patients achieved SVR, a response rate of 86% (95% CI, 83.0% to 88.7%), with no major safety signals. Response rates were consistent across the 3 provider types: NPs, 89.3% (CI, 83.3% to 93.8%); PCPs, 86.9% (CI, 80.6% to 91.7%); and specialists, 83.8% (CI, 79.0% to 87.8%). Patient loss to follow-up was the major cause of non-SVR. Nonrandomized patient distribution; possible referral bias. In a real-world cohort of patients at urban FQHCs, HCV treatment administered by nonspecialist providers was as safe and effective as that provided by specialists. Nurse practitioners and PCPs with compact didactic training could substantially expand the availability of community-based providers to escalate HCV therapy, bridging existing gaps in the continuum of care for patients with

Seasonal and temporal variation in release of antibiotics in hospital wastewater: estimation using continuous and grab sampling.

Science.gov (United States)

Diwan, Vishal; Stålsby Lundborg, Cecilia; Tamhankar, Ashok J

2013-01-01

The presence of antibiotics in the environment and their subsequent impact on resistance development has raised concerns globally. Hospitals are a major source of antibiotics released into the environment. To reduce these residues, research to improve knowledge of the dynamics of antibiotic release from hospitals is essential. Therefore, we undertook a study to estimate seasonal and temporal variation in antibiotic release from two hospitals in India over a period of two years. For this, 6 sampling sessions of 24 hours each were conducted in the three prominent seasons of India, at all wastewater outlets of the two hospitals, using continuous and grab sampling methods. An in-house wastewater sampler was designed for continuous sampling. Eight antibiotics from four major antibiotic groups were selected for the study. To understand the temporal pattern of antibiotic release, each of the 24-hour sessions were divided in three sub-sampling sessions of 8 hours each. Solid phase extraction followed by liquid chromatography/tandem mass spectrometry (LC-MS/MS) was used to determine the antibiotic residues. Six of the eight antibiotics studied were detected in the wastewater samples. Both continuous and grab sampling methods indicated that the highest quantities of fluoroquinolones were released in winter followed by the rainy season and the summer. No temporal pattern in antibiotic release was detected. In general, in a common timeframe, continuous sampling showed less concentration of antibiotics in wastewater as compared to grab sampling. It is suggested that continuous sampling should be the method of choice as grab sampling gives erroneous results, it being indicative of the quantities of antibiotics present in wastewater only at the time of sampling. Based on our studies, calculations indicate that from hospitals in India, an estimated 89, 1 and 25 ng/L/day of fluroquinolones, metronidazole and sulfamethoxazole respectively, might be getting released into the

An analysis of the delivery of anaesthetic training sessions in the United Kingdom.

Science.gov (United States)

Green, A; Tatham, K C; Yentis, S M; Wilson, J; Cox, M

2017-11-01

We analysed data from the electronic rota system CLWRota, covering 2,689,962 anaesthetic sessions between 01/01/2014 and 31/12/2015, in 91 UK Trusts, in order to investigate trainees' supervision. There were 8209 trainee attachments analysed, during which 618,695 sessions were undertaken by trainees. The number of supervised sessions per week that trainees worked varied considerably (median (IQR [range]) 2.6 (1.6-3.6 [0-10]) for all grades combined), with senior trainees more likely than junior trainees to be supervised for fewer than the three sessions per week mandated by the Royal College of Anaesthetists. The number of supervised sessions was unrelated to Trusts' size, suggesting that trainees in smaller hospitals receive the same level of supervision as in larger teaching hospitals. Analysis of a dataset of this size should be a good reflection of the delivery of anaesthesia training in the UK. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

A tertiary hospital audit of the use of medical imaging in the 24 h preceding death.

Science.gov (United States)

Liu, D; Weil, J; Boughey, M; Sutherland, T

2016-02-01

This study aims to investigate the number, modality and indication for imaging studies performed on acute hospital inpatients in the 24 h prior to death. Data were obtained from retrospective analysis of deceased patients from a university affiliated tertiary hospital over a 2-year period and it was found that around one in five inpatients received medical imaging in the last 24 h of their life (364 of 1855, 19.6%). © 2016 Royal Australasian College of Physicians.

A nonrandomized controlled clinical pilot trial on 8 wk of intermittent fasting (24 h/wk).

Science.gov (United States)

Kessler, Christian S; Stange, Rainer; Schlenkermann, Maike; Jeitler, Michael; Michalsen, Andreas; Selle, Antonia; Raucci, Franca; Steckhan, Nico

2018-02-01

The aim of the study was to evaluate whether intermittent fasting (IF) is an effective preventive measure, and whether it is feasible for healthy volunteers under every day conditions. A nonrandomized controlled clinical trial on IF was performed with healthy volunteers over a period of 8 wk, and a subsequent 4-mo follow-up. Outcomes were assessed at baseline, after 8 wk, and after 6 mo. Volunteers who were not interested in fasting served as a control group. Participants in the fasting group were asked to continue their regular nutritional habits on the nonfasting days, whereas the control group maintained their habitual nutrition throughout the whole period. Outcomes included changes of metabolic parameters (insulin, glucose, insulin resistance, insulin-like growth factor-1, brain-derived neurotropic factor, lipids, liver enzymes, hemoglobin A1c) and coagulation markers; bioelectrical impedance analysis; body mass index; abdominal girth; blood pressure; general quality of life (five-item World Health Organization Well-Being Index [WHO-5] questionnaire), as well as mood and anxiety (Hospital Anxiety and Depression Scale [HADS], Profile of Mood States, Flourishing-Scale, visual analog scale, Likert scales). The intervention consisted of a fasting day, which was repeated every week for 8 wk, with abstinence from solid food between 00:00 and 23:59 at minimum and a maximum caloric intake of 300 kcal on each fasting day. A per-protocol analysis was performed. P < 0.05 was considered significant. Thirty-six volunteers were included; 22 allocated themselves to the fasting group, and 14 to the control group. Thirty-three data sets were included in the final analysis. Although significant in-group changes were observed in both groups for a number of outcomes after 8 wk and 6 mo, no significant between-group differences were observed for any outcome other than overall body fat mass after 8 wk as well as for the HADS total score and the WHO-5 total score after 6�

Manometric Biofeedback Effectiveness on Urinary Incontinence and Quality of Life: A Non-Randomized Control Trial

Directory of Open Access Journals (Sweden)

Marcos E Fernandez-Cuadros

2017-04-01

Full Text Available Objectives This study aimed at examining if a 6-session protocol of tonic-phasic exercises using manometric biofeedback (BFB is capable of improving quality of life (QoL and muscular strength in patients with urinary incontinence (UI. Methods A prospective quasi-experimental before-after study was performed on 31 patients with Urinary Incontinence (UI referred to the rehabilitation department of Santa Cristina’s University hospital, Madrid, Spain. The study was performed from January to December 2016. At initial evaluation, affiliation of data, predisposing factors, and type of UI were recorded. Patients were given lifestyle recommendations and international consultation on incontinence questionnaire short form (ICIQ-SF/ incontinence quality-of-life measure (I-QOL questionnaires/scales to be fulfilled at the beginning/end of treatment. Manometric evaluation was recorded at initial/final evaluation by MYOMED ® 932. Manometric-BFB protocol consisted of a 30-minute session of tonic/phasic exercises (15 minutes each, 2 times a week for up to 6 sessions, supervised by a physiotherapist. Results Mean age was 52 ± 12.1 years. Overall, 96.7% (n = 31 of the participants were females. Maximum and mean strength of pelvic floor contraction was 24 ± 17.72 and 4.9 ± 4.1 mmHg, and increased significantly after treatment to 35 ± 20.85 and 7.45 ± 4.92 mmHg (P < 0.01. The mean ICIQ-SF score was 9.13 ± 5.18 and decreased significantly to 6.13 ± 4.75 (P = 0.003. The mean I-QoL score increased significantly from 70.33 ± 22.12 to 81.25 ± 16.72 (P = 0.0017. The I-QoL Limiting Behaviour (LB-subscale raised from 68.38 ± 23.33 to 80 ± 16.56 (P = 0.0015; I-QoL Psychosocial Impact (PI-subscale increased from 77.43 ± 24.51 to 80 ± 17.47 (p = 0.0152; and I-QoL social embarrassment (SE-subscale incremented from 60.72 ± 22.37 to 74.37 ± 20.86 (P = 0.0007. Conclusions Manometric-BFB protocol is capable of decreasing UI and to improve QoL and manometric values

A Non-randomized Controlled Trial of EMDR on Affective Symptoms in Patients With Glioblastoma Multiforme

Directory of Open Access Journals (Sweden)

Monika Szpringer

2018-05-01

Full Text Available Glioblastoma multiforme (GBM is a highly aggressive brain cancer and its survival after diagnosis is less than 2 years. Therefore, GBM patients are especially prone to co-occurring psychological conditions such as anxiety and depressive disorders. Furthermore, aggressive medical therapies affect patients’ lives, undermining their sense of meaning and coherence. The main aim of this study was to determine the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR therapy on anxiety, depression and sense of coherence in patients with GBM. Thirty-seven GBM-diagnosed women were included in this trial and received standard medical care. Of those, 18 patients were treated during 4 months with 10–12 individual EMDR sessions (60–90 minutes each. Nineteen GBM patients were used as a non-randomized control group as they consented to psychological evaluations but not to a psychotherapeutic intervention. The groups were homogeneous in terms of gender, age, educational level and treatment, but not in anxiety and depressive levels at baseline. All patients were evaluated at baseline, after treatment (4 months and at follow-up (further 4 months by the Hospital Anxiety and Depression Scale (HADS-M and the Sense of Coherence Scale (SOC-29. Caregivers in both groups were interviewed by the Patient Caregiver Questionnaire after 4 months follow-up. Statistical analyses were conducted using ANOVA statistics, correlation and regression analysis. Results showed a statistically significant decrease in the EMDR group in anxiety, depression and anger, when compared to the experimental group. EMDR therapy also had a positive impact upon the sense of coherence level in the experimental group, whereas in the control group this declined. Finally, the caregivers reported beneficial outcomes of the EMDR therapy with less anxiety- and anger-related behaviors in patients in the experimental group compared to the control group. This study is the first to show

Admission Serum Uric Acid Levels and In-Hospital Outcomes in Patients with Acute Coronary Syndrome

Directory of Open Access Journals (Sweden)

Abu Sadique Abdullah

2015-05-01

Full Text Available Background: Uric acid is an independent risk factor for cardiovascular disease. Hospital admission for ischemic heart disease (IHD is increasing rapidly in our country. Although studies were conducted abroad regarding association of serum uric acid with in-hospital outcomes in patients with acute coronary syndrome (ACS, no data is yet available to show the association in our country. Objective: The objective of this study was to assess the association of serum uric acid level on admission with in-hospital outcomes of the patients with ACS. Materials and Methods: This cross sectional comparative study was done in the Department of Cardiology, Dhaka Medical College Hospital (DMCH from January to December 2012. After proper ethical consideration total 93 ACS patients were enrolled in the study by nonrandom sampling. Serum uric acid of all subjects was measured within 24 hours of admission. Then in-hospital outcomes were observed in all subjects. Results: The frequency of hyperuricemia among ACS patients was 24.7% (22.54% in male and 31.82% in female. Hyperuricemic patients significantly developed heart failure (30.4% vs 11.4%, p=0.032 and conduction defect (13.0% vs 1.4%, p=0.017 than normouricemic subjects. The mean ejection fraction was significantly lower in hyperuricemic patients than patients with normal uric acid level (50.87 ± 10.27% vs 55.94 ± 6.66%. The mean ± SD duration of hospital stay of hyperuricemic group was significantly longer in patients with ACS (8.26 ± 1.18 vs 7.51±1.18 days, p=0.010. Conclusion: The measurement of serum uric acid level, an easily available and inexpensive biochemical tool, might turn out as a valuable risk marker for prediction of in-hospital outcomes in patients with ACS.

Quantitative assessment of unobserved confounding is mandatory in nonrandomized intervention studies

NARCIS (Netherlands)

Groenwold, R H H; Hak, E; Hoes, A W

OBJECTIVE: In nonrandomized intervention studies unequal distribution of patient characteristics in the groups under study may hinder comparability of prognosis and therefore lead to confounding bias. Our objective was to review methods to control for observed confounding, as well as unobserved

Papers from the NSU Summer session of 2014 - study group 3

DEFF Research Database (Denmark)

Rendtorff, Jacob Dahl

2014-01-01

In this special issue we present the conference papers by the study group “Crisis and Crisis Scenarios: Normativity, Possibilities and Dilemmas” at the 2014 NSU Summer Session, held between 24th July and 31st July 2014 in Sauðárkrókur, Northern Iceland.......In this special issue we present the conference papers by the study group “Crisis and Crisis Scenarios: Normativity, Possibilities and Dilemmas” at the 2014 NSU Summer Session, held between 24th July and 31st July 2014 in Sauðárkrókur, Northern Iceland....

Correction of confounding bias in non-randomized studies by appropriate weighting.

Science.gov (United States)

Schmoor, Claudia; Gall, Christine; Stampf, Susanne; Graf, Erika

2011-03-01

In non-randomized studies, the assessment of a causal effect of treatment or exposure on outcome is hampered by possible confounding. Applying multiple regression models including the effects of treatment and covariates on outcome is the well-known classical approach to adjust for confounding. In recent years other approaches have been promoted. One of them is based on the propensity score and considers the effect of possible confounders on treatment as a relevant criterion for adjustment. Another proposal is based on using an instrumental variable. Here inference relies on a factor, the instrument, which affects treatment but is thought to be otherwise unrelated to outcome, so that it mimics randomization. Each of these approaches can basically be interpreted as a simple reweighting scheme, designed to address confounding. The procedures will be compared with respect to their fundamental properties, namely, which bias they aim to eliminate, which effect they aim to estimate, and which parameter is modelled. We will expand our overview of methods for analysis of non-randomized studies to methods for analysis of randomized controlled trials and show that analyses of both study types may target different effects and different parameters. The considerations will be illustrated using a breast cancer study with a so-called Comprehensive Cohort Study design, including a randomized controlled trial and a non-randomized study in the same patient population as sub-cohorts. This design offers ideal opportunities to discuss and illustrate the properties of the different approaches. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Second ICASE/LaRC Industry Roundtable: Session Proceedings

Science.gov (United States)

Girimaji, Sharath

1997-01-01

The second ICASE/LaRC Industry Roundtable was held October 7-9, 1996 at the Williamsburg Hospitality House, Williamsburg, Virginia. Like the first roundtable in 1994, this meeting had two objectives: (1) to expose ICASE and LaRC scientists to industrial research agendas; and (2) to acquaint industry with the capabilities and technology available at ICASE, LaRC and academic partners of ICASE. Nineteen sessions were held in three parallel tracks. Of the 170 participants, over one third were affiliated with various industries. Proceedings from the different sessions are summarized in this report.

Closing session

International Nuclear Information System (INIS)

2014-01-01

This part makes a summary of the different sessions and discussions of the workshop in a series of slide presentations: Summary of Opening Session; Summary of Session 1: Analysis of External Hazard Potential; Summary of session 2: Specific features of analysis and modeling of particular natural external hazards; Summary of session-3: Practices and research efforts on natural external events PSA; Summary of session 4: Modeling of NPP response to natural external events in PSA; Summary of session 5: Seismic Risk Analysis; Summary of session 6: Use of external events PSA with the focus on regulatory body role; Facilitated discussion 1 summary: Where do we stand in the analysis of external events?; Summary Facilitated Discussion 2: Findings and Good Practices for External Events Analysis

A process evaluation of a worksite vitality intervention among ageing hospital workers

Directory of Open Access Journals (Sweden)

van der Beek Allard J

2011-06-01

Full Text Available Abstract Background The process evaluation of the Vital@Work intervention was primary aimed at gaining insight into the context, dose delivered, fidelity, reach, dose received, and participants' attitude. Further, the differences between intervention locations were evaluated. Methods Eligible for this study were 730 workers, aged ≥ 45 years, from two academic hospitals. Workers randomised to the intervention group (n = 367 received a 6-months intervention consisting a Vitality Exercise Programme (VEP combined with three visits to a Personal Vitality Coach (PVC, aimed at goal setting, feedback, and problem solving. The VEP consisted of a guided yoga session, a guided workout session, and aerobic exercising without direct face-to-face instruction, all once a week. Data were collected by means of a questionnaire after the intervention, attendance registration forms (i.e. attendance at guided VEP group sessions, and coaching registration forms (filled in by the PVCs. Results The dose delivered of the yoga and workout sessions were 72.3% and 96.3%. All PVC visits (100% were offered. The reach for the yoga sessions, workout sessions and PVC visits was 70.6%, 63.8%, and 89.6%, respectively. When taken these three intervention components together, the reach was 52%. This differed between the two locations (59.2% versus 36.8%. The dose received was for the yoga 10.4 sessions/24 weeks and for the workout 11.1 sessions/24 weeks. The attendance rate, defined as the mean percentage of attended group sessions in relation to the total provided group sessions, for the yoga and workout sessions was 51.7% and 44.8%, respectively. For the yoga sessions this rate was different between the two locations (63.2% versus 46.5%. No differences were found between the locations regarding the workout sessions and PVC visits. Workers attended on average 2.7 PVC visits. Overall, workers were satisfied with the intervention components: 7.5 for yoga sessions, 7.8 for workout

Effect of patients' rights training sessions for nurses on perceptions of nurses and patients.

Science.gov (United States)

Ibrahim, Sanaa A; Hassan, Mona A; Hamouda, Seham Ibrahim; Abd Allah, Nama M

2017-11-01

Patients' rights are universal values that must be respected; however, it is not easy to put such values and principles into effect as approaches and attitudes differ from individual to individual, from society to society, and from country to country. If we want to reach a general conclusion about the status of patient rights in the world as whole, we should examine the situation in individual countries. To study the effect of training sessions for nurses about patients' rights on the perceptions of nurses and patients in two Egyptian hospitals. Quasi-experimental with pre- and posttest design was used in this study. Two groups of participants were included in the study: the first with 97 nurses and the second with 135 patients. A questionnaire sheet was used for nurses and patients to assess their perceptions about patients' rights before starting sessions. The training sessions were developed based on the baseline information gathered in the assessment phase and related literature. After the implementation of the sessions, a posttest was immediately conducted for nurses, while for patients the posttest was conducted 1 month after implementation to evaluate the effect of the nurses' training sessions on the patients' perceptions. The same tools were used in pretest and posttest. Ethical considerations: Written approval was sought and obtained from the administrators of the studied hospitals prior to conducting the study. Oral consent was obtained from nurses and patients willing to participate. Confidentiality and anonymity of the participants were strictly maintained through code numbers on the questionnaires. The improvement in nurses' knowledge and perceptions about patients' rights after implementation of the training sessions was remarkable. Moreover, an improvement in patients' perceptions regarding their rights was reported. Repetition of the training sessions is suggested to achieve continuous improvement. Provision of posters and booklets about a bill of

Effect of Pre-Hospital Ticagrelor During the First 24 h After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction

DEFF Research Database (Denmark)

Montalescot, Gilles; van 't Hof, Arnoud W; Bolognese, Leonardo

2016-01-01

OBJECTIVES: The aim of this landmark exploratory analysis, ATLANTIC-H(24), was to evaluate the effects of pre-hospital ticagrelor during the first 24 h after primary percutaneous coronary intervention (PCI) in the ATLANTIC (Administration of Ticagrelor in the cath Lab or in the Ambulance for New ST...... hypothesized that the effect of pre-hospital ticagrelor may not have manifested until after PCI due to the rapid transfer time (31 min). METHODS: The ATLANTIC-H(24) analysis included 1,629 patients who underwent PCI, evaluating platelet reactivity, Thrombolysis In Myocardial Infarction flow grade 3, ≥ 70% ST...... except death (1.1% vs. 0.2%; p = 0.048) favored pre-hospital ticagrelor, with no differences in bleeding events. CONCLUSIONS: The effects of pre-hospital ticagrelor became apparent after PCI, with numerical differences in platelet reactivity and immediate post-PCI reperfusion, associated with reductions...

Safety Training: scheduled sessions in March

CERN Multimedia

DGS Unit

2011-01-01

The following training courses are scheduled in March. You can find the full Safety Training programme on the Safety Training online catalogue. If you are interested in attending any of the below courses, please talk to your supervisor, then apply electronically via EDH from the course description pages, by clicking on SIGN-UP. Registration for all courses is always open – sessions for the less-requested courses are organized on a demand-basis only. Depending on the demand, a session will be organised later in the year. Biocell Training 08-MAR-11 (08.30 – 10.00) in English 08-MAR-11 (10.30 – 12.00) in French 15-MAR-11 (08.30 – 10.00) in French 15-MAR-11 (10.30 – 12.00) in French 17-MAR-11 (08.30 – 10.00) in English 17-MAR-11 (10.30 – 12.00) in English 22-MAR-11 (08.30 – 10.00) in French 22-MAR-11 (10.30 – 12.00) in French 24-MAR-11 (08.30 – 10.00) in French 24-MAR-11 (10.30 – 12.00) in French 29-MAR...

Safety Training: scheduled sessions in May

CERN Multimedia

Isabelle Cusato (HSE Unit)

2011-01-01

The following training courses are scheduled in March. You can find the full Safety Training programme on the Safety Training online catalogue. If you are interested in attending any of the below courses, please talk to your supervisor, then apply electronically via EDH from the course description pages, by clicking on SIGN-UP. Registration for all courses is always open – sessions for the less-requested courses are organized on a demand-basis only. Depending on the demand, a session will be organised later in the year.   Biocell Training 10-MAY-11 (08.30 – 10.00) in French 10-MAY-11 (10.30 – 12.00) in French 12-MAY-11 (08.30 – 10.00) in English 12-MAY-11 (10.30 – 12.00) in English 19-MAY-11 (08.30 – 10.00) in French 19-MAY-11 (10.30 – 12.00) in French 24-MAY-11 (08.30 – 10.00) in English 24-MAY-11 (10.30 – 12.00) in English   Champs Magnétiques 13-MAY-11 (09.30 – 11.30) in French...

[Surgery is unlikely to be enough for a patient to stop smoking 24h prior to hospital admission].

Science.gov (United States)

Marinho, Igor Maia; Carmona, Maria José C; Benseñor, Fábio Ely Martins; Hertel, Julia Mintz; Moraes, Marcos Fernando Breda de; Santos, Paulo Caleb Junior Lima; Vane, Matheus Fachini; Issa, Jaqueline Scholz

2018-06-07

The need for surgery can be a decisive factor for long-term smoking cessation. On the other hand, situations that precipitate stress could precipitate smoking relapse. The authors decided to study the impact of a surgery on the patient's effort to cease smoking for, at least, 24h before hospital admission and possible relapse on the last 24h before hospital admission for ex-smokers. Smoker, ex-smokers and non-smokers adults, either from pre-anesthetic clinic or recently hospital admitted for scheduled elective surgeries that were, at most, 6h inside the hospital buildings were included in the study. The patients answered a questionnaire at the ward or at the entrance of the operating room (Admitted group) or at the beginning of the first pre-anesthetic consultation (Clinic group) and performed CO measurements. 241 patients were included, being 52 ex-smokers and 109 never smokers and 80 non-smokers. Smokers had higher levels of expired carbon monoxide than non-smokers and ex-smokers (9.97±6.50 vs. 2.26±1.65 vs. 2.98±2.69; p=0.02). Among the smokers, the Clinic group had CO levels not statistically different of those on the Admitted group (10.93±7.5 vs. 8.65±4.56; p=0.21). The ex-smokers presented with no significant differences for the carbon monoxide levels between the Clinic and Admitted groups (2.9±2.3 vs. 2.82±2.15; p=0.45). A medical condition, such as a surgery, without proper assistance is unlikely to be enough for a patient to stop smoking for, at least, 24h prior to admission. The proximity of a surgery was not associated with smoking relapse 24h before the procedure. Copyright © 2018. Publicado por Elsevier Editora Ltda.

The Teratology Society 2007 strategic planning session: a desire to inspire.

Science.gov (United States)

2008-05-01

On April 18-20, 2007, the Teratology Society held its third strategic planning session (SPS) in San Diego, CA. The purpose of this session was to build on the successful work generated by the previous strategic plans [Nashville, TN 2002 and Cincinnati, OH 1997] and importantly, to provide a path forward to inspire the Society, create deeper connections with members that speak to their individual passion for the science of teratology and to increase the Society's visibility within the larger scientific community. The following summary report provides an overview of the session's pre-work, objective, and discussions. A total of 24 attendees were present at the session. The group included representation from Council, various committees and different members constituencies. This plan and the activities subsequent to the session will provide a path forward for our Society for the next five years.

Adherence to treatment and hospitalization risk in hemodialysis patients.

Science.gov (United States)

Vaiciuniene, Ruta; Kuzminskis, Vytautas; Ziginskiene, Edita; Skarupskiene, Inga; Bumblyte, Inga A

2012-01-01

The aim of this study was to evaluate whether adherence to treatment is associated with hospitalization risk in hemodialysis patients. We completed a cohort analysis of risk factors during 1 census month (November) and 1 year of follow-up during 5 consecutive years (2002-2006) in all end-stage renal disease patients hemodialyzed in the Kaunas region. During the census month, we collected data on noncompliance defined as (i) skipping of a hemodialysis (HD) session, (ii) shortening of 1 or more HD sessions, (iii) presence of hyperkalemia, (iv) presence of hyperphosphatemia, or (v) interdialytic weight gain (IDWG). In addition, data on age, sex, disability status, comorbidities, anemia control, malnutrition and inflammation, calcium-phosphorus metabolism and hospitalization rate were collected. Relative risk of hospitalization was estimated using Cox regression evaluating time to first hospitalization. We analyzed 559 patients for a total of 1,163 patient-years during the 5 years of the study. On multivariate analysis, adjusting for ischemic heart disease, diabetes mellitus, higher number of comorbid conditions, higher systolic blood pressure before dialysis, worse disability status, lower hemoglobin, albumin and urea before dialysis, the relative risk for hospitalization increased by 1.1 for every additional percentage point of IDWG and by 1.19 with each 1 mmol/L rise of serum phosphorus level. Skipping or shortening of hemodialysis sessions and serum potassium level were not associated with hospitalization. Higher IDWG and higher serum levels of phosphorus independently increased the relative risk of hospitalizations in hemodialysis patients. With skipped and shortened dialysis sessions, higher serum potassium level was not associated with hospitalization risk.

Use of prophylactic Saccharomyces boulardii to prevent Clostridium difficile infection in hospitalized patients: a controlled prospective intervention study.

Science.gov (United States)

Carstensen, Jeppe West; Chehri, Mahtab; Schønning, Kristian; Rasmussen, Steen Christian; Anhøj, Jacob; Godtfredsen, Nina Skavlan; Andersen, Christian Østergaard; Petersen, Andreas Munk

2018-05-03

Clostridium difficile infection (CDI) is a common complication to antibiotic use. Saccharomyces boulardii has shown effect as a prophylactic agent. We aimed to evaluate the efficacy of S. boulardii in preventing CDI in unselected hospitalized patients treated with antibiotics. We conducted a 1 year controlled prospective intervention study aiming to prescribe Sacchaflor (S. boulardii 5 × 10 9 , Pharmaforce ApS) twice daily to hospitalized patients treated with antibiotics. Comparable departments from three other hospitals in our region were included as controls. All occurrences of CDI in patients receiving antibiotics were reported and compared to a baseline period defined as 2 years prior to intervention. Results were analyzed using run chart tests for non-random variation in CDI rates. In addition, odds ratios for CDI were calculated. S. boulardii compliance reached 44% at the intervention hospital, and 1389 patients were treated with Sacchaflor. Monthly CDI rates dropped from a median of 3.6% in the baseline period to 1.5% in the intervention period. S. boulardii treatment was associated with a reduced risk of CDI at the intervention hospital: OR = 0.06 (95% CI 0.02-0.16). At two control hospitals, CDI rates did not change. At one control hospital, the median CDI rate dropped from 3.5 to 2.4%, possibly reflecting the effects of simultaneous multifaceted intervention against CDI at that hospital. The results from this controlled prospective interventional study indicate that S. boulardii is effective for the prevention of CDI in an unselected cohort of mainly elderly patients from departments of internal medicine.

A theory-driven, longitudinal evaluation of the impact of team training on safety culture in 24 hospitals.

Science.gov (United States)

Jones, Katherine J; Skinner, Anne M; High, Robin; Reiter-Palmon, Roni

2013-05-01

Effective teamwork facilitates collective learning, which is integral to safety culture. There are no rigorous evaluations of the impact of team training on the four components of safety culture-reporting, just, flexible and learning cultures. We evaluated the impact of a year-long team training programme on safety culture in 24 hospitals using two theoretical frameworks. We used two quasi-experimental designs: a cross-sectional comparison of hospital survey on patient safety culture (HSOPS) results from an intervention group of 24 hospitals to a static group of 13 hospitals and a pre-post comparison of HSOPS results within intervention hospitals. Dependent variables were HSOPS items representing the four components of safety culture; independent variables were derived from items added to the HSOPS that measured the extent of team training, learning and transfer. We used a generalised linear mixed model approach to account for the correlated nature of the data. 59% of 2137 respondents from the intervention group reported receiving team training. Intervention group HSOPS scores were significantly higher than static group scores in three dimensions assessing the flexible and learning components of safety culture. The distribution of the adoption of team behaviours (transfer) varied in the intervention group from 2.8% to 31.0%. Adoption of team behaviours was significantly associated with odds of an individual reacting more positively at reassessment than baseline to nine items reflecting all four components of safety culture. Team training can result in transformational change in safety culture when the work environment supports the transfer of learning to new behaviour.

Demographic factors and hospital size predict patient satisfaction variance--implications for hospital value-based purchasing.

Science.gov (United States)

McFarland, Daniel C; Ornstein, Katherine A; Holcombe, Randall F

2015-08-01

Hospital Value-Based Purchasing (HVBP) incentivizes quality performance-based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population-dense areas and could bias Centers for Medicare & Medicaid Services (CMS) reimbursement. Assess nonrandom variation in patient satisfaction as determined by HCAHPS. Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized 4 highly predictive variables, and hospitals were reranked accordingly. A total of 3907 HVBP-participating hospitals. There were 934,800 patient surveys by the most conservative estimate. A total of 3144 county demographics (US Census) and HCAHPS surveys. Hospital size and primary language (non-English speaking) most strongly predicted unfavorable HCAHPS scores, whereas education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals' locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. Demographic and structural factors (eg, hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct. © 2015 Society of Hospital Medicine.

Frugivores bias seed-adult tree associations through nonrandom seed dispersal: a phylogenetic approach.

Science.gov (United States)

Razafindratsima, Onja H; Dunham, Amy E

2016-08-01

Frugivores are the main seed dispersers in many ecosystems, such that behaviorally driven, nonrandom patterns of seed dispersal are a common process; but patterns are poorly understood. Characterizing these patterns may be essential for understanding spatial organization of fruiting trees and drivers of seed-dispersal limitation in biodiverse forests. To address this, we studied resulting spatial associations between dispersed seeds and adult tree neighbors in a diverse rainforest in Madagascar, using a temporal and phylogenetic approach. Data show that by using fruiting trees as seed-dispersal foci, frugivores bias seed dispersal under conspecific adults and under heterospecific trees that share dispersers and fruiting time with the dispersed species. Frugivore-mediated seed dispersal also resulted in nonrandom phylogenetic associations of dispersed seeds with their nearest adult neighbors, in nine out of the 16 months of our study. However, these nonrandom phylogenetic associations fluctuated unpredictably over time, ranging from clustered to overdispersed. The spatial and phylogenetic template of seed dispersal did not translate to similar patterns of association in adult tree neighborhoods, suggesting the importance of post-dispersal processes in structuring plant communities. Results suggest that frugivore-mediated seed dispersal is important for structuring early stages of plant-plant associations, setting the template for post-dispersal processes that influence ultimate patterns of plant recruitment. Importantly, if biased patterns of dispersal are common in other systems, frugivores may promote tree coexistence in biodiverse forests by limiting the frequency and diversity of heterospecific interactions of seeds they disperse. © 2016 by the Ecological Society of America.

Positive effect of human milk feeding during NICU hospitalization on 24 month neurodevelopment of very low birth weight infants: an Italian cohort study.

Directory of Open Access Journals (Sweden)

Dino Gibertoni

Full Text Available The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 very low birth weight newborns (weight ≤ 1500 g was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths Mental Development Scale. The effect of human milk nutrition on neurodevelopment was first investigated using a multiple linear regression model, to adjust for the effects of gestational age, small for gestational age, complications at birth and during hospitalization, growth restriction at discharge and socio-economic status. Path analysis was then used to refine the multiple regression model, taking into account the relationships among predictors and their temporal sequence. Human milk feeding during NICU hospitalization and higher socio-economic status were associated with better neurodevelopment at 24 months in both models. In the path analysis model intraventricular hemorrhage-periventricular leukomalacia and growth restriction at discharge proved to be directly and independently associated with poorer neurodevelopment. Gestational age and growth restriction at birth had indirect significant effects on neurodevelopment, which were mediated by complications that occurred at birth and during hospitalization, growth restriction at discharge and type of feeding. In conclusion, our findings suggest that mother's human milk feeding during hospitalization can be encouraged because it may improve neurodevelopment at 24 months corrected age.

Session-RPE for quantifying the load of different youth basketball training sessions.

Science.gov (United States)

Lupo, C; Tessitore, A; Gasperi, L; Gomez, Mar

2017-03-01

The aim of the study was to evaluate youth basketball training, verifying the reliability of the session-RPE method in relation to session duration (session) categories. Six male youth basketball players (age, 16.5±0.5 years; height, 195.5±6.75 cm; body mass, 93.9±10.9 kg; and body mass index, 23.6±2.8 kg.m -2 ) were monitored (HR, type and duration of workouts) during 15 (66 individual) training sessions (80±26 minutes). Edwards' HR method was used as a reference measure of internal training load (ITL); the CR-10 RPE scale was administered 30 minutes after the end of each session. The results obtained showed that all comparisons between different session durations and workout portions revealed effects in term of Edwards' ITLs except for warm-up portions. Moderate to strong relationships between Edwards' and session- RPE methods emerged for all sessions (r = .85, P sessions (r range = .79 - .95, P session durations (session-RPE to monitor the ITL, regardless of session durations and workout portions.

Demographic Factors and Hospital Size Predict Patient Satisfaction Variance- Implications for Hospital Value-Based Purchasing

Science.gov (United States)

McFarland, Daniel C.; Ornstein, Katherine; Holcombe, Randall F.

2016-01-01

Background Hospital Value-Based Purchasing (HVBP) incentivizes quality performance based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population dense areas and could bias CMS reimbursement. Objective Assess nonrandom variation in patient satisfaction as determined by HCAHPS. Design Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized four highly predictive variables and hospitals were re-ranked accordingly. Setting 3,907 HVBP-participating hospitals. Patients 934,800 patient surveys, by most conservative estimate. Measurements 3,144 county demographics (U.S. Census), and HCAHPS. Results Hospital size and primary language (‘non-English speaking’) most strongly predicted unfavorable HCAHPS scores while education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals’ locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. Conclusions Demographic and structural factors (e.g., hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct. PMID:25940305

Outcomes of a telemonitoring-based program (telEPOC in frequently hospitalized COPD patients

Directory of Open Access Journals (Sweden)

Esteban C

2016-11-01

Full Text Available Cristóbal Esteban,1,2 Javier Moraza,1 Milagros Iriberri,3 Urko Aguirre,2,4 Begoña Goiria,5 José M Quintana,2,4 Myriam Aburto,1 Alberto Capelastegui1 1Pneumology Department, Galdakao-Usansolo Hospital, Galdakao, 2Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC, Bilbao, 3Pneumology Department, Cruces Hospital, Barakaldo, 4Research Unit, Galdakao-Usansolo Hospital, Galdakao, 5Primary Care Unit, Barrualde Integrated Healthcare Organisation (OSI-Barrualde, Spain Background: The increasing prevalence of chronic diseases requires changes in health care delivery. In COPD, telemedicine appears to be a useful tool. Our objective was to evaluate the efficacy (in improving health care-resource use and clinical outcomes of a telemonitoring-based program (telEPOC in COPD patients with frequent hospitalizations. Materials and methods: We conducted a nonrandomized observational study in an intervention cohort of 119 patients (Galdakao-Usansolo Hospital and a control cohort of 78 patients (Cruces Hospital, followed up for 2 years (ClinicalTrials.gov identifier: NCT02528370. The inclusion criteria were two or more hospital admissions in the previous year or three or more admissions in the previous 2 years. The intervention group received telemonitoring plus education and controls usual care. Results: Most participants were men (13% women, and the sample had a mean age of 70 years, forced expiratory volume in 1 second of 45%, Charlson comorbidity index score of 3.5, and BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity index score of 4.1. In multivariate analysis, the intervention was independently related to lower rates of hospital admission (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.27–0.54; P<0.0001, emergency department attendance (OR 0.56, 95% CI 0.35–0.92; P<0.02, and 30-day readmission (OR 0.46, 95% CI 0.29–0.74; P<0.001, as well as cumulative length of stay (OR 0.58, 95% CI 0

Post-Session Authentication

DEFF Research Database (Denmark)

Ahmed, Naveed; Jensen, Christian D.

2012-01-01

Entity authentication provides confidence in the claimed identity of a peer entity, but the manner in which this goal is achieved results in different types of authentication. An important factor in this regard is the order between authentication and the execution of the associated session....... In this paper, we consider the case of post-session authentication, where parties authenticate each other at the end of their interactive session. This use of authentication is different from session-less authentication (e.g., in RFID) and pre-session authentication (e.g., for access control.) Post......-session authentication, although a new term, is not a new concept; it is the basis of at least a few practical schemes. We, for the first time, systematically study it and present the underlying authentication model. Further, we show that an important class of problems is solvable using post-session authentication...

A single alcohol drinking session is sufficient to enable subsequent aversion-resistant consumption in mice.

Science.gov (United States)

Lei, Kelly; Wegner, Scott A; Yu, Ji-Hwan; Simms, Jeffrey A; Hopf, F Woodward

2016-09-01

Addiction is mediated in large part by pathological motivation for rewarding, addictive substances, and alcohol-use disorders (AUDs) continue to extract a very high physical and economic toll on society. Compulsive alcohol drinking, where intake continues despite negative consequences, is considered a particular obstacle during treatment of AUDs. Aversion-resistant drives for alcohol have been modeled in rodents, where animals continue to consume even when alcohol is adulterated with the bitter tastant quinine, or is paired with another aversive consequence. Here, we describe a two-bottle choice paradigm where C57BL/6 mice first had 24-h access to 15% alcohol or water. Afterward, they drank quinine-free alcohol (alcohol-only) or alcohol with quinine (100 μM), in a limited daily access (LDA) two-bottle-choice paradigm (2 h/day, 5 days/week, starting 3 h into the dark cycle), and achieved nearly binge-level blood alcohol concentrations. Interestingly, a single, initial 24-h experience with alcohol-only enhanced subsequent quinine-resistant drinking. In contrast, mice that drank alcohol-quinine in the 24-h session showed significantly reduced alcohol-quinine intake and preference during the subsequent LDA sessions, relative to mice that drank alcohol-only in the initial 24-h session and alcohol-quinine in LDA sessions. Thus, mice could find the concentration of quinine we used aversive, but were able to disregard the quinine after a single alcohol-only drinking session. Finally, mice had low intake and preference for quinine in water, both before and after weeks of alcohol-drinking sessions, suggesting that quinine resistance was not a consequence of increased quinine preference after weeks of drinking of alcohol-quinine. Together, we demonstrate that a single alcohol-only session was sufficient to enable subsequent aversion-resistant consumption in C57BL/6 mice, which did not reflect changes in quinine taste palatability. Given the rapid development of quinine

Does balneotherapy with low radon concentration in water influence the endocrine system? A controlled non-randomized pilot study.

Science.gov (United States)

Nagy, Katalin; Berhés, István; Kovács, Tibor; Kávási, Norbert; Somlai, János; Bender, Tamás

2009-08-01

Radon bath is a well-established modality of balneotherapy for the management of degenerative musculoskeletal disorders. The present study was conducted to ascertain whether baths of relatively low (80 Bq/l) radon concentration have any influence on the functioning of the endocrine system. In the study, a non-randomized pilot study, 27 patients with degenerative musculoskeletal disorders received 30-min radon baths (of 31-32 degrees C temperature and 80 Bq/l average radon concentration) daily, for 15 days. Twenty-five patients with matching pathologies were subjected to balneotherapy according to the same protocol, using thermal water with negligible radon content (6 Bq/l). Serum thyroid stimulating hormone, prolactin, cortisol, adrenocorticotropic hormone, and dehydroepiandrosterone levels were measured before and after a balneotherapy course of 15 sessions. Comparison of the accumulated data using the Wilcoxon test did not reveal any significant difference between pre- and post-treatment values or between the two patient groups. It is noted that while the beneficial effects of balneotherapy with radon-containing water on degenerative disorders is widely known, only few data have been published in the literature on its effect on endocrine functions. The present study failed to demonstrate any substantial effect of thermal water with relatively low radon content on the functioning of the endocrine system.

98th LHCC meeting Agenda OPEN Session and CLOSED Session

CERN Document Server

CERN. Geneva

2009-01-01

OPEN Session on Wednesday, 8 July at 9h00-11h00 in Main Auditorium, Live webcast, followed by CLOSED Session, Conference room 160-1-009 11h20-17h00. CLOSED Session continued on Thursday, 9 July at 9h00-12h30

Session-RPE for quantifying the load of different youth basketball training sessions

Directory of Open Access Journals (Sweden)

C Lupo

2016-12-01

Full Text Available The aim of the study was to evaluate youth basketball training, verifying the reliability of the session-RPE method in relation to session duration (< and ≥ 80 minutes and workout typology (reduced and high warm-up, conditioning, technical, tactical, game portions within a single session categories. Six male youth basketball players (age, 16.5±0.5 years; height, 195.5±6.75 cm; body mass, 93.9±10.9 kg; and body mass index, 23.6±2.8 kg.m-2 were monitored (HR, type and duration of workouts during 15 (66 individual training sessions (80±26 minutes. Edwards’ HR method was used as a reference measure of internal training load (ITL; the CR-10 RPE scale was administered 30 minutes after the end of each session. The results obtained showed that all comparisons between different session durations and workout portions revealed effects in term of Edwards’ ITLs except for warm-up portions. Moderate to strong relationships between Edwards’ and session- RPE methods emerged for all sessions (r = .85, P < .001, player’s sessions (r range = .79 - .95, P < .001, session durations (< 80 minutes: r = .67, P < .001; ≥ 80 minutes: r = .75, P < .001, and workout portions (r range = .78 - .89, P range = .002 - < .001. The findings indicated that coaches of youth basketball players can successfully use session-RPE to monitor the ITL, regardless of session durations and workout portions.

Non-random distribution of instability-associated chromosomal rearrangement breakpoints in human lymphoblastoid cells

International Nuclear Information System (INIS)

Moore, Stephen R.; Papworth, David; Grosovsky, Andrew J.

2006-01-01

Genomic instability is observed in tumors and in a large fraction of the progeny surviving irradiation. One of the best-characterized phenotypic manifestations of genomic instability is delayed chromosome aberrations. Our working hypothesis for the current study was that if genomic instability is in part attributable to cis mechanisms, we should observe a non-random distribution of chromosomes or sites involved in instability-associated rearrangements, regardless of radiation quality, dose, or trans factor expression. We report here the karyotypic examination of 296 instability-associated chromosomal rearrangement breaksites (IACRB) from 118 unstable TK6 human B lymphoblast, and isogenic derivative, clones. When we tested whether IACRB were distributed across the chromosomes based on target size, a significant non-random distribution was evident (p < 0.00001), and three IACRB hotspots (chromosomes 11, 12, and 22) and one IACRB coldspot (chromosome 2) were identified. Statistical analysis at the chromosomal band-level identified four IACRB hotspots accounting for 20% of all instability-associated breaks, two of which account for over 14% of all IACRB. Further, analysis of independent clones provided evidence within 14 individual clones of IACRB clustering at the chromosomal band level, suggesting a predisposition for further breaks after an initial break at some chromosomal bands. All of these events, independently, or when taken together, were highly unlikely to have occurred by chance (p < 0.000001). These IACRB band-level cluster hotspots were observed independent of radiation quality, dose, or cellular p53 status. The non-random distribution of instability-associated chromosomal rearrangements described here significantly differs from the distribution that was observed in a first-division post-irradiation metaphase analysis (p = 0.0004). Taken together, these results suggest that genomic instability may be in part driven by chromosomal cis mechanisms

Does the Timing of Measurement Alter Session-RPE in Boxers?

Science.gov (United States)

Uchida, Marco C; Teixeira, Luis F M; Godoi, Vladmir J; Marchetti, Paulo H; Conte, Marcelo; Coutts, Aaron J; Bacurau, Reury F P

2014-01-01

The purpose of this study was to compare the influence of measuring the overall session rating of perceived exertion (session-RPE) at 10 vs. 30 minutes following exercise. Eight boxers completed three different standardized training sessions of different intensities (easy, moderate and hard) in a matchedpairs, randomized research design. Exercise intensity was assessed during each bout by measuring heart rate, blood lactate concentration and session-RPE. To assess the effect of measurement timing on session-RPE, RPE data were collected either 10 or 30 minutes post-exercise. There was no significant effect of measurement time on session-RPE values following easy (10 minutes: session-RPE = 1.3 ± 1.0 Arbitrary Unit (AU), %Heart Rate Reserve (HRR) = 49.5 ± 11.1, and ∆Blood lactate = -2.3 ± 16.3%; 30 minutes: session-RPE = 1.7 ± 1.0 AU, %HRR = 51.3 ± 10.8, and ∆Blood lactate = 0.7 ± 25.2%), moderate (10 minutes: session-RPE = 2.7 ± 1.6 AU, %HRR = 67.2 ± 10.8, and ∆Blood lactate = 2.2 ± 19%; 30 minutes: session-RPE = 2.5 ± 0.9 AU, %HRR = 67.2 ± 5.9, and ∆Blood lactate = 24.5 ± 17.1%) and hard (10 minutes: session-RPE = 5.7 ± 1.0 AU, %HRR = 88.1 ± 6.3, and ∆Blood lactate = 146.3 ± 87.9%; 30 minutes: session-RPE = 5.8 ± 1.9 AU, %HRR> = 83.3 ± 8.0, and ∆Blood lactate = 91.6 ± 39%) sessions. In conclusion, our findings suggest that session-RPE can be used in boxing training routines across a range of intensities and accurate measurements can be determined as early as 10 minutes after exercise. Key PointsIt is difficult to quantify and monitoring the external training load in martial arts (e.g. Aikido, Kung Fu, Judo) and physical combat sports (e.g. Boxing, Muay Thai), session RPE method appears to be a reliable method to quantifying training load in those sports.For many athletes it is impractical to wait 30 minutes after training session to provide a session-RPE. The present findings show that collecting ses-sion-RPE measures at 10 min

Variation of mutational burden in healthy human tissues suggests non-random strand segregation and allows measuring somatic mutation rates.

Science.gov (United States)

Werner, Benjamin; Sottoriva, Andrea

2018-06-01

The immortal strand hypothesis poses that stem cells could produce differentiated progeny while conserving the original template strand, thus avoiding accumulating somatic mutations. However, quantitating the extent of non-random DNA strand segregation in human stem cells remains difficult in vivo. Here we show that the change of the mean and variance of the mutational burden with age in healthy human tissues allows estimating strand segregation probabilities and somatic mutation rates. We analysed deep sequencing data from healthy human colon, small intestine, liver, skin and brain. We found highly effective non-random DNA strand segregation in all adult tissues (mean strand segregation probability: 0.98, standard error bounds (0.97,0.99)). In contrast, non-random strand segregation efficiency is reduced to 0.87 (0.78,0.88) in neural tissue during early development, suggesting stem cell pool expansions due to symmetric self-renewal. Healthy somatic mutation rates differed across tissue types, ranging from 3.5 × 10-9/bp/division in small intestine to 1.6 × 10-7/bp/division in skin.

Variation of mutational burden in healthy human tissues suggests non-random strand segregation and allows measuring somatic mutation rates.

Directory of Open Access Journals (Sweden)

Benjamin Werner

2018-06-01

Full Text Available The immortal strand hypothesis poses that stem cells could produce differentiated progeny while conserving the original template strand, thus avoiding accumulating somatic mutations. However, quantitating the extent of non-random DNA strand segregation in human stem cells remains difficult in vivo. Here we show that the change of the mean and variance of the mutational burden with age in healthy human tissues allows estimating strand segregation probabilities and somatic mutation rates. We analysed deep sequencing data from healthy human colon, small intestine, liver, skin and brain. We found highly effective non-random DNA strand segregation in all adult tissues (mean strand segregation probability: 0.98, standard error bounds (0.97,0.99. In contrast, non-random strand segregation efficiency is reduced to 0.87 (0.78,0.88 in neural tissue during early development, suggesting stem cell pool expansions due to symmetric self-renewal. Healthy somatic mutation rates differed across tissue types, ranging from 3.5 × 10-9/bp/division in small intestine to 1.6 × 10-7/bp/division in skin.

A systematic review of nonrandomized controlled trials on the curative effects of aquatic exercise

Directory of Open Access Journals (Sweden)

Kamioka H

2011-03-01

Full Text Available Hiroharu Kamioka1, Kiichiro Tsutani2, Yoshiteru Mutoh3, Hiroyasu Okuizum4, Miho Ohta5, Shuichi Handa4, Shinpei Okada6, Jun Kitayuguchi7, Masamitsu Kamada7, Nobuyoshi Shiozawa8, Sang-Jun Park4, Takuya Honda4, Shoko Moriyama41Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, Japan; 2Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, 3Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan; 4Mimaki Onsen (Spa Clinic, Tomi City, Japan; 5Laboratory of Aqua, Health, and Sports Medicine, 6Physical Education and Medicine Research Foundation, Nagano, Japan; 7Physical Education and Medicine Research Center Unnan, Unnan City, Japan; 8Department of Longevity and Social Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanBackground: The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of nonrandomized controlled trials (nRCTs.Methods: Study design was a systematic review of nonrandomized controlled trials. Trials were eligible if they were nonrandomized clinical trials. Studies included one treatment group in which aquatic exercise was applied. We searched the following databases from 2000 up to July 20, 2009: MEDLINE via PubMed, CINAHL, and Ichushi-Web.Results: Twenty-one trials met all inclusion criteria. Languages included were English (N = 9, Japanese (N = 11, and Korean (N = 1. Target diseases were knee and/or hip osteoarthritis, poliomyelitis, chronic kidney disease, discomforts of pregnancy, cardiovascular diseases, and rotator cuff tears. Many studies on nonspecific disease (healthy participants were included. All studies reported significant effectiveness in at least one or more outcomes. However results of evaluations with the TREND and CLEAR-NPT checklists generally

Session-RPE for quantifying load of different youth taekwondo training sessions.

Science.gov (United States)

Lupo, Corrado; Capranica, Laura; Cortis, Cristina; Guidotti, Flavia; Bianco, Antonino; Tessitore, Antonio

2017-03-01

The session rating of perceived exertion (session-RPE) proved to be a valuable method to quantify the internal training load (ITL) in taekwondo. However, no study validated this method in youth taekwondo athletes performing different training sessions. Thus this study aimed at evaluating the reliability of the session-RPE to monitor the ITL of prepubescent taekwondo athletes during pre-competitive (PC) and competitive (C) training sessions. Five female (age: 12.0±0.7 y; height: 1.54±0.08 m; body mass: 48.8±7.3 kg) and four male (age: 12.0±0.8 yrs; height: 1.55±0.07 m; body mass: 47.3±5.3 kg) taekwondo athletes were monitored during 100 individual sessions (PC: N.=33; C: N.=67). The Edwards' HR method was used as reference measure of ITL; the CR-10 RPE scale was administered at 1- and 30-minutes from the end of each session. No difference for gender emerged. The ITLs of C (Edwards: 228±40 arbitrary units, AU) resulted higher than that of PC (192±26 AU; P=0.04). Although all training typologies and data collections achieved significant correlations between Edwards' and session-RPE methods, a large relationship (r =0.71, Psessions evaluated at 30 minutes of the recovery phases. Findings support coaches of prepubescent taekwondo athletes to successfully use session-RPE to monitor the ITL of different training typologies. However, PC training evaluated at 30 minutes of the recovery phase represents the best condition for a highly reliable ITL perception.

Education in geriatric medicine for community hospital staff.

LENUS (Irish Health Repository)

O'Hanlon, Shane

2010-12-01

Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.

Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.

Science.gov (United States)

Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Stangier, Ulrich

2014-07-01

The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence. Copyright © 2014. Published by Elsevier Ltd.

Multimedia consultation session recording and playback using Java-based browser in global PACS

Science.gov (United States)

Martinez, Ralph; Shah, Pinkesh J.; Yu, Yuan-Pin

1998-07-01

The current version of the Global PACS software system uses a Java-based implementation of the Remote Consultation and Diagnosis (RCD) system. The Java RCD includes a multimedia consultation session between physicians that includes text, static image, image annotation, and audio data. The JAVA RCD allows 2-4 physicians to collaborate on a patient case. It allows physicians to join the session via WWW Java-enabled browsers or stand alone RCD application. The RCD system includes a distributed database archive system for archiving and retrieving patient and session data. The RCD system can be used for store and forward scenarios, case reviews, and interactive RCD multimedia sessions. The RCD system operates over the Internet, telephone lines, or in a private Intranet. A multimedia consultation session can be recorded, and then played back at a later time for review, comments, and education. A session can be played back using Java-enabled WWW browsers on any operating system platform. The JAVA RCD system shows that a case diagnosis can be captured digitally and played back with the original real-time temporal relationships between data streams. In this paper, we describe design and implementation of the RCD session playback.

Formal description of the OSI session layer: session service

NARCIS (Netherlands)

van Sinderen, Marten J.; van Eijk, P.H.J.; Vissers, C.A.; Diaz, M.

1989-01-01

The LOTOS formal description of the OSI session service is presented on basis of specification samples from the full description, giving account of how specification styles and session service architectural elements are reflected in the description. Both information (data types) and process

The effect of chain membership on hospital costs.

Science.gov (United States)

Menke, T J

1997-06-01

To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. Data from all sources were merged at the hospital level to form the study sample. Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals.

The repeated bout effect of typical lower body strength training sessions on sub-maximal running performance and hormonal response.

Science.gov (United States)

Doma, Kenji; Schumann, Moritz; Sinclair, Wade H; Leicht, Anthony S; Deakin, Glen B; Häkkinen, Keijo

2015-08-01

This study examined the effects of two typical strength training sessions performed 1 week apart (i.e. repeated bout effect) on sub-maximal running performance and hormonal. Fourteen resistance-untrained men (age 24.0 ± 3.9 years; height 1.83 ± 0.11 m; body mass 77.4 ± 14.0 kg; VOpeak 48.1 ± 6.1 M kg(-1) min(-1)) undertook two bouts of high-intensity strength training sessions (i.e. six-repetition maximum). Creatine kinase (CK), delayed-onset muscle soreness (DOMS), counter-movement jump (CMJ) as well as concentrations of serum testosterone, cortisol and testosterone/cortisol ratio (T/C) were examined prior to and immediately post, 24 (T24) and 48 (T48) h post each strength training bout. Sub-maximal running performance was also conducted at T24 and T48 of each bout. When measures were compared between bouts at T48, the degree of elevation in CK (-58.4 ± 55.6 %) and DOMS (-31.43 ± 42.9 %) and acute reduction in CMJ measures (4.1 ± 5.4 %) were attenuated (p 0.05). Sub-maximal running performance was impaired until T24, although changes were not attenuated following the second bout. The initial bout appeared to provide protection against a number of muscle damage indicators suggesting a greater need for recovery following the initial session of typical lower body resistance exercises in resistance-untrained men although sub-maximal running should be avoided following the first two sessions.

An intervention to reduce HIV risk behavior of substance-using men who have sex with men: a two-group randomized trial with a nonrandomized third group.

Directory of Open Access Journals (Sweden)

Gordon Mansergh

2010-08-01

Full Text Available Substance use during sex is associated with sexual risk behavior among men who have sex with men (MSM, and MSM continue to be the group at highest risk for incident HIV in the United States. The objective of this study is to test the efficacy of a group-based, cognitive-behavioral intervention to reduce risk behavior of substance-using MSM, compared to a randomized attention-control group and a nonrandomized standard HIV-testing group.Participants (n = 1,686 were enrolled in Chicago, Los Angeles, New York City, and San Francisco and randomized to a cognitive-behavioral intervention or attention-control comparison. The nonrandomized group received standard HIV counseling and testing. Intervention group participants received six 2-h group sessions focused on reducing substance use and sexual risk behavior. Attention-control group participants received six 2-h group sessions of videos and discussion of MSM community issues unrelated to substance use, sexual risk, and HIV/AIDS. All three groups received HIV counseling and testing at baseline. The sample reported high-risk behavior during the past 3 mo prior to their baseline visit: 67% reported unprotected anal sex, and 77% reported substance use during their most recent anal sex encounter with a nonprimary partner. The three groups significantly (p0.05 from each other at 3-, 6-, and 12-mo follow-up. Outcomes for the 2-arm comparisons were not significantly different at 12-mo follow-up (e.g., unprotected anal sex, odds ratio = 1.14, confidence interval = 0.86-1.51, nor at earlier time points. Similar results were found for each outcome variable in both 2- and 3-arm comparisons.These results for reducing sexual risk behavior of substance-using MSM are consistent with results of intervention trials for other populations, which collectively suggest critical challenges for the field of HIV behavioral interventions. Several mechanisms may contribute to statistically indistinguishable reductions in risk

Early Outcomes of Out-of-Hospital Cardiac Arrest after Early Defibrillation: a 24 Months Retrospective Analysis

Directory of Open Access Journals (Sweden)

Paolo Terranova

2006-10-01

Full Text Available Introduction: Cardiovascular disease remains the most common cause of death in the United States and most other Western nations. Among these deaths, sudden, out-of-hospital cardiac arrest claims approximately 1000 lives each day in the United States alone. Most of these cardiac arrests are due to ventricular fibrillation. Though highly reversible with the rapid application of a defibrillator, ventricular fibrillation is otherwise fatal within minutes, even when cardiopulmonary resuscitation is provided immediately. The overall survival rate in the United States is estimated to be less than 5 percent. Recent developments in automated-external-defibrillator technology have provided a means of increasing the rate of prompt defibrillation after out-of-hospital cardiac arrest. After minimal training, nonmedical personnel (e.g., flight attendants and casino workers are also able to use defibrillators in the workplace, with lifesaving effects. Nonetheless, such programs have involved designated personnel whose job description includes assisting persons who have had sudden cardiac arrest. Data are still lacking on the success of programs in which automated external defibrillators have been installed in public places to be used by persons who have no specific training or duty to act. Materials and Methods: All patients who had an out-of-hospital cardiac arrest between January 2003 and December 2004 and who received early defibrillation for ventricular fibrillation were included. We conducted a 24 months retrospective population-based analysis of the outcome in our population. Results: Over a 24 month period, 446 people had non–traumatic cardiac arrest, and in all of them it was observed to be ventricular fibrillation. In a very few cases, the defibrillator operators were good Samaritans, acting voluntarily. Eighty-nine patients (about 19% with ventricular fibrillation were successfully resuscitated, including eighteen who regained consciousness before

Tests for nonrandomness in quantum jumps

International Nuclear Information System (INIS)

Berkeland, D.J.; Raymondson, D.A.; Tassin, V.M.

2004-01-01

In a fundamental test of quantum mechanics, we have observed 228 000 quantum jumps of a single trapped and laser cooled 88 Sr + ion. This represents a statistical increase of two orders of magnitude over previous similar analyses of quantum jumps. Compared to other searches for nonrandomness in quantum-mechanical processes, using quantum jumps simplifies the interpretation of data by eliminated multiparticle effects and providing near-unit detection efficiency of transitions. We measure the fractional reduction in the entropy of information to be -4 when the value of any interval between quantum jumps is known. We also find that the number of runs of successively increasing or decreasing interval times agrees with the theoretically expected values. Furthermore, we analyze 238 000 quantum jumps from two simultaneously confined ions and find that the number of apparently coincidental transitions is as expected. Finally, we observe 8400 spontaneous decays of two simultaneously trapped ions and find that the number of apparently coincidental decays from the metastable state agrees with the expected value. We find no evidence for short- or long-term correlations in the intervals of the quantum jumps or in the decay of the quantum states, in agreement with quantum theory

Hospital staffing and hospital costs.

Science.gov (United States)

Andrew, R R

1976-08-07

A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

Clarifying perspectives: Ethics case reflection sessions in childhood cancer care.

Science.gov (United States)

Bartholdson, Cecilia; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2016-06-01

Childhood cancer care involves many ethical concerns. Deciding on treatment levels and providing care that infringes on the child's growing autonomy are known ethical concerns that involve the whole professional team around the child's care. The purpose of this study was to explore healthcare professionals' experiences of participating in ethics case reflection sessions in childhood cancer care. Data collection by observations, individual interviews, and individual encounters. Data analysis were conducted following grounded theory methodology. Healthcare professionals working at a publicly funded children's hospital in Sweden participated in ethics case reflection sessions in which ethical issues concerning clinical cases were reflected on. The children's and their parents' integrity was preserved through measures taken to protect patient identity during ethics case reflection sessions. The study was approved by a regional ethical review board. Consolidating care by clarifying perspectives emerged. Consolidating care entails striving for common care goals and creating a shared view of care and the ethical concern in the specific case. The inter-professional perspectives on the ethical aspects of care are clarified by the participants' articulated views on the case. Different approaches for deliberating ethics are used during the sessions including raising values and making sense, leading to unifying interactions. The findings indicate that ethical concerns could be eased by implementing ethics case reflection sessions. Conflicting perspectives can be turned into unifying interactions in the healthcare professional team with the common aim to achieve good pediatric care. Ethics case reflection sessions is valuable as it permits the discussion of values in healthcare-related issues in childhood cancer care. Clarifying perspectives, on the ethical concerns, enables healthcare professionals to reflect on the most reasonable and ethically defensible care for the child

Introduction and Overview of the Industrial Interactive Panel Session

Science.gov (United States)

Seiler, David

2014-03-01

A unique industrial panel covering the challenges and needs of various industries and how being innovative is important. The session involves two invited industry speakers (24 minutes each) who will set the stage for the interactive round table panel session. The Panel, led by moderator Mark Bernius (Morgan Advanced Materials), consists of the two invited speakers plus an additional five industry panelists. The first thirty minutes of the panel session has the five additional panelists introducing themselves and their work/company. These introductions could include what they or their company does, sharing one or two technical highlights, listing some challenges or needs for physicists, and what innovation breakthroughs are needed in their industries. The final hour of the session will be highly interactive with questions to the panel coming from the moderator, the audience, and the panelists themselves. Questions that might be addressed include: how physicists are or could be critical in advancing innovation; how can AIP/APS/FIAP help industry get the physics help they need to be innovative (knowledge, the right staff, etc.); what role can students and post docs play in advancing industry's mission; etc. We invite you to participate in this interactive session and ask our industry experts your own interesting and challenging questions. The invited speakers are George Thompson, Intel, and Rick Watkins, Nike. The panel members also include Jason Cleveland, Asylum Research; Robert Doering, Texas Instruments; William Gallagher, IBM T.J. Watson Research Center; James Hollenhorst, Agilent Technologies; and Martin Poitzsch, Schlumberger-Doll Research.

Post-Session Authentication

OpenAIRE

Ahmed , Naveed; Jensen , Christian ,

2012-01-01

Part 1: Full Papers; International audience; Entity authentication provides confidence in the claimed identity of a peer entity, but the manner in which this goal is achieved results in different types of authentication. An important factor in this regard is the order between authentication and the execution of the associated session. In this paper, we consider the case of post-session authentication, where parties authenticate each other at the end of their interactive session. This use of a...

Non-random mating and convergence over time for alcohol consumption, smoking, and exercise: the Nord-Trøndelag Health Study.

Science.gov (United States)

Ask, Helga; Rognmo, Kamilla; Torvik, Fartein Ask; Røysamb, Espen; Tambs, Kristian

2012-05-01

Spouses tend to have similar lifestyles. We explored the degree to which spouse similarity in alcohol use, smoking, and physical exercise is caused by non-random mating or convergence. We used data collected for the Nord-Trøndelag Health Study from 1984 to 1986 and prospective registry information about when and with whom people entered marriage/cohabitation between 1970 and 2000. Our sample included 19,599 married/cohabitating couples and 1,551 future couples that were to marry/cohabitate in the 14-16 years following data collection. All couples were grouped according to the duration between data collection and entering into marriage/cohabitation. Age-adjusted polychoric spouse correlations were used as the dependent variables in non-linear segmented regression analysis; the independent variable was time. The results indicate that spouse concordance in lifestyle is due to both non-random mating and convergence. Non-random mating appeared to be strongest for smoking. Convergence in alcohol use and smoking was evident during the period prior to marriage/cohabitation, whereas convergence in exercise was evident throughout life. Reduced spouse similarity in smoking with relationship duration may reflect secular trends.

AN ASSESSMENT OF THE STATUS OF HIV COUNSELLING AND TESTING FACILITY IN GOVERNMENT HOSPITALS OF DISTRICT JHANSI UTTAR PRADESH

Directory of Open Access Journals (Sweden)

Atul Kumar Singh

2010-06-01

Full Text Available Background: Counseling is the face to face communication by which counselor can help the person” client to make decisions and act on them, Effective Counseling and Testing programs can help patients identify and limit- behaviors that increase the risk of’ HIV infection or transmission. Objective: ToAssess the status of HlV Counseling and Testing facilities in Government Hospitals of District Jhansi. Study design: Cross-sectional study. Settings: Four Government Hospitals namely Mèdical College, District Hospital, Railway Hospital and Military Hospital of district Jhansi. Study Period: Two months (l5th August to 15’ October 2008. StatisticalAnalysis: Percentages Results: In most (87.5% of the sessions of all the centers only signature of the patients was taken instead of filling the full consent form whereas rapport with the patients by the counselor was maintained only in 37.5% sessions. In 80% of the sessions the patients were not been told about ‘window period” by the counselors. In 75% of the sessions counselors were not fully attentive towards patient’s concerns. Only in 5% sessions patients were correctly informed about HI V/AIDS. In all the centers, there was no provision for group- session and usually the test results of HlV infection (positive or negative was not provided on the very same day, due to heavy patient load.

Use of prophylactic Saccharomyces boulardii to prevent Clostridium difficile infection in hospitalized patients

DEFF Research Database (Denmark)

Carstensen, Jeppe West; Chehri, Mahtab; Schønning, Kristian

2018-01-01

Clostridium difficile infection (CDI) is a common complication to antibiotic use. Saccharomyces boulardii has shown effect as a prophylactic agent. We aimed to evaluate the efficacy of S. boulardii in preventing CDI in unselected hospitalized patients treated with antibiotics. We conducted a 1 year...... controlled prospective intervention study aiming to prescribe Sacchaflor (S. boulardii 5 × 109, Pharmaforce ApS) twice daily to hospitalized patients treated with antibiotics. Comparable departments from three other hospitals in our region were included as controls. All occurrences of CDI in patients...... receiving antibiotics were reported and compared to a baseline period defined as 2 years prior to intervention. Results were analyzed using run chart tests for non-random variation in CDI rates. In addition, odds ratios for CDI were calculated. S. boulardii compliance reached 44% at the intervention...

Proceedings of the 24th KAIF/KNS Annual Conference

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-04-15

This proceedings contains articles of the 24th KAIF/KNS Annual Conference of the KAIF and Korean Nuclear Society. It was held on Apr. 8-10, 2009 in Seoul, Korea and subject of 24th Conference is the role of nuclear energy: Green enertopia with nuclear. This proceedings is comprised of 8 sessions. The main topic titles of session are as follows: Operation and maintenance of nuclear power plants, Betterment of nuclear power utilization, Enhanced future application of nuclear science and technology, Radioactive waste management, RI production and its utilization, Design, engineering, manufacturing, and construction of NPP in Korea, Nuclear fuel cycle, Nuclear safety and regulation. (Yi, J. H.)

Statistical method on nonrandom clustering with application to somatic mutations in cancer

Directory of Open Access Journals (Sweden)

Rejto Paul A

2010-01-01

Full Text Available Abstract Background Human cancer is caused by the accumulation of tumor-specific mutations in oncogenes and tumor suppressors that confer a selective growth advantage to cells. As a consequence of genomic instability and high levels of proliferation, many passenger mutations that do not contribute to the cancer phenotype arise alongside mutations that drive oncogenesis. While several approaches have been developed to separate driver mutations from passengers, few approaches can specifically identify activating driver mutations in oncogenes, which are more amenable for pharmacological intervention. Results We propose a new statistical method for detecting activating mutations in cancer by identifying nonrandom clusters of amino acid mutations in protein sequences. A probability model is derived using order statistics assuming that the location of amino acid mutations on a protein follows a uniform distribution. Our statistical measure is the differences between pair-wise order statistics, which is equivalent to the size of an amino acid mutation cluster, and the probabilities are derived from exact and approximate distributions of the statistical measure. Using data in the Catalog of Somatic Mutations in Cancer (COSMIC database, we have demonstrated that our method detects well-known clusters of activating mutations in KRAS, BRAF, PI3K, and β-catenin. The method can also identify new cancer targets as well as gain-of-function mutations in tumor suppressors. Conclusions Our proposed method is useful to discover activating driver mutations in cancer by identifying nonrandom clusters of somatic amino acid mutations in protein sequences.

STUDY ON WASTEWATER TREATMENT SYSTEMS IN HOSPITALS OF IRAN

Directory of Open Access Journals (Sweden)

M. Majlesi Nasr, A. R. Yazdanbakhsh

2008-07-01

Full Text Available Nowadays, water resources shortage is one of the most important issues for environmental engineers and managers as well as its conservation due to population growth and ever-increasing water demands. Besides, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components. In this paper, physical and chemical specifications of produced wastewater in hospitals of Iran were investigated experiments. Results were compared with the effluent parameters of wastewater standards of Iranian Department of the Environment. 70 governmental hospitals from different provinces of Iran were selected by purposive (non-random sampling method. For data analysis, SPSS and EXCEL softwares were applied. The findings of the study showed that 52% of the surveyed hospitals were not equipped and 48% were equipped with wastewater treatment systems. The mean of Biochemical Oxygen Demand, Chemical Oxygen Demand and Total Suspended Solids of the effluent of wastewater treatment systems were reported as 113, 188 and 99 mg/L respectively. Comparison of the indicators between effluents of wastewater treatment systems and the standards of Departments of the Environment, showed the inefficiency in these systems and it was concluded that despite the recent improvements in hospital wastewater treatment systems, they should be upgraded based on the remarks in this paper.

Analysis and comparison of intensity in specific soccer training sessions

Directory of Open Access Journals (Sweden)

Luciano Antonacci Condessa

2015-03-01

Full Text Available This study compared the exercise intensity of four specific soccer training sessions (friendly and training match, tactical and technical workouts. Ten professional soccer players (24.2 ± 3.7 years, 177.9 ± 7.3 cm, 63.2 ± 4.6 mLO2•kg-1•min-l were recruited. A treadmill progressive interval test was performed to determine the players' VO2max, maximal heart rate (HRmax, HR-VO2 curve, and the heart rate corresponding to blood lactate concentrations of 2 and 4 mmol/L. The heart rate during the training sessions was used to estimate the exercise intensity and to classify them into intensity zones (low-intensity: 4 mmol/L. Exercise intensities were different among training sessions (friendly match: 86.0 ± 5.1% HRmax; training match: 81.2 ± 4.1% HRmax; tactical workout: 70.4 ± 5.3% HRmax; technical workout: 62.1 ± 3.6% HRmax. The friendly match presented the highest percentage of time performed in the high-intensity zone.

Sessions and Separability in Security Protocols

DEFF Research Database (Denmark)

Carbone, Marco; Guttman, Joshua

2013-01-01

Despite much work on sessions and session types in non- adversarial contexts, session-like behavior given an active adversary has not received an adequate definition and proof methods. We provide a syntactic property that guarantees that a protocol has session-respecting executions. Any uncomprom......Despite much work on sessions and session types in non- adversarial contexts, session-like behavior given an active adversary has not received an adequate definition and proof methods. We provide a syntactic property that guarantees that a protocol has session-respecting executions. Any...

Multiparty Asynchronous Session Types

DEFF Research Database (Denmark)

Honda, Kohei; Yoshida, Nobuko; Carbone, Marco

2016-01-01

. This work extends the foregoing theories of binary session types to multiparty, asynchronous sessions, which often arise in practical communication-centered applications. Presented as a typed calculus for mobile processes, the theory introduces a new notion of types in which interactions involving multiple......Communication is a central elements in software development. As a potential typed foundation for structured communication-centered programming, session types have been studied over the past decade for a wide range of process calculi and programming languages, focusing on binary (two-party) sessions...... peers are directly abstracted as a global scenario. Global types retain the friendly type syntax of binary session types while specifying dependencies and capturing complex causal chains of multiparty asynchronous interactions. A global type plays the role of a shared agreement among communication peers...

Improved Clinical Efficacy with Wound Support Network Between Hospital and Home Care Service.

Science.gov (United States)

Bergersen, Tone Kristin; Storheim, Elisabeth; Gundersen, Stina; Kleven, Linn; Johnson, Maria; Sandvik, Leiv; Kvaerner, Kari Jorunn; Ørjasæter, Nils-Otto

2016-11-01

The aim of this study was to test the efficacy of a wound support network model between the primary home care service and the hospital. The impact on wound healing rate, cost benefit, and transfer of knowledge was investigated. The intervention group was exposed to a wound support network (n = 32), and the control group continued standard organization of treatment (n = 21). Nonrandomized controlled study; observations were made before (baseline) and after the implementation of the intervention (12 weeks). Patients with chronic wounds (lasting >6 weeks and with wound area >1 cm) in Oslo, Norway. Closure of the observation wound; wound size; total number of wounds; presence of eczema, edema, and pain; number of dressings per week; time spent per dressing; and number of control appointments at the hospital. The economic impact is calculated for the hospital and for the community of Oslo, Norway. The number of control appointments (t = 3.80, P home care service and the hospital is cost-effective, improves clinical efficacy of the home care services' work, and reduces the need for consultations at the hospital.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

Science.gov (United States)

Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

2011-08-01

Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Influencing Nursing Knowledge and Attitudes to Positively Affect Care of Patients with Persistent Pain in the Hospital Setting.

Science.gov (United States)

Keen, Alyson; McCrate, Brian; McLennon, Susan; Ellis, Alexis; Wall, Donna; Jones, Sarah

2017-06-01

Hospitalized patients with persistent pain are among the most challenging populations to effectively manage because of coexistence with acute pain. Nurses play a vital role in pain management; however, gaps in knowledge and detrimental attitudes exist. The purpose of this study was to evaluate the effectiveness of a targeted evidence-based pain education program to increase nurses' knowledge and attitudes about pain management. One group, paired, pretest/posttest educational intervention. A convenience sample of nurses from three medical and surgical inpatient units were recruited. Participants completed a pretest, the Knowledge and Attitudes Survey Regarding Pain Scale, to assess education needs. Identified gaps were targeted during program design. The program consisted of two 30-minute interactive educational sessions approximately 1 month apart. The first session, delivered by a pharmacist, covered pharmacology and pathophysiology content. The second session, delivered by trained registered nurses, used case studies paired with video scenarios. A total of 51 nurses completed the pretest. The final sample consisted of 24 nurses who completed both the pretest and posttest. The mean age was 30 years; 88% were female, and 92% were baccalaureate prepared. Paired t tests indicated higher posttest total scores (p pain management knowledge and attitudes among direct care nurses caring for hospitalized patients. A targeted educational program may be an effective and efficient delivery method. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Effects of Post-Session Wheel Running on Within-Session Changes in Operant Responding

Science.gov (United States)

Aoyama, Kenjiro

2007-01-01

This study tested the effects of post-session wheel running on within-session changes in operant responding. Lever-pressing by six rats was reinforced by a food pellet under a continuous reinforcement (CRF) schedule in 30-min sessions. Two different flavored food pellets were used as reinforcers. In the wheel conditions, 30-min operant-sessions…

Sharps injury reduction using a sharps container with enhanced engineering: a 28 hospital nonrandomized intervention and cohort study.

Science.gov (United States)

Grimmond, Terry; Bylund, Suzann; Anglea, Candace; Beeke, Lou; Callahan, Angela; Christiansen, Erik; Flewelling, Kelly; McIntosh, Kathleen; Richter, Kay; Vitale, Monica

2010-12-01

The decrease in reported sharps injuries (SI) in the United States has markedly slowed. Additional devices and strategies need investigation. Sharps containers are associated with SI, and more than 90% of these injuries are related to container design. This study addresses the hypothesis that containers with enhanced engineering can reduce SI. In a before/after intervention study from 2006 to 2008, we examined the impact of conversion to a sharps container with enhanced engineering (the Device) on SI categories in 14 Ascension Health hospitals (study group). The Device's safety features included large horizontal aperture, sensitive counterbalanced door, large atrium, and passive overfill prevention. Study group results were also compared with a control cohort of 14 contemporaneous size-matched, Ascension Health hospitals (control group). The Device was associated with significant reductions in after-procedure (-30%), disposal-related (-57%), and container-associated (-81%) SI in the study group. No significant reductions occurred in container-associated sharps injuries in the control group. Hospitals using the Device had significantly fewer total SI than control hospitals. Enhanced aperture design can significantly reduce container-associated sharps injuries. Other factors contributing to reduced injuries may include 1-hand deposit, safe closure, hand restriction, and preassembly. These results, from a country where sharps safety devices are widespread, are particularly applicable to countries where safety devices are not extensively used. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Association of Unfinished Root Canal Treatments with the Risk of Pneumonia Hospitalization.

Science.gov (United States)

Lin, Po-Yen; Chiang, Yu-Chih; Chou, Yu-Ju; Chang, Hong-Ji; Chi, Lin-Yang

2017-01-01

The objective of root canal treatments (RCTs) is to control pulpal diseases and salvage infected teeth by eradicating microorganisms within the root canal system. However, an unfinished RCT can leave a space for bacterial accumulation, which can leak into the oral cavity and then aspirate into the lower respiratory tract and the lungs, causing infection. This study investigated the association of unfinished RCTs with the possible risk of pneumonia hospitalization using a nationwide population-based database. After a matching process, we recruited 116,490 subjects who received an initiated RCT and had no history of pneumonia before 2005 and observed until the end of 2011. An unfinished RCT was operationally defined as an endodontic session that was started on a tooth but had no subsequent completion records. Cox proportional hazards models and subgroup analyses were used to estimate the association of unfinished RCTs on the risk of pneumonia hospitalization. In total, 1285 subjects were hospitalized for pneumonia during 2005 to 2011 with an overall pneumonia hospitalization incidence rate of 0.22% per person year. After adjusting for confounding factors, the adjusted pneumonia hospitalization hazard ratio for subjects who had unfinished RCTs was 1.40 (95% confidence interval, 1.24-1.59) compared with subjects without unfinished RCTs (P endodontic treatments once started. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Observations of youth football training: How do coaches structure training sessions for player development?

Science.gov (United States)

O'Connor, Donna; Larkin, Paul; Williams, A Mark

2018-01-01

We used systematic observation tools to explore the structure (i.e., activity and inactivity) and sequencing (i.e., the types of activities used) of football coaching sessions in Australia following the implementation of a new National Curriculum. Youth soccer coaches (n = 34), coaching within the Skill Acquisition (U11-U13 n = 19) and Game Training (U14-U17 n = 15) phases of the Football Federation Australia National Curriculum participated. Participants were filmed during a regular coaching session, with systematic observation of the session undertaken to provide a detailed analysis of the practice activities and coach behaviours. Findings indicated a session comprised of Playing Form activities (40.9%), Training Form activities (22.3%), inactivity (31%), and transitions between activities (5.8%). Coaches prescribed more Training Form activities (e.g., individual (5.4%) and drills (15.1%)) early in the session and progressed to Playing Form activities (i.e., small-sided games (15.3%) then larger games (24.8%)) later in the session. Most inactivity reflected the players listening to the coach - either in a team huddle (9.9%) or frozen on the spot during an activity (16.5%). In addition, coaches generally spent over 3 min communicating to players prior to explaining and introducing an activity regardless of when in the session the activity was scheduled.

Network meta-analysis incorporating randomized controlled trials and non-randomized comparative cohort studies for assessing the safety and effectiveness of medical treatments: challenges and opportunities

OpenAIRE

Cameron, Chris; Fireman, Bruce; Hutton, Brian; Clifford, Tammy; Coyle, Doug; Wells, George; Dormuth, Colin R.; Platt, Robert; Toh, Sengwee

2015-01-01

Network meta-analysis is increasingly used to allow comparison of multiple treatment alternatives simultaneously, some of which may not have been compared directly in primary research studies. The majority of network meta-analyses published to date have incorporated data from randomized controlled trials (RCTs) only; however, inclusion of non-randomized studies may sometimes be considered. Non-randomized studies can complement RCTs or address some of their limitations, such as short follow-up...

Panel Session

DEFF Research Database (Denmark)

Bertelsen, Olav Wedege

2004-01-01

In this panel session, four researchers will discuss the role of a theoretical foundation, in particular AT, in the design of information technology based artefacts. The general discussion will take of from a specific examination of the ActAD approach.......In this panel session, four researchers will discuss the role of a theoretical foundation, in particular AT, in the design of information technology based artefacts. The general discussion will take of from a specific examination of the ActAD approach....

24 CFR 214.300 - Counseling services.

Science.gov (United States)

2010-04-01

... to provide specified types of counseling nationally. (6) All participating agencies that offer group educational sessions must also offer individual counseling on the same topics covered in the group educational... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Counseling services. 214.300...

Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest

DEFF Research Database (Denmark)

Kirkegaard, Hans; Søreide, Eldar; de Haas, Inge

2017-01-01

Importance: International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients with out-of-hospital cardiac arrest for at least 24 hours, but the optimal duration of TTM is uncertain. Objective: To determine whether TTM at 33°C for 48....... Secondary outcomes included 6-month mortality, including time to death, the occurrence of adverse events, and intensive care unit resource use. Results: In 355 patients who were randomized (mean age, 60 years; 295 [83%] men), 351 (99%) completed the trial. Of these patients, 69% (120/175) in the 48-hour.......5%; 95% CI, -16.1% to 3.1%; RR, 0.81; 95% CI, 0.59-1.11; P = .19). There was no significant difference in the time to mortality between the 48-hour group and the 24-hour group (hazard ratio, 0.79; 95% CI, 0.54-1.15; P = .22). Adverse events were more common in the 48-hour group (97%) than in the 24-hour...

Session Types at the Mirror

Directory of Open Access Journals (Sweden)

Luca Padovani

2009-12-01

Full Text Available We (redefine session types as projections of process behaviors with respect to the communication channels they use. In this setting, we give session types a semantics based on fair testing. The outcome is a unified theory of behavioral types that shares common aspects with conversation types and that encompass features of both dyadic and multi-party session types. The point of view we provide sheds light on the nature of session types and gives us a chance to reason about them in a framework where every notion, from well-typedness to the subtyping relation between session types, is semantically -rather than syntactically- grounded.

24 CFR 242.57 - Maintenance of hospital facility.

Science.gov (United States)

2010-04-01

... HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Regulatory Agreement, Accounting and Reporting, and Financial...

Constructing Episodes of Inpatient Care: How to Define Hospital Transfer in Hospital Administrative Health Data?

Science.gov (United States)

Peng, Mingkai; Li, Bing; Southern, Danielle A; Eastwood, Cathy A; Quan, Hude

2017-01-01

Hospital administrative health data create separate records for each hospital stay of patients. Treating a hospital transfer as a readmission could lead to biased results in health service research. This is a cross-sectional study. We used the hospital discharge abstract database in 2013 from Alberta, Canada. Transfer cases were defined by transfer institution code and were used as the reference standard. Four time gaps between 2 hospitalizations (6, 9, 12, and 24 h) and 2 day gaps between hospitalizations [same day (up to 24 h), ≤1 d (up to 48 h)] were used to identify transfer cases. We compared the sensitivity and positive predictive value (PPV) of 6 definitions across different categories of sex, age, and location of residence. Readmission rates within 30 days were compared after episodes of care were defined at the different time gaps. Among the 6 definitions, sensitivity ranged from 93.3% to 98.7% and PPV ranged from 86.4% to 96%. The time gap of 9 hours had the optimal balance of sensitivity and PPV. The time gaps of same day (up to 24 h) and 9 hours had comparable 30-day readmission rates as the transfer indicator after defining episode of care. We recommend the use of a time gap of 9 hours between 2 hospitalizations to define hospital transfer in inpatient databases. When admission or discharge time is not available in the database, a time gap of same day (up to 24 h) can be used to define hospital transfer.

Locomotor Training and Strength and Balance Exercises for Walking Recovery After Stroke: Response to Number of Training Sessions.

Science.gov (United States)

Rose, Dorian K; Nadeau, Stephen E; Wu, Samuel S; Tilson, Julie K; Dobkin, Bruce H; Pei, Qinglin; Duncan, Pamela W

2017-11-01

Evidence-based guidelines are needed to inform rehabilitation practice, including the effect of number of exercise training sessions on recovery of walking ability after stroke. The objective of this study was to determine the response to increasing number of training sessions of 2 interventions-locomotor training and strength and balance exercises-on poststroke walking recovery. This is a secondary analysis of the Locomotor Experience Applied Post-Stroke (LEAPS) randomized controlled trial. Six rehabilitation sites in California and Florida and participants' homes were used. Participants were adults who dwelled in the community (N=347), had had a stroke, were able to walk at least 3 m (10 ft) with assistance, and had completed the required number of intervention sessions. Participants received 36 sessions (3 times per week for 12 weeks), 90 minutes in duration, of locomotor training (gait training on a treadmill with body-weight support and overground training) or strength and balance training. Talking speed, as measured by the 10-Meter Walk Test, and 6-minute walking distance were assessed before training and following 12, 24, and 36 intervention sessions. Participants at 2 and 6 months after stroke gained in gait speed and walking endurance after up to 36 sessions of treatment, but the rate of gain diminished steadily and, on average, was very low during the 25- to 36-session epoch, regardless of treatment type or severity of impairment. Results may not generalize to people who are unable to initiate a step at 2 months after stroke or people with severe cardiac disease. In general, people who dwelled in the community showed improvements in gait speed and walking distance with up to 36 sessions of locomotor training or strength and balance exercises at both 2 and 6 months after stroke. However, gains beyond 24 sessions tended to be very modest. The tracking of individual response trajectories is imperative in planning treatment. Published by Oxford University

Economic analysis of two-stage septic revision after total hip arthroplasty: What are the relevant costs for the hospital's orthopedic department?

Science.gov (United States)

Kasch, R; Assmann, G; Merk, S; Barz, T; Melloh, M; Hofer, A; Merk, H; Flessa, S

2016-03-01

The number of septic total hip arthroplasty (THA) revisions is increasing continuously, placing a growing financial burden on hospitals. Orthopedic departments performing septic THA revisions have no basis for decision making regarding resource allocation as the costs of this procedure for the departments are unknown. It is widely assumed that septic THA procedures can only be performed at a loss for the department. Therefore, the purpose of this study was to investigate whether this assumption is true by performing a detailed analysis of the costs and revenues for two-stage septic THA revision. Patients who underwent revision THA for septic loosening in two sessions from January 2009 through March 2012 were included in this retrospective, consecutive cost study from the orthopedic department's point of view. We analyzed variable and case-fixed costs for septic revision THA with special regard to implantation and explantation stay. By using marginal costing approach we neglected hospital-fixed costs. Outcome measures include reimbursement and daily contribution margins. The average direct costs (reimbursement) incurred for septic two-stage revision THA was €10,828 (€24,201). The difference in cost and contribution margins per day was significant (p cost for septic revision THA performed in two sessions. Disregarding hospital-fixed costs the included variable and case fixed-costs were covered by revenues. This study provides cost data, which will be guidance for health care decision makers.

Neurophysiological correlates of eye movement desensitization and reprocessing sessions: preliminary evidence for traumatic memories integration.

Science.gov (United States)

Farina, Benedetto; Imperatori, Claudio; Quintiliani, Maria I; Castelli Gattinara, Paola; Onofri, Antonio; Lepore, Marta; Brunetti, Riccardo; Losurdo, Anna; Testani, Elisa; Della Marca, Giacomo

2015-11-01

We have investigated the potential role of eye movement desensitization and reprocessing (EMDR) in enhancing the integration of traumatic memories by measuring EEG coherence, power spectra and autonomic variables before (pre-EMDR) and after (post-EMDR) EMDR sessions during the recall of patient's traumatic memory. Thirteen EMDR sessions of six patients with post-traumatic stress disorder were recorded. EEG analyses were conducted by means of the standardized Low Resolution Electric Tomography (sLORETA) software. Power spectra, EEG coherence and heart rate variability (HRV) were compared between pre- and post-EMDR sessions. After EMDR, we observed a significant increase of alpha power in the left inferior temporal gyrus (T = 3.879; P = 0.041) and an increased EEG coherence in beta band between C3 and T5 electrodes (T = 6.358; P < 0.001). Furthermore, a significant increase of HRV in the post-EMDR sessions was also observed (pre-EMDR: 6.38 ± 6.83; post-EMDR: 2.46 ± 2.95; U-Test = 45, P = 0.043). Finally, the values of lagged coherence were negatively associated with subjective units of disturbance (r(24) = -0.44, P < 0.05) and positively associated with parasympathetic activity (r(24) = 0.40, P < 0.05). Our results suggest that EMDR leads to an integration of dissociated aspects of traumatic memories and, consequently, a decrease of hyperarousal symptoms [Correction made here after initial publication]. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Feasibility, Acceptability, and Preliminary Effectiveness of a 4-week Mindfulness-Based Cognitive Therapy Protocol for Hospital Employees.

Science.gov (United States)

Luberto, Christina M; Wasson, Rachel S; Kraemer, Kristen M; Sears, Richard W; Hueber, Carly; Cotton, Sian

2017-12-01

Hospital employees may experience occupational stress and burnout, which negatively impact quality of life and job performance. Evidence-based interventions implemented within the hospital setting are needed to promote employees' well-being. We offered a 4-week Mindfulness-Based Cognitive Therapy group program for hospital employees, and used a mixed-methods practice-based research approach to explore feasibility, acceptability, and effects on stress and burnout. Participants were 65 hospital employees ( M age = 44.06; 85% white) who participated between September 2015 and January 2016. Participants completed validated measures of stress and burnout before and after the program, and answered open-ended satisfaction questions after the program. Groups consistently enrolled at least 10 participants, but attendance rates declined across sessions (76% at session 2 vs. 54% at session 4) due primarily to work-related scheduling conflicts. The program content was acceptable as evidenced by high perceived value ( M = 9.18 out of 10), homework compliance (51% practicing at least 3 times/week), and qualitative requests for program expansion. There were large, statistically significant decreases in stress (Δ M = 2.1, p strategies to enhance session attendance.

Records of the 13. regular session (23-29 September 1969). 133. plenary meeting

International Nuclear Information System (INIS)

1970-01-01

Indonesia Pakistan Italy Ghana Credentials of delegates to the thirteenth regular session (b) Report of the Credentials Committee Appointment of the Director General Opening date of the fourteenth (1970) regular session The Agency's annual reports to United Nations organs Appointment of the External Auditor Elections to the Agency's Staff Pension Committee The Agency's budget for 1970 Scale of Members' contributions for 1970 The Agency's responsibility to provide services in connection with nuclear explosions for peaceful purposes Paragraphs 1-42 1? 8 9?23 24?38 39?42 43?58 59?77 78?79 80?83 84?87 88?90 91?95 96?97 98

Records of the 13. regular session (23-29 September 1969). 133. plenary meeting

Energy Technology Data Exchange (ETDEWEB)

NONE

1970-01-27

Indonesia Pakistan Italy Ghana Credentials of delegates to the thirteenth regular session (b) Report of the Credentials Committee Appointment of the Director General Opening date of the fourteenth (1970) regular session The Agency's annual reports to United Nations organs Appointment of the External Auditor Elections to the Agency's Staff Pension Committee The Agency's budget for 1970 Scale of Members' contributions for 1970 The Agency's responsibility to provide services in connection with nuclear explosions for peaceful purposes Paragraphs 1-42 1? 8 9?23 24?38 39?42 43?58 59?77 78?79 80?83 84?87 88?90 91?95 96?97 98

Summary: Hadron dynamics sessions

International Nuclear Information System (INIS)

Carroll, A.S.; Londergan, J.T.

1993-01-01

Four sessions on Hadron Dynamics were organized at this Workshop. The first topic, QCD Exclusive Reactions and Color Transparency, featured talks by Ralston, Heppelman and Strikman; the second, QCD and Inclusive Reactions had talks by Garvey, Speth and Kisslinger. The third dynamics session, Medium Modification of Elementary Interactions had contributions from Kopeliovich, Alves and Gyulassy; the fourth session Pre-QCD Dynamics and Scattering, had talks by Harris, Myhrer and Brown. An additional joint Spectroscopy/Dynamics session featured talks by Zumbro, Johnson and McClelland. These contributions are reviewed briefly in this summary. Two additional joint sessions between Dynamics and η physics are reviewed by the organizers of the Eta sessions. In such a brief review there is no way the authors can adequately summarize the details of the physics presented here. As a result, they concentrate only on brief impressionistic sketches of the physics topics discussed and their interrelations. They include no bibliography in this summary, but simply refer to the talks given in more detail in the Workshop proceedings. They focus on topics which were common to several presentations in these sessions. First, nuclear and particle descriptions of phenomena are now clearly converging, in both a qualitative and quantitative sense; they show several examples of this convergence. Second, an important issue in hadron dynamics is the extent to which elementary interactions are modified in nuclei at high energies and/or densities, and they illustrate some of these medium effects. Finally, they focus on those dynamical issues where hadron facilities can make an important, or even a unique, contribution to the knowledge of particle and nuclear physics

The period of the day affects the twenty-four hour blood pressure response to an acute combined exercise session in Brazilian jiu jitsu athletes

Directory of Open Access Journals (Sweden)

Rafaello Pinheiro Mazzoccante

2015-09-01

Full Text Available AbstractThe purpose of this study was to compare the effect of a combined exercise session performed at different periods of the day on the 24h blood pressure (BP response. Anaerobic threshold (AT and 12 repetition maximum (12RM tests were evaluated in nine Brazilian jiu-jitsu athletes (male (22±3.7 y; 176±5.0 cm; 73.4±9.7 kg; 6.8±2.1 % body fat. Four experimental sessions were performed: resistance exercise followed by aerobic exercise [Morning (MornS and Afternoon (AfternS] and Control (C [Morning and Afternoon]. The morning sessions were conducted at 09:00 a.m. and the afternoon sessions were conducted at 3:00 p.m. The resistance exercise consisted of three sets at 90% of a 12RM for six resistance exercises. The aerobic exercise consisted of 15min at 90% of the AT. Blood pressure (BP was measured before, during and 1h (Microlife(r BP3A1C after the performance of exercises in laboratory, and then during daily activities for the succeeding 23h by ambulatory BP monitoring (Dyna-MAPA(r. Analysis of the area under the curve (AUC indicated significant reductions in blood pressure parameters at various time points during the 24h monitoring period. For systolic BP (SBP, significantly lower values were shown following the morning session versus the control (MornS: 1756.2±100.8 vs. C: 1818.2±84.3 mmHg*15h; p < .05 and total-24h (MornS: 2695.8±143.3 vs. C: 2784.1±143.2 mmHg*24h; p < .05. The total-24h mean BP (MAP was also significantly lower following the morning session versus the control (MornS: 2015.7±121.2 vs. C: 2087.3±153.8 mmHg*24h; p < .05. There were significant differences in the sleeping AUC of SBP (AfternS: 883.6±27.0 vs. C: 965.2±67.9 mmHg*9h; p< .05, diastolic BP (DBP (AfternS: 481.4±30.9 vs. MornS: 552.9±34.2 and C: 562.1±52.3 mmHg*9h; p < .01 and MBP (AfternS: 651.9±22.4 vs. MornS: 708.7±43.1 and C: 726.9±64.7 mmHg*9h; p < .01. The combined exercise performed at different periods of the day contributed distinctly to

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS

Directory of Open Access Journals (Sweden)

Mohammad Hossein Yarmohammadian

2011-01-01

Full Text Available Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS. Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational, barriers (internal and external of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Contradictions within a Knotworking session of an interior décor project

DEFF Research Database (Denmark)

Rasmussen, Mai; Jensen, Rasmus Lund; Svidt, Kjeld

actors with an interest in the specific ‘knot’ (Engeström 2008). Moreover this presentation presents an analysis of contradictions within a Knotworking session of an interior décor project. The interior décor project is targeted a new building for Department of Civil Engineering at Aalborg University...... in Denmark aiming to generate an ownership among the users of the building. Through this presentation the audience will discover advantages and disadvantages of the utilization of Knotowkring as a method for making interior décor at a Danish University. Moreover, the audience will notify Knotworking...... been utilized in contexts as the library, hospital and construction industry. By investigating Knotworking in the context of interior décor through an analysis by activity theory systems, this research contributes to knowledge about contradictions within a Knotworking session and potential solutions...

Run charts revisited: a simulation study of run chart rules for detection of non-random variation in health care processes.

Science.gov (United States)

Anhøj, Jacob; Olesen, Anne Vingaard

2014-01-01

A run chart is a line graph of a measure plotted over time with the median as a horizontal line. The main purpose of the run chart is to identify process improvement or degradation, which may be detected by statistical tests for non-random patterns in the data sequence. We studied the sensitivity to shifts and linear drifts in simulated processes using the shift, crossings and trend rules for detecting non-random variation in run charts. The shift and crossings rules are effective in detecting shifts and drifts in process centre over time while keeping the false signal rate constant around 5% and independent of the number of data points in the chart. The trend rule is virtually useless for detection of linear drift over time, the purpose it was intended for.

In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy

Directory of Open Access Journals (Sweden)

Andreas Michalsen

2013-01-01

Full Text Available Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM. We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014 and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.

No influence of one right-sided prefrontal HF-rTMS session on alcohol craving in recently detoxified alcohol-dependent patients: results of a naturalistic study.

Science.gov (United States)

Herremans, S C; Baeken, C; Vanderbruggen, N; Vanderhasselt, M A; Zeeuws, D; Santermans, L; De Raedt, R

2012-01-01

Prior research in substance dependence has suggested potential anti-craving effects of repetitive transcranial magnetic stimulation (rTMS) when applied to the dorsolateral prefrontal cortex (DLPFC). However, no single sham-controlled session studies applied to the right DLPFC have been carried-out in recently detoxified alcohol-dependent patients. Furthermore, no studies examined the effect of a single HF-rTMS session on craving in these patients' natural habitat. To further investigate the effect of high-frequency (HF)-rTMS of the right DLPFC on alcohol craving, we performed a prospective, single-blind, sham-controlled study involving 36 hospitalized patients with alcohol dependence syndrome. After successful detoxification, patients were allocated receiving one active or one sham HF-rTMS session. The obsessive-compulsive drinking scale (OCDS) was administered to evaluate the extent of craving just before and after the HF-rTMS session (on Friday), on Saturday and Sunday during the weekend at home, and on Monday when the patient returned to the hospital. One single blind sham-controlled HF-rTMS session applied to the right DLPFC did not result in changes in craving (neither immediately after the stimulation session, nor in patients' natural environment during the weekend). One HF-rTMS stimulation session applied to the right DLPFC had no significant effects on alcohol craving in alcohol dependent patients. One such session could have been too short to alter alcohol craving in a sample of alcohol dependent patients. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Discovering non-random segregation of sister chromatids: The naïve treatment of a premature discovery

Directory of Open Access Journals (Sweden)

Karl G. Lark

2013-02-01

Full Text Available The discovery of non-random chromosome segregation is discussed from the perspective of what was known in1965 and1966. The distinction between daughter, parent or grandparent strands of DNA was developed in a bacterial system and led to the discovery that multiple copies of DNA elements of bacteria are not distributed randomly with respect to the age of the template strand. Experiments with higher eukaryotic cells demonstrated that during mitosis Mendel’s laws were violated; and the initial serendipitous choice of eukaryotic cell system led to the striking example of non-random segregation of parent and grand-parent DNA template strands in primary cultures of cells derived from mouse embryos. Attempts to extrapolate these findings to established TC lines demonstrated that the property could be lost. Experiments using plant root tips demonstrated that the phenomenon exists in plants and that it was, at some level, under genetic control. Despite publication in major journals and symposia (Lark et al. (1966a; Lark (1967a; 1967b; 1969, 1969a; 1969b the potential implications of these findings were ignored for several decades. Here we explore possible reasons for the pre-maturity (Stent, 1972 of this discovery.

Assessment of hospital pharmacists' clinical knowledge and ...

African Journals Online (AJOL)

Purpose: To evaluate hospital pharmacists' clinical knowledge and practical skill levels for pharmaceutical care. Methods: A quasi-experimental prospective longitudinal study design was used to evaluate the level of clinical skills with problem-based learning (PBL) sessions. Pharmacists' in three different government ...

Polyacrylamide gel for facial wasting rehabilitation: how many milliliters per session?

Science.gov (United States)

Rauso, R; Gherardini, G; Parlato, V; Amore, R; Tartaro, G

2012-02-01

Facial lipoatrophy is most distressing for HIV patients in pharmacologic treatment. Nonabsorbable fillers are widely used to restore facial features in these patients. We evaluated the safety and aesthetic outcomes of two samples of HIV+ patients affected by facial wasting who received different filling protocols of the nonabsorbable filler Aquamid® to restore facial wasting. Thirty-one HIV+ patients affected by facial wasting received injections of the nonabsorbable filler Aquamid for facial wasting rehabilitation. Patients were randomly divided into two groups: A and B. In group A, the facial defect was corrected by injecting up to 8 ml of product in the first session; patients were retreated after every 8th week with touch-up procedures until full correction was observed. In group B, facial defects were corrected by injecting 2 ml of product per session; patients were retreated after every 8th week until full correction was observed. Patients of group A noted a great improvement after the first filling procedure. Patients in group B noted improvement of their face after four filling procedures on average. Local infection, foreign-body reaction, and migration of the product were not observed in either group during follow-up. The rehabilitation obtained with a megafilling session and further touch-up procedures and that with a gradual build-up of the localized soft-tissue loss seem not to have differences in terms of safety for the patients. However, with a megafilling session satisfaction is achieved earlier and it is possible to reduce hospital costs in terms of gauze, gloves, and other items.

Treatment of benign esophageal stricture by Eder-Puestow or balloon dilators: a comparison between randomized and prospective nonrandomized trials.

Science.gov (United States)

Yamamoto, H; Hughes, R W; Schroeder, K W; Viggiano, T R; DiMagno, E P

1992-03-01

To determine whether the natural history of strictures is affected by the type of dilator used to treat newly diagnosed peptic strictures, we designed a prospective randomized trial to compare the results after Eder-Puestow or Medi-Tech balloon dilation. We entered 31 patients into the trial. We also prospectively followed up all 92 nonrandomized patients who underwent their first dilation for a benign stricture during the same period as the prospective randomized trial. The nonrandomized patients also underwent dilation with either the Eder-Puestow or the balloon technique at the discretion of the gastroenterologist performing the endoscopy. We found no statistically significant differences in the immediate or long-term results of the two methods among the randomized, nonrandomized, and overall combined groups. All but 1 of the 123 patients had immediate relief of dysphagia. Within each group of patients, the probability of remaining free of dysphagia 1 year after the initial dilation was approximately 20%, and the probability of not requiring a second dilation was approximately 65% with either technique. Major (esophageal rupture) and minor (bleeding or chest pain) complications occurred in 1% and 5% of the patients and 0.4% and 3% of the total dilation procedures, respectively. The esophageal rupture and four of six minor complications occurred after repeated dilations. Five of the six minor complications occurred with use of the Eder-Puestow dilators. We conclude that Eder-Puestow and balloon dilations of benign esophageal strictures are associated with similar outcomes, but repeated dilations and the Eder-Puestow technique may be associated with an increased risk of complications.

Strategies to enhance venous thromboprophylaxis in hospitalized medical patients (SENTRY: a pilot cluster randomized trial

Directory of Open Access Journals (Sweden)

Pai Menaka

2013-01-01

Full Text Available Abstract Background Venous thromboembolism (VTE is a common preventable cause of mortality in hospitalized medical patients. Despite rigorous randomized trials generating strong recommendations for anticoagulant use to prevent VTE, nearly 40% of medical patients receive inappropriate thromboprophylaxis. Knowledge-translation strategies are needed to bridge this gap. Methods We conducted a 16-week pilot cluster randomized controlled trial (RCT to determine the proportion of medical patients that were appropriately managed for thromboprophylaxis (according to the American College of Chest Physician guidelines within 24 hours of admission, through the use of a multicomponent knowledge-translation intervention. Our primary goal was to determine the feasibility of conducting this study on a larger scale. The intervention comprised clinician education, a paper-based VTE risk assessment algorithm, printed physicians’ orders, and audit and feedback sessions. Medical wards at six hospitals (representing clusters in Ontario, Canada were included; three were randomized to the multicomponent intervention and three to usual care (i.e., no active strategies for thromboprophylaxis in place. Blinding was not used. Results A total of 2,611 patients (1,154 in the intervention and 1,457 in the control group were eligible and included in the analysis. This multicomponent intervention did not lead to a significant difference in appropriate VTE prophylaxis rates between intervention and control hospitals (appropriate management rate odds ratio = 0.80; 95% confidence interval: 0.50, 1.28; p = 0.36; intra-class correlation coefficient: 0.022, and thus was not considered feasible. Major barriers to effective knowledge translation were poor attendance by clinical staff at education and feedback sessions, difficulty locating preprinted orders, and lack of involvement by clinical and administrative leaders. We identified several factors that may increase uptake of a VTE

Hourly awakening vs continuous contact lens sensor measurements of 24-hour intraocular pressure: effect on sleep macrostructure and intraocular pressure rhythm.

Science.gov (United States)

Aptel, Florent; Tamisier, Renaud; Pépin, Jean-Louis; Mottet, Benjamin; Hubanova, Ralitsa; Romanet, Jean-Paul; Chiquet, Christophe

2014-10-01

All studies of 24-hour intraocular pressure (IOP) rhythm conducted to date have used repeated IOP measurements requiring nocturnal awakenings, potentially disturbing sleep macrostructure. To evaluate the effects on sleep architecture and IOP rhythm of hourly awakening vs a contact lens sensor (CLS) to continuously monitor IOP without awakening. Cross-sectional study at a referral center of chronobiology among 12 young healthy volunteers, with a mean (SD) age of 22.3 (2.3) years. Volunteers underwent two 24-hour IOP measurement sessions during a 2-month period. The eye order and session order were randomized. During one session, the IOP of the first eye was continuously monitored using a CLS, and the IOP of the fellow eye was measured hourly using a portable noncontact tonometer (session with nocturnal hourly awakening). During the other session, the IOP of the first eye was continuously monitored using a CLS, and the IOP of the fellow eye was not measured (session without nocturnal awakening). Overnight polysomnography was performed during the 2 sessions. A nonlinear least squares, dual-harmonic regression analysis was used to model the 24-hour IOP rhythm from the CLS data. Comparisons of acrophase, bathyphase, amplitude, and the midline estimating statistic of rhythm were used to evaluate the effect of hourly awakening on IOP rhythm. To evaluate the effects of hourly awakening on sleep architecture, comparisons of sleep structure were used, including total sleep period, rapid eye movement, wake after sleep onset, absolute and relative total sleep time, and non-rapid eye movement sleep (N1, N2, and N3). A 24-hour IOP rhythm was found in all individuals for the sessions with and without awakening (P  .30). Hourly awakening during noncontact tonometer IOP measurements did not seem to alter the mean variables of the 24-hour IOP pattern evaluated using CLS, including signal, maximum signal, minimum signal, acrophase, and bathyphase (P > .15). The 24-hour IOP

An Approach to Distinguish between Plasticity and Non-random Distributions of Behavioral Types Along Urban Gradients in a Wild Passerine Bird

Directory of Open Access Journals (Sweden)

Philipp Sprau

2017-08-01

Full Text Available The impact of urbanization has been widely studied in the context of species diversity and life history evolution. Behavioral adaptation, by contrast, remains poorly understood because empirical studies rarely investigate the relative importance of two key mechanisms: plastic responses vs. non-random distributions of behavioral types. We propose here an approach that enables the simultaneous estimation of the respective roles of these distinct mechanisms. We investigated why risky behaviors are often associated with urbanization, using an urban nest box population of great tits (Parus major as a study system. We simultaneously and repeatedly quantified individual behavior (aggression and flight initiation distance as well as environmental factors characterizing level of urbanization (numbers of pedestrians, cars and cyclists. This enabled us to statistically distinguish plastic responses from patterns of non-random distributions of behavioral types. Data analyses revealed that individuals did not plastically adjust their behavior to the level of urbanization. Behavioral types were instead non-randomly distributed: bold birds occurred more frequently in areas with more cars and fewer pedestrians while shy individuals were predominantly found in areas with fewer cars and more pedestrians. These novel findings imply a major role for behavioral types in the evolutionary ecology of urban environments and call for the full integration of among- and within-individual variation in urban ecological studies.

100th anniversary of the discovery of cosmic rays (Scientific session of the Physical Sciences Division of the Russian Academy of Sciences, 24 October 2012)

International Nuclear Information System (INIS)

2013-01-01

A scientific session of the Physical Sciences Division of the Russian Academy of Sciences (RAS), entitled ''100th anniversary of the discovery of cosmic rays'', was held on 24 October 2012 in the conference hall of the Lebedev Physical Institute, RAS. The agenda of the session announced on the RAS Physical Sciences Division website www.gpad.ac.ru included the following reports: (1) Panasyuk M I (Skobeltsyn Institute of Nuclear Physics of the Lomonosov State University, Moscow) T he contribution of Russian scientists to the centennial history of the development of the physics of cosmic rays ; (2) Ryazhskaya O G (Institute for Nuclear Research, Russian Academy of Sciences, Moscow) O n experiments in underground physics ; (3) Krymskii G F, Berezhko E G (Shafer Institute of Cosmophysical Research and Aeronomy, Siberian Branch of the Russian Academy of Sciences, Yakutsk) T he origin of cosmic rays ; (4) Stozhkov Yu I (Lebedev Physical Institute, Russian Academy of Sciences, Moscow) C osmic rays in the heliosphere ; (5) Troitsky S V (Institute for Nuclear Research, Russian Academy of Sciences, Moscow) ''Cosmic particles of energies >10 19 eV: a short review of results''. Papers based on reports 2 and 5 are presented below. . On experiments in Underground Physics, O G Ryazhskaya Physics-Uspekhi, 2013, Volume 56, Number 3, Pages 296–304 . Cosmic particles with energies above 10 19 eV: a brief summary of results, S V Troitsky Physics-Uspekhi, 2013, Volume 56, Number 3, Pages 304–310 (conferences and symposia)

24 CFR 242.61 - Management.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Management. 242.61 Section 242.61... Management. The mortgagor shall provide for management of the hospital in a manner satisfactory to HUD. (a) Contract Management of Hospital. The mortgagor shall not execute a management agreement or any other...

Secure Execution of Distributed Session Programs

Directory of Open Access Journals (Sweden)

Nuno Alves

2011-10-01

Full Text Available The development of the SJ Framework for session-based distributed programming is part of recent and ongoing research into integrating session types and practical, real-world programming languages. SJ programs featuring session types (protocols are statically checked by the SJ compiler to verify the key property of communication safety, meaning that parties engaged in a session only communicate messages, including higher-order communications via session delegation, that are compatible with the message types expected by the recipient. This paper presents current work on security aspects of the SJ Framework. Firstly, we discuss our implementation experience from improving the SJ Runtime platform with security measures to protect and augment communication safety at runtime. We implement a transport component for secure session execution that uses a modified TLS connection with authentication based on the Secure Remote Password (SRP protocol. The key technical point is the delicate treatment of secure session delegation to counter a previous vulnerability. We find that the modular design of the SJ Runtime, based on the notion of an Abstract Transport for session communication, supports rapid extension to utilise additional transports whilst separating this concern from the application-level session programming task. In the second part of this abstract, we formally prove the target security properties by modelling the extended SJ delegation protocols in the pi-calculus.

Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity.

Science.gov (United States)

Wakeman, Sarah E; Metlay, Joshua P; Chang, Yuchiao; Herman, Grace E; Rigotti, Nancy A

2017-08-01

Alcohol and drug use results in substantial morbidity, mortality, and cost. Individuals with alcohol and drug use disorders are overrepresented in general medical settings. Hospital-based interventions offer an opportunity to engage with a vulnerable population that may not otherwise seek treatment. To determine whether inpatient addiction consultation improves substance use outcomes 1 month after discharge. Prospective quasi-experimental evaluation comparing 30-day post-discharge outcomes between participants who were and were not seen by an addiction consult team during hospitalization at an urban academic hospital. Three hundred ninety-nine hospitalized adults who screened as high risk for having an alcohol or drug use disorder or who were clinically identified by the primary nurse as having a substance use disorder. Addiction consultation from a multidisciplinary specialty team offering pharmacotherapy initiation, motivational counseling, treatment planning, and direct linkage to ongoing addiction treatment. Addiction Severity Index (ASI) composite score for alcohol and drug use and self-reported abstinence at 30 days post-discharge. Secondary outcomes included 90-day substance use measures and self-reported hospital and ED utilization. Among 265 participants with 30-day follow-up, a greater reduction in the ASI composite score for drug or alcohol use was seen in the intervention group than in the control group (mean ASI-alcohol decreased by 0.24 vs. 0.08, p drug decreased by 0.05 vs. 0.02, p = 0.003.) There was also a greater increase in the number of days of abstinence in the intervention group versus the control group (+12.7 days vs. +5.6, p drug, and days abstinent all remained statistically significant after controlling for age, gender, employment status, smoking status, and baseline addiction severity (p = 0.018, 0.018, and 0.02, respectively). In a sensitivity analysis, assuming that patients who were lost to follow-up had no change from baseline

The Nonrandom Distribution of Interior Landforms for 100-km Diameter Craters on Mercury Suggests Regional Variations in Near-Surface Mechanical Properties

Science.gov (United States)

Herrick, R. R.

2018-05-01

There is great diversity of appearance in the interiors of 100-km diameter craters. The spatial distribution of interior landforms is clustered and nonrandom, but does not clearly correlate with Mercury's surface geology patterns.

Evaluation of lidocaine treatment on frequency of cardiac arrhythmias, acute kidney injury, and hospitalization time in dogs with gastric dilatation volvulus.

Science.gov (United States)

Bruchim, Yaron; Itay, Srugo; Shira, Ben-Halevy; Kelmer, Efrat; Sigal, Yudelecitch; Itamar, Aroch; Gilad, Segev

2012-08-01

To assess the efficacy of IV lidocaine in decreasing complication rate and improving the outcome in dogs with gastric dilatation volvulus (GDV). Prospective non-controlled study of 83 lidocaine-treated dogs with GDV compared to 47 untreated historical controls with GDV. University veterinary teaching hospital. One hundred and thirty client-owned dogs with naturally occurring GDV. Study group dogs were treated at presentation with lidocaine (2 mg/kg, IV bolus) followed by constant rate infusion (CRI) of 0.05 mg/kg/min for 24 h. Historical control dogs did not receive any lidocaine. There were no group differences in age, body weight, time lag from onset of clinical signs to presentation, rectal temperature and pulse rate at presentation, and proportion of gastric wall necrosis. The proportions of cardiac arrhythmias and acute kidney injury (AKI) were significantly (Pdogs with GDV compared to untreated historical controls. Due to the nonblinded, placebo-uncontrolled, nonrandomized nature of the current study, further evaluation of the efficacy of lidocaine in dogs with GDV is warranted. © Veterinary Emergency and Critical Care Society 2012.

A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

Science.gov (United States)

Logie, Carmen H; Daniel, CarolAnn; Newman, Peter A; Weaver, James; Loutfy, Mona R

2014-01-01

Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI) prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo) (Women Taking Action For Their Health) study examined the effectiveness of a peer health worker (PHW) delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti. This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829). Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88%) completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26), STI knowledge (β = 0.84; 95% CI 0.70-0.99), condom use (AOR = 4.05, 95% CI 1.86-8.83), and depression (β = -0.63, 95% CI -0.88--0.39) scores showed statistically significant change post-intervention (pHaiti. Pilot studies are an important approach to understand feasibility and scientific impacts of HIV prevention strategies in disaster contexts. Study results may inform HIV prevention interventions among internally displaced women in

Prognostic Factors for Persistent Leg-Pain in Patients Hospitalized With Acute Sciatica.

Science.gov (United States)

Fjeld, Olaf; Grotle, Margreth; Siewers, Vibeke; Pedersen, Linda M; Nilsen, Kristian Bernhard; Zwart, John-Anker

2017-03-01

Prospective cohort study. To identify potential prognostic factors for persistent leg-pain at 12 months among patients hospitalized with acute severe sciatica. The long-term outcome for patients admitted to hospital with sciatica is generally unfavorable. Results concerning prognostic factors for persistent sciatica are limited and conflicting. A total of 210 patients acutely admitted to hospital for either surgical or nonsurgical treatment of sciatica were consecutively recruited and received a thorough clinical and radiographic examination in addition to responding to a comprehensive questionnaire. Follow-up assessments were done at 6 weeks, 6 months, and 12 months. Potential prognostic factors were measured at baseline and at 6 weeks. The impact of these factors on leg-pain was analyzed by multiple linear regression modeling. A total of 151 patients completed the entire study, 93 receiving nonrandomized surgical treatment. The final multivariate models showed that the following factors were significantly associated with leg-pain at 12 months: high psychosocial risk according to the Örebro Musculosceletal Pain Questionnaire (unstandardized beta coefficient 1.55, 95% confidence interval [CI] 0.72-2.38, P sciatica. 2.

Evaluation of aviation-based safety team training in a hospital in The Netherlands.

Science.gov (United States)

De Korne, Dirk F; Van Wijngaarden, Jeroen D H; Van Dyck, Cathy; Hiddema, U Francis; Klazinga, Niek S

2014-01-01

The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program's content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture. Pre- and post-assessments of the hospitals' safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice. The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction. The study was observational and the hospital's variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention. Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on "team" instead of "profession" seems both necessary and difficult in hospital care.

A high-protein diet during hospitalization is associated with an accelerated decrease in soluble urokinase plasminogen activator receptor levels in acutely ill elderly medical patients with SIRS

DEFF Research Database (Denmark)

Tavenier, Juliette; Haupt, Thomas Huneck; Andersen, Aino L

2017-01-01

inflammation in healthy elderly. We hypothesized that nutritional support and resistance training would accelerate the resolution of inflammation in hospitalized elderly patients with SIRS. Acutely admitted patients aged >65 years with SIRS were randomized to an intervention consisting of a high-protein diet...... (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge (Intervention, n=14), or to standard-care (Control, n=15). Plasma levels of the inflammatory biomarkers soluble urokinase plasminogen activator...... receptor (suPAR), interleukin-6, C-reactive protein (CRP), and albumin were measured at admission, discharge, and 4 and 13 weeks after discharge. The Intervention group had an earlier decrease in suPAR levels than the Control group: -15.4% vs. +14.5%, P=.007 during hospitalization, and -2.4% vs. -28.6%, P...

Workshop: poster session

International Nuclear Information System (INIS)

Schell, W.R.; Colgan, P.A.

1990-01-01

The poster session consisted of a microcosm of projects encompassing the wide range of problems in the radioecology of natural and semi-natural ecosystems. The authors presented a brief resume of the poster at a plenary session during which highlights were pointed out. The range of studies covered microbial transfer, fungi, insects herbicides, lichens, solid speciation of cesium, soil properties, plant cover, transfer factors from soil to plants, uptake by sludge fertilizers, fertilizer remediation and compartmental models for soil-plant uptake. (author)

Patients with schizophrenia or schizoaffective disorder who receive multiple electroconvulsive therapy sessions: characteristics, indications, and results.

Science.gov (United States)

Iancu, Iulian; Pick, Nimrod; Seener-Lorsh, Orit; Dannon, Pinhas

2015-01-01

While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to characterize a series of patients who received 30 ECT sessions or more, to describe treatment regimens in actual practice, and to examine the results of C/M-ECT in terms of safety and efficacy, especially the effect on aggression and functioning. We performed a retrospective chart review of 20 consecutive patients (mean age 64.6 years) with schizophrenia (n=16) or schizoaffective disorder (n=4) who received at least 30 ECT sessions at our ECT unit, and also interviewed the treating physician and filled out the Clinical Global Impression-Severity, Global Assessment of Functioning, and the Staff Observation Aggression Scale-Revised. Patients received a mean of 91.3 ECT sessions at a mean interval of 2.6 weeks. All had been hospitalized for most or all of the previous 3 years. There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment). We found that ECT significantly reduced scores on the Staff Observation Aggression Scale-Revised subscales for verbal aggression and self-harm, and improved Global Assessment of Functioning scores. There were reductions in total aggression scores, subscale scores for harm to objects and to others, and Clinical Global Impression-Severity scores, these were not statistically significant. C/M-ECT is safe and effective for chronically hospitalized patients. It improves general functioning and reduces verbal aggression and self-harm. More research using other aggression tools is needed to determine its effects and to reproduce our findings in prospective and controlled studies.

Nutritional State of the Children from 6 to 24 Months Seen in Paediatric Consultation at the General Hospital of National Reference of N'Djamena (Chad)

International Nuclear Information System (INIS)

Morgaye, Aicha; Ag Iknane, Akory

2014-01-01

Full text: Summary: Objectives: Infantile malnutrition is a problem of public health major in the Development Countries. In Chad, it constitutes a real problem of public health in particular in the children of less than 24 months. The present study aims at evaluating the nutritional statute of the children from 6 to 24 months seen in pediatric consultation at the general hospital of reference of Djamena to Chad. We proposed to make a descriptive cross-sectional study allowing to make the photography of the situation at a given time. Methods: A descriptive exploratory study proceeded for two months and concerned 400 old children from 6 to 24 months, seen in pediatric consultation at the general hospital of national reference. Results: The nutritional statute of the children in hospital medium with the HGRN of Djamena is not alarming with a prevalence of 41,5% from emaciation, 33,3% of delay of growth and 52% of underweight according to NHCS. The fever was the most frequent sign having pushed the mother to consult, that is to say 40% of the children consulted for the fever, 25% for the acute respiratory infections, 24% for the diarrhoea. Our study found 56,8% of the mothers living in polygamies. 36% of the questioned women had a primary level but 37% were still illiterate. approximately 38% of the mothers of the children of 12 à17 month were illiterate and depended on their husband. 29,5% of the mothers were multipares and 6% were large multipares. 46% pauci avoid and 18,5% first calf cow. The level of knowledge of the mothers remains acceptable on the food diversification of the children because more the share began it between 6 and 24 months, are 65,5% had a liquid feeding, 89% had a semi-fluid feeding and 86% had a solid feeding between 6 and 24 months. The enriched pulp was the food more used by approximately 75% of the mothers. We noted 26,3% children separated before 24 months whose more share are those from 18 to 24 months. The reason for weaning according to

The Public Poster Session

Science.gov (United States)

Levine-Rasky, Cynthia

2009-01-01

This note describes the use of a student poster session as an innovative approach to student learning. The local context for the assignment is provided, followed by a description of the course for which the poster was prepared, details about the assignment including its evaluation, and practical considerations for planning a poster session. The…

Soccer and zumba as health-promoting activities among female hospital employees

DEFF Research Database (Denmark)

Barene, Svein; Krustrup, Peter; Brekke, Ole Lars

2014-01-01

 = 39). Both training groups were encouraged to perform 1-h training sessions twice a week outside working hours throughout the 40 weeks. Maximal oxygen uptake (VO2 max), blood pressure and body composition were measured and blood samples collected before and after the intervention period. Using......Abstract The aim of this study was to evaluate the physiological effects of soccer and Zumba among female hospital employees during a 40-week intervention period. Hospital employees (n = 118) were cluster-randomised to either a soccer group (n = 41), a Zumba group (n = 38) or a control group (n...... intention-to-treat analyses, the Zumba group improved VO2 max compared to the control group (2.2 mL · kg(-1) · min(-1), 95% CI, 0.9, 3.5, P = 0.001), with no significant increase in the soccer group (1.1 mL · kg(-1) · min(-1), 95% CI, -0.2, 2.4, P = 0.08). Both intervention groups reduced total body fat...

A prospective nonrandomized comparison of laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication in Indian population using detailed objective and subjective criteria

Directory of Open Access Journals (Sweden)

Pawanindra Lal

2012-01-01

Full Text Available Background: Laparoscopic Nissen fundoplication (LNF is a commonly performed procedure for the treatment of gastro esophageal reflux disease (GERD worldwide. However, unfavourable postoperative sequel, including gas bloat and dysphagia, has encouraged surgeons to perform alternative procedures such as laparoscopic Toupet fundoplication (LTF. This prospective nonrandomized study was designed to compare LNF with LTF in patients with GERD. Materials and Methods: Hundred and ten patients symptomatic for GERD were included in the study after having received intensive acid suppression therapy for a minimum of 8 weeks. A 24-hour pH metry was done on all patients. Fifty patients having reflux on 24-hour pH metry were taken up for the surgery. Patients were further divided into group-A (LNF and group-B (LTF. Results: The median percentage time with esophageal pH < 4 decreased from 10.18% and 12.31% preoperatively to 0.85% and 1.94% postoperatively in LNF and LTF-groups, respectively. There was a significant and comparable increase in length of lower esophageal sphincter (LES, length of intraabdominal part of LES and LES pressure at respiratory inversion point in both the groups. In LNF-group, five patients had early dysphagia that improved afterwards. There were no significant postoperative complications. Conclusion: LNF and LTF are highly effective in the management of GERD with significant improvement in symptoms and objective parameters. LNF may be associated with significantly higher incidence of short onset transient dysphagia that improves with time. Patients in both the groups showed excellent symptom and objective control on 24-hour pH metry on short term follow-up.

24th Annual ESNA/IUR Meeting: Soil-Plant Relationships

International Nuclear Information System (INIS)

Gerzabek, M. H.

1994-11-01

The 24 th annual meeting of ESNA was jointly organized with the IUR (International Union of Radioecologists), working group soil-to-plant transfer in Varna, Bulgaria. For INIS interesting is the session 'behaviour of radionuclides in the terrestrial foodchain'. (Botek)

Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

Science.gov (United States)

Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

2012-12-01

Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

Is it safe to combine abdominoplasty and posterior vaginal repair in one surgical session?

Directory of Open Access Journals (Sweden)

Farroha Azzam

2008-01-01

Full Text Available Many multiparous women complain of protruded and pendulous abdomens and vaginal outlet relaxation which affect their sexual relationships with their male partners. This study included 47 patients who had these complaints. Some of these patients were working outside the homes and all were mothers of 2-5 children. Due of their home and job responsibilities, they did not have enough time or money for multiple surgeries in more than one session. Material and Methods: The age of these patients was 26-54 years and all patients had poor skin elasticity, pendulous excess subcutaneous fat and skin below the level of the anterior vulvar commissure, and a lax musculoaponeurotic anterior abdominal wall. Also, all patients had a relaxed vaginal outlet and 32 patients had rectocele. Careful perioperative assessment and management was done for each patient to ensure fitness for the long operation and to avoid complications. The combined surgical session consisted of two steps: abdominoplasty and posterior vaginal repair. All the patients were kept in the hospital for two days and they returned to their usual routines in the third week after surgery, and they resumed their sexual relationships with their male partners in the sixth week after surgery. Results: There were no serious complications and this approach was convenient for the patients and their families. The recovery time of the combined surgical session was the same as that of just abdominoplasty, and significantly less than the sum of the recovery periods if the two surgeries had been performed in two sessions. The cost of the combined surgical session was significantly less than doing the surgeries in two sessions. All the patients had significant improvement in their sexual relationships

Linearly Refined Session Types

Directory of Open Access Journals (Sweden)

Pedro Baltazar

2012-11-01

Full Text Available Session types capture precise protocol structure in concurrent programming, but do not specify properties of the exchanged values beyond their basic type. Refinement types are a form of dependent types that can address this limitation, combining types with logical formulae that may refer to program values and can constrain types using arbitrary predicates. We present a pi calculus with assume and assert operations, typed using a session discipline that incorporates refinement formulae written in a fragment of Multiplicative Linear Logic. Our original combination of session and refinement types, together with the well established benefits of linearity, allows very fine-grained specifications of communication protocols in which refinement formulae are treated as logical resources rather than persistent truths.

The Analysis of the Causes of Prolonged Hospitalization after Transarterial Chemoembolization in Patients with Unresectable Hepatocellular Carcinoma

International Nuclear Information System (INIS)

Chang, Nam Kyu; Jeong, Yong Yeon; Park, Seo Yeon; Kim, Jae Kyu

2011-01-01

We wanted to analyze the causes of prolonged hospitalization (over 7 days) after transarterial chemoembolization (TACE) in patients with unresectable Hepatocellular Carcinoma and its related factors. We analyzed the total hospital days after patients with unresectable Hepatocellular Carcinoma received transarterial chemoembolization, and these patients were treated during the recent 6 month at our hospital. Two hundred twenty three sessions showed a short term hospital stay (less than 7 days) and 57 sessions showed a prolonged hospital stay (more than 7 days), so a total of 280 sessions were analyzed. The hospital stay less than seven days was set for the control group and this was correlated with the patient's age, gender, the level of bilirubin and albumin, the platelet counts, the AST/ALT ratio, the a-FT, the presence of portal vein thrombosis and ascites, several scoring systems (Child-Pugh, CLIP, and OKUDA score) and the need for additional embolization at the time of the procedure. Compared with that of the control group, ascites (p=0.004), portal vein thrombosis (p=0.000), a platelet count below the hundred thousand (p=0.012), a Child-Pugh score more than B (p=0.023), a CLIP score more than 2 (p=0.000) and a OKUDA score more than II (p=0.000) showed significant differences. The evaluation of patients' factors would be useful to predict extended post-procedural hospitalization after hepatic chemoembolisation

Pharmacological evidence that both cognitive memory and habit formation contribute to within-session learning of concurrent visual discriminations.

Science.gov (United States)

Turchi, Janita; Devan, Bryan; Yin, Pingbo; Sigrist, Emmalynn; Mishkin, Mortimer

2010-07-01

The monkey's ability to learn a set of visual discriminations presented concurrently just once a day on successive days (24-h ITI task) is based on habit formation, which is known to rely on a visuo-striatal circuit and to be independent of visuo-rhinal circuits that support one-trial memory. Consistent with this dissociation, we recently reported that performance on the 24-h ITI task is impaired by a striatal-function blocking agent, the dopaminergic antagonist haloperidol, and not by a rhinal-function blocking agent, the muscarinic cholinergic antagonist scopolamine. In the present study, monkeys were trained on a short-ITI form of concurrent visual discrimination learning, one in which a set of stimulus pairs is repeated not only across daily sessions but also several times within each session (in this case, at about 4-min ITIs). Asymptotic discrimination learning rates in the non-drug condition were reduced by half, from approximately 11 trials/pair on the 24-h ITI task to approximately 5 trials/pair on the 4-min ITI task, and this faster learning was impaired by systemic injections of either haloperidol or scopolamine. The results suggest that in the version of concurrent discrimination learning used here, the short ITIs within a session recruit both visuo-rhinal and visuo-striatal circuits, and that the final performance level is driven by both cognitive memory and habit formation working in concert.

Reassessing the forest impacts of protection: the challenge of nonrandom location and a corrective method.

Science.gov (United States)

Joppa, Lucas; Pfaff, Alexander

2010-01-01

Protected areas are leading tools in efforts to slow global species loss and appear also to have a role in climate change policy. Understanding their impacts on deforestation informs environmental policies. We review several approaches to evaluating protection's impact on deforestation, given three hurdles to empirical evaluation, and note that "matching" techniques from economic impact evaluation address those hurdles. The central hurdle derives from the fact that protected areas are distributed nonrandomly across landscapes. Nonrandom location can be intentional, and for good reasons, including biological and political ones. Yet even so, when protected areas are biased in their locations toward less-threatened areas, many methods for impact evaluation will overestimate protection's effect. The use of matching techniques allows one to control for known landscape biases when inferring the impact of protection. Applications of matching have revealed considerably lower impact estimates of forest protection than produced by other methods. A reduction in the estimated impact from existing parks does not suggest, however, that protection is unable to lower clearing. Rather, it indicates the importance of variation across locations in how much impact protection could possibly have on rates of deforestation. Matching, then, bundles improved estimates of the average impact of protection with guidance on where new parks' impacts will be highest. While many factors will determine where new protected areas will be sited in the future, we claim that the variation across space in protection's impact on deforestation rates should inform site choice.

47 CFR 97.513 - VE session manager requirements.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false VE session manager requirements. 97.513 Section... SERVICES AMATEUR RADIO SERVICE Qualifying Examination Systems § 97.513 VE session manager requirements. (a) A VE session manager may be selected by the VE team for each examination session. The VE session...

Transient global amnesia following a whole-body cryotherapy session.

Science.gov (United States)

Carrard, Justin; Lambert, Anne Chantal; Genné, Daniel

2017-10-13

Whole-body cryotherapy (WBC), which consists of a short exposure to very cold and dry air in special 'cryo-chambers', is believed to reduce inflammation and musculoskeletal pain as well as improve athletes' recovery. This is the case of a 63-year-old male, who presented with transient global amnesia (TGA) after undertaking a WBC session. TGA is a clinical syndrome characterised by a sudden onset of anterograde amnesia, sometimes coupled with a retrograde component, lasting up to 24 hours without other neurological deficits. Even though the patient completely recovered, as expected, in 24 hours, this case highlights that WBC is potentially not as risk free as thought to be initially. To conclude, before WBC can be medically recommended, well-conducted studies investigating the possible adverse events are required. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Summary of Technical Sessions - Summary and Recommendations

International Nuclear Information System (INIS)

2013-01-01

Technical Session 1 - Development achievements of BEPU methods and State of the Art: The objective of this session was to present the different approaches dealing with Best Estimate codes and uncertainties evaluations. Existing methods were summarized and different papers were focused on specific methods stressing their bases, peculiarities, advantages and limitations. As a result of the session a picture of the current State of the Art was obtained. The session comprised six papers. Technical Session 2 - International comparative activities: This session had as a main objective to review the activities launched in the past and present from the NEA in connection with BEPU methods, with focus on the applicability of conclusions derived from former benchmarks like UMS, the main outcomes of the recently finished BEMUSE project, and the objectives and relevance of UAM and PREMIUM projects. The session comprised four papers. Technical Session 3 - Applications: Licensing, safety analysis support, regulatory body views and industry activities: This session focused on the application of current methods in safety analyses. Contributions from industry, technical safety organizations and regulatory bodies were provided. As a result, a view of the penetration of BEPU methods in current safety analyses was obtained, as well as an indication of the evolution in the near future. Elements such as licensing practices, assessment process, etc. were considered. The session comprised nine papers. Technical Session 4. BEPU methods extension to new fields The session addressed the extension of BEPU methods beyond their current use. By now such methods are mainly applied to classic deterministic environment but it is believed that their benefits could be extended to other fields. Seven papers were presented in the session dealing with subjects that fit in the objectives established in the workshop programme. The papers cover areas like: extension to CFD, quantification of global safety

Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial.

Science.gov (United States)

Carey, M E; Mandalia, P K; Daly, H; Gray, L J; Hale, R; Martin Stacey, L; Taub, N; Skinner, T C; Stone, M; Heller, S; Khunti, K; Davies, M J

2014-11-01

To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Skipping one or more dialysis sessions significantly increases mortality: measuring the impact of non-adherence

Directory of Open Access Journals (Sweden)

Eduardo Gottlieb

2014-06-01

Full Text Available Introduction: Non-adherence to the prescribed dialysis sessions frequency ranges from 2% to 50% of patients. The objective of this study was to evaluate the impact of detecting and measuring the non-adherence to the prescribed dialysis frequency and to determine the importance of a multidisciplinary approach with the aim of improving adherence. Methods: longitudinal cohort study including 8,164 prevalent hemodialysis patients in April 2010, with more than 90 days of treatment, in Fresenius Medical Care Argentina units that were monitored for 3 years. The survey evaluated: interruption of at least one dialysis session in a month or reduction at least 10 minutes of a dialysis session in a month, during 6 months prior to the survey. Relative mortality risks were evaluated among groups. Results: 648 patients (7.9% interrupted dialysis sessions: 320 (3.9% interrupted one session per month and 328 (4.01% interrupted more than one session per month. After 3 years monitoring, 349 patients (53.8 % remained active in hemodialysis and 299 were inactive due to different reasons: 206 deceased (31.8 %, 47 transfers or monitoring losses (7.25 %, 36 transplanted (5.55 %, 8 changes to PD modality (1.2% and 2 recovered their kidney function (0.3 %.Interrupting one session per month significantly increased the mortality risk comparing both groups (interrupters and non-interrupters: RR 2.65 (IC 95% 2.24 – 3.14. Interrupting more than one dialysis session also increased significantly mortality risk comparing to the non-interrupters: RR 2.8 (IC 95% 2.39 – 3.28. After 3 years monitoring, 41.6 % of interrupters at the beginning had improved their adherence through a multidisciplinary program of quality improvement. Conclusion: Global mortality was greater among patients who interrupted dialysis sessions. A considerable proportion of interrupter patients at the beginning modified their behavior through the implementation of a multidisciplinary program of quality

24{sup th} Annual ESNA/IUR Meeting: Soil-Plant Relationships

Energy Technology Data Exchange (ETDEWEB)

Gerzabek, M H [ed.; Oesterreichisches Forschungszentrum Seibersdorf, 2444 Seibersdorf (Austria)

1994-11-01

The 24{sup th} annual meeting of ESNA was jointly organized with the IUR (International Union of Radioecologists), working group soil-to-plant transfer in Varna, Bulgaria. For INIS interesting is the session 'behaviour of radionuclides in the terrestrial foodchain'. (Botek)

Spaced sessions of avoidance extinction reduce spontaneous recovery and promote infralimbic cortex activation.

Science.gov (United States)

Tapias-Espinosa, Carles; Kádár, Elisabet; Segura-Torres, Pilar

2018-01-15

Extinction-based therapies (EBT) are the psychological treatments of choice for certain anxiety disorders, such as post-traumatic stress disorder. However, some patients relapse and suffer spontaneous recovery (SR) of anxiety symptoms and persistence of avoidance behaviour, which underlines the need for improving EBT. In rats, recent evidence has highlighted the relevance of the temporal distribution of extinction sessions in reducing SR of auditory fear conditioning, although it has seldom been studied in procedures involving proactive avoidance responses, such as two-way active avoidance conditioning (TWAA). We examined whether the temporal distribution of two extinction sessions separated by 24h or 7days (contiguous versus spaced extinction paradigms, respectively), influences SR after 28days of a TWAA task. c-Fos expression, as a marker of neuronal activation, was also measured by immunohistochemistry 90min after the SR test in the amygdala and the medial prefrontal cortex. The temporal distribution of extinction sessions did not affect the degree of extinction learning. However, only the rats that underwent the 7-day spaced extinction paradigm maintained the level of extinction in the long term, showing no SR in TWAA. This behavioural finding was consistent with a greater number of c-Fos-labelled neurons in the infralimbic cortex in the 7-day group, and in the Lateral and Central nuclei of the amygdala in the 24-hour group. These findings show that a time-spaced extinction paradigm reduces the spontaneous recovery of active avoidance behaviour, and that this behavioural advantage appears to be related to the activation of the infralimbic cortex. Copyright © 2017 Elsevier B.V. All rights reserved.

[Training of residents in obstetrics and gynecology: Assessment of an educational program including formal lectures and practical sessions using simulators].

Science.gov (United States)

Jordan, A; El Haloui, O; Breaud, J; Chevalier, D; Antomarchi, J; Bongain, A; Boucoiran, I; Delotte, J

2015-01-01

Evaluate an educational program in the training of residents in gynecology-obstetrics (GO) with a theory session and a practical session on simulators and analyze their learning curve. Single-center prospective study, at the university hospital (CHU). Two-day sessions were leaded in April and July 2013. An evaluation on obstetric and gynecological surgery simulator was available to all residents. Theoretical knowledge principles of obstetrics were evaluated early in the session and after formal lectures was taught to them. At the end of the first session, a satisfaction questionnaire was distributed to all participants. Twenty residents agreed to participate to the training sessions. Evaluation of theoretical knowledge: at the end of the session, the residents obtained a significant improvement in their score on 20 testing knowledge. Obstetrical simulator: a statistically significant improvement in scores on assessments simulator vaginal delivery between the first and second session. Subjectively, a larger increase feeling was seen after breech delivery simulation than for the cephalic vaginal delivery. However, the confidence level of the resident after breech delivery simulation has not been improved at the end of the second session. Simulation in gynecological surgery: a trend towards improvement in the time realized on the peg-transfer between the two sessions was noted. In the virtual simulation, no statistically significant differences showed, no improvement for in salpingectomy's time. Subjectively, the residents felt an increase in the precision of their gesture. Satisfaction: All residents have tried the whole program. They considered the pursuit of these sessions on simulators was necessary and even mandatory. The approach chosen by this structured educational program allowed a progression for the residents, both objectively and subjectively. This simulation program type for the resident's training would use this tool in assessing their skills and develop

Comparison of two different running models for the shock wave lithotripsy machine in Taipei City Hospital: self-support versus outsourcing cooperation.

Science.gov (United States)

Huang, Chi-Yi; Chen, Shiou-Sheng; Chen, Li-Kuei

2009-10-01

To compare two different running models including self-support and outsourcing cooperation for the extracorporeal shock wave lithotripsy (SWL) machine in Taipei City Hospital, we made a retrospective study. Self-support means that the hospital has to buy an SWL machine and get all the payment from SWL. In outsourcing cooperation, the cooperative company provides an SWL machine and shares the payment with the hospital. Between January 2002 and December 2006, we used self-support for the SWL machine, and from January 2007 to December 2008, we used outsourcing cooperation. We used the method of full costing to calculate the cost of SWL, and the break-even point was the lowest number of treatment sessions of SWL to make balance of payments every month. Quality parameters including stone-free rate, retreatment rate, additional procedures and complication rate were evaluated. When outsourcing cooperation was used, there were significantly more treatment sessions of SWL every month than when utilizing self-support (36.3 +/- 5.1 vs. 48.1 +/- 8.4, P = 0.03). The cost of SWL for every treatment session was significantly higher using self-support than with outsourcing cooperation (25027.5 +/- 1789.8 NT$ vs. 21367.4 +/- 201.0 NT$). The break-even point was 28.3 (treatment sessions) for self-support, and 28.4 for outsourcing cooperation, when the hospital got 40% of the payment, which would decrease if the percentage increased. No significant differences were noticed for stone-free rate, retreatment rate, additional procedures and complication rate of SWL between the two running models. Besides, outsourcing cooperation had lower cost (every treatment session), but a greater number of treatment sessions of SWL every month than self-support.

Nurse-physician collaboration impacts job satisfaction and turnover among nurses: A hospital-based cross-sectional study in Beijing.

Science.gov (United States)

Zhang, Lin; Huang, Lei; Liu, Meng; Yan, Hong; Li, Xiue

2016-06-01

This study aims to explore the impact of physician-nurse collaboration on nurse job satisfaction and turnover in a dental hospital. Physician-nurse collaboration is important for the stability of the entire nursing team. Few studies have shown the impact on job satisfaction and turnover among nurses working in Chinese dental hospitals. This was a prospective, cross-sectional study and investigated nurses from a tertiary dental hospital in Beijing using convenience non-randomized sampling. A structured questionnaire was used to collect data, which included general information, the Index of Work Satisfaction, the Nurse-Physician Collaboration Scale and the Turnover Intention Scale. The scores of physician-nurse collaboration correlated positively with those for job satisfaction and negatively with the stated likelihood of turnover intention. Physician-nurse collaboration scores positively predicted job satisfaction and negatively predicted the likelihood of quitting the current job. In conclusion, improving the level of physician-nurse collaboration is helpful to enhance job satisfaction and reduce turnover among nurses in a dental hospital. © 2016 John Wiley & Sons Australia, Ltd.

Nutritional Status and Non-Diet Associated Factors of Hospitalized Heart-Failure Elderly Patients

Directory of Open Access Journals (Sweden)

Shirin Hosseini

2010-07-01

Full Text Available Objectives: The aim of this study was to assess nutritional status and identify the most significant MNA-items (Mini Nutritional assessment to accelerate the determination of nutritional risk of heart-failure in elderly patients. Methods and Materials: The present research was a cross-sectional descriptive analytical survey on hospitalized heart- failure elderly patients (n=225. The sampling method was enrolled nonrandomly. The MNA questionnaires (18 items were used for nutritional assessment. Results: Based on the MNA questionnaire, 9.8% of the elderly were malnourished, 80.9% were at risk of malnutrition and 9.3% were well-nourished. Conclusion: Regarding the factors related to nutritional status of heart failure elderly patient, it is indicated that bed sore, the ability of eating, self-view of nutritional status and self-rated health status relative to peers had significant relationship with the nutritional status according to MNA (P<0.005. Regarding high prevalence of vulnerable or malnourished hospitalized elderly, nutritional intervention is necessary.

Attitudes of Registered and Licensed Practical Nurses About the Importance of Families in Surgical Hospital Units: Findings From the Landspitali University Hospital Family Nursing Implementation Project.

Science.gov (United States)

Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis

2014-08-01

The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration. © The Author(s) 2014.

Patients with schizophrenia or schizoaffective disorder who receive multiple electroconvulsive therapy sessions: characteristics, indications, and results

Directory of Open Access Journals (Sweden)

Iancu I

2015-03-01

Full Text Available Iulian Iancu,* Nimrod Pick,* Orit Seener-Lorsh, Pinhas Dannon Be’er Ya’akov Mental Health Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel *These authors share first authorship of this paper Background: While electroconvulsive therapy (ECT has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to characterize a series of patients who received 30 ECT sessions or more, to describe treatment regimens in actual practice, and to examine the results of C/M-ECT in terms of safety and efficacy, especially the effect on aggression and functioning.Methods: We performed a retrospective chart review of 20 consecutive patients (mean age 64.6 years with schizophrenia (n=16 or schizoaffective disorder (n=4 who received at least 30 ECT sessions at our ECT unit, and also interviewed the treating physician and filled out the Clinical Global Impression-Severity, Global Assessment of Functioning, and the Staff Observation Aggression Scale-Revised.Results: Patients received a mean of 91.3 ECT sessions at a mean interval of 2.6 weeks. All had been hospitalized for most or all of the previous 3 years. There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment. We found that ECT significantly reduced scores on the Staff Observation Aggression Scale-Revised subscales for verbal aggression and self-harm, and improved Global Assessment of Functioning scores. There were reductions in total aggression scores, subscale scores for harm to objects and to others, and Clinical Global Impression-Severity scores, these were not statistically significant.Conclusion: C/M-ECT is safe and effective for

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.

Poster Sessions in Marketing Education: An Empirical Examination

Science.gov (United States)

Stegemann, Nicole; Sutton-Brady, Catherine

2009-01-01

Poster sessions provide a creative and stimulating alternative to traditional assessment methods in marketing. Poster sessions, as a means of assessment, have long been used in science fields. This article presents the successful implementation of poster sessions as a means of assessment in a postgraduate unit of study. Poster sessions in…

Inpatient Portals for Hospitalized Patients and Caregivers: A Systematic Review.

Science.gov (United States)

Kelly, Michelle M; Coller, Ryan J; Hoonakker, Peter Lt

2018-06-01

Patient portals, web-based personal health records linked to electronic health records (EHRs), provide patients access to their healthcare information and facilitate communication with providers. Growing evidence supports portal use in ambulatory settings; however, only recently have portals been used with hospitalized patients. Our objective was to review the literature evaluating the design, use, and impact of inpatient portals, which are patient portals designed to give hospitalized patients and caregivers inpatient EHR clinical information for the purpose of engaging them in hospital care. Literature was reviewed from 2006 to 2017 in PubMed, Web of Science, CINALPlus, Cochrane, and Scopus to identify English language studies evaluating patient portals, engagement, and inpatient care. Data were analyzed considering the following 3 themes: inpatient portal design, use and usability, and impact. Of 731 studies, 17 were included, 9 of which were published after 2015. Most studies were qualitative with small samples focusing on inpatient portal design; 1 nonrandomized trial was identified. Studies described hospitalized patients' and caregivers' information needs and design recommendations. Most patient and caregiver participants in included studies were interested in using an inpatient portal, used it when offered, and found it easy to use and/or useful. Evidence supporting the role of inpatient portals in improving patient and caregiver engagement, knowledge, communication, and care quality and safety is limited. Included studies indicated providers had concerns about using inpatient portals; however, the extent to which these concerns have been realized remains unclear. Inpatient portal research is emerging. Further investigation is needed to optimally design inpatient portals to maximize potential benefits for hospitalized patients and caregivers while minimizing unintended consequences for healthcare teams. © 2017 Society of Hospital Medicine.

A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

Directory of Open Access Journals (Sweden)

Carmen H Logie

Full Text Available Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo (Women Taking Action For Their Health study examined the effectiveness of a peer health worker (PHW delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti.This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829.Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88% completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26, STI knowledge (β = 0.84; 95% CI 0.70-0.99, condom use (AOR = 4.05, 95% CI 1.86-8.83, and depression (β = -0.63, 95% CI -0.88--0.39 scores showed statistically significant change post-intervention (p<0.05.This pilot study evaluated a PHW psycho-educational HIV/STI prevention intervention among internally displaced women in post-earthquake Haiti. Pilot studies are an important approach to understand feasibility and scientific

Attendance at NHS mandatory training sessions.

Science.gov (United States)

Brand, Darren

2015-02-17

To identify factors that affect NHS healthcare professionals' attendance at mandatory training sessions. A quantitative approach was used, with a questionnaire sent to 400 randomly selected participants. A total of 122 responses were received, providing a mix of qualitative and quantitative data. Quantitative data were analysed using statistical methods. Open-ended responses were reviewed using thematic analysis. Clinical staff value mandatory training sessions highly. They are aware of the requirement to keep practice up-to-date and ensure patient safety remains a priority. However, changes to the delivery format of mandatory training sessions are required to enable staff to participate more easily, as staff are often unable to attend. The delivery of mandatory training should move from classroom-based sessions into the clinical area to maximise participation. Delivery should be assisted by local 'experts' who are able to customise course content to meet local requirements and the requirements of different staff groups. Improved arrangements to provide staff cover, for those attending training, would enable more staff to attend training sessions.

Using session types as an effect system

Directory of Open Access Journals (Sweden)

Dominic Orchard

2016-02-01

Full Text Available Side effects are a core part of practical programming. However, they are often hard to reason about, particularly in a concurrent setting. We propose a foundation for reasoning about concurrent side effects using sessions. Primarily, we show that session types are expressive enough to encode an effect system for stateful processes. This is formalised via an effect-preserving encoding of a simple imperative language with an effect system into the pi-calculus with session primitives and session types (into which we encode effect specifications. This result goes towards showing a connection between the expressivity of session types and effect systems. We briefly discuss how the encoding could be extended and applied to reason about and control concurrent side effects.

Prospective Nonrandomized Trial of Manual Compression and Angio-Seal and Starclose Arterial Closure Devices in Common Femoral Punctures

International Nuclear Information System (INIS)

Ratnam, Lakshmi A.; Raja, Jowad; Munneke, Graham J.; Morgan, Robert A.; Belli, Anna-Maria

2007-01-01

We compared the use of manual compression and Angio-Seal and Starclose arterial closure devices to achieve hemostasis following common femoral artery (CFA) punctures in order to evaluate safety and efficacy. A prospective nonrandomized, single-center study was carried out on all patients undergoing CFA punctures over 1 year. Hemostasis was achieved using manual compression in 108 cases, Angio-Seal in 167 cases, and Starclose in 151 cases. Device-failure rates were low and not significantly different in the two groups (manual compression and closure devices; p = 0.8). There were significantly more Starclose (11.9%) patients compared to Angio-Seal (2.4%), with successful initial deployment subsequently requiring additional manual compression to achieve hemostasis (p < 0.0001). A significant number of very thin patients failed to achieve hemostasis (p = 0.014). Major complications were seen in 2.9% of Angio-Seal, 1.9% of Starclose, and 3.7% of manual compression patients, with no significant difference demonstrated; 4.7% of the major complications were seen in female patients compared to 1.3% in males (p = 0.0415). All three methods showed comparable safety and efficacy. Very thin patients are more likely to have failed hemostasis with the Starclose device, although this did not translate into an increased complication rate. There is a significant increased risk of major puncture-site complications in women with peripheral vascular disease

Does Gender Influence Electroconvulsive Therapy Sessions Required across Psychiatric Diagnoses? A 5-Year Experience from a Single Center

Science.gov (United States)

Manohar, Harshini; Subramanian, Karthick; Menon, Vikas; Kattimani, Shivanand

2017-01-01

Context: There is a paucity of systematic data reflecting the practice of electroconvulsive therapy (ECT) from developing countries. Aim: We aimed to identify the number of ECT sessions required to yield response and gender diffeferences in the number of sessions across various diagnostic categories. Setting and Design: A record-based study from a teaching cum tertiary care hospital in South India. Subjects and Methods: Case records of patients who received modified ECT from January 2011 to January 2016 were reviewed. The sociodemographic details and ECT-related data were collected. Psychiatric diagnoses were ascertained as per the International Classification of Diseases, 10th Revision criteria. Statistical Analysis Used: Kruskal–Wallis test and Mann–Whitney U-test. Results: Among 148 patients, 82 (55.4%) had mood disorder (bipolar disorder and recurrent depressive disorder), 43 (29.1%) had schizophrenia, and 22 (14.9%) had other acute and transient psychotic disorders (ATPDs). Patients with mood disorders, schizophrenia, and other ATPD received 7.3 (± 3.8), 9.7 (± 6.1), and 5.4 (± 2.0) ECT sessions, respectively, to achieve response. There was no gender difference in the number of sessions received. Conclusion: Our findings show that number of ECT sessions required to yield response may be disorder-specific. Gender does not influence the ECT dose requirement. Variations in ECT parameters across settings may limit the generalizability of results. PMID:28694625

PET/CT and contrast enhanced CT in single vs. two separate sessions: a cost analysis study.

Science.gov (United States)

Picchio, M; Mansueto, M; Crivellaro, C; Guerra, L; Marcelli, S; Arosio, M; Sironi, S; Gianolli, L; Grimaldi, A; Messa, C

2012-06-01

Aim of the study was to quantify the economic impact of PET/CT and contrast enhanced (c.e.) CT performed in a single session examination vs. stand-alone modalities in oncological patients. One-hundred-forty-five cancer patients referred to both PET/CT and c.e. CT, to either stage (N.=46) or re-stage (N.=99) the disease, were included. Seventy-two/145 performed both studies in a single session (innovative method) and 73/145 in two different sessions (traditional method). The cost-minimization analysis was performed by evaluating: 1) institutional costs, data obtained by hospital accountability (staff, medical materials, equipment maintenance and depreciation, departments utilities); 2) patients costs, data obtained by a specific survey provided to patients (travel, food, accommodation costs, productivity loss). Economic data analysis showed that the costs for innovative method was lower than those of traditional method, both for Institution (106 € less per test) and for patient (21 € less per patient). The loss of productivity for patient and caregivers resulted lower for the innovative method than the traditional method (3 work-hour less per person). PET/CT and c.e. CT performed in a single session is more cost-effective than stand-alone modalities, by reducing both Institutional and patients costs. These advantages are mainly due to lower Institutional cost (single procedure) and to lower cost related to travel and housing.

Acute hemodynamic responses following a training session with active video game in wheelchair

Directory of Open Access Journals (Sweden)

Raphael José Perrier Melo

2016-04-01

Full Text Available Aimed:This study aimed to analyze the hemodynamic responses during an active game session (VGA with the use of a wheelchair. Method: Twelve subjects (6 men and 6 women (24 ± 3.98 years; 22.6 ± 2.17 kg / m2 , apparently healthy (PAR-Q, not wheelchair users. Rest measures for heart rate (HR: bpm, blood pressure (BP;mmHg and calculation of double product (DP; mmHg/bpm were taken following the anthropometric assessment. Subsequently, they performed a session of Kinect Sports Boxing game for 15 minutes. The variables HR, BP and DP were measured at rest, during and after the session. Data was analyzed using the Friedman’s test with Dunn’s post hoc test for no parametric data to compare pre, during and post session. Values of p<0.05 were accepted as significant. Results: Immediately post session data showed significant increases in HR, SBP and DP for both men (HR: 68.00 ± 8.99 vs 105.17 ± 22.55; PAS: 123.67 ± 68 vs 134.17 ± 8.23; DP = 8446.00 ± 1453.54 vs 3628.76 ± 14217.50 and women (HR: 68.00 ± 8.00 vs 126.00 ± 20.44; PAS: 100.33 ± 8.82 vs 113.17 ± 9.15; DP: 6.843 ± 1160.36 vs 3597.45 ± 14 405. Similarly, after the experimental session were observed significant decreases in HR, SBP and DP compared to the immediately post session, for both boys and for girls. (HR: 74.67 ± 9.46 vs 105.17 ± 22.55; SBP: 121 ± 5.62 vs 134.17 ± 8.23; SD: 9066.50 ± 1449.98 vs 14217.50 ± 3628.76 and for women (HR: 76.83 ± 9.02 vs 126.00 ± 20.44; PAS: 100.67 ± 3.01 vs 113.17 ± 9.15; DP= 7745.33 ± 1025.34 vs 3597.45 ± 14.405. Conclusion: The practice of VGAs contributes to increased hemodynamic demands, being a safe alternative in the period of rehabilitation and training for athletes using wheelchair.

Graph Transformation for Consolidation of Creativity Sessions Results

DEFF Research Database (Denmark)

Dolog, Peter

2010-01-01

Graph transformation approach for consolidation of creativity sessions results is part of the FP7 EU/IST project idSpace: Tooling of and training for collaborative, distributed product innovation. The goal of graph transformation approach is to provide a tool for merging results of various sessions...... (such as brainstorming sessions), which are represented as graphs, when the session participants- are physically distributed....

Review for session K - benchmarks

International Nuclear Information System (INIS)

McCracken, A.K.

1980-01-01

Eight of the papers to be considered in Session K are directly concerned, at least in part, with the Pool Critical Assembly (P.C.A.) benchmark at Oak Ridge. The remaining seven papers in this session, the subject of this review, are concerned with a variety of topics related to the general theme of Benchmarks and will be considered individually

Session 2: Machine studies

International Nuclear Information System (INIS)

Assmann, R.W.; Papotti, G.

2012-01-01

This document summarizes the talks and discussion that took place in the second session of the Chamonix 2012 workshop concerning results from machine studies performed in 2011. The session consisted of the following presentations: -) LHC experience with different bunch spacings by G. Rumolo; -) Observations of beam-beam effects in MDs in 2011 by W. Herr; -) Beam-induced heating/ bunch length/RF and lessons for 2012 by E. Metral; -) Lessons in beam diagnostics by R. Jones; -) Quench margins by M. Sapinski; and -) First demonstration with beam of the Achromatic Telescopic Squeeze (ATS) by S. Fartoukh. (authors)

Breakout Sessions

CERN Multimedia

CERN. Geneva

2004-01-01

Participants are split into small groups for detailed discussion on their chosen topic. To register please click on 'See details' link from the agenda and then on the link to send an email to the session for which you would like to book. Please don't change the subject line of the email.

Flexible session management in a distributed environment

Energy Technology Data Exchange (ETDEWEB)

Miller, Zach; /Wisconsin U., Madison; Bradley, Dan; /Wisconsin U., Madison; Tannenbaum, Todd; /Wisconsin U., Madison; Sfiligoi, Igor; /Fermilab

2010-01-01

Many secure communication libraries used by distributed systems, such as SSL, TLS, and Kerberos, fail to make a clear distinction between the authentication, session, and communication layers. In this paper we introduce CEDAR, the secure communication library used by the Condor High Throughput Computing software, and present the advantages to a distributed computing system resulting from CEDAR's separation of these layers. Regardless of the authentication method used, CEDAR establishes a secure session key, which has the flexibility to be used for multiple capabilities. We demonstrate how a layered approach to security sessions can avoid round-trips and latency inherent in network authentication. The creation of a distinct session management layer allows for optimizations to improve scalability by way of delegating sessions to other components in the system. This session delegation creates a chain of trust that reduces the overhead of establishing secure connections and enables centralized enforcement of system-wide security policies. Additionally, secure channels based upon UDP datagrams are often overlooked by existing libraries; we show how CEDAR's structure accommodates this as well. As an example of the utility of this work, we show how the use of delegated security sessions and other techniques inherent in CEDAR's architecture enables US CMS to meet their scalability requirements in deploying Condor over large-scale, wide-area grid systems.

Flexible session management in a distributed environment

International Nuclear Information System (INIS)

Miller, Zach; Bradley, Dan; Tannenbaum, Todd; Sfiligoi, Igor

2010-01-01

Many secure communication libraries used by distributed systems, such as SSL, TLS, and Kerberos, fail to make a clear distinction between the authentication, session, and communication layers. In this paper we introduce CEDAR, the secure communication library used by the Condor High Throughput Computing software, and present the advantages to a distributed computing system resulting from CEDAR's separation of these layers. Regardless of the authentication method used, CEDAR establishes a secure session key, which has the flexibility to be used for multiple capabilities. We demonstrate how a layered approach to security sessions can avoid round-trips and latency inherent in network authentication. The creation of a distinct session management layer allows for optimizations to improve scalability by way of delegating sessions to other components in the system. This session delegation creates a chain of trust that reduces the overhead of establishing secure connections and enables centralized enforcement of system-wide security policies. Additionally, secure channels based upon UDP datagrams are often overlooked by existing libraries; we show how CEDAR's structure accommodates this as well. As an example of the utility of this work, we show how the use of delegated security sessions and other techniques inherent in CEDAR's architecture enables US CMS to meet their scalability requirements in deploying Condor over large-scale, wide-area grid systems.

Flexible session management in a distributed environment

Energy Technology Data Exchange (ETDEWEB)

Miller, Zach; Bradley, Dan; Tannenbaum, Todd [University of Wisconsin, Madison, WI (United States); Sfiligoi, Igor, E-mail: zmiller@cs.wisc.ed [Fermi National Acceleartor Laboratory, Batavia, IL (United States)

2010-04-01

Many secure communication libraries used by distributed systems, such as SSL, TLS, and Kerberos, fail to make a clear distinction between the authentication, session, and communication layers. In this paper we introduce CEDAR, the secure communication library used by the Condor High Throughput Computing software, and present the advantages to a distributed computing system resulting from CEDAR's separation of these layers. Regardless of the authentication method used, CEDAR establishes a secure session key, which has the flexibility to be used for multiple capabilities. We demonstrate how a layered approach to security sessions can avoid round-trips and latency inherent in network authentication. The creation of a distinct session management layer allows for optimizations to improve scalability by way of delegating sessions to other components in the system. This session delegation creates a chain of trust that reduces the overhead of establishing secure connections and enables centralized enforcement of system-wide security policies. Additionally, secure channels based upon UDP datagrams are often overlooked by existing libraries; we show how CEDAR's structure accommodates this as well. As an example of the utility of this work, we show how the use of delegated security sessions and other techniques inherent in CEDAR's architecture enables US CMS to meet their scalability requirements in deploying Condor over large-scale, wide-area grid systems.

Flexible session management in a distributed environment

Science.gov (United States)

Miller, Zach; Bradley, Dan; Tannenbaum, Todd; Sfiligoi, Igor

2010-04-01

Many secure communication libraries used by distributed systems, such as SSL, TLS, and Kerberos, fail to make a clear distinction between the authentication, session, and communication layers. In this paper we introduce CEDAR, the secure communication library used by the Condor High Throughput Computing software, and present the advantages to a distributed computing system resulting from CEDAR's separation of these layers. Regardless of the authentication method used, CEDAR establishes a secure session key, which has the flexibility to be used for multiple capabilities. We demonstrate how a layered approach to security sessions can avoid round-trips and latency inherent in network authentication. The creation of a distinct session management layer allows for optimizations to improve scalability by way of delegating sessions to other components in the system. This session delegation creates a chain of trust that reduces the overhead of establishing secure connections and enables centralized enforcement of system-wide security policies. Additionally, secure channels based upon UDP datagrams are often overlooked by existing libraries; we show how CEDAR's structure accommodates this as well. As an example of the utility of this work, we show how the use of delegated security sessions and other techniques inherent in CEDAR's architecture enables US CMS to meet their scalability requirements in deploying Condor over large-scale, wide-area grid systems.

Complex Systems Analysis of Cell Cycling Models in Carcinogenesis:II. Cell Genome and Interactome, Neoplastic Non-random Transformation Models in Topoi with Lukasiewicz-Logic and MV Algebras

CERN Document Server

Baianu, I C

2004-01-01

Quantitative Biology, abstract q-bio.OT/0406045 From: I.C. Baianu Dr. [view email] Date (v1): Thu, 24 Jun 2004 02:45:13 GMT (164kb) Date (revised v2): Fri, 2 Jul 2004 00:58:06 GMT (160kb) Complex Systems Analysis of Cell Cycling Models in Carcinogenesis: II. Authors: I.C. Baianu Comments: 23 pages, 1 Figure Report-no: CC04 Subj-class: Other Carcinogenesis is a complex process that involves dynamically inter-connected modular sub-networks that evolve under the influence of micro-environmentally induced perturbations, in non-random, pseudo-Markov chain processes. An appropriate n-stage model of carcinogenesis involves therefore n-valued Logic treatments of nonlinear dynamic transformations of complex functional genomes and cell interactomes. Lukasiewicz Algebraic Logic models of genetic networks and signaling pathways in cells are formulated in terms of nonlinear dynamic systems with n-state components that allow for the generalization of previous, Boolean or "fuzzy", logic models of genetic activities in vivo....

Strength and Conditioning Coaches’ Application of the Session Rating of Perceived Exertion Method of Monitoring Within Professional Rugby Union

Directory of Open Access Journals (Sweden)

Comyns Thomas

2018-03-01

Full Text Available Session rating of perceived exertion (session-RPE is a method of monitoring and managing training loads. The purpose of this study was to research how and for what purpose strength and conditioning (S&C coaches implement this monitoring method within professional rugby union. The study also aimed to assess if S&C coaches found this monitoring method to be valid and effective. An online survey containing 24 fixed response questions was used to assess how S&C coaches applied the session-RPE method. The survey was piloted with expert researchers and practitioners in the area of session-RPE prior to distribution and alterations were made to the survey based on the experts’ feedback. Twenty S&C coaches working with professional rugby union clubs in Ireland, England, Scotland and Wales completed the survey. The coaches’ responses indicated that the majority found the session-RPE to be a valid and effective monitoring method. While some good implementation practices were identified, not all of the coaches adhered to these guidelines which may impact on the accuracy of the collected data. For example, 30% of coaches do not collect the RPE for every session that a player does per week limiting the use of the session-RPE variables cumulative training load, training monotony, training strain and acute:chronic load ratio. S&C coaches within rugby should consider using session-RPE as a method of monitoring and implement the method in a manner reflective of research findings to enhance the potential applications of this system in maximising adaptations and minimising the risk of injury.

Session summaries

International Nuclear Information System (INIS)

Sudo, Y.

2002-01-01

In the summary session, possible international activities in the field of basic studies on high-temperature engineering were discussed within the framework of the OECD/NEA Nuclear Science Committee (NSC). It was recommended to include topics relevant to fission-product behaviour and safety issues of HTGR in next meeting, in addition to the topics discussed in this meeting. The chairperson of the last session summarised the recommendations to be presented to the NSC into the following five topics as possible international activities: - Basic studies on behaviour of irradiated graphite/carbon and ceramic materials including their composites under both operation and storage conditions. - Development of in-core material characterisation and instrumentation methods. - Improvement in material properties through high-temperature irradiation. - Basic studies on HTGR fuel fabrication and performance including fission-product release. - Basic studies on safety issues of HTGR. It was also recommended that a further information exchange meeting focused on the organisation of the interactive collaboration activity with regard to the above topics be planned in 2003, tentatively in Oarai, Japan. (author)

Paralysis following stereotactic spinal irradiation in pigs suggests a tolerance constraint for single-session irradiation of the spinal nerve

International Nuclear Information System (INIS)

Medin, Paul M.; Foster, Ryan D.; Kogel, Albert J. van der; Meyer, Jeffrey; Sayre, James W.; Huang, Hao; Öz, Orhan K.

2013-01-01

Background and purpose: Paralysis observed during a study of vertebral bone tolerance to single-session irradiation led to further study of the dose-related incidence of motor peripheral neuropathy. Materials and methods: During a bone tolerance study, cervical spinal nerves of 15 minipigs received bilateral irradiation to levels C5–C8 distributed into three dose groups with mean maximum spinal nerve doses of 16.9 ± 0.3 Gy (n = 5), 18.7 ± 0.5 Gy (n = 5), and 24.3 ± 0.8 Gy (n = 5). Changes developing in the gait of the group of pigs receiving a mean maximum dose of 24.3 Gy after 10–15 weeks led to the irradiation of two additional animals. They received mean maximum dose of 24.9 ± 0.2 Gy (n = 2), targeted to the left spinal nerves of C5–C8. The followup period was one year. Histologic sections from spinal cords and available spinal nerves were evaluated. MR imaging was performed on pigs in the 24.9 Gy group. Results: No pig that received a maximum spinal nerve point dose ⩽19.0 Gy experienced a change in gait while all pigs that received ⩾24.1 Gy experienced paralysis. Extensive degeneration and fibrosis were observed in irradiated spinal nerves of the 24.9 Gy animals. All spinal cord sections were normal. Irradiated spinal nerve regions showed increased thickness and hypointensity on MR imaging. Conclusion: The single-session tolerance dose of the cervical spinal nerves lies between 19.0 and 24.1 Gy for this model

Ethics case reflection sessions: Enablers and barriers.

Science.gov (United States)

Bartholdson, Cecilia; Molewijk, Bert; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2018-03-01

In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included 'increased understanding', 'group strengthening' and 'decision grounding'. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions. The aim of this study was to explore conditions for clarifying perspectives during ECR sessions. Data were collected from observations and interviews and the results emerged from an inductive analysis using grounded theory. Participants and research context: Six observations during ECR sessions and 10 interviews were performed with healthcare professionals working in childhood cancer care and advanced paediatric homecare. Ethical considerations: The study was approved by a regional ethical review board. Participants were informed about their voluntary involvement and that they could withdraw their participation without explaining why. Two categories emerged: organizational enablers and barriers and team-related enablers and barriers. Organizational enablers and barriers included the following sub-categories: the timing of the ECR session, the structure during the ECR session and the climate during the ECR session. Sub-categories to team-related enablers and barriers were identified as space for inter-professional perspectives, varying levels of ethical skills and space for the patient's and the family's perspectives. Space for inter-professional perspectives included the dominance of a particular perspective that can result from hierarchical positions. The medical perspective is relevant for understanding the child's situation but should not dominate the ethical reflection. Conditions for ECR sessions have been explored and the new knowledge can be used when training

Single-Session Transcranial Direct Current Stimulation Temporarily Improves Symptoms, Mood, and Self-Regulatory Control in Bulimia Nervosa: A Randomised Controlled Trial.

Science.gov (United States)

Kekic, Maria; McClelland, Jessica; Bartholdy, Savani; Boysen, Elena; Musiat, Peter; Dalton, Bethan; Tiza, Meyzi; David, Anthony S; Campbell, Iain C; Schmidt, Ulrike

2017-01-01

Evidence suggests that pathological eating behaviours in bulimia nervosa (BN) are underpinned by alterations in reward processing and self-regulatory control, and by functional changes in neurocircuitry encompassing the dorsolateral prefrontal cortex (DLPFC). Manipulation of this region with transcranial direct current stimulation (tDCS) may therefore alleviate symptoms of the disorder. This double-blind sham-controlled proof-of-principle trial investigated the effects of bilateral tDCS over the DLPFC in adults with BN. Thirty-nine participants (two males) received three sessions of tDCS in a randomised and counterbalanced order: anode right/cathode left (AR/CL), anode left/cathode right (AL/CR), and sham. A battery of psychological/neurocognitive measures was completed before and after each session and the frequency of bulimic behaviours during the following 24-hours was recorded. AR/CL tDCS reduced eating disorder cognitions (indexed by the Mizes Eating Disorder Cognitions Questionnaire-Revised) when compared to AL/CR and sham tDCS. Both active conditions suppressed the self-reported urge to binge-eat and increased self-regulatory control during a temporal discounting task. Compared to sham stimulation, mood (assessed with the Profile of Mood States) improved after AR/CL but not AL/CR tDCS. Lastly, the three tDCS sessions had comparable effects on the wanting/liking of food and on bulimic behaviours during the 24 hours post-stimulation. These data suggest that single-session tDCS transiently improves symptoms of BN. They also help to elucidate possible mechanisms of action and highlight the importance of selecting the optimal electrode montage. Multi-session trials are needed to determine whether tDCS has potential for development as a treatment for adult BN.

Multiparty session types as coherence proofs

DEFF Research Database (Denmark)

Carbone, Marco; Montesi, Fabrizio; Schürmann, Carsten

2017-01-01

We propose a Curry–Howard correspondence between a language for programming multiparty sessions and a generalisation of Classical Linear Logic (CLL). In this framework, propositions correspond to the local behaviour of a participant in a multiparty session type, proofs to processes, and proof nor...

BILATERAL SINGLE SESSION URETEROSCOPY FOR URETERAL ...

African Journals Online (AJOL)

Objectives: To determine the feasibility, safety and success rate of bilateral single session rigid retrograde ureteroscopy (URS) for bilateral ureteral calculi. Patients and Methods: Thirty-five patients underwent bilateral single session ureteroscopic calculus removal. Results: Out of 70 renal units in 35 patients treated, ...

Semi-Automated Discovery of Application Session Structure

Energy Technology Data Exchange (ETDEWEB)

Kannan, J.; Jung, J.; Paxson, V.; Koksal, C.

2006-09-07

While the problem of analyzing network traffic at the granularity of individual connections has seen considerable previous work and tool development, understanding traffic at a higher level---the structure of user-initiated sessions comprised of groups of related connections---remains much less explored. Some types of session structure, such as the coupling between an FTP control connection and the data connections it spawns, have prespecified forms, though the specifications do not guarantee how the forms appear in practice. Other types of sessions, such as a user reading email with a browser, only manifest empirically. Still other sessions might exist without us even knowing of their presence, such as a botnet zombie receiving instructions from its master and proceeding in turn to carry them out. We present algorithms rooted in the statistics of Poisson processes that can mine a large corpus of network connection logs to extract the apparent structure of application sessions embedded in the connections. Our methods are semi-automated in that we aim to present an analyst with high-quality information (expressed as regular expressions) reflecting different possible abstractions of an application's session structure. We develop and test our methods using traces from a large Internet site, finding diversity in the number of applications that manifest, their different session structures, and the presence of abnormal behavior. Our work has applications to traffic characterization and monitoring, source models for synthesizing network traffic, and anomaly detection.

Selecting for extinction: nonrandom disease-associated extinction homogenizes amphibian biotas.

Science.gov (United States)

Smith, Kevin G; Lips, Karen R; Chase, Jonathan M

2009-10-01

Studying the patterns in which local extinctions occur is critical to understanding how extinctions affect biodiversity at local, regional and global spatial scales. To understand the importance of patterns of extinction at a regional spatial scale, we use data from extirpations associated with a widespread pathogenic agent of amphibian decline, Batrachochytrium dendrobatidis (Bd) as a model system. We apply novel null model analyses to these data to determine whether recent extirpations associated with Bd have resulted in selective extinction and homogenization of diverse tropical American amphibian biotas. We find that Bd-associated extinctions in this region were nonrandom and disproportionately, but not exclusively, affected low-occupancy and endemic species, resulting in homogenization of the remnant amphibian fauna. The pattern of extirpations also resulted in phylogenetic homogenization at the family level and ecological homogenization of reproductive mode and habitat association. Additionally, many more species were extirpated from the region than would be expected if extirpations occurred randomly. Our results indicate that amphibian declines in this region are an extinction filter, reducing regional amphibian biodiversity to highly similar relict assemblages and ultimately causing amplified biodiversity loss at regional and global scales.

Experiences of clinical teaching for dental core trainees working in hospital.

Science.gov (United States)

Mannion, C J; Brotherton, P

2014-07-11

There is recognition that the provision of excellence in education and training results in a skilled and competent workforce. However, the educational experiences of dental core trainees (DCT's) working in the hospital oral and maxillofacial surgery (OMFS) setting have not been previously investigated. In this paper, we examine DCT's learning experiences both 'formal' and 'non-formal' within the hospital setting of ward and clinic-based teaching. Are hospital dental core trainees receiving a meaningful educational experience? To conclude this paper, the authors recommend methods, based upon sound educational principles, to maximise the value of clinical sessions for teaching.

Human Reliability Analysis: session summary

International Nuclear Information System (INIS)

Hall, R.E.

1985-01-01

The use of Human Reliability Analysis (HRA) to identify and resolve human factors issues has significantly increased over the past two years. Today, utilities, research institutions, consulting firms, and the regulatory agency have found a common application of HRA tools and Probabilistic Risk Assessment (PRA). The ''1985 IEEE Third Conference on Human Factors and Power Plants'' devoted three sessions to the discussion of these applications and a review of the insights so gained. This paper summarizes the three sessions and presents those common conclusions that were discussed during the meeting. The paper concludes that session participants supported the use of an adequately documented ''living PRA'' to address human factors issues in design and procedural changes, regulatory compliance, and training and that the techniques can produce cost effective qualitative results that are complementary to more classical human factors methods

Changing Behavior among Nurses to Track Indwelling Urinary Catheters in Hospitalized Patients

Directory of Open Access Journals (Sweden)

Bona Yoon

2013-01-01

Full Text Available Catheter-associated urinary tract infections (CAUTIs are preventable complications of hospitalization. An interdisciplinary team developed a curriculum to increase awareness of the presence of indwelling urinary catheters (IUCs in hospitalized patients, addressed practical, primarily nurse-controlled inpatient risk-reduction interventions, and promoted the use of the IUC labels (“tags”. Five thirty-minute educational sessions were cycled over three daily nursing shifts on two inpatient medical floors over a 1-year period; participants were surveyed (n=152 to elicit feedback and provide real-time insight on the learning objectives. Nurse self-reported IUC tagging was early and sustained; after the IUC tag was introduced, there was a significant increase in tagging reported by the end of the block of educational sessions (from 46.2% to 84.6%, P=0.001. Early engagement combined with a targeted educational initiative led to increased knowledge, changes in behavior, and renewed CAUTI awareness in hospitalized patients with IUCs. The processes employed in this small-scale project can be applied to broader, hospitalwide initiatives and to large-scale initiatives for healthcare interventions. As first-line providers with responsibility for the placement and daily maintenance of IUCs, nurses are ideally positioned to implement efforts addressing CAUTIs in the hospital setting.

Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado Comparative study of cesarean section indications between a public university hospital and a private hospital

Directory of Open Access Journals (Sweden)

Renato Humberto Fabri

2002-04-01

Full Text Available OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%, distócia (22,4% e o sofrimento fetal agudo (18,2%, e no hospital privado foram cesárea iterativa (36% e distócia (36%. As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.OBJECTIVES: to analyse the incidence and the indications of cesarean section performed in the University Hospital of the "Triângulo Mineiro Faculty of Medicine " and a private hospital in Uberaba, Minas Gerais, Brazil. METHODS: a cross sectional study was carried out by using the data source of the medical files from both hospitals consisting of patient age, place of origin, marital status, education level, parity and cesarean sections indications. RESULTS: the cesarean sections rate was 24,3 % (325 of 1.441 births at the university hospital against 89,2% (100 of 112 births of the private hospital. The most frequent indications in the University Hospital were previous cesarean sections (26,7%, dystocia (22,4% and acute fetal distress (18,2%. In the private hospital, indications were previous cesarean section (36% and dystocia (36%. The private hospital's patients had higher education levels. CONCLUSIONS: the higher rate of cesarean sections observed in the private hospital

Cardiorespiratory responses of a dance session designed for older women: A cross sectional study.

Science.gov (United States)

Rodrigues-Krause, Josianne; Farinha, Juliano Boufleur; Ramis, Thiago Rozales; Boeno, Francesco Pinto; Dos Santos, Gabriela Cristina; Krause, Mauricio; Reischak-Oliveira, Alvaro

2018-06-04

Dancing has been increasingly used as a type of exercise intervention to improve cardiovascular fitness of older people. However, it is unclear which may be the exercise intensity of the dance sessions. To describe cardiorespiratory responses of a dance session for older women, and to identify intensity zones in relation to peak oxygen consumption (VO 2 peak), first and second ventilatory thresholds (VT1 and VT2). Ten women (66 ± 5 yrs., BMI 27 ± 4) were examined on three occasions: Familiarization, maximum effort and dance sessions. Incremental treadmill test: 5 km/h, 2% slope each min, until maximum effort. Dance class (60 min): warm-up (20 min), across-the-floor (10 min), choreography (15 min), show (10 min) and cool-down (5 min). Ventilatory parameters were measured continuously (breath-by-breath). VO 2 (mL·kg -1 ·min -1 ): Maximum effort: VO 2 peak (23.3 ± 4.3), VT1 (17.2 ± 3.5) and VT2 (20.9 ± 3.4). Dancing: warm-up (12.8 ± 2.4, ~55%VO 2 peak), across-the-floor (14.2 ± 2.4 ~62%VO 2 peak), choreography (14.6 ± 3.2 ~63%VO 2 peak) and show (16.1 ± 3.3, ~69% VO 2 peak). Show was similar to VT1. Cardiorespiratory demands of a dance class for older women are at low aerobic intensity. Show was similar to VT1, indicating that a dance class may be modulated to improve aerobic fitness, at least at initial stages of training. Copyright © 2018 Elsevier Inc. All rights reserved.

Undergraduate Researchers and the Poster Session

Science.gov (United States)

Johnson, Gail; Green, Raymond

2007-01-01

Undergraduates presented original research in classroom poster sessions open to students, faculty, and friends. We assessed the reaction of the students to the experience and their reported change in their interest in presenting at conferences. Students enjoyed the poster session experience and indicated they preferred this method over other…

Ann Arbor Session I: Breaking Ground.

Science.gov (United States)

Music Educators Journal, 1979

1979-01-01

Summarizes the first session of the National Symposium on the Applications of Psychology to the Teaching and Learning of Music held at Ann Arbor from October 30 to November 2, 1978. Sessions concerned auditory perception, motor learning, child development, memory and information processing, and affect and motivation. (SJL)

Non-random intrachromosomal distribution of radiation-induced chromatid aberrations in Vicia faba. [Aberration clustering

Energy Technology Data Exchange (ETDEWEB)

Schubert, I; Rieger, R [Akademie der Wissenschaften der DDR, Gatersleben. Zentralinst. fuer Genetik und Kulturpflanzenforschung

1976-04-01

A reconstructed karyotype of Vicia faba, with all chromosomes individually distinguishable, was treated with X-rays, fast neutrons, (/sup 3/H) uridine (/sup 3/HU). The distribution within metaphase chromosomes of induced chromatid aberrations was non-random for all agents used. Aberration clustering, in part agent specific, occurred in chromosome segments containing heterochromatin as defined by the presence of G bands. The pattern of aberration clustering found after treatment with /sup 3/HU did not allow the recognition of chromosome regions active in transcription during treatment. Furthermore, it was impossible to obtain unambiguous indications of the presence of AT- and GC-base clusters from the patterns of /sup 3/HT- and /sup 3/HC-induced chromatid aberrations, respectively. Possible reasons underlying these observations are discussed.

SUCCESS RATE OF ONE SESSION AND TWO SESSION TECHNIQUES FOR TREATMENT OF ASYMPTOMATIC PULPITIS OF PRIMARY TEETH WITH INDIRECT PULP CAPPING.

Directory of Open Access Journals (Sweden)

Rossitza Kabaktchieva

2013-01-01

Full Text Available Objective: Objective: To compare the success rate between the one session and two session indirect pulp capping of asymptomatic pulpitis for 1 year after the treatment was performed in children with different caries risk. Material and Methods: The children and the teeth were selected according to certain criteria for inclusion in the study. According to that, 72 children with low, moderate and high caries risk were included and 131 teeth with asymptomatic pulpitis were treated. The clinical protocols for indirect pulp capping (IPC in one session and two sessions were defined. The review appointments were performed 6 and 12 months after the treatment using certain clinical and radiographic criteria which defined success or post-treatment complications. The results are statistically analysed using One Sided Exact Two-Proportion Test with 95% Significance level (5% risk of type I error. Results: The statistical test showed that between the compared success rates of the one session and two sessions IPC, on the 6th and 12th month, there wasn’t a significant difference (p>0.05. This was valid for every one of the examined groups of patients (p>0. 05. This proves that there is no difference in the success rates of treatment of pulpitis in primary teeth using one or two sessions. Conclusions: The results about the success of treatment of asymptomatic pulpitis in primary teeth during one or two sessions have confirmed the results showed in other current studies. Our study has confirmed (clinically and radiographically the success of both techniques and we have concluded that in children with high caries risk, more appropriate technique is the one performed in two sessions. Treatment in one session is recommended in children with low or moderate caries risk.

Occupational Therapy and Physiotherapy in Acute Stroke: Do Rural Patients Receive Less Therapy?

Directory of Open Access Journals (Sweden)

Josie Merchant

2016-01-01

Full Text Available Objective. To assess whether acute stroke patients in rural hospitals receive less occupational therapy and physiotherapy than those in metropolitan hospitals. Design. Retrospective case-control study of health data in patients ≤10 days after stroke. Setting. Occupational therapy and physiotherapy services in four rural hospitals and one metropolitan hospital. Participants. Acute stroke patients admitted in one health district. Main Outcome Measures. Frequency and duration of face-to-face and indirect therapy sessions. Results. Rural hospitals admitted 363 patients and metropolitan hospital admitted 378 patients. Mean age was 73 years. Those in rural hospitals received more face-to-face (p>0.0014 and indirect (p=0.001 occupational therapy when compared to those in the metropolitan hospital. Face-to-face sessions lasted longer (p=0.001. Patients admitted to the metropolitan hospital received more face-to-face (p>0.000 and indirect (p>0.000 physiotherapy when compared to those admitted to rural hospitals. Face-to-face sessions were shorter (p>0.000. Almost all were seen within 24 hours of referral. Conclusions. Acute stroke patients in Australian rural hospital may receive more occupational therapy and less physiotherapy than those in metropolitan hospitals. The dose of therapy was lower than recommended, and the referral process may unnecessarily delay the time from admission to a patient’s first therapy session.

Positioning hospitals for improved access to capital.

Science.gov (United States)

Ponton, Kevin T; Sandrick, Karen M

2002-11-01

Hospitals need to actively position themselves in the next 18 to 24 months to ensure continued access to financing. Hospitals need to shift their focus from investment income to operations. Hospitals should recognize the importance of balance-sheet liquidity to institutional investors. Not-for-profit hospitals should focus on both sides of the balance sheet. Healthcare executives need to develop effective leadership and investor-relations skills.

Offender and offense characteristics of a nonrandom sample of mass murderers.

Science.gov (United States)

Hempel, A G; Meloy, J R; Richards, T C

1999-01-01

A nonrandom sample (N = 30) of mass murderers in the United States and Canada during the past 50 years was studied. Data suggest that such individuals are single or divorced males in their fourth decade of life with various Axis I paranoid and/or depressive conditions and Axis II personality traits and disorders, usually Clusters A and B. The mass murder is precipitated by a major loss related to employment or relationship. A warrior mentality suffuses the planning and attack behavior of the subject, and greater deaths and higher casualty rates are significantly more likely if the perpetrator is psychotic at the time of the offense. Alcohol plays a very minor role. A large proportion of subjects will convey their central motivation in a psychological abstract, a phrase or sentence yelled with great emotion at the beginning of the mass murder; but in our study sample, only 20 percent directly threatened their victims before the offense. Death by suicide or at the hands of others is the usual outcome for the mass murderer.

Summary of southeastern group breakout sessions

Science.gov (United States)

Bob Ford; Charles P. Nicholson

1993-01-01

The breakout sessions held by the southeastern representatives at the Partners In Flight meeting in Colorado were extremely well attended Most states were represented, as well as several federal agencies (including USFS, USFWS, TVA, EPA), and non-government organizations. Two sessions were held, one to discuss a strategy of management by...

[Effect of maximum blood pressure fluctuation on prognosis of patients with acute ischemic stroke within 24 hours after hospital admission].

Science.gov (United States)

Wang, H; Tang, Y; Zhang, Y; Xu, K; Zhao, J B

2018-05-10

Objective: To investigate the relationship between the maximum blood pressure fluctuation within 24 hours after admission and the prognosis at discharge. Methods: The patients with ischemic stroke admitted in Department of Neurology of the First Affiliated Hospital of Harbin Medical University within 24 hours after onset were consecutively selected from April 2016 to March 2017. The patients were grouped according to the diagnostic criteria of hypertension. Ambulatory blood pressure of the patients within 24 hours after admission were measured with bedside monitors and baseline data were collected. The patients were scored by NIHSS at discharge. The relationships between the maximum values of systolic blood pressure (SBP) or diastolic blood pressure (DBP) and the prognosis at discharge were analyzed. Results: A total of 521 patients with acute ischemic stroke were enrolled. They were divided into normal blood pressure group (82 cases) and hypertension group(439 cases). In normal blood pressure group, the maximum values of SBP and DBP were all in normal distribution ( P >0.05). The maximum value of SBP fluctuation was set at 146.6 mmHg. After adjustment for potential confounders, the OR for poor prognosis at discharge in patients with SBP fluctuation ≥146.6 mmHg was 2.669 (95 %CI : 0.594-11.992) compared with those with SBP fluctuation blood pressure at admission, the maximum values of SBP and DBP within 24 hours after admission had no relationship with prognosis at discharge. In acute ischemic stroke patients with hypertension at admission, the maximum values of SBP and DBP within 24 hours after admission were associated with poor prognosis at discharge.

Session Introduction

Science.gov (United States)

Eliane Lessner, Co-Chair:

2009-03-01

A panel discussion session providing a worldwide assessment of the status and experiences of women in physics, paying attention to the different cultures and environments they work in and to how the age of the physicist affects their perspective. We will hear about women physicists in Korea in particular and Asia in general, in Egypt in particular and Africa in general, and in the Caribbean. Six invited speakers will present analyses of the progress being made in promoting women in physics from their personal experiences and as assessed from their participation in the Third International Conference on Women In Physics (ICWIP2008) convened in Seoul, Korea in October 2008. From Albania to Zimbabwe, with representation of all the continents, ICWIP2008 congregated 283 women and men physicists from 57 countries to share the participants' scientific accomplishments and evaluate international progress in improving the status of women in physics. This three-hour session is organized jointly by the Committee on the Status of Women in Physics of the APS (CSWP) and the Forum on International Physics of the APS (FIP). Audience participation in the panel discussion will be strongly encouraged.

Topical Session on Materials Management

International Nuclear Information System (INIS)

2002-01-01

At its second meeting, in Paris, 5-7 December 2001, the WPDD held two topical sessions on the D and D Safety Case and on the Management of Materials from D and D, respectively. This report documents the topical session on the management of materials. Presentations during the topical session covered key aspects of the management of materials and meant to provide an exchange of information and experience, including: Experience and lessons learnt from VLLW and non-radioactive material management in Spain and Germany with special attention to recycling (How specific solutions came about? Are there 'generic' examples for wider adoption?); Risk assessment of recycling and non-recycling: a CPD study; Waste acceptance issues within different national contexts (What constraints are there on the waste receiving body and what flexibility can the latter have? What constraints does this impose on D and D implementers? What about wastes are without current solution? What needs to be done? What about large items and 'difficult' waste in general?); Radiological characterisation of materials during decommissioning, particularly difficult situations - large volumes, large items,.. wastes, heterogeneous streams (What examples of established practice? What are the approaches or aspects that set the regulatory requirements? How can the flow rates be large but the answers acceptable? How much is needed to be known for later action, e. g., disposal, release, protection of worker, etc.); Radiological characterisation of buildings as they stand, in order to allow conventional demolition (What are strategies for optimisation of characterisation? How much needs to be known to take action later? e.g. for storage, disposal, release, cost estimation and ALARA? What needs to be done in advance and after decommissioning/dismantling?). At the end of each presentation time was allotted for discussion of the paper. Integral to the Topical Session was a facilitated plenary discussion on the topical

Basic life support knowledge, self-reported skills and fears in Danish high school students and effect of a single 45-min training session run by junior doctors; a prospective cohort study

DEFF Research Database (Denmark)

Aaberg, Anne Marie Roust; Larsen, Caroline Emilie Brenner; Rasmussen, Bodil Steen

2014-01-01

BACKGROUND: Early recognition and immediate bystander cardiopulmonary resuscitation are critical determinants of survival after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate current knowledge on basic life support (BLS) in Danish high school students and benefits of a single...... training session run by junior doctors. METHODS: Six-hundred-fifty-one students were included. They underwent one 45-minute BLS training session including theoretical aspects and hands-on training with mannequins. The students completed a baseline questionnaire before the training session and a follow...... areas of BLS is poor among high school students. One hands-on training session run by junior doctors seems to be efficient to empower the students to be first responders to OHCA....

The impact of compliant surfaces on in-hospital chest compressions: effects of common mattresses and a backboard.

NARCIS (Netherlands)

Noordergraaf, G.J.; Paulussen, I.W.; Venema, A.; Berkom, P.F. van; Woerlee, P.H.; Scheffer, G.J.; Noordergraaf, A.

2009-01-01

PURPOSE: To evaluate, in a hospital setting, the influence of different, common mattresses, with and without a backboard, on chest movement during CPR. DESIGN AND SETTING: Sixty CPR sessions (140s each, 30:2, C:R ratio 1:1) were performed using a manikin on standard hospital mattresses, with or

Session 8: biofuels; Session 8: Les biocarburants

Energy Technology Data Exchange (ETDEWEB)

Botte, J.M.

2006-01-15

Here are given the summaries of the speeches of Mr Daniel Le Breton (Total): the transports of the future: the role of biofuels; of Mr Pierre Rouveirolles (Renault): the future expectations and needs; of Mr Frederic Monot (IFP): the developments of new generations of biofuels from biomass; of Mr Willem Jan Laan (Unilever): the use of bio resources for food and fuel: a fair competition? All these speeches have been presented at the AFTP yearly days (12-13 october 2005) on the session 8 concerning the biofuels. (O.M.)

Non-random alkylation of DNA sequences induced in vivo by chemical mutagens

Energy Technology Data Exchange (ETDEWEB)

Durante, M.; Geri, C.; Bonatti, S.; Parenti, R. (Universita di Pisa (Italy))

1989-08-01

Previous studies of the interaction of alkylating agents on the eukaryotic genome support the idea that induction of DNA adducts is at specific genomic sites. Here we show molecular and cytological evidence that alkylation is rather specific. Mammalian cell cultures were exposed to different doses of mutagens and the DNA was analyzed by density gradient ultracentrifugation, hydroxylapatite fractionation, and by restriction enzyme analysis. Studies with the labelled mutagens N-ethyl-N-nitrosourea and N-methyl-N'-nitro-N-nitrosoguanidine show that there is a non-random distribution of the adducts. The adducts are found more frequently in A-T, G-C rich satellite DNA and highly repetitive sequences. Analysis with restriction enzymes shows that both methyl and ethyl groups influence the restriction patterns of the enzymes HpaII and MspI that recognize specific endogenous DNA methylation. These data suggest, as a subsequent mechanism, a modification in the pattern of the normal endogenous methylation of 5-methylcytosine.

Asynchronous Session Types – Exceptions and Multiparty Interactions

DEFF Research Database (Denmark)

Carbone, Marco; Yoshida, Nobuko; Honda, Kohei

2009-01-01

Session types are a formalism for structuring communication based on the notion of session: the structure of a conversation is abstracted as a type which is then used as a basis of validating programs through an associated type discipline. While standard session types have proven to be able to ca...

Research on design of dialogue session concerning nuclear technology

International Nuclear Information System (INIS)

Karikawa, Daisuke; Takahashi, Makoto; Yagi, Ekou; Toba, Tae; Kitamura, Masaharu

2010-01-01

Toward resolving nuclear conflict, deep dialogue sessions among stakeholders having different opinions concerning nuclear technology are strongly required. In order to realize a fair and constructive dialogue session, it is necessary to pay attention to the design of the dialogue session, e.g., participant selection, agenda setting, facilitation, and rules of dialogue. The basic requirements for a dialogue session have been proposed in this study based on theoretical and empirical analyses of previous dialogue sessions on nuclear issues. The theoretical analysis has been performed based on various aspects concerning defects in nuclear communication mentioned in science and technology studies. The empirical analysis has been performed by analyzing participants' responses and by systematizing practical findings of previous dialogues. The proposed requirements for a dialogue session were utilized for the design and operation of a preliminary attempt of a dialogue session named 'Open Forum for Nuclear Communication.' Through the analysis of data, such as minutes and recorded conversations collected after the session, it has been confirmed that the prespecified requirements have been satisfied. In addition, the participants' responses have shown a high acceptance for an open forum. According to these results, the basic validity and effectiveness of the proposed requirements in the design of a dialogue session have been successfully demonstrated. (author)

Single-Session Transcranial Direct Current Stimulation Temporarily Improves Symptoms, Mood, and Self-Regulatory Control in Bulimia Nervosa: A Randomised Controlled Trial.

Directory of Open Access Journals (Sweden)

Maria Kekic

Full Text Available Evidence suggests that pathological eating behaviours in bulimia nervosa (BN are underpinned by alterations in reward processing and self-regulatory control, and by functional changes in neurocircuitry encompassing the dorsolateral prefrontal cortex (DLPFC. Manipulation of this region with transcranial direct current stimulation (tDCS may therefore alleviate symptoms of the disorder.This double-blind sham-controlled proof-of-principle trial investigated the effects of bilateral tDCS over the DLPFC in adults with BN.Thirty-nine participants (two males received three sessions of tDCS in a randomised and counterbalanced order: anode right/cathode left (AR/CL, anode left/cathode right (AL/CR, and sham. A battery of psychological/neurocognitive measures was completed before and after each session and the frequency of bulimic behaviours during the following 24-hours was recorded.AR/CL tDCS reduced eating disorder cognitions (indexed by the Mizes Eating Disorder Cognitions Questionnaire-Revised when compared to AL/CR and sham tDCS. Both active conditions suppressed the self-reported urge to binge-eat and increased self-regulatory control during a temporal discounting task. Compared to sham stimulation, mood (assessed with the Profile of Mood States improved after AR/CL but not AL/CR tDCS. Lastly, the three tDCS sessions had comparable effects on the wanting/liking of food and on bulimic behaviours during the 24 hours post-stimulation.These data suggest that single-session tDCS transiently improves symptoms of BN. They also help to elucidate possible mechanisms of action and highlight the importance of selecting the optimal electrode montage. Multi-session trials are needed to determine whether tDCS has potential for development as a treatment for adult BN.

Intersections and Unions of Session Types

Directory of Open Access Journals (Sweden)

Coşku Acay

2017-02-01

Full Text Available Prior work has extended the deep, logical connection between the linear sequent calculus and session-typed message-passing concurrent computation with equi-recursive types and a natural notion of subtyping. In this paper, we extend this further by intersection and union types in order to express multiple behavioral properties of processes in a single type. We prove session fidelity and absence of deadlock and illustrate the expressive power of our system with some simple examples. We observe that we can represent internal and external choice by intersection and union, respectively, which was previously suggested by Padovani for a different language of session types motivated by operational rather than logical concerns.

Multiparty Session Types as Coherence Proofs

DEFF Research Database (Denmark)

Carbone, Marco; Montesi, Fabrizio; Schürmann, Carsten

2015-01-01

We propose a Curry-Howard correspondence between a language for programming multiparty sessions and a generalisation of Classical Linear Logic (CLL). In this framework, propositions correspond to the local behaviour of a participant in a multiparty session type, proofs to processes, and proof...... normalisation to executing communications. Our key contribution is generalising duality, from CLL, to a new notion of n-ary compatibility, called coherence. Building on coherence as a principle of compositionality, we generalise the cut rule of CLL to a new rule for composing many processes communicating...... in a multiparty session. We prove the soundness of our model by showing the admissibility of our new rule, which entails deadlock-freedom via our correspondence....

Evaluation of a mock interview session on residency interview skills.

Science.gov (United States)

Buckley, Kelsey; Karr, Samantha; Nisly, Sarah A; Kelley, Kristi

2018-04-01

To evaluate the impact of student pharmacist participation in a mock interview session on confidence level and preparation regarding residency interview skills. The study setting was a mock interview session, held in conjunction with student programming at the American College of Clinical Pharmacy (ACCP) Annual Meeting. Prior to the mock interview session, final year student pharmacists seeking residency program placement were asked to complete a pre-session survey assessing confidence level for residency interviews. Each student pharmacist participated in up to three mock interviews. A post-session survey evaluating confidence level was then administered to consenting participants. Following the American Society for Health-System Pharmacists (ASHP) Pharmacy Resident Matching Program (RMP), a post-match electronic survey was sent to study participants to determine their perception of the influence of the mock interview session on achieving successful interactions during residency interviews. A total of 59 student pharmacists participated in the mock interview session and completed the pre-session survey. Participants completing the post-session survey (88%, n = 52) unanimously reported an enhanced confidence in interviewing skills following the session. Thirty responders reported a program match rate of 83%. Approximately 97% (n = 29) of the respondents agreed or strongly agreed that the questions asked during the mock interview session were reflective of questions asked during residency interviews. Lessons learned from this mock interview session can be applied to PGY1 residency mock interview sessions held locally, regionally, and nationally. Students participating in the ACCP Mock Interview Session recognized the importance of the interview component in obtaining a postgraduate year 1 (PGY1) pharmacy residency. Copyright © 2017 Elsevier Inc. All rights reserved.

Influence of training and competitive sessions on peripheral ?-endorphin levels in training show jumping horses

OpenAIRE

Cravana, Cristina; Medica, P.; Ragonese, G.; Fazio, E.

2017-01-01

Aim: To investigate the effects of training sessions on circulating ?-endorphin changes in sport horses before and after competition and to ascertain whether competition would affect this response. Materials and Methods: A total of 24 trained jumping horses were randomly assigned to one of two training groups: Group A (competing) and Group B (not competing). To determined plasma ?-endorphin concentrations, two pre- and post-competition training weeks at aerobic workout and two competitive sho...

A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study.

Science.gov (United States)

Patel, Manish V; Patel, Kalapi B; Gupta, Shivenarain; Michalsen, Andreas; Stapelfeldt, Elmar; Kessler, Christian S

2015-01-01

Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.

Personal best marathon time and longest training run, not anthropometry, predict performance in recreational 24-hour ultrarunners.

Science.gov (United States)

Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

2011-08-01

In recent studies, a relationship between both low body fat and low thicknesses of selected skinfolds has been demonstrated for running performance of distances from 100 m to the marathon but not in ultramarathon. We investigated the association of anthropometric and training characteristics with race performance in 63 male recreational ultrarunners in a 24-hour run using bi and multivariate analysis. The athletes achieved an average distance of 146.1 (43.1) km. In the bivariate analysis, body mass (r = -0.25), the sum of 9 skinfolds (r = -0.32), the sum of upper body skinfolds (r = -0.34), body fat percentage (r = -0.32), weekly kilometers ran (r = 0.31), longest training session before the 24-hour run (r = 0.56), and personal best marathon time (r = -0.58) were related to race performance. Stepwise multiple regression showed that both the longest training session before the 24-hour run (p = 0.0013) and the personal best marathon time (p = 0.0015) had the best correlation with race performance. Performance in these 24-hour runners may be predicted (r2 = 0.46) by the following equation: Performance in a 24-hour run, km) = 234.7 + 0.481 (longest training session before the 24-hour run, km) - 0.594 (personal best marathon time, minutes). For practical applications, training variables such as volume and intensity were associated with performance but not anthropometric variables. To achieve maximum kilometers in a 24-hour run, recreational ultrarunners should have a personal best marathon time of ∼3 hours 20 minutes and complete a long training run of ∼60 km before the race, whereas anthropometric characteristics such as low body fat or low skinfold thicknesses showed no association with performance.

A comparison of pre-dropout and temporary rupture sessions in psychotherapy.

Science.gov (United States)

Gülüm, I Volkan; Soygüt, Gonca; Safran, Jeremy D

2016-11-15

Although numerous studies have investigated the relationship between the therapeutic alliance and dropout, most have focused on the relationship between alliance quality and psychotherapy outcomes. To compare sessions with therapeutic alliance ruptures and two sessions prior to treatment dropout (pre-dropout) in terms of rupture subtypes, psychotherapists' behavior, attitudes, and session content. We implemented quantitative methods to select the sessions and qualitative methods to analyze them. We analyzed 16 temporary rupture sessions from 12 therapist-patient dyads and 16 pre-dropout sessions from 8 different therapist-patient dyads. The sessions originate from clinical psychology Master's or Doctoral students under supervision in either cognitive behavioral or schema therapy. Pre-dropout sessions were considered unrepaired rupture sessions while rupture sessions were subsequently repaired. Results revealed apparent differences and similarities between the session types in positive and negative psychotherapist behaviors, content intensity, and the type and frequency of ruptures. We explored three new rupture subtypes: attributing positive developments to other sources, indirect speech, and sarcastic hostility. A striking implication is that the frequency of positive and negative psychotherapist behaviors, ruptures, and session content is more likely to decrease in the pre-dropout sessions than in the temporary rupture sessions.

Influence of training and competitive sessions on peripheral β-endorphin levels in training show jumping horses.

Science.gov (United States)

Cravana, Cristina; Medica, P; Ragonese, G; Fazio, E

2017-01-01

To investigate the effects of training sessions on circulating β-endorphin changes in sport horses before and after competition and to ascertain whether competition would affect this response. A total of 24 trained jumping horses were randomly assigned to one of two training groups: Group A (competing) and Group B (not competing). To determined plasma β-endorphin concentrations, two pre- and post-competition training weeks at aerobic workout and two competitive show jumping event days at anaerobic workout were measured before, 5 and 30 min after exercise. Exercise intensity is described using lactate concentrations and heart rate. The circuit design, intensity, and duration of training sessions were the same for both groups. In Group A, one-way analysis of variance for repeated measures (RM-ANOVA) showed significant effects of exercise on β-endorphin changes (F=14.41; prelease of β-endorphin and it may depend on the duration of the exercise program. Moreover, the responses during exercise in the course of post-competition training sessions seem to be significantly different from those the pre-competition training. These data show that the preliminary competitive stress induced additional significant changes of β-endorphin pattern. It would reflect the need of a long-lasting modulation of fatigue and pain perception related to the effect of an additional physical and mental effort for the consecutive competitive and training sessions.

Transarterial embolisation of renal arteriovenous malformation: safety and efficacy in 24 patients with follow-up

International Nuclear Information System (INIS)

Eom, H.-J.; Shin, J.H.; Cho, Y.J.; Nam, D.H.; Ko, G.-Y.; Yoon, H.-K.

2015-01-01

Aim: To evaluate the efficacy and safety of renal artery embolisation (RAE) for renal arteriovenous malformation (AVM) as well as its outcomes. Materials and methods: The technical and clinical success rates, radiological and laboratory findings, and complications of RAE for 31 renal AVMs in 24 patients (M:F=9:15, mean age 46 years) at two separate medical institutions were retrospectively evaluated. Technical success was defined as complete occlusion of feeding arteries with no residual nidus seen on post-treatment angiography. Clinical failure was defined as recurrence of haematuria, presence of AVM on follow-up ultrasound or computed tomography, repeated RAE or surgery for the control of haematuria. Overall clinical success was defined as resolution haematuria or disappearance of AVM on follow-up imaging after single or multiple sessions of RAE. Results: Types of renal AVM were AVM, arterio-venous fistula (AVF) with intranidal aneurysm, and acquired AVF in 19, 1, and 4 patients, respectively. 18 patients (75%) underwent a single session of RAE, while 6 patients (25%) had two or more sessions of RAE. The level of embolisation was feeder, segmental artery, and main renal artery in 28 (90%), 2 (6%), and 1 (4%) procedures, respectively. Coil, n-butyl 2-cyanoacrylate, and polyvinyl alcohol were the most frequently chosen embolic materials and were used in 19, 14, and 8 procedures, respectively. The clinical success rate after initial RAE was 67% (16/24). Overall clinical success rate, including multisession RAE, was 88% (21/24). The technical success rate of 31 procedures was 65% (20/31). Among 11 technical failures in 10 patients, 4 achieved clinical success without additional RAE, 3 underwent second session RAE to achieve clinical success, and 3 patients underwent nephrectomy due to recurrence. Conclusion: RAE is a safe and effective treatment for renal AVM. Technical failure of RAE does not always lead to clinical failure and multiple embolisation sessions may be

Session 2: Availability

CERN Document Server

Uythoven, J

2012-01-01

This session concentrated on the main players affecting the availability of the LHC: the Quench Protection System (QPS), the cryogenics system, the regularly foreseen technical stops and the effect of radiation on equipment failures. A forecast for operation in 2012 was made for all these items.

Colonic stem cell data are consistent with the immortal model of stem cell division under non-random strand segregation.

Science.gov (United States)

Walters, K

2009-06-01

Colonic stem cells are thought to reside towards the base of crypts of the colon, but their numbers and proliferation mechanisms are not well characterized. A defining property of stem cells is that they are able to divide asymmetrically, but it is not known whether they always divide asymmetrically (immortal model) or whether there are occasional symmetrical divisions (stochastic model). By measuring diversity of methylation patterns in colon crypt samples, a recent study found evidence in favour of the stochastic model, assuming random segregation of stem cell DNA strands during cell division. Here, the effect of preferential segregation of the template strand is considered to be consistent with the 'immortal strand hypothesis', and explore the effect on conclusions of previously published results. For a sample of crypts, it is shown how, under the immortal model, to calculate mean and variance of the number of unique methylation patterns allowing for non-random strand segregation and compare them with those observed. The calculated mean and variance are consistent with an immortal model that incorporates non-random strand segregation for a range of stem cell numbers and levels of preferential strand segregation. Allowing for preferential strand segregation considerably alters previously published conclusions relating to stem cell numbers and turnover mechanisms. Evidence in favour of the stochastic model may not be as strong as previously thought.

Influence of training and competitive sessions on peripheral β-endorphin levels in training show jumping horses

Directory of Open Access Journals (Sweden)

Cristina Cravana

2017-01-01

Full Text Available Aim: To investigate the effects of training sessions on circulating β-endorphin changes in sport horses before and after competition and to ascertain whether competition would affect this response. Materials and Methods: A total of 24 trained jumping horses were randomly assigned to one of two training groups: Group A (competing and Group B (not competing. To determined plasma β-endorphin concentrations, two pre- and postcompetition training weeks at aerobic workout and two competitive show jumping event days at anaerobic workout were measured before, 5 and 30 min after exercise. Exercise intensity is described using lactate concentrations and heart rate. The circuit design, intensity, and duration of training sessions were the same for both groups. Results: In Group A, one-way analysis of variance for repeated measures (RM-ANOVA showed significant effects of exercise on β-endorphin changes (F=14.41; p<0.001, only in the post-competition training sessions, while in Group B showed no significant effects. Two-way RM-ANOVA showed, after post-competition training sessions, a significant difference between Group A and Group B (F=6.235; p=0.023, with higher β-endorphin changes in Group A, compared to Group B. During the competitive show jumping sessions, one-way RM ANOVA showed significant effects of exercise on β-endorphin changes (F=51.10; p<0.001. The statistical analysis, in Group A, showed a significant difference between postcompetition training and competitive exercise (F=6.32; p=0.024 with higher β-endorphin values in competitive sessions compared to those of post-competition training. Conclusion: Lactate concentrations seem to be the main factors being correlated with the raise of β-endorphin during anaerobic exercise of competitive events. Exercise of low intensity, as well as that one of training sessions, does not appear to stimulate a significant increased release of β-endorphin and it may depend on the duration of the exercise

O PAPEL DE DUAS SESSÕES EXTENUANTES COM DIFERENTES INTERVALOS ENTRE AS SESSÕES – 24 e 48 HORAS – E O EFEITO PROTETOR DA CARGA

Directory of Open Access Journals (Sweden)

Rodrigo Bergome Muniz

2014-02-01

Full Text Available It is reported that a single session of resistance exercise provides to our bodies with an adaptation of shape subsequent exercises do not have the same effect stressful. Objective: To evaluate the repeated bout effect in exercise sessions with different intervals after a week of the first session. Materials and Methods: 14 men (18 to 30 years engaged in strength training for a minimum of 6 months were divided into two groups A and B. The participants performed five sets, maximum repetitions with two minutes of rest between sets at 85% 1RM in biceps curl exercise unilateral Scott on the bench with the non-dominant arm. The second training session was performed 24 h later, for group A, and 48 hours later for group B. Blood samples were collected in pre measures, 24h, 48h, 72h and 96h, arm girth measurements, range of motion in flexion and extension, and measures of subjective perception of pain on palpation and by extension, before and after exercise every day of the tests. Results: When the first two exercise sessions were performed with shorter rest intervals (24 hours due to increased pain sensation, maintaining range of motion and reduced activity for longer serum CK higher. Conclusion: Exercises with short intervals (24 hours may modulate the repeated bout effect increasing the values of physiological variables and significant reductions in joint range of motion.

Mitochondrial Respiration after One Session of Calf Raise Exercise in Patients with Peripheral Vascular Disease and Healthy Older Adults.

Science.gov (United States)

van Schaardenburgh, Michel; Wohlwend, Martin; Rognmo, Øivind; Mattsson, Erney J R

2016-01-01

Mitochondria are essential for energy production in the muscle cell and for this they are dependent upon a sufficient supply of oxygen by the circulation. Exercise training has shown to be a potent stimulus for physiological adaptations and mitochondria play a central role. Whether changes in mitochondrial respiration are seen after exercise in patients with a reduced circulation is unknown. The aim of the study was to evaluate the time course and whether one session of calf raise exercise stimulates mitochondrial respiration in the calf muscle of patients with peripheral vascular disease. One group of patients with peripheral vascular disease (n = 11) and one group of healthy older adults (n = 11) were included. Patients performed one session of continuous calf raises followed by 5 extra repetitions after initiation of pain. Healthy older adults performed 100 continuous calf raises. Gastrocnemius muscle biopsies were collected at baseline and 15 minutes, one hour, three hours and 24 hours after one session of calf raise exercise. A multi substrate (octanoylcarnitine, malate, adp, glutamate, succinate, FCCP, rotenone) approach was used to analyze mitochondrial respiration in permeabilized fibers. Mixed-linear model for repeated measures was used for statistical analyses. Patients with peripheral vascular disease have a lower baseline respiration supported by complex I and they increase respiration supported by complex II at one hour post-exercise. Healthy older adults increase respiration supported by electron transfer flavoprotein and complex I at one hour and 24 hours post-exercise. Our results indicate a shift towards mitochondrial respiration supported by complex II as being a pathophysiological component of peripheral vascular disease. Furthermore exercise stimulates mitochondrial respiration already after one session of calf raise exercise in patients with peripheral vascular disease and healthy older adults. ClinicalTrials.gov NCT01842412.

Informal caregivers in hospitals: Opportunities and threats.

Science.gov (United States)

Amiresmaili, Mohammadreza; Emrani, Zahra

2018-05-20

High hospital costs are a challenge that health system face. Additionally, studies identified manpower deficiency as a problem in health system. Hospital is a place where patients with different physical and mental conditions come to. Their families and friends' companionship can facilitate this situation for them. This study illustrates the roles of informal caregivers in hospital. This is a phenomenological qualitative study. Data were gathered through semistructured interviews. We interviewed 22 informal caregivers and 9 nurse staffs from different departments of hospital. They were selected through purposeful and snowball sampling approach. The framework method was used for data analysis. We found 3 main themes including (a) roles of informal caregivers, (b) opportunities of presence of the informal caregivers in the hospital, and (c) threats of presence of informal caregivers. This study shows some roles for informal caregivers including mental supports, consultation, decision-making, and care roles. Concerning the shortage of manpower in Iran's hospitals, nurses have less time to take care of each patient; therefore, using informal caregivers as an implicit strategy to overcome nursing shortage and to reduce hospital costs seems to be beneficial. We suggest that an appropriate plan is necessary to make use of them for filling this gap to some extent, as well as providing training sessions and facilities for companions acting as informal caregivers. Copyright © 2018 John Wiley & Sons, Ltd.

Rural versus urban academic hospital mortality following stroke in Canada.

Science.gov (United States)

Fleet, Richard; Bussières, Sylvain; Tounkara, Fatoumata Korika; Turcotte, Stéphane; Légaré, France; Plant, Jeff; Poitras, Julien; Archambault, Patrick M; Dupuis, Gilles

2018-01-01

Stroke is one of the leading causes of death in Canada. While stroke care has improved dramatically over the last decade, outcomes following stroke among patients treated in rural hospitals have not yet been reported in Canada. To describe variation in 30-day post-stroke in-hospital mortality rates between rural and urban academic hospitals in Canada. We also examined 24/7 in-hospital access to CT scanners and selected services in rural hospitals. We included Canadian Institute for Health Information (CIHI) data on adjusted 30-day in-hospital mortality following stroke from 2007 to 2011 for all acute care hospitals in Canada excluding Quebec and the Territories. We categorized rural hospitals as those located in rural small towns providing 24/7 emergency physician coverage with inpatient beds. Urban hospitals were academic centres designated as Level 1 or 2 trauma centres. We computed descriptive data on local access to a CT scanner and other services and compared mean 30-day adjusted post-stroke mortality rates for rural and urban hospitals to the overall Canadian rate. A total of 286 rural hospitals (3.4 million emergency department (ED) visits/year) and 24 urban hospitals (1.5 million ED visits/year) met inclusion criteria. From 2007 to 2011, 30-day in-hospital mortality rates following stroke were significantly higher in rural than in urban hospitals and higher than the Canadian average for every year except 2008 (rural average range = 18.26 to 21.04 and urban average range = 14.11 to 16.78). Only 11% of rural hospitals had a CT-scanner, 1% had MRI, 21% had in-hospital ICU, 94% had laboratory and 92% had basic x-ray facilities. Rural hospitals in Canada had higher 30-day in-hospital mortality rates following stroke than urban academic hospitals and the Canadian average. Rural hospitals also have very limited local access to CT scanners and ICUs. These rural/urban discrepancies are cause for concern in the context of Canada's universal health care system.

Session 7: Reserve

International Nuclear Information System (INIS)

Bailey, R.; Crockford, G.

2001-01-01

The reserve session was devoted to some issues that came up through the workshop, which were grouped into three main areas: The Global Accelerator Network, Problems of stress and how to get organized to minimize them, What should an operations group be responsible for? This paper summarizes the discussions that took place. (author)

Group versus individual sessions delivered by a physiotherapist for female urinary incontinence: an interview study with women attending group sessions nested within a randomised controlled trial

Directory of Open Access Journals (Sweden)

Smith Jan

2009-09-01

Full Text Available Abstract Background The aim was to explore the concerns and expectations of women invited to attend group physiotherapy sessions for the management of female urinary incontinence and whether the experience changed their views; and to gather recommendations from women attending group sessions on the design and delivery of these sessions Methods An interview study nested within a randomised controlled trial in five British NHS physiotherapy departments, including 22 women who had expressed a preference for an individual physiotherapy session but were randomised to, and attended, group sessions. Results Embarrassment was woven throughout women's accounts of experiencing urinary incontinence and seeking health care. Uncertainty about the nature of group sessions was a source of concern. Attending the first session was seen as a big hurdle by many women. However, a sense of relief was common once the session started, with most women describing some benefit from attendance. Recommendations for design and delivery of the sessions from women focused on reducing embarrassment and uncertainty prior to attendance. Conclusion Taking account of women's embarrassment and providing detailed information about the content of group sessions will enable women to benefit from group physiotherapy sessions for the management of female urinary incontinence. Trial Registration Trial registration number: ISRCTN 16772662

An Erlang Implementation of Multiparty Session Actors

Directory of Open Access Journals (Sweden)

Simon Fowler

2016-08-01

Full Text Available By requiring co-ordination to take place using explicit message passing instead of relying on shared memory, actor-based programming languages have been shown to be effective tools for building reliable and fault-tolerant distributed systems. Although naturally communication-centric, communication patterns in actor-based applications remain informally specified, meaning that errors in communication are detected late, if at all. Multiparty session types are a formalism to describe, at a global level, the interactions between multiple communicating entities. This article describes the implementation of a prototype framework for monitoring Erlang/OTP gen_server applications against multiparty session types, showing how previous work on multiparty session actors can be adapted to a purely actor-based language, and how monitor violations and termination of session participants can be reported in line with the Erlang mantra of "let it fail". Finally, the framework is used to implement two case studies: an adaptation of a freely-available DNS server, and a chat server.

Case-based learning and simulation: useful tools to enhance nurses' education? Nonrandomized controlled trial.

Science.gov (United States)

Raurell-Torredà, Marta; Olivet-Pujol, Josep; Romero-Collado, Àngel; Malagon-Aguilera, Maria Carmen; Patiño-Masó, Josefina; Baltasar-Bagué, Alícia

2015-01-01

To compare skills acquired by undergraduate nursing students enrolled in a medical-surgical course. To compare skills demonstrated by students with no previous clinical practice (undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE). In a nonrandomized clinical trial, 101 undergraduates enrolled in the "Adult Patients 1" course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case-based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes. Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test). Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, -1.2 [95% confidence interval (CI) -2.4 to -0.03]) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, -1.3 [95% CI -2.6 to 0.04]). The CPE nurses committed more "rules-based errors" than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1). The intervention group developed better patient assessment skills than the control group. Case-based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols. Case-based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice. © 2014 Sigma Theta Tau International.

Nigerian Quarterly Journal of Hospital Medicine - Vol 24, No 2 (2014)

African Journals Online (AJOL)

Pattern of tooth replacement and colour choice among patients in a Nigerian teaching hospital · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. OA Oremosu, DC Umesi, OH Savage, 169-174 ...

NSSS vendors session

International Nuclear Information System (INIS)

Anon.

1982-01-01

A transcription of a question and answer session at the 1982 Nuclear Commerce Conference was presented. Standardization of nuclear power plant design, and the effects it would have on Nuclear Regulatory Commission licensing and regulations, was of particular interest. Forecasts of the demand for nuclear power for the rest of this country were also discussed

Translocation 1;7 in dyshematopoiesis: possibly induced with a nonrandom geographic distribution

International Nuclear Information System (INIS)

Scheres, J.M.; Hustinx, T.W.; Holdrinet, R.S.; Geraedts, J.P.; Hagemeijer, A.; van der Blij-Philipsen, M.

1984-01-01

Eight patients with various hematologic disorders had an identical chromosomal aberration in their bone marrow or unstimulated peripheral blood, a translocation t(1;7) interpreted as t(1;7)(p11;p11). The translocation chromosome replaced one normal chromosome number7; therefore, the karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Including four cases from the literature, a total of 12 patients (4 women, 8 men) with this translocation are known at the moment. The translocation does not seem to be associated with a specific disorder, but almost all patients had a preleukemic syndrome during some stage of their disease. It is very remarkable that 11 of the 12 patients lived in the Netherlands, and 7 patients had a history of iatrogenic exposure to alkylating agents or irradiation; one patient was a radiation worker and another one had a history of toxic exposure to chloramphenicol. It is suggested, therefore, that the t(1;7) is a possibly induced chromosomal aberration with a clearly nonrandom geographic distribution

Additive Complex Ayurvedic Treatment in Patients with Fibromyalgia Syndrome Compared to Conventional Standard Care Alone: A Nonrandomized Controlled Clinical Pilot Study (KAFA Trial

Directory of Open Access Journals (Sweden)

Christian S. Kessler

2013-01-01

Full Text Available Background. Fibromyalgia (FMS is a challenging condition for health care systems worldwide. Only limited trial data is available for FMS for outcomes of complex treatment interventions of complementary and integrative (CIM approaches. Methods. We conducted a controlled, nonrandomized feasibility study that compared outcomes in 21 patients treated with Ayurveda with those of 11 patients treated with a conventional approach at the end of a two-week inpatient hospital stay. Primary outcome was the impact of fibromyalgia on patients as assessed by the FIQ. Secondary outcomes included scores of pain intensity, pain perception, depression, anxiety, and quality of sleep. Follow-up assessments were done after 6 months. Results. At 2 weeks, there were comparable and significant improvements in the FIQ and for most of secondary outcomes in both groups with no significant in-between-group differences. The beneficial effects for both treatment groups were partly maintained for the main outcome and a number of secondary outcomes at the 6-month followup, again with no significant in-between-group differences. Discussion. The findings of this feasibility study suggest that Ayurvedic therapy is noninferior to conventional treatment in patients with severe FMS. Since Ayurveda was only used as add-on treatment, RCTs on Ayurveda alone are warranted to increase model validity. This trial is registered with NCT01389336.

2,4-Dinitrophenol: A threat to Chinese body-conscious groups

Directory of Open Access Journals (Sweden)

Han Chih Hencher Lee

2014-08-01

Full Text Available 2,4-Dinitrophenol (2,4-DNP, a yellowish compound, has historically been used in the manufacture of dyes, explosives, and fungicides. As it uncouples mitochondrial oxidative phosphorylation, the compound was also used as an antiobesity agent early in the past century. The compound was subsequently banned by the United States Food and Drug Administration in 1938 due to its potentially fatal adverse effects, including hyperthermia, cataract, agranulocytosis, hepatoxicity, nephrotoxicity, and cardiotoxicity. However, the popularity of 2,4-DNP as a slimming aid has appeared to increase again in recent years. The Hong Kong Hospital Authority Toxicology Reference Laboratory recently confirmed two cases of self-administered 2,4-DNP with different clinical presentations to hospitals in the area. Here we describe those two cases, in an attempt to underscore the potential of misuse of this substance by body-conscious groups among the Chinese population.

[Historical origins between National Medical Association of China and Boji Hospital in Guangzhou].

Science.gov (United States)

Liu, Pinming

2015-09-01

In 2015, National Medical Association of China, now being called the Chinese Medical Association, celebrates its centennial and Boji Hospital in Guangzhou ( also known as Canton Hospital, or the Canton Pok Tsai Hospital, and now Sun Yat-sen Memorial Hospital of Sun Yat-sen University ) marks its 180th anniversary. Three major historical events establish the role of Boji Hospital in the founding and development of the National Medical Association of China during the last 100 years, viz.: ①hosting and participating in the establishment of the Medical Missionary Association of China and its official journal: the China Medical Missionary Journal; ②holding the 11th scientific sessions of the National Medical Association of China; ③nominating Dr. Wu Lien-teh as a candidate for the Nobel Prize in Physiology or Medicine in 1935 by William Warder Cadbury, the president of Boji Hospital.

Telemedicine in Majuro Hospital, Marshall Islands.

Science.gov (United States)

Gunawardane, K J

2000-09-01

Since March 1998 up to June 2000, telemedicine activities in Marshall Islands have mainly been for Referrals to Tripler Army Medical Center (TAMC) in Hawaii. The activities are based on a computer which has the Internet connection and accessories including a digital camera, flatbed scanner with a transparency adapter, color printer, a video printer, ophthalmoscope, otoscope and a video Lens, all of which were donated by Project Akamai in Hawaii. Two sessions of training were conducted by representatives from Akamai Project and from PBMA at the very beginning of the establishment of the unit, to all levels of Health Care Providers in Ministry of Health in Majuro. The computer and Internet facility is available 24 hours. Since March 1998 to June 2000, there had been 144 telemedicine consultations to TAMC. Out of a total of 326 off-island referrals for the same period, approximately 80 patients have been sent to TAMC using the PIHCP/Telemedicine program. This accounts for approximately 25% of total off-island referrals. This represents a significant reduction in cost. In addition to cost reduction the telemedicine unit most important impact is on the health providers, especially the physicians working at Majuro Hospital. Availability of medical information through internet has helped them to feel less isolated from the constantly changing field of medical science.

The effects of session length on demand functions generated using FR schedules.

Science.gov (United States)

Foster, T Mary; Kinloch, Jennifer; Poling, Alan

2011-05-01

In comparing open and closed economies, researchers often arrange shorter sessions under the former condition than under the latter. Several studies indicate that session length per se can affect performance and there are some data that indicate that this variable can influence demand functions. To provide further data, the present study exposed domestic hens to series of increasing fixed-ratio schedules with the length of the open-economy sessions varied over 10, 40, 60, and 120 min. Session time affected the total-session response rates and pause lengths. The shortest session gave the greatest response rates and shortest pauses and the longest gave the lowest response rates and longest pauses. The total-session demand functions also changed with session length: The shortest session gave steeper initial slopes (i.e., the functions were more elastic at small ratios) and smaller rates of change of elasticity than the longest session. Response rates, pauses, and demand functions were, however, similar for equivalent periods of responding taken from within sessions of different overall lengths (e.g., total-session data for 10-min sessions and the data for the first 10 min of 120-min sessions). These findings suggest that differences in session length can confound the results of studies comparing open and closed economies when those economies are arranged in sessions that differ substantially in length, hence data for equivalent-length periods of responding, rather than total-session data, should be of primary interest under these conditions.

A report on the UN special session on disarmament

International Nuclear Information System (INIS)

1978-01-01

Slow progress in disarmament led many of the United Nations Member States, particularly the non-aligned countries, to request the convening of a Special Session of the General Assembly Devoted to Disarmament. The idea of such a special session had evolved over the past few years as an alternative to a World Disarmament Conference and in contrast to the limited possibilities for discussion provided by a regular session of the General Assembly. A special session was perceived as offering the appropriate opportunity to discuss comprehensive disarmament in a practically universal forum The decision to hold the special session was taken by the General Assembly on 21 December 1976 by resolution 31/189 B, which also established a Preparatory Committee to examine all questions relevant to the special session. Fifty-four countries were appointed members of the Preparatory Committee, which met in five sessions. The United Nations Special Session on Disarmament (SSOD) was held in New York from May 23 to June 30, 1978. One hundred and forty-five nations attended and this was the first time since the Disarmament Conference of 1932 that virtually all countries of the world met to discuss all aspects of disarmament. The agenda for the SSOD included inter alia: a review and appraisal of the present international situation, the adoption of a Declaration on Disarmament, the adoption of a Programme of Action on Disarmament, a review of the role of the UN in disarmament and of the international machinery for negotiations on disarmament, including, in particular, the question of convening a world disarmament conference. The various proposals made at the sessions of the Preparatory Committee and at the SSOD itself were consolidated into one document. Consensus on this Final Document was reached on June 30, the concluding day of the session. The Final Document consists of three major parts: Declaration of Principles, Programme of Action and Disarmament Machinery

A randomised controlled trial of three or one breathing technique training sessions for breathlessness in people with malignant lung disease.

Science.gov (United States)

Johnson, Miriam J; Kanaan, Mona; Richardson, Gerry; Nabb, Samantha; Torgerson, David; English, Anne; Barton, Rachael; Booth, Sara

2015-09-07

About 90 % of patients with intra-thoracic malignancy experience breathlessness. Breathing training is helpful, but it is unknown whether repeated sessions are needed. The present study aims to test whether three sessions are better than one for breathlessness in this population. This is a multi-centre randomised controlled non-blinded parallel arm trial. Participants were allocated to three sessions or single (1:2 ratio) using central computer-generated block randomisation by an independent Trials Unit and stratified for centre. The setting was respiratory, oncology or palliative care clinics at eight UK centres. Inclusion criteria were people with intrathoracic cancer and refractory breathlessness, expected prognosis ≥3 months, and no prior experience of breathing training. The trial intervention was a complex breathlessness intervention (breathing training, anxiety management, relaxation, pacing, and prioritisation) delivered over three hour-long sessions at weekly intervals, or during a single hour-long session. The main primary outcome was worst breathlessness over the previous 24 hours ('worst'), by numerical rating scale (0 = none; 10 = worst imaginable). Our primary analysis was area under the curve (AUC) 'worst' from baseline to 4 weeks. All analyses were by intention to treat. Between April 2011 and October 2013, 156 consenting participants were randomised (52 three; 104 single). Overall, the 'worst' score reduced from 6.81 (SD, 1.89) to 5.84 (2.39). Primary analysis [n = 124 (79 %)], showed no between-arm difference in the AUC: three sessions 22.86 (7.12) vs single session 22.58 (7.10); P value = 0.83); mean difference 0.2, 95 % CIs (-2.31 to 2.97). Complete case analysis showed a non-significant reduction in QALYs with three sessions (mean difference -0.006, 95 % CIs -0.018 to 0.006). Sensitivity analyses found similar results. The probability of the single session being cost-effective (threshold value of £20,000 per QALY) was over 80 %. There was no

Temporal Patterns of In-Hospital Falls of Elderly Patients.

Science.gov (United States)

López-Soto, Pablo J; Smolensky, Michael H; Sackett-Lundeen, Linda L; De Giorgi, Alfredo; Rodríguez-Borrego, María A; Manfredini, Roberto; Pelati, Cristiano; Fabbian, Fabio

A potentially important factor yet to receive adequate study is the time when hospital falls occur. A prior study conducted before the system-wide introduction of preventive measures revealed a biphasic 24-hour pattern of hospital falls with major peak in the morning. The purpose was to identify the temporal patterning of falls among elderly patients in hospitals with comprehensive fall prevention programs in place. A 4-year observational study was conducted by the local health authority in the five nonteaching public hospitals located in the province of Ferrara, Italy. Fall records involving patients of ages ≥65 years hospitalized in the general medical departments were used. Single- and multiple-component cosinor (time series) analyses were used to explore 24-hour, weekly, and annual patterns of falls. A total of 763 falls were experienced by 709 different elderly hospitalized patients. Falls typically took place in the patient's hospital room (72%) and bathroom (23%). Major causes were patient instability (32%) and accident (13%), and most occurred when not wearing footwear (45%) or wearing inappropriate sling-back open-toe shoes (39%). Falls happened while standing (39%), while seated (21%), and while getting into, out of, or laying in bed (32%)-either with the bed rails raised or lowered. Fall outcome usually involved no injury (58%) or slight injury (35%), but some (7%) were disabling. Fall occurrence was higher during the night (46%) compared to either the morning (30%) or afternoon (24%) shift. Patterns across 24 hours were characterized by a single major and one or more minor peaks that seemed to be associated with a variety of scheduled patient, hospital, and nursing activities. Multiple-component cosinor analysis identified significant (p footwear. Falls were more frequent, but not significantly so, on Fridays, Sundays, and Mondays compared with Tuesdays, and were more frequent in winter and spring (p = .003). Documentation by cause and circumstance of

p15PAF is an intrinsically disordered protein with nonrandom structural preferences at sites of interaction with other proteins.

Science.gov (United States)

De Biasio, Alfredo; Ibáñez de Opakua, Alain; Cordeiro, Tiago N; Villate, Maider; Merino, Nekane; Sibille, Nathalie; Lelli, Moreno; Diercks, Tammo; Bernadó, Pau; Blanco, Francisco J

2014-02-18

We present to our knowledge the first structural characterization of the proliferating-cell-nuclear-antigen-associated factor p15(PAF), showing that it is monomeric and intrinsically disordered in solution but has nonrandom conformational preferences at sites of protein-protein interactions. p15(PAF) is a 12 kDa nuclear protein that acts as a regulator of DNA repair during DNA replication. The p15(PAF) gene is overexpressed in several types of human cancer. The nearly complete NMR backbone assignment of p15(PAF) allowed us to measure 86 N-H(N) residual dipolar couplings. Our residual dipolar coupling analysis reveals nonrandom conformational preferences in distinct regions, including the proliferating-cell-nuclear-antigen-interacting protein motif (PIP-box) and the KEN-box (recognized by the ubiquitin ligase that targets p15(PAF) for degradation). In accordance with these findings, analysis of the (15)N R2 relaxation rates shows a relatively reduced mobility for the residues in these regions. The agreement between the experimental small angle x-ray scattering curve of p15(PAF) and that computed from a statistical coil ensemble corrected for the presence of local secondary structural elements further validates our structural model for p15(PAF). The coincidence of these transiently structured regions with protein-protein interaction and posttranslational modification sites suggests a possible role for these structures as molecular recognition elements for p15(PAF). Copyright © 2014 Biophysical Society. Published by Elsevier Inc. All rights reserved.

A nonrandomized trial of vitamin D supplementation for Barrett's esophagus.

Directory of Open Access Journals (Sweden)

Linda C Cummings

Full Text Available Vitamin D deficiency may increase esophageal cancer risk. Vitamin D affects genes regulating proliferation, apoptosis, and differentiation and induces the tumor suppressor 15-hydroxyprostaglandin dehydrogenase (PGDH in other cancers. This nonrandomized interventional study assessed effects of vitamin D supplementation in Barrett's esophagus (BE. We hypothesized that vitamin D supplementation may have beneficial effects on gene expression including 15-PGDH in BE.BE subjects with low grade or no dysplasia received vitamin D3 (cholecalciferol 50,000 international units weekly plus a proton pump inhibitor for 12 weeks. Esophageal biopsies from normal plus metaplastic BE epithelium and blood samples were obtained before and after vitamin D supplementation. Serum 25-hydroxyvitamin D was measured to characterize vitamin D status. Esophageal gene expression was assessed using microarrays.18 study subjects were evaluated. The baseline mean serum 25-hydroxyvitamin D level was 27 ng/mL (normal ≥30 ng/mL. After vitamin D supplementation, 25-hydroxyvitamin D levels rose significantly (median increase of 31.6 ng/mL, p<0.001. There were no significant changes in gene expression from esophageal squamous or Barrett's epithelium including 15-PGDH after supplementation.BE subjects were vitamin D insufficient. Despite improved vitamin D status with supplementation, no significant alterations in gene expression profiles were noted. If vitamin D supplementation benefits BE, a longer duration or higher dose of supplementation may be needed.

Effect of cognitive behavioral group therapy for recovery of self-esteem on community-living individuals with mental illness: Non-randomized controlled trial.

Science.gov (United States)

Kunikata, Hiroko; Yoshinaga, Naoki; Nakajima, Kazuo

2016-10-01

The aim of this study was to examine over a 12-month post-intervention period whether the participation of community-living individuals with mental illness in cognitive behavioral group therapy for recovery of self-esteem (CBGTRS) resulted in improved outcomes. This was a non-randomized controlled trial. The participants were persons with mental illness who resided in communities in the Chugoku region of Japan. In total, 41 were assigned to an experimental group (CBGTRS intervention, 12 group sessions), and 21 to a control group. Outcome indices (self-esteem, moods, cognition, subjective well-being, psychiatric symptoms) were measured for the experimental group prior to intervention (T0), immediately post-intervention (T1), and at 3 (T2) and 12 (T3) months post-intervention. The control group was measured at the same intervals. For the experimental group, self-esteem scores at T1, T2, and T3 were significantly higher than at T0. Moods and cognition scores remained significantly low until T2. Scores for Inadequate Mental Mastery in the subjective well-being index had not decreased by T3. Confidence in Coping remained significantly high until T2. Psychiatric symptoms scores at T0, T1, T2, and T3 were significantly lower than at T0. The means and standard errors for self-esteem and Inadequate Mental Mastery increased until T3, and those for Tension-Anxiety, Depression-Dejection, and Confusion decreased until T2. From within-group trends and between-group differences in self-esteem, we conclude that CBGTRS may have a relatively long-term effect on self-esteem recovery. T2 is the turning point for moods and cognition; thus, follow-up is needed 3 months following the initial program. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

24 CFR 242.52 - Construction contracts.

Science.gov (United States)

2010-04-01

...; a construction management contract with a guaranteed maximum price, the final costs of which are... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Construction contracts. 242.52... MORTGAGE INSURANCE FOR HOSPITALS Construction § 242.52 Construction contracts. (a) Awarding of contract. A...

Psychophysiological Responses to Group Exercise Training Sessions: Does Exercise Intensity Matter?

Science.gov (United States)

Vandoni, Matteo; Codrons, Erwan; Marin, Luca; Correale, Luca; Bigliassi, Marcelo; Buzzachera, Cosme Franklim

2016-01-01

Group exercise training programs were introduced as a strategy for improving health and fitness and potentially reducing dropout rates. This study examined the psychophysiological responses to group exercise training sessions. Twenty-seven adults completed two group exercise training sessions of moderate and vigorous exercise intensities in a random and counterbalanced order. The %HRR and the exertional and arousal responses to vigorous session were higher than those during the moderate session (psession were less pleasant than those during moderate session (ptraining sessions are intensity-dependent. From an adherence perspective, interventionists are encouraged to emphasize group exercise training sessions at a moderate intensity to maximize affective responses and to minimize exertional responses, which in turn may positively affect future exercise behavior.

Adaptations to Short, Frequent Sessions of Endurance and Strength Training Are Similar to Longer, Less Frequent Exercise Sessions When the Total Volume Is the Same.

Science.gov (United States)

Kilen, Anders; Hjelvang, Line B; Dall, Niels; Kruse, Nanna L; Nordsborg, Nikolai B

2015-11-01

The hypothesis that the distribution of weekly training across several short sessions, as opposed to fewer longer sessions, enhances maximal strength gain without compromising maximal oxygen uptake was evaluated. Twenty-nine subjects completed an 8-week controlled parallel-group training intervention. One group ("micro training" [MI]: n = 21) performed nine 15-minute training sessions weekly, whereas a second group ("classical training" [CL]: n = 8) completed exactly the same training on a weekly basis but as three 45-minute sessions. For each group, each session comprised exclusively strength, high-intensity cardiovascular training or muscle endurance training. Both groups increased shuttle run performance (MI: 1,373 ± 133 m vs. 1,498 ± 126 m, p ≤ 0.05; CL: 1,074 ± 213 m vs. 1,451 ± 202 m, p training intervention. In conclusion, similar training adaptations can be obtained with short, frequent exercise sessions or longer, less frequent sessions where the total volume of weekly training performed is the same.

Summary of Session III

International Nuclear Information System (INIS)

Furman, M.A.

2002-01-01

This is a summary of the talks presented in Session III ''Simulations of Electron-Cloud Build Up'' of the Mini-Workshop on Electron-Cloud Simulations for Proton and Positron Beams ECLOUD-02, held at CERN, 15-18 April 2002

Innovative Software Algorithms and Tools parallel sessions summary

International Nuclear Information System (INIS)

Gaines, Irwin

2001-01-01

A variety of results were presented in the poster and 5 parallel sessions of the Innovative Software, Algorithms and Tools (ISAT) sessions. I will briefly summarize these presentations and attempt to identify some unifying trends

Added value of multiple versus single sessions of repetitive transcranial magnetic stimulation in predicting motor cortex stimulation efficacy for refractory neuropathic pain.

Science.gov (United States)

Pommier, Benjamin; Quesada, Charles; Fauchon, Camille; Nuti, Christophe; Vassal, François; Peyron, Roland

2018-05-18

OBJECTIVE Selection criteria for offering patients motor cortex stimulation (MCS) for refractory neuropathic pain are a critical topic of research. A single session of repetitive transcranial magnetic stimulation (rTMS) has been advocated for selecting MCS candidates, but it has a low negative predictive value. Here the authors investigated whether multiple rTMS sessions would more accurately predict MCS efficacy. METHODS Patients included in this longitudinal study could access MCS after at least four rTMS sessions performed 3-4 weeks apart. The positive (PPV) and negative (NPV) predictive values of the four rTMS sessions and the correlation between the analgesic effects of the two treatments were assessed. RESULTS Twelve MCS patients underwent an average of 15.9 rTMS sessions prior to surgery; nine of the patients were rTMS responders. Postoperative follow-up was 57.8 ± 15.6 months (mean ± standard deviation). Mean percentage of pain relief (%R) was 21% and 40% after the first and fourth rTMS sessions, respectively. The corresponding mean durations of pain relief were respectively 2.4 and 12.9 days. A cumulative effect of the rTMS sessions was observed on both %R and duration of pain relief (p < 0.01). The %R value obtained with MCS was 35% after 6 months and 43% at the last follow-up. Both the PPV and NPV of rTMS were 100% after the fourth rTMS session (p = 0.0045). A significant correlation was found between %R or duration of pain relief after the fourth rTMS session and %R at the last MCS follow-up (R 2 = 0.83, p = 0.0003). CONCLUSIONS Four rTMS sessions predicted MCS efficacy better than a single session in neuropathic pain patients. Taking into account the cumulative effects of rTMS, the authors found a high-level correlation between the analgesic effects of rTMS and MCS.

Spacing extinction sessions as a behavioral technique for preventing relapse in an animal model of voluntary actions.

Science.gov (United States)

Bernal-Gamboa, Rodolfo; Gámez, A Matías; Nieto, Javier

2018-06-01

Instrumental extinction has been proposed as a model for understanding the suppression of problematic voluntary actions. Consequently, it has been suggested that response recovery after extinction could model relapse. Four experiments with rats used a free operant procedure to explore the impact of spacing extinction sessions on spontaneous recovery, renewal, reinstatement, and rapid reacquisition of extinguished lever-pressing. Initially, in all experiments, hungry rats were trained to perform two responses (R1 and R2) for food. Then, all responses underwent extinction. For R1, rats experienced a longer intersession interval (72 h) than for R2 (24 h). During the final restoration test, it was observed that using spaced extinction sessions reduced spontaneous recovery, renewal, and reinstatement. However, implementing a longer intersession interval throughout extinction exposure did not slow the rate of reacquisition of operant responses. The present findings suggest that in most cases extinction is more enduring when the extinction sessions are spaced. Since expanding the intersession interval during extinction might be interpreted as conducting extinction in multiple temporal contexts, the overall pattern of results was explained based on contextual modulation. Copyright © 2018 Elsevier B.V. All rights reserved.

New hospital payment systems: comparing medical strategies in The Netherlands, Germany and England.

Science.gov (United States)

van Essen, Anne Marije

2009-01-01

This paper seeks to identify different medical strategies adopted in relation to the new hospital payment systems in Germany, The Netherlands and England and analyse how the medical strategies have impacted on the emergence of these New Public Management policy tools between 2002 and 2007. A comparative approach is applied. In addition to secondary sources, the study uses publications in professional journals, official publications of the (national) physician organisations and a (non-random) expert questionnaire to obtain the views of the medical corporate bodies in the three countries. The results reveal differences in the medical strategies in the three countries that point towards the significance of institutional and interest configurations. The Dutch corporate medical body was most willing to solve the conflict, while the German and English corporate medical bodies seem to be keen to use a strategy of confrontation. The differences in medical strategies also impact on the ways in which hospital payment systems have emerged in the three countries. Further research is necessary to study the medical strategies in healthcare reforms from a broader perspective, for instance by including other countries. The paper gives insights into the interplay between the medical profession and the government in the context of new managerial governance practices in the hospital sector. It adds to the scholarly debates about the role of the medical profession in health policy-making.

Chapter II: Twenty Eighth General Assembly Business Sessions

Science.gov (United States)

Williams, Robert

2015-08-01

The President of the IAU, Prof. Robert Williams, welcomed the delegates and members to this first business session of the General Assembly. The President invited the General Secretary, Dr. Ian Corbett, to start the business session.

Epidemic spreading in networks with nonrandom long-range interactions.

Science.gov (United States)

Estrada, Ernesto; Kalala-Mutombo, Franck; Valverde-Colmeiro, Alba

2011-09-01

An "infection," understood here in a very broad sense, can be propagated through the network of social contacts among individuals. These social contacts include both "close" contacts and "casual" encounters among individuals in transport, leisure, shopping, etc. Knowing the first through the study of the social networks is not a difficult task, but having a clear picture of the network of casual contacts is a very hard problem in a society of increasing mobility. Here we assume, on the basis of several pieces of empirical evidence, that the casual contacts between two individuals are a function of their social distance in the network of close contacts. Then, we assume that we know the network of close contacts and infer the casual encounters by means of nonrandom long-range (LR) interactions determined by the social proximity of the two individuals. This approach is then implemented in a susceptible-infected-susceptible (SIS) model accounting for the spread of infections in complex networks. A parameter called "conductance" controls the feasibility of those casual encounters. In a zero conductance network only contagion through close contacts is allowed. As the conductance increases the probability of having casual encounters also increases. We show here that as the conductance parameter increases, the rate of propagation increases dramatically and the infection is less likely to die out. This increment is particularly marked in networks with scale-free degree distributions, where infections easily become epidemics. Our model provides a general framework for studying epidemic spreading in networks with arbitrary topology with and without casual contacts accounted for by means of LR interactions.

Abstracts of SIG Sessions.

Science.gov (United States)

Proceedings of the ASIS Annual Meeting, 1994

1994-01-01

Includes abstracts of 18 special interest group (SIG) sessions. Highlights include natural language processing, information science and terminology science, classification, knowledge-intensive information systems, information value and ownership issues, economics and theories of information science, information retrieval interfaces, fuzzy thinking…

Psychophysiological Responses to Group Exercise Training Sessions: Does Exercise Intensity Matter?

Directory of Open Access Journals (Sweden)

Matteo Vandoni

Full Text Available Group exercise training programs were introduced as a strategy for improving health and fitness and potentially reducing dropout rates. This study examined the psychophysiological responses to group exercise training sessions. Twenty-seven adults completed two group exercise training sessions of moderate and vigorous exercise intensities in a random and counterbalanced order. The %HRR and the exertional and arousal responses to vigorous session were higher than those during the moderate session (p<0.05. Consequently, the affective responses to vigorous session were less pleasant than those during moderate session (p<0.05. These results suggest that the psychophysiological responses to group exercise training sessions are intensity-dependent. From an adherence perspective, interventionists are encouraged to emphasize group exercise training sessions at a moderate intensity to maximize affective responses and to minimize exertional responses, which in turn may positively affect future exercise behavior.

Relative effects of bronchial drainage and exercise for in-hospital care of patients with cystic fibrosis.

Science.gov (United States)

Cerny, F J

1989-08-01

Bronchial hygiene therapy is a standard part of the treatment of patients with cystic fibrosis (CF). Coughing alone promotes sputum expectoration and is probably the primary effective component of standard bronchial hygiene therapy. The purpose of this study was to determine whether substituting regular exercise, which also promotes coughing, for two of three daily bronchial hygiene treatments would affect the expected improvements in pulmonary function and exercise response in hospitalized patients with CF. Seventeen patients with CF hospitalized (means length of stay = 13.0 +/- 2.6 days) for an acute exacerbation of their pulmonary disease participated in the study. The patients were randomly assigned to either a group that participated in two cycle ergometer exercise sessions and one bronchial hygiene treatment session per day (EX Group [n = 9]) or a group that participated in three bronchial hygiene treatment sessions per day (PD Group [n = 8]). Pulmonary functions and responses to a progressive, incremental cycle ergometer exercise test were measured on admission and before discharge. Bronchial hygiene therapy consisted of postural drainage, in six positions, with chest percussion and vibration. Therapeutic exercise was of moderate intensity and was individually adjusted based on the patient's heart rate and arterial oxygen saturation response to the admission exercise test. Coughing was encouraged during and after all treatments. Pulmonary function and exercise response were significantly improved over the period of hospitalization in both groups; the improvements were the same in the two groups. These results indicate that, in some hospitalized patients with CF, exercise therapy may be substituted for at least part of the standard protocol of bronchial hygiene therapy.

24 CFR 3.525 - Fringe benefits.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Fringe benefits. 3.525 Section 3... benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit, service, policy or plan, any...

Hospital-based versus hybrid cardiac rehabilitation program in coronary bypass surgery patients in western Iran: effects on exercise capacity, risk factors, psychological factors, and quality of life.

Science.gov (United States)

Najafi, Farid; Nalini, Mahdi

2015-01-01

The efficacy of alternative delivery models for a cardiac rehabilitation program (CRP) in low- and middle-income countries is not well documented. This study compared the traditional hospital-based CRP with a hybrid CRP in western Iran. This observational study was conducted with postcoronary surgery patients in Imam-Ali Hospital in Kermanshah, Iran. Both program models included 2 phases: (1) a common preliminary phase (2-4 weeks) involving exercise training and a plan to control cardiac risk factors; and (2) a complementary phase (8 weeks) consisting of group educational classes and exercise training conducted 3 times a week in the hospital or once a week accompanied by phone calls in the hybrid program. Changes in exercise capacity, blood pressure, lipids, resting heart rate, body mass index, waist circumference, smoking, depression, anxiety, and quality of life as well as differences in attendance at hospital sessions were investigated. From a total of 887 patients, 780 (87.9%) completed the programs. There was no association between course completion and type of CRP. Mean age of patients completing the programs was 55.6 ± 8.7 years and 23.8% were female. The hospital-based (n = 585) and hybrid (n = 195) programs resulted in a significant increase in exercise capacity (P countries where there are no appropriate health facilities in remote areas.

Working through: In-Session Processes that Promote Between-Session Thoughts and Activities

Science.gov (United States)

Owen, Jesse; Quirk, Kelley; Hilsenroth, Mark J.; Rodolfa, Emil

2012-01-01

This study examined whether clients' ratings of the working alliance as well as their perception of cognitive-behavioral (CB) and psychodynamic-interpersonal (PI) techniques (delivered by therapists who used both) were associated with clients' intersession processes (i.e., their thoughts about therapy and therapeutic activity between sessions).…

Balance maintenance as an acquired motor skill: Delayed gains and robust retention after a single session of training in a virtual environment.

Science.gov (United States)

Elion, Orit; Sela, Itamar; Bahat, Yotam; Siev-Ner, Itzhak; Weiss, Patrice L Tamar; Karni, Avi

2015-06-03

Does the learning of a balance and stability skill exhibit time-course phases and transfer limitations characteristic of the acquisition and consolidation of voluntary movement sequences? Here we followed the performance of young adults trained in maintaining balance while standing on a moving platform synchronized with a virtual reality road travel scene. The training protocol included eight 3 min long iterations of the road scene. Center of Pressure (CoP) displacements were analyzed for each task iteration within the training session, as well as during tests at 24h, 4 weeks and 12 weeks post-training to test for consolidation phase ("offline") gains and assess retention. In addition, CoP displacements in reaction to external perturbations were assessed before and after the training session and in the 3 subsequent post-training assessments (stability tests). There were significant reductions in CoP displacements as experience accumulated within session, with performance stabilizing by the end of the session. However, CoP displacements were further reduced at 24h post-training (delayed "offline" gains) and these gains were robustly retained. There was no transfer of the practice-related gains to performance in the stability tests. The time-course of learning the balance maintenance task, as well as the limitation on generalizing the gains to untrained conditions, are in line with the results of studies of manual movement skill learning. The current results support the conjecture that a similar repertoire of basic neuronal mechanisms of plasticity may underlay skill (procedural, "how to" knowledge) acquisition and skill memory consolidation in voluntary and balance maintenance tasks. Copyright © 2015 Elsevier B.V. All rights reserved.

The microbiological effects of hospital wastes on the environment ...

African Journals Online (AJOL)

The effect of twenty four (24) hospital wastes samples taken from different hospitals waste dumpsites on its surrounding soil was examined. The counts of microorganisms in hospital dumpsite soil include the following; aerobic heterotrophic counts from 4.2 x 105 to 1.6 x 1010, anaerobic heterotrophic counts from 1.0 x 105 to ...

Summary of the session on other effects

International Nuclear Information System (INIS)

Chao, A.

1997-07-01

The theme of this workshop is to discuss the effects of foreign particles on the native beam in a storage ring. This paper summarizes the session on effects not covered in sessions on fast ion instability, electron cloud instability, and cures. The topics discussed are the beam, the foreign particle, how are foreign particles trapped, and how do foreign particles and beam couple

Financial Performance of Hospitals in the Mississippi Delta Region Under the Hospital Readmissions Reduction Program and Hospital Value-based Purchasing Program.

Science.gov (United States)

Chen, Hsueh-Fen; Karim, Saleema; Wan, Fei; Nevola, Adrienne; Morris, Michael E; Bird, T Mac; Tilford, J Mick

2017-11-01

Previous studies showed that the Hospital Readmissions Reduction Program (HRRP) and the Hospital Value-based Purchasing Program (HVBP) disproportionately penalized hospitals caring for the poor. The Mississippi Delta Region (Delta Region) is among the most socioeconomically disadvantaged areas in the United States. The financial performance of hospitals in the Delta Region under both HRRP and HVBP remains unclear. To compare the differences in financial performance under both HRRP and HVBP between hospitals in the Delta Region (Delta hospitals) and others in the nation (non-Delta hospitals). We used a 7-year panel dataset and applied difference-in-difference models to examine operating and total margin between Delta and non-Delta hospitals in 3 time periods: preperiod (2008-2010); postperiod 1 (2011-2012); and postperiod 2 (2013-2014). The Delta hospitals had a 0.89% and 4.24% reduction in operating margin in postperiods 1 and 2, respectively, whereas the non-Delta hospitals had 1.13% and 1% increases in operating margin in postperiods 1 and 2, respectively. The disparity in total margins also widened as Delta hospitals had a 1.98% increase in postperiod 1, but a 0.30% reduction in postperiod 2, whereas non-Delta hospitals had 1.27% and 2.28% increases in postperiods 1 and 2, respectively. The gap in financial performance between Delta and non-Delta hospitals widened following the implementation of HRRP and HVBP. Policy makers should modify these 2 programs to ensure that resources are not moved from the communities that need them most.

What is significant about a single nursing session? An exploratory study.

Science.gov (United States)

Miller, Elizabeth M

2017-09-10

Researchers and clinicians specializing in breastfeeding often rely on measuring one nursing session to characterize the breastfeeding relationship. However, less is known about the descriptive or statistically predictive characteristics of one nursing session. The purposes of this study are twofold: (1) to explore the relationships between variables in a single nursing session; and (2) to study the association between variables in a single nursing session and infant length-for-age (LAZ) and weight-for-age (WAZ). In 63 nursing mother-infant pairs in the United States, anthropometric measurement and observation of a single nursing session revealed six nursing session variables: fore milk fat percent, hind milk fat percent, infant milk intake, duration of session, time since last session, and time of day of session. A principle factor analysis, undertaken to explore latent variables underlying the six session variables, revealed two factors: (1) loaded highly on fore and hind milk fat percentage, reflecting the overall fat percent in a feed; and (2) loaded highly on milk intake and hind milk fat percentage, indicating the process of breast emptying. In multivariate analyses of all session variables on infant LAZ and WAZ, only hind milk fat percentage was significantly negatively associated with LAZ (β = -0.14, P = .01 (two-tailed), R 2  = 0.070), confirmed by a significant negative association between LAZ and factor one (β = -0.32, P = .05 (two-tailed), R 2  = 0.090). This research describes the dynamics of a single nursing session, and has the potential to help explain variation in infant growth and nutrition. © 2017 Wiley Periodicals, Inc.

Poster session in instructional technology course

Science.gov (United States)

Diniaty, Artina; Fauzi'ah, Lina; Wulan Febriana, Beta; Arlianty, Widinda Normalia

2017-12-01

Instructional technology course must be studied by students in order to 1) understand the role of technology in learning, 2) capable of analyzing advantages and disadvantages of using technology in teaching, 3) capable of performing technology in teaching. A poster session in instructional technology course was performed to 1) enhance students' interest in this course and develop students' creativity. The step of this research includes: planning, implementation, and evaluation. The result showed that students' responses towards poster session in instructional technology course were good.

Influência do intervalo de tempo entre as sessões de alongamento no ganho de flexibilidade dos isquiotibiais Influence of the time interval between stretching sessions on increased hamstring flexibility

Directory of Open Access Journals (Sweden)

Zenewton André da Silva Gama

2009-04-01

Full Text Available CONTEXTO: A otimização do treino de flexibilidade está relacionada com o uso de parâmetros adequados de alongamento. Entretanto, o intervalo de tempo adequado entre as sessões de alongamento tem sido pouco investigado. OBJETIVO: Verificar se a variação no intervalo de tempo entre sessões de alongamento influencia no ganho de flexibilidade. MÉTODOS: 28 mulheres, com idade de 22,5 ± 1,8 anos, foram distribuídas aleatoriamente em três grupos. Aplicaram-se 10 sessões de alongamento nos isquiotibiais do membro direito. O grupo 0X (n = 8 foi o controle e não recebeu alongamento. O grupo 3X (n = 10 alongou três vezes por semana (intervalo de 48 horas e o grupo 5X (n = 10, cinco vezes (intervalo de 24 horas. Aplicaram-se 10 sessões de alongamento (sustentar-relaxar nos isquiotibiais direitos. As medidas foram tomadas por análise fotométrica no programa AutoCad® 2000. A análise estatística foi realizada com ANOVA e teste post hoc de Newman-Keuls adotando um p-valor referencial de 0,05. RESULTADOS: Após 10 sessões, identificou-se aumento da flexibilidade nos grupos experimentais, porém sem diferença entre estes. O grupo 3X aumentou significativamente a partir do 10º dia do programa (quinta sessão e o grupo 5X, a partir do terceiro (terceira sessão. CONCLUSÕES: O alongamento aumenta a flexibilidade dos isquiotibiais, independente do tempo entre as sessões (24 ou 48 horas; e a variável tempo não influencia o ganho de flexibilidade total. Porém, com cinco sessões semanais, ganha-se flexibilidade mais rapidamente. Isso sugere que o ganho de flexibilidade é sessão-dependente.CONTEXT: The optimization of flexibility training is related to the use of ideal stretching parameters. However, the time interval between sessions has been little investigated. OBJECTIVE: To verify if the variation in time interval between stretching sessions influences in flexibility gain. METHODOLOGY: Twenty-eight women, average age of 22.5 ± 1

77 FR 75491 - Entry-Level Driver Training; Public Listening Session

Science.gov (United States)

2012-12-20

... identified are supported by research and data analyses, including cost/benefit considerations. The session...-27748] Entry-Level Driver Training; Public Listening Session AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of public listening session. SUMMARY: FMCSA announces that it will...

Session 1 - discussion

International Nuclear Information System (INIS)

Wells, C.; Richards, K.M.; McKerrow, J.F.

1991-01-01

This discussion session of the Landfill Gas-Energy and Environment 90 Conference covered the landfill gas potential, the setting up of the Non-Fossil Fuel Obligation; anticipated developments in the post 1998 period, the problem of smell for those who live near a landfill, and the length of time a landfill site is productive in terms of gas evolution. Relevant regulations in California are briefly discussed. (author)

First Doctoral student assembly and poster session at CERN

CERN Multimedia

2010-01-01

Presently, 130 doctoral students at CERN do their research on “technical” subjects such as magnets and cryogenics, beam and detector physics, computing and vacuum, among others.   Student present  their scientific achievements at the first doctoral student assembly. To present their scientific achievements and to bring together the students with CERN supervisors and CERN’s management was the main objective of the first doctoral student assembly and poster session, held June 30. The photograph shows about half of those who presented posters, all in their second year of assignment, and ready to attach their work to the panels. Another aim of the assembly was to discuss the outcome of the anonymous questionnaire and to gain feedback for the improvement of the doctoral student program. While there is vast overall satisfaction, improvements should aim at strengthening the links between students, CERN supervisors, and university professors. With 24 posters prese...

Evaluating the efficacy of Regulated 12-Session Matrix Model in reducing susceptibility in methamphetamine-dependent individuals

Directory of Open Access Journals (Sweden)

Zahra Amiri

2016-02-01

Full Text Available Methamphetamine (abuse have gained popularity among youth and is increasingly become a part of mainstream culture. Methamphetamine(abuse is dangerous because of its wide range adverse outcomes and hazardous sustaining side effects. Its dependence is hardly withdrawn by routine therapeutic methods. This study is devoted to evaluate the efficacy of Regulated 12-Session Matrix Model in outpatient methamphetamine-dependent individuals. 24 individuals were chosen according to inclusion/exclusion criteria of the study and randomly assigned to equal experimental (age range 19-41; mean age: 46.9 and control groups (age range: 21-42; mean age: 27.8. Experimental group members partook Regulated 12-Session Matrix Model once a week in 12 consecutive weeks, while control group members remained at waitlist. Independent t-test in 12th week showed that experimental group had lower methamphetamine use, comparing to control group (p<.05.Phillai’s Trace, Wilk’s Lambda, HotellingLawley's trace, and Roy's largest root showed that there are significant association between experimental and control groups in reduction of methamphetamine-use lapse (p<.05.Within-subject F ratio revealed that “methamphetamine use” was significantly reduced in experimental group after clinical intervention (p<.001. Findings of the study indicate the efficacy of Regulated 12-Session Matrix Model in craving management and control as well as reduction of lapse and substance (abuse in methamphetamine-dependent patients. It appears that the Regulated 12-Session Matrix Model would be a new reliable solution to treat methamphetamine-dependence in Iran and other alike cultural and social atmospheres. Limitations and future implications are discussed.

Stepped care cognitive behavioural therapy for children with anxiety disorders: a new treatment approach

NARCIS (Netherlands)

van der Leeden, Adelinde J. M.; van Widenfelt, Brigit M.; van der Leeden, Rien; Liber, Juliette M.; Utens, Elisabeth M. W. J.; Treffers, Philip D. A.

2011-01-01

The current nonrandomized clinical trial explored changes over time in children with an anxiety disorder during stepped care, manual-based cognitive behaviour therapy (CBT). Clinically anxious children (8-12 years, n = 133) and their parents participated in child focused CBT (10 sessions). If

Summary of Session 3

International Nuclear Information System (INIS)

Fleischer, J.

2004-01-01

In Session 3, the speakers were dealing with the following topics: Automatization of Feynman Diagram Calculations (FDC), Event generators, Analytical approaches to FDC and various Mathematical innovations related to different physical problems. A more general, 'brainstorming', talk was given by J. Vermaseren as first talk

Working session 4: Preventative and corrective measures

International Nuclear Information System (INIS)

Clark, R.; Slama, G.

1997-01-01

The Preventive and Corrective Measures working session included 13 members from France, Germany, Japan, Spain, Slovenia, and the United States. Attendee experience included regulators, utilities, three steam generator vendors, consultants and researchers. Discussions centered on four principal topics: (1) alternate materials, (2) mechanical mitigation, (3) maintenance, and (4) water chemistry. New or replacement steam generators and original equipment steam generators were separately addressed. Four papers were presented to the session, to provide information and stimulate various discussion topics. Topics discussed and issues raised during the several meeting sessions are provided below, followed by summary conclusions and recommendations on which the group was able to reach a majority consensus. The working session was composed of individuals with diverse experience and varied areas of specialized expertise. The somewhat broad range of topics addressed by the group at times saw discussion participation by only a few individuals. As in any technical meeting where all are allowed the opportunity to speak their mind, straying from an Individual topic was not unusual. Where useful, these stray topics are also presented below within the context In which they occurred. The main categories of discussion were: minimize sludge; new steam generators; maintenance; mechanical mitigation; water chemistry

ECG changes after a session of regional intraarterial hyperglycemia

International Nuclear Information System (INIS)

Korobchenko, Z.A.; Livshits, L.I.

1988-01-01

ECG changes after a session of regional intraarterial hyperglycemia (RIH) in 13 patients (the mean age of 49 years) with locally advanced cancer of the tongue, oral mucosa and oropharynx were presented. Taking into account the mean age of patients and the negative ECG time course after a RIH session, the necessity of patients' examination (including ECG after a RIH session and, when indicated, a consultation by a cardiologist) was emphasized

Proceedings of the 7th International Meeting on Nuclear Reactor Thermal-Hydraulics NURETH-7. Sessions 17-24

Energy Technology Data Exchange (ETDEWEB)

Block, R.C.; Feiner, F. [American Nuclear Society, La Grange Park, IL (United States)

1995-09-01

Technical papers accepted for presentation at the Seventh International Topical Meeting on Nuclear Reactor Thermal-Hydraulics are included in the present Proceedings. Except for the invited papers in the plenary session, all other papers are contributed papers. The topics of the meeting encompass all major areas of nuclear thermal-hydraulics, including analytical and experimental works on the fundamental mechanisms of fluid flow and heat transfer, the development of advanced mathematical and numerical methods, and the application of advancements in the field in the development of novel reactor concepts. Because of the complex nature of nuclear reactors and power plants, several papers deal with the combined issues of thermal-hydraulics and reactor/power-plant safety, core neutronics and/or radiation. The participation in the conference by the authors from several countries and four continents makes the Proceedings a comprehensive review of the recent progress in the field of nuclear reactor thermal-hydraulics worldwide. Individual papers have been cataloged separately.

Proceedings of the 7th International Meeting on Nuclear Reactor Thermal-Hydraulics NURETH-7. Sessions 17-24

International Nuclear Information System (INIS)

Block, R.C.; Feiner, F.

1995-09-01

Technical papers accepted for presentation at the Seventh International Topical Meeting on Nuclear Reactor Thermal-Hydraulics are included in the present Proceedings. Except for the invited papers in the plenary session, all other papers are contributed papers. The topics of the meeting encompass all major areas of nuclear thermal-hydraulics, including analytical and experimental works on the fundamental mechanisms of fluid flow and heat transfer, the development of advanced mathematical and numerical methods, and the application of advancements in the field in the development of novel reactor concepts. Because of the complex nature of nuclear reactors and power plants, several papers deal with the combined issues of thermal-hydraulics and reactor/power-plant safety, core neutronics and/or radiation. The participation in the conference by the authors from several countries and four continents makes the Proceedings a comprehensive review of the recent progress in the field of nuclear reactor thermal-hydraulics worldwide. Individual papers have been cataloged separately

Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

Directory of Open Access Journals (Sweden)

Thiago da Silva Domingos

Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

Directory of Open Access Journals (Sweden)

Thiago da Silva Domingos

2015-06-01

Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

Adaptations to short, frequent sessions of endurance and strength training are similar to longer, less frequent exercise sessions when the total volume is the same

DEFF Research Database (Denmark)

Kilen, Anders; Hjelvang, Line B; Dall, Niels

2015-01-01

]: n = 21) performed nine 15-minute training sessions weekly, whereas a second group ("classical training" [CL]: n = 8) completed exactly the same training on a weekly basis but as three 45-minute sessions. For each group, each session comprised exclusively strength, high-intensity cardiovascular...

A Faculty Development Session or Resident as Teacher Session for Didactic and Clinical Teaching Techniques; Part 1 of 2: Engaging Learners with Effective Didactic Teaching

Directory of Open Access Journals (Sweden)

Megan Boysen-Osborn

2016-07-01

Full Text Available Audience: This workshop is intended for faculty members in an emergency medicine (or other residency program, but is also appropriate for chief residents and medical student educators, including basic science faculty. Introduction: Faculty development sessions are required by the Accreditation Council for Graduate Medical Education and enhance the learning environment within residency programs. Resident as teacher sessions are important in helping residents transition from junior learners to supervisors of medical students and junior residents. Part I of this two-part workshop introduces learners to effective techniques to engaging learners during didactic sessions. Objectives: By the end of this workshop, the learner will: 1 describe eight teaching techniques that encourage active learning during didactic sessions; 2 plan a didactic session using at least one of eight new teaching techniques for didactic instruction. Methods: This educational session is uses several blended instructional methods, including team-based learning (classic and modified, the flipped classroom, audience response systems, pause procedures in order to demonstrate effective didactic teaching techniques.

Epidemic spreading in networks with nonrandom long-range interactions

Science.gov (United States)

Estrada, Ernesto; Kalala-Mutombo, Franck; Valverde-Colmeiro, Alba

2011-09-01

An “infection,” understood here in a very broad sense, can be propagated through the network of social contacts among individuals. These social contacts include both “close” contacts and “casual” encounters among individuals in transport, leisure, shopping, etc. Knowing the first through the study of the social networks is not a difficult task, but having a clear picture of the network of casual contacts is a very hard problem in a society of increasing mobility. Here we assume, on the basis of several pieces of empirical evidence, that the casual contacts between two individuals are a function of their social distance in the network of close contacts. Then, we assume that we know the network of close contacts and infer the casual encounters by means of nonrandom long-range (LR) interactions determined by the social proximity of the two individuals. This approach is then implemented in a susceptible-infected-susceptible (SIS) model accounting for the spread of infections in complex networks. A parameter called “conductance” controls the feasibility of those casual encounters. In a zero conductance network only contagion through close contacts is allowed. As the conductance increases the probability of having casual encounters also increases. We show here that as the conductance parameter increases, the rate of propagation increases dramatically and the infection is less likely to die out. This increment is particularly marked in networks with scale-free degree distributions, where infections easily become epidemics. Our model provides a general framework for studying epidemic spreading in networks with arbitrary topology with and without casual contacts accounted for by means of LR interactions.

Safety Training: scheduled sessions in April

CERN Multimedia

DGS Unit

2011-01-01

The following training courses are scheduled in April. You can find the full Safety Training programme on the Safety Training online catalogue. If you are interested in attending any of the below courses, please talk to your supervisor, then apply electronically via EDH from the course description pages, by clicking on SIGN-UP. Registration for all courses is always open – sessions for the less-requested courses are organized on a demand-basis only. Depending on the demand, a session will be organised later in the year. Biocell Training 26-APR-11 (08.30 – 10.00) in French 26-APR-11 (10.30 – 12.00) in French Conduite de plates-formes élévatrices mobiles de personnel (PEMP) 28-APR-11 to 29-APR-11 (08.00 – 17.30) in French* Sécurité chimique – Introduction 29-APR-11 (09.00 – 11.30) in French (*) session in French with the possibility of receiving the documentation in English   By Isabelle Cusato (H...

Particle accelerators installed in hospitals: the need for a program of training for medical physicists

International Nuclear Information System (INIS)

Brandan, M.E.

1989-01-01

This paper was presented at the session which closed the round table. The need for setting up a program of professional training directed by hospital physicists who have functioned for some time as medical physicists in the health centers of the country was proposed. (Author)

24 CFR 242.90 - Eligibility of mortgages covering hospitals in certain neighborhoods.

Science.gov (United States)

2010-04-01

..., except such requirements (other than those relating to labor standards and prevailing wages or... there is a need in the area for an adequate hospital to serve low and moderate income families. (3) That...

Microstructural descriptors and cellular automata simulation of the effects of non-random nuclei location on recrystallization in two dimensions

Directory of Open Access Journals (Sweden)

Paulo Rangel Rios

2006-06-01

Full Text Available The effect of non-random nuclei location and the efficiency of microstructural descriptors in assessing such a situation are studied. Cellular automata simulation of recrystallization in two dimensions is carried out to simulate microstrutural evolution for nuclei distribution ranging from a periodic arrangement to clusters of nuclei. The simulation results are compared in detail with microstrutural descriptors normally used to follow transformation evolution. It is shown that the contiguity is particularly relevant to detect microstructural deviations from randomness. This work focuses on recrystallization but its results are applicable to any nucleation and growth transformation.

Hypnosis can reduce pain in hospitalized older patients: a randomized controlled study.

Science.gov (United States)

Ardigo, Sheila; Herrmann, François R; Moret, Véronique; Déramé, Laurence; Giannelli, Sandra; Gold, Gabriel; Pautex, Sophie

2016-01-15

Chronic pain is a common and serious health problem in older patients. Treatment often includes non pharmacological approaches despite a relatively modest evidence base in this population. Hypnosis has been used in younger adults with positive results. The main objective of this study was to measure the feasibility and efficacy of hypnosis (including self hypnosis) in the management of chronic pain in older hospitalized patients. A single center randomized controlled trial using a two arm parallel group design (hypnosis versus massage). Inclusion criteria were chronic pain for more than 3 months with impact on daily life activities, intensity of > 4; adapted analgesic treatment; no cognitive impairment. Brief pain inventory was completed. Fifty-three patients were included (mean age: 80.6 ± 8.2--14 men; 26 hypnosis; 27 massage. Pain intensity decreased significantly in both groups after each session. Average pain measured by the brief pain index sustained a greater decrease in the hypnosis group compared to the massage group during the hospitalisation. This was confirmed by the measure of intensity of the pain before each session that decreased only in the hypnosis group over time (P = 0.008). Depression scores improved significantly over the time only in the hypnosis group (P = 0.049). There was no effect in either group 3 months post hospitals discharge. Hypnosis represents a safe and valuable tool in chronic pain management of hospitalized older patients. In hospital interventions did not provide long term post discharge relief. ISRCTN15615614; registered 2/1/2015.

Summary Of Session 5: How Should We Handle Safety?

Energy Technology Data Exchange (ETDEWEB)

Albert, M.; Roy, G

2001-07-01

This session was originally titled 'Safety: Who cares?' in a fairly provocative way. A clear conclusion of this session and discussions that were held at the workshop is that there is a wide concern for safety among the people in charge of control room operations. This was shown as well by the quality of the seven talks presented in this session on subjects ranging from safety standards to a practical case of a safety incident. (author)

Summary Of Session 5: How Should We Handle Safety?

International Nuclear Information System (INIS)

Albert, M.; Roy, G.

2001-01-01

This session was originally titled 'Safety: Who cares?' in a fairly provocative way. A clear conclusion of this session and discussions that were held at the workshop is that there is a wide concern for safety among the people in charge of control room operations. This was shown as well by the quality of the seven talks presented in this session on subjects ranging from safety standards to a practical case of a safety incident. (author)

Pain prevalence in hospitalized children

DEFF Research Database (Denmark)

Walther-Larsen, S; Pedersen, M T; Friis, S M

2017-01-01

admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation. CONCLUSION: This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority......BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...

Processes of early stroke care and hospital costs.

Science.gov (United States)

Svendsen, Marie Louise; Ehlers, Lars H; Hundborg, Heidi H; Ingeman, Annette; Johnsen, Søren P

2014-08-01

The relationship between processes of early stroke care and hospital costs remains unclear. We therefore examined the association in a population based cohort study. We identified 5909 stroke patients who were admitted to stroke units in a Danish county between 2005 and 2010.The examined recommended processes of care included early admission to a stroke unit, early initiation of antiplatelet or anticoagulant therapy, early computed tomography/magnetic resonance imaging (CT/MRI) scan, early physiotherapy and occupational therapy, early assessment of nutritional risk, constipation risk and of swallowing function, early mobilization,early catheterization, and early thromboembolism prophylaxis.Hospital costs were assessed for each patient based on the number of days spent in different in-hospital facilities using local hospital charges. The mean costs of hospitalization were $23 352 (standard deviation 27 827). The relationship between receiving more relevant processes of early stroke care and lower hospital costs followed a dose–response relationship. The adjusted costs were $24 566 (95% confidence interval 19 364–29 769) lower for patients who received 75–100% of the relevant processes of care compared with patients receiving 0–24%. All processes of care were associated with potential cost savings, except for early catheterization and early thromboembolism prophylaxis. Early care in agreement with key guidelines recommendations for the management of patients with stroke may be associated with hospital savings.

A hospital-randomized controlled trial of a formal quality improvement educational program in rural and small community Texas hospitals: one year results.

Science.gov (United States)

Filardo, Giovanni; Nicewander, David; Herrin, Jeph; Edwards, Janine; Galimbertti, Percy; Tietze, Mari; McBride, Susan; Gunderson, Julie; Collinsworth, Ashley; Haydar, Ziad; Williams, Josie; Ballard, David J

2009-08-01

To investigate the effectiveness of a quality improvement educational program in rural hospitals. Hospital-randomized controlled trial. A total of 47 rural and small community hospitals in Texas that had previously received a web-based benchmarking and case-review tool. The 47 hospitals were randomized either to receive formal quality improvement educational program or to a control group. The educational program consisted of two 2-day didactic sessions on continuous quality improvement techniques, followed by the design, implementation and reporting of a local quality improvement project, with monthly coaching conference calls and annual follow-up conclaves. Performance on core measures for community-acquired pneumonia and congestive heart failure were compared between study groups to evaluate the impact of the educational program. No significant differences were observed between the study groups on any measures. Of the 23 hospitals in the intervention group, only 16 completed the didactic program and 6 the full training program. Similar results were obtained when these groups were compared with the control group. While the observed results suggest no incremental benefit of the quality improvement educational program following implementation of a web-based benchmarking and case-review tool in rural hospitals, given the small number of hospitals that completed the program, it is not conclusive that such programs are ineffective. Further research incorporating supporting infrastructure, such as physician champions, financial incentives and greater involvement of senior leadership, is needed to assess the value of quality improvement educational programs in rural hospitals.

Hospital waste management status in Lebanon

International Nuclear Information System (INIS)

Karam, R.; Oueida, F.; Tissot-Guerraz, F.; Trepo, D.; Collombel, C.

2000-01-01

author.The existing management of hospital waste in Lebanon currently poses both an environmental hazard as well as a public health risk. This is due mainly to lack of legislation, information and modern treatment and disposal facilities designed for this purpose. A nation-wide questionnaire survey was conducted to asses the status of hospital waste management. The study started from October 1997 till August 1998. We found that 75% of the surveyed hospitals completely ignore their total waste quantity: 73% of hospitals surveyed practice segregation at source of infectious, pathological, sharps and pharmaceuticals; more than 40% dispose of their hospital risk wastes through the municipality waste disposal, 24% by burning in open fires, 14% by on-site hospital incinerators, 11% in on-site dumping, 8% handled by a private contractor and 1% in uncontrolled landfill. We conclude that with some exceptions, the hospital waste management situation in Lebanon is very far from being satisfactory and therefore needs to be reconsidered. 1 Fig., 6 tabs., 18 refs

Feasibility of integrated home/hospital physiotherapeutic support for children with cancer.

Science.gov (United States)

Savio, Christian; Garaventa, Alberto; Gremmo, Marina; Camoriano, Riccardo; Manfredini, Luca; Fieramosca, Sara; Dini, Giorgio; Miano, Maurizio

2007-01-01

Children suffering from cancer often have to undergo physiotherapy that either extends the duration of in-patient hospitalisation or requires more frequent visits to the outpatient clinic. To improve care and to decrease the length of hospitalisation of children being treated at the Dept. of Haematoloy/Oncology of the Gaslini Children's Hospital, a programme of Home Care was set up in April 2000. In June 2003, rehabilitation was added to the procedures that were feasible at home and included i.v. therapy administration, blood examinations, transfusion and/or psychological support, as well as palliative care for terminally ill children. The physiotherapy sessions were done in the ward, in the Rehabilitation Unit Gym, or at home, depending on the clinical conditions and the needs of the child and the family. Between June 2003 and May 2005, 46 children, whose median age was 7 years (range 6 months-21 years) suffering from CNS tumours (13), leukaemia (13), neuroblastoma (7), bone tumours (6), sarcoma (4) and lymphoma (3), underwent 1,398 physiotherapy sessions for neuro-motor re-education (534), motor rehabilitation (485), strain re-education and training (250), respiratory care (79), or to improve comfort during the terminal phase of the disease (50). To maintain continuity of care, the treatments were performed at home (931), in the hospital ward (282), or in the gymnasium of our Physiotherapy Service (185). The physiotherapist was able to start or to continue assistance at home or in the hospital, and to keep up the programme based on the child's needs. Integrated home/hospital physiotherapy for children suffering from cancer is feasible and is useful for maintaining continuity of treatment without lengthening hospitalisation.

Summary of Session 2 'Machine Studies'

Energy Technology Data Exchange (ETDEWEB)

Assmann, R W; Papotti, G [European Organization for Nuclear Research, Geneva (Switzerland)

2012-07-01

This document summarizes the talks and discussion that took place in the second session of the Chamonix 2012 workshop concerning results from machine studies performed in 2011. The session consisted of the following presentations: “LHC experience with different bunch spacings” by G. Rumolo; “Observations of beam-beam effects in MDs in 2011” by W. Herr; “Beam-induced heating/ bunch length/RF and lessons for 2012” by E. Metral; “Lessons in beam diagnostics” by R. Jones; “Quench margins” by M. Sapinski; “First demonstration with beam of the Achromatic Telescopic Squeeze (ATS)” by S. Fartoukh. (author)

Summary of Session 2 "Machine Studies"

CERN Document Server

Assmann, R W

2012-01-01

This document summarizes the talks and discussion that took place in the second session of the Chamonix 2012 workshop concerning results from machine studies performed in 2011. The session consisted of the following presentations: “LHC experience with different bunch spacings” by G. Rumolo; “Observations of beam-beam effects in MDs in 2011” by W. Herr; “Beam-induced heating/ bunch length/RF and lessons for 2012” by E. Metral; “Lessons in beam diagnostics” by R. Jones; “Quench margins” by M. Sapinski; “First demonstration with beam of the Achromatic Telescopic Squeeze (ATS)” by S. Fartoukh.

The assessment of neonates’ exposure to traumatic factors in the cardiac ward within the first 24 hours of hospitalization

Directory of Open Access Journals (Sweden)

Grażyna Cepuch

2016-03-01

Full Text Available Introduction: During the first 24 hours of hospitalization, neonates with ductus-dependent CHD are exposed to a number of traumatic impulses arising from the need for necessary care and therapeutic procedures. Material and methods: The studied group consisted of neonates in a stable condition, suffering from ductusdependent CHD, monitored from the first to the fifth day of their life. The research involved the observation of 10 patients of the cardiac ward at the University Children’s Hospital. The research was carried out by means of the following methods: observation with available assessment tools, such as author’s questionnaire, CRIES scale, sound level meter and stopper. Results: The total number of all procedures performed on the group of 10 neonates amounted to 622 per day. The average number of invasive procedures per day performed on one patient was 6.6, while the procedures connected with touching averaged at 57.3. The average daily noise level amounted to 72.2 dB; the total daily time of exposure to artificial light averaged at 87 minutes, with the average duration of a single lighting episode lasting 14.6 minutes. The average pain level of a neonate connected with chosen invasive procedures fell between 5 and 7 points in the CRIES scale. Conclusions: The impact of traumatic factors disrupts the process of adaptation, may adversely influence further development of central nervous system, perception and sense organs and disturbs psychological development.

Outbreak by ventilator-associated ST11 K. pneumoniae with co-production of CTX-M-24 and KPC-2 in SICU of a tertiary teaching hospital in central China

Directory of Open Access Journals (Sweden)

Longhua Hu

2016-08-01

Full Text Available The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU and 13 were isolated from ventilators. Twenty-four of 28 patients infected by CRKP have been submitted to mechanical ventilation using ventilator. More than 95% of the CRKP isolates were resistant to 13 antimicrobials tested.All CRKP isolates were confirmed as carbapenemase producer and were positive for blaKPC-2, with one positive for both blaKPC-2 and blaNDM-1. All carbapenemase-producing isolates harbored at least one of extended spectrum βlactamase genes tested, among which95.1% (39/41 of the tested isolates were found to harbor both blaCTX-M-24 and blaKPC-2, Of note, one isolate harbored simultaneously two carbapenemase genes (blaKPC-2 and blaNDM-1 and two ESBL genes (blaCTX-M-3 and blaTEM-104 . To the best of our knowledge, coexistence of blaKPC-2 and blaCTX-M-24 in one isolate is first reported. MLST results showed that 41 CRKP isolates belonged to 4 sequence types (STs including ST11, novel ST1854, novel ST1855 and ST1224. PFGE results displayed 3 PFGE clusters. Thirty-eight ST11 CRKP isolates (92.7%, 38/41 including all 13 isolates from ventilators and 25 isolates from patients from 7 wards (18 from是ICU belonged to same PFGE cluster, indicating these isolates were clonally related. Fifteen isolates have an identical undistinguished pattern (100% similarity forming a single clonal population. Moreover, this clone was exclusively linked to the cases attended in SICU and linked to the Ventilators. Additionally, the other SICU cases were

Application of a nonrandomized stepped wedge design to evaluate an evidence-based quality improvement intervention: a proof of concept using simulated data on patient-centered medical homes.

Science.gov (United States)

Huynh, Alexis K; Lee, Martin L; Farmer, Melissa M; Rubenstein, Lisa V

2016-10-21

Stepped wedge designs have gained recognition as a method for rigorously assessing implementation of evidence-based quality improvement interventions (QIIs) across multiple healthcare sites. In theory, this design uses random assignment of sites to successive QII implementation start dates based on a timeline determined by evaluators. However, in practice, QII timing is often controlled more by site readiness. We propose an alternate version of the stepped wedge design that does not assume the randomized timing of implementation while retaining the method's analytic advantages and applying to a broader set of evaluations. To test the feasibility of a nonrandomized stepped wedge design, we developed simulated data on patient care experiences and on QII implementation that had the structures and features of the expected data from a planned QII. We then applied the design in anticipation of performing an actual QII evaluation. We used simulated data on 108,000 patients to model nonrandomized stepped wedge results from QII implementation across nine primary care sites over 12 quarters. The outcome we simulated was change in a single self-administered question on access to care used by Veterans Health Administration (VA), based in the United States, as part of its quarterly patient ratings of quality of care. Our main predictors were QII exposure and time. Based on study hypotheses, we assigned values of 4 to 11 % for improvement in access when sites were first exposed to implementation and 1 to 3 % improvement in each ensuing time period thereafter when sites continued with implementation. We included site-level (practice size) and respondent-level (gender, race/ethnicity) characteristics that might account for nonrandomized timing in site implementation of the QII. We analyzed the resulting data as a repeated cross-sectional model using HLM 7 with a three-level hierarchical data structure and an ordinal outcome. Levels in the data structure included patient ratings

Random and non-random mating populations: Evolutionary dynamics in meiotic drive.

Science.gov (United States)

Sarkar, Bijan

2016-01-01

Game theoretic tools are utilized to analyze a one-locus continuous selection model of sex-specific meiotic drive by considering nonequivalence of the viabilities of reciprocal heterozygotes that might be noticed at an imprinted locus. The model draws attention to the role of viability selections of different types to examine the stable nature of polymorphic equilibrium. A bridge between population genetics and evolutionary game theory has been built up by applying the concept of the Fundamental Theorem of Natural Selection. In addition to pointing out the influences of male and female segregation ratios on selection, configuration structure reveals some noted results, e.g., Hardy-Weinberg frequencies hold in replicator dynamics, occurrence of faster evolution at the maximized variance fitness, existence of mixed Evolutionarily Stable Strategy (ESS) in asymmetric games, the tending evolution to follow not only a 1:1 sex ratio but also a 1:1 different alleles ratio at particular gene locus. Through construction of replicator dynamics in the group selection framework, our selection model introduces a redefining bases of game theory to incorporate non-random mating where a mating parameter associated with population structure is dependent on the social structure. Also, the model exposes the fact that the number of polymorphic equilibria will depend on the algebraic expression of population structure. Copyright © 2015 Elsevier Inc. All rights reserved.

Predicting E-commerce Consumer Behaviour Using Sparse Session Data

OpenAIRE

Thorrud, Thorstein Kaldahl; Myklatun, Øyvind

2015-01-01

This thesis research consumer behavior in an e-commerce domain by using a data set of sparse session data collected from an anonymous European e-commerce site. The goal is to predict whether a consumer session results in a purchase, and if so, which items are purchased. The data is supplied by the ACM Recommender System Challenge, which is a yearly challenge held by the ACM Recommender System Conference. Classification is used for predicting whether or not a session made a purchase, as w...

Summary of the relativistic heavy ion sessions

International Nuclear Information System (INIS)

Harris, J.W.

1988-01-01

The topics covered in the Relativistic Heavy Ion Sessions span four orders of magnitude in energy in the laboratory and a few more in theory. In the two years since the last Intersections conference, experiments in the field of very high energy heavy ion research have begun at CERN and Brookhaven. The prime motivation for these experiments is the possibility of forming quark matter. This paper is a review of the topics covered in the Relativistic Heavy Ion Sessions

Proceedings of the eighth annual DOE low-level waste management forum: Executive summary, opening plenary session, closing plenary session, attendees

Energy Technology Data Exchange (ETDEWEB)

1987-02-01

The Eighth Annual DOE (Department of Energy) Low-Level Waste Management Forum was held in September 1986, in Denver, Colorado, to provide a forum for exchange of information on low-level radioactive waste (LLW) management activities, requirements, and plans. The one hundred ninety attendees included representatives from the DOE Nuclear Energy and Defense Low-Level Waste Management Programs, DOE Operations Offices and their contractors; representatives from the US Nuclear Regulatory Commission (NRC), US Environmental Protection Agency (EPA), US Geological Survey, and their contractors; representatives of states and regions responsible for development of new commercial low-level waste disposal facilities; representatives of utilities, private contractors, disposal facility operators, and other parties concerned with low-level waste management issues. Plenary sessions were held at the beginning and conclusion of the meeting, while eight concurrent topical sessions were held during the intervening two days. The meeting was organized by topical areas to allow for information exchange and discussion on current and future low-level radioactive waste management challenges. Session chairmen presented summaries of the discussions and conclusions resulting from their respective sessions. Selected papers in this volume have been processed for inclusion in the Energy Data Base.

Proceedings of the eighth annual DOE low-level waste management forum: Executive summary, opening plenary session, closing plenary session, attendees

International Nuclear Information System (INIS)

1987-02-01

The Eighth Annual DOE (Department of Energy) Low-Level Waste Management Forum was held in September 1986, in Denver, Colorado, to provide a forum for exchange of information on low-level radioactive waste (LLW) management activities, requirements, and plans. The one hundred ninety attendees included representatives from the DOE Nuclear Energy and Defense Low-Level Waste Management Programs, DOE Operations Offices and their contractors; representatives from the US Nuclear Regulatory Commission (NRC), US Environmental Protection Agency (EPA), US Geological Survey, and their contractors; representatives of states and regions responsible for development of new commercial low-level waste disposal facilities; representatives of utilities, private contractors, disposal facility operators, and other parties concerned with low-level waste management issues. Plenary sessions were held at the beginning and conclusion of the meeting, while eight concurrent topical sessions were held during the intervening two days. The meeting was organized by topical areas to allow for information exchange and discussion on current and future low-level radioactive waste management challenges. Session chairmen presented summaries of the discussions and conclusions resulting from their respective sessions. Selected papers in this volume have been processed for inclusion in the Energy Data Base

Effects of two physiotherapy booster sessions on outcomes with home exercise in people with knee osteoarthritis: a randomized controlled trial.

Science.gov (United States)

Bennell, Kim L; Kyriakides, Mary; Hodges, Paul W; Hinman, Rana S

2014-11-01

Enhancing exercise adherence over the longer term is an important goal in self-management of knee osteoarthritis (OA). Following an initial period of more intensive exercise supervision, this study investigated whether 2 additional physiotherapy visits improved outcomes with continued home exercise over a subsequent 24-week period. A total of 78 people with medial knee OA (mean ± SD age 62.1 ± 6.9 years, mean ± SD body mass index 29.4 ± 4.0 kg/m(2) , and radiographic disease severity 19% mild, 49% moderate, and 32% severe) who completed a 12-week physiotherapist-supervised exercise trial were randomly allocated to 2 30-minute physiotherapy booster sessions (delivered by 8 physiotherapists in private clinics) or no booster sessions for the subsequent 24 weeks. All participants were asked to continue home exercises 4 times weekly. Primary outcomes were change in pain, using a 100-mm visual analog scale, and self-reported physical function, measured using the Western Ontario McMaster Universities Osteoarthritis Index. Participants and physiotherapists were unblinded to group allocation, although participants were blinded to the study hypothesis. A total of 74 participants (95%) completed the trial. There was no significant difference between groups for change in pain (mean difference [95% confidence interval (95% CI)] 0.7 mm [-9.4, 8.0]; P = 0.88) or physical function (-0.3 units [95% CI -4.0, 3.5]; P = 0.88). The mean ± SD percentage of home exercise sessions completed was 56% ± 34% in the booster group and 51% ± 37% in the control group (P > 0.05). Two booster sessions with a physiotherapist did not influence pain or physical function outcomes, or measures of home exercise adherence. These findings suggest other more effective strategies are needed to maximize longer-term adherence with the aim to achieve greater improvements in clinical outcomes from exercise in this patient population. Copyright © 2014 by the American College of Rheumatology.

Instruments for documentation of music therapy sessions

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner

It is an important part of the clinical music therapy work to document the daily sessions. For the clinician it is necessary to have a brief overview of each session in order to assess the methods and the process, and not least to be able to give clear reports of these issues to other health care...... professionals at staff meetings, conferences, etc. For music therapists with many clients there is not time enough during a working day to provide comprehensive process descriptions in the music therapy log. Therefore instruments that help the clinician in reducing and structuring this information are needed....... Danish and Norwegian music therapist have collaborated on developing a one page sheet with a structured form where they after each music therapy session document their use of methods and techniques in individual music therapy with persons with dementia. With this instrument therapists have easy access...

Validity and reliability of the session-RPE method for quantifying training load in karate athletes.

Science.gov (United States)

Tabben, M; Tourny, C; Haddad, M; Chaabane, H; Chamari, K; Coquart, J B

2015-04-24

To test the construct validity and reliability of the session rating of perceived exertion (sRPE) method by examining the relationship between RPE and physiological parameters (heart rate: HR and blood lactate concentration: [La --] ) and the correlations between sRPE and two HR--based methods for quantifying internal training load (Banister's method and Edwards's method) during karate training camp. Eighteen elite karate athletes: ten men (age: 24.2 ± 2.3 y, body mass: 71.2 ± 9.0 kg, body fat: 8.2 ± 1.3% and height: 178 ± 7 cm) and eight women (age: 22.6 ± 1.2 y, body mass: 59.8 ± 8.4 kg, body fat: 20.2 ± 4.4%, height: 169 ± 4 cm) were included in the study. During training camp, subjects participated in eight karate--training sessions including three training modes (4 tactical--technical, 2 technical--development, and 2 randori training), during which RPE, HR, and [La -- ] were recorded. Significant correlations were found between RPE and physiological parameters (percentage of maximal HR: r = 0.75, 95% CI = 0.64--0.86; [La --] : r = 0.62, 95% CI = 0.49--0.75; P training load ( r = 0.65--0.95; P reliability of the same intensity across training sessions (Cronbach's α = 0.81, 95% CI = 0.61--0.92). This study demonstrates that the sRPE method is valid for quantifying internal training load and intensity in karate.

77 FR 55860 - Tribal Listening Sessions on Sacred Sites on Federal Lands

Science.gov (United States)

2012-09-11

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Tribal Listening Sessions on Sacred Sites on... conduct a listening session with Indian tribes to obtain oral and written comments concerning sacred sites located on Federal lands. This session in Tulsa, Oklahoma, is the sixth in a series of listening sessions...

24th ICM

CERN Document Server

Yeung, David

2003-01-01

Since the first Congress in Zürich in 1897, the ICM has been an eagerly­ awaited event every four years. Many of these occasions are celebrated for historie developments and seminal contributions to mathematics. 2002 marks the year of the 24th ICM, the first of the new millennium. Also historie is the first ICM Satellite Conference devoted to game theory and applications. It is one of those rare occasions, in which masters of the field are able to meet under congenial surroundings to talk and share their gathered wisdom. As is usually the case in ICM meetings, participants of the ICM Satellite Conference on Game Theory and Applications (Qingdao, August 2(02) hailed from the four corners of the world. In addition to presentations of high qual­ ity research, the program also included twelve invited plenary sessions with distinguished speakers. This volume, which gathers together selected papers read at the conference, is divided into four sections: (I) Foundations, Concepts, and Structure. (II) Equilibrium P...

Can electrical stimulation enhance effects of a functional training program in hospitalized geriatric patients?

Science.gov (United States)

Zinglersen, Amanda Hempel; Halsteen, Malte Bjoern; Kjaer, Michael; Karlsen, Anders

2018-06-01

Hospitalization of older medical patients may lead to functional decline. This study investigated whether simultaneously applied neuromuscular electrical stimulation (NMES) can enhance the effects of a functional training program in hospitalized geriatric patients. This was a quasi-randomized controlled trial in geriatric hospitalized patients (N = 16, age = 83.1 ± 8.1 years, mean ± SD). The patients performed a simple and time efficient chair-stand based functional exercise program daily, either with (FT + NMES, N = 8) or without (FT, N = 8) simultaneous NMES to the knee extensor muscles. Physical function was assessed at day 2 and 6-10 of the hospitalization with the De Morton Mobility Index (DEMMI), a 30-second chair stand test (30 s-CST) and a 4-meter gait speed test (4 m-GST). Additionally, the pooled results of training from the two training groups (TRAINING, N = 16) was compared to a similar historical control-group (CON, N = 48) receiving only standard-care. Eight patients were assigned to FT, 12 to FT+NMES with 4 dropouts during intervention. During the 6-10 days of hospitalization, both groups improved in all functional measures (p  0.05). The training sessions within the FT+NMES-group were more time consuming (~11 vs ~7 min) and entailed higher levels of discomfort than FT-training sessions. Compared to standard-care, training resulted in significantly larger improvements in the 30 s-CST (TRAINING: +3.8 repetitions; CON: +1.4 repetitions, p functional training program improves chair stand performance in hospitalized geriatric patients, with no additional effect of simultaneous electrical muscle stimulation. Copyright © 2018 Elsevier Inc. All rights reserved.

Pain Levels Within 24 Hours After UFE: A Comparison of Morphine and Fentanyl Patient-Controlled Analgesia

International Nuclear Information System (INIS)

Kim, Hyun S.; Czuczman, Gregory J.; Nicholson, Wanda K.; Pham, Luu D.; Richman, Jeffrey M.

2008-01-01

The purpose of this study was to assess the presence and severity of pain levels during 24 h after uterine fibroid embolization (UFE) for symptomatic leiomyomata and compare the effectiveness and adverse effects of morphine patient-controlled analgesia (PCA) versus fentanyl PCA. We carried out a prospective, nonrandomized study of 200 consecutive women who received UFE and morphine or fentanyl PCA after UFE. Pain perception levels were obtained on a 0-10 scale for the 24-h period after UFE. Linear regression methods were used to determine pain trends and differences in pain trends between two groups and the association between pain scores and patient covariates. One hundred eighty-five patients (92.5%) reported greater-than-baseline pain after UFE, and 198 patients (99%) required IV opioid PCA. One hundred thirty-six patients (68.0%) developed nausea during the 24-h period. Seventy-two patients (36%) received morphine PCA and 128 (64%) received fentanyl PCA, without demographic differences. The mean dose of morphine used was 33.8 ± 26.7 mg, while the mean dose of fentanyl was 698.7 ± 537.4 μg. Using this regimen, patients who received morphine PCA had significantly lower pain levels than those who received fentanyl PCA (p < 0.0001). We conclude that patients develop pain requiring IV opioid PCA within 24 h after UFE. Morphine PCA is more effective in reducing post-uterine artery embolization pain than fentanyl PCA. Nausea is a significant adverse effect from opioid PCA.

The physiological response to cold-water immersion following a mixed martial arts training session.

Science.gov (United States)

Lindsay, Angus; Carr, Sam; Cross, Sean; Petersen, Carl; Lewis, John G; Gieseg, Steven P

2017-05-01

Combative sport is one of the most physically intense forms of exercise, yet the effect of recovery interventions has been largely unexplored. We investigated the effect of cold-water immersion on structural, inflammatory, and physiological stress biomarkers following a mixed martial arts (MMA) contest preparation training session in comparison with passive recovery. Semiprofessional MMA competitors (n = 15) were randomly assigned to a cold-water immersion (15 min at 10 °C) or passive recovery protocol (ambient air) completed immediately following a contest preparation training session. Markers of muscle damage (urinary myoglobin), inflammation/oxidative stress (urinary neopterin + total neopterin (neopterin + 7,8-dihydroneopterin)), and hypothalamic-pituitary axis (HPA) activation (saliva cortisol) were determined before, immediately after, and 1, 2, and 24 h postsession. Ratings of perceived soreness and fatigue, counter movement jump, and gastrointestinal temperature were also measured. Concentrations of all biomarkers increased significantly (p < 0.05) postsession. Cold water immersion attenuated increases in urinary neopterin (p < 0.05, d = 0.58), total neopterin (p < 0.05, d = 0.89), and saliva cortisol after 2 h (p < 0.05, d = 0.68) and urinary neopterin again at 24 h (p < 0.01, d = 0.57) in comparison with passive recovery. Perceived soreness, fatigue, and gastrointestinal temperatures were also lower for the cold-water immersion group at several time points postsession whilst counter movement jump did not differ. Combative sport athletes who are subjected to impact-induced stress may benefit from immediate cold-water immersion as a simple recovery intervention that reduces delayed onset muscle soreness as well as macrophage and HPA activation whilst not impairing functional performance.

Secured Session-key Distribution using control Vector Encryption / Decryption Process

International Nuclear Information System (INIS)

Ismail Jabiullah, M.; Abdullah Al-Shamim; Khaleqdad Khan, ANM; Lutfar Rahman, M.

2006-01-01

Frequent key changes are very much desirable for the secret communications and are thus in high demand. A session-key distribution technique has been designed and implemented using the programming language C on which the communication between the end-users is encrypted is used for the duration of a logical connection. Each session-key is obtained from the key distribution center (KDC) over the same networking facilities used for end-user communication. The control vector is cryptographically coupled with the session-key at the time of key generation in the KDC. For this, the generated hash function, master key and the session-key are used for producing the encrypted session-key, which has to be transferred. All the operations have been performed using the C programming language. This process can be widely applicable to all sorts of electronic transactions online or offline; commercially and academically.(authors)

Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers.

Science.gov (United States)

Myers Virtue, Shannon; Manne, Sharon L; Darabos, Kathleen; Heckman, Carolyn J; Ozga, Melissa; Kissane, David; Rubin, Stephen; Rosenblum, Norman

2015-09-01

The aim of this study was to describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotion episodes during early and later sessions was associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention and a supportive counseling intervention, for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy sessions for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = 0.02). A higher number of emotion episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p psychotherapy among women diagnosed with gynecological cancer. Copyright © 2014 John Wiley & Sons, Ltd.

Outcomes of antiretroviral treatment: a comparison between hospitals and health centers in Ethiopia.

Science.gov (United States)

Balcha, Taye T; Jeppsson, Anders

2010-01-01

the objective of this study was to compare the outcomes of antiretroviral therapy (ART) between hospital and health center levels in Ethiopia. medical records of 1709 ART patients followed for 24 months at 2 hospitals and 3 health centers in the Oromia region of Ethiopia were reviewed. Noted outcomes of ART were currently alive and on treatment; lost to follow-up (LTFU); transferred out (TO); and died (D). of 1709 HIV-positive patients started on ART between September 2006 and February 2007, 1044 (61%) remained alive and were on treatment after 24-month follow-up. In all, 835 (57%) of ART patients at hospitals and 209 (83%) at health centers were retained in the program. Of those who were alive and receiving ART, 79% of patients at health centers and 72% at hospitals were clinically or immunologically improving. In addition, 331 (23%) patients at hospitals were LFTU as compared to 24 (10%) of patients at health centers (relative risk [RR] at 95% confidence interval [CI]: .358 [.231-.555]). While 11% was the mortality rate at hospitals, 5% of patients at health centers also died (RR at 95% CI: .360 [.192-.673]). antiretroviral therapy at health centers was associated with more favorable outcomes than at hospitals.

Surveillance of multidrug resistant suppurative infection causing bacteria in hospitalized patients in an Indian tertiary care hospital

OpenAIRE

Nabakishore Nayak; Rajesh K. Lenka; Rabindra N. Padhy

2014-01-01

Objective: To examine antibiograms of a cohort of suppurative bacteria isolated from wound-swabs from hospitalized patients of all economic groups of a typical Indian teaching hospital. Methods: In surveillance, antibiotic resistance patterns of 10 species of suppurative bacteria isolated from wound-swabs over a period of 24 months were recorded. Those were subjected to antibiotic sensitivity test, using 16 prescribed antibiotics of 5 different groups (3 aminoglycosides, 4 beta-lactams, 3 ...

Stapled hemorrhoidopexy: The Aga Khan University Hospital Experience

International Nuclear Information System (INIS)

Athar, Ali; Chawla, Tabish; Turab, Pishori

2009-01-01

Stapled hemorrhoidopexy for prolapsing hemorrhoids is conceptually different from excision hemorrhoidectomy. It does not accompany the pain that usually occurs after resection of the sensitive anoderm. This study was carried out to evaluate the clinical outcome of stapled hemorrhoidopexy at The Aga Khan University Hospital. A sample of 140 patients with symptomatic second-, third-, and fourth-degree hemorrhoids and circumferential mucosal prolapse underwent stapled hemorrhoidopexy from July 2002 to July 2007. They were evaluated for postoperative morbidity, analgesic requirement, and recurrence. Seventy-eight percent were males and the mean age was 45 (range 16-90) years. The mean operative time was 35 (15-78) min. The mean parenteral analgesic doses during the first 24 h were 2.1. All patients received oral analgesics alone after 24 h. No significant postoperative morbidity was observed. The mean in-patient hospital stay was 1.3 (0-5) days. Patients were followed-up for 24 (range, 2-48) months. Minor local recurrence of hemorrhoids was seen in four patients and was managed by band ligation. Stapled hemorrhoidopexy procedure was found safe, well tolerated by patients with minimal parenteral analgesic use and early discharge from the hospital. (author)

Topical Session on the Decommissioning and Dismantling Safety Case

International Nuclear Information System (INIS)

2002-01-01

Set up by the Radioactive Waste Management Committee (RWMC), the WPDD brings together senior representatives of national organisations who have a broad overview of Decommissioning and Dismantling (D and D) issues through their work as regulators, implementers, R and D experts or policy makers. These include representatives from regulatory authorities, industrial decommissioners from the NEA Cooperative Programme on Exchange of Scientific and Technical Information on Nuclear Installation Decommissioning Projects (CPD), and cross-representation from the NEA Committee on Nuclear Regulatory Activities, the Committee on Radiation Protection and Public Health, and the RWMC. The EC is a member of the WPDD and the IAEA also participates. This ensures co-ordination amongst activities in these international programmes. Participation from civil society organisations is considered on a case by case basis, and has already taken place through the active involvement of the Group of Municipalities with Nuclear Installations at the first meeting of the WPDD At its second meeting, in Paris, 5-7 December 2001, the WPDD held two topical sessions on the D and D Safety Case and on the Management of Materials from D and D, respectively. This report documents the topical session on the safety case. The topical session was meant to provide an exchange of information and experience on the following issues: What topics should be included in a safety case? Of what should it consist? Is there sufficient and complete guidance nationally and internationally? How do practices differ internationally? Main boundary condition to this session was that it would deal with plants where spent fuel has been removed. Also the topical sessions was kept at a level that makes the most of the varied constituency of the WPDD. Namely, interface issues are important, and issue-identification and discussion was the immediate goal. There was less interest in examining areas where variability amongst national

An open-label, non-randomized comparison of venlafaxine and gabapentin as monotherapy or adjuvant therapy in the management of neuropathic pain in patients with peripheral neuropathy

Directory of Open Access Journals (Sweden)

William Eardley

2010-04-01

Full Text Available William Eardley, Cory TothDepartment of Clinical Neurosciences and the University of Calgary, Calgary, AB, CanadaAbstract: Although many therapies are used in the management of neuropathic pain (NeP due to polyneuropathy (PN, few comparison studies exist. We performed a prospective, non-randomized, unblended, efficacy comparison of the serotonin-norepinephrine reuptake inhibitor venlafaxine, as either monotherapy or adjuvant therapy, with a first-line medication for NeP, gabapentin, in patients with PN-related NeP. VAS pain scores were assessed after 3 and 6 months in intervention groups and in a cohort of patients receiving no pharmacotherapy. In a total of 223 patients, we analyzed pain quantity and quality (visual analogue scale [VAS] score, Brief Pain Inventory [BPI], quality of life and health status measures [EuroQol 5 Domains, EQ-5D], Medical Outcomes Sleep Study Scale [MOSSS], Hospital Anxiety and Depression Scale [HADS] and Short Form 36 Health Survey [SF-36] after 6 months of therapy. Significant improvements in VAS pain scores occurred for all treatment groups after 6 months. Improvements in aspects of daily life and anxiety were identified in all treatment groups. Our data suggest that monotherapy or adjuvant therapy with venlafaxine is comparable to gabapentin for NeP management. We advocate for head-to-head, randomized, double-blinded studies of current NeP therapies.Keywords: peripheral neuropathy, neuropathic pain, pharmacotherapy, venlafaxine, gabapentin

Environmental crimes at the Rocky Flats Nuclear Weapons Facility. Hearings before the Subcommittee on Investigations and Oversight of the Committee on Science, Space and Technology, US House of Representatives, One Hundred Second Congress, Second Session, Volume I

International Nuclear Information System (INIS)

Anon.

1992-01-01

Documented here are the executive session: September 10, 11, 17, 18, 23 [11:00 a.m.], 24, 25, 30, 1992 and the public session: September 23 [2:15 p.m.]; October 2, 5, 1992 of the hearings on the Environmental Crimes at the Rocky Flats Nuclear Weapons Facility. This document is Volume I of the hearings

Beam instability Workshop - plenary sessions

International Nuclear Information System (INIS)

2001-01-01

The purpose of this workshop was to provide a review of the mechanisms of limiting beam instabilities, their cures, including feedback, and beam measurement for synchrotron radiation light sources. 12 plenary sessions took place whose titles are: 1) challenging brilliance and lifetime issues with increasing currents; 2) limiting instabilities in multibunch; 3) experience from high currents in B factories; 4) longitudinal dynamics in high intensity/bunch; 5) Transverse instabilities for high intensity/bunch; 6) working group introduction from ESRF experience; 7) impedance modelling: simulations, minimization; 8) report on the broadband impedance measurements and modelling workshop; 9) feedback systems for synchrotron light sources; 10) beam instabilities diagnostics; 11) harmonic cavities: the pros and cons; and 12) experimental study of fast beam-ion instabilities at PLS. This document gathers the 12 articles that were presented during these sessions

Beam instability Workshop - plenary sessions

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

The purpose of this workshop was to provide a review of the mechanisms of limiting beam instabilities, their cures, including feedback, and beam measurement for synchrotron radiation light sources. 12 plenary sessions took place whose titles are: 1) challenging brilliance and lifetime issues with increasing currents; 2) limiting instabilities in multibunch; 3) experience from high currents in B factories; 4) longitudinal dynamics in high intensity/bunch; 5) Transverse instabilities for high intensity/bunch; 6) working group introduction from ESRF experience; 7) impedance modelling: simulations, minimization; 8) report on the broadband impedance measurements and modelling workshop; 9) feedback systems for synchrotron light sources; 10) beam instabilities diagnostics; 11) harmonic cavities: the pros and cons; and 12) experimental study of fast beam-ion instabilities at PLS. This document gathers the 12 articles that were presented during these sessions.

Antidepressant-like effect of fluoxetine may depend on translocator protein activity and pretest session duration in forced swimming test in mice.

Science.gov (United States)

Kudryashov, Nikita V; Kalinina, Tatiana S; Shimshirt, Alexander A; Korolev, Anton O; Volkova, Anna V; Voronina, Tatiana A

2018-06-01

The antidepressant-like effect of fluoxetine (20 mg/kg i.p.) has been assessed using the forced swimming test (FST) in IRC (CD-1) mice exposed or not to a pretest session of different duration (5 or 20 min). The influence of the mitochondrial translocator protein (TSPO) activity on the antidepressant-like effect of fluoxetine (20 mg/kg i.p.) in the FST was also studied. The antidepressant-like effect of fluoxetine was observed only in mice subjected to a 5-min pretest session 24 h before the FST. The TSPO antagonist PK11195 [1-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinolinecarboxamide; 1 or 3 mg/kg i.p.] inhibited the antidepressant activity of fluoxetine in the FST. In the present study, fluoxetine or PK11195 was administered for a short duration. We suppose that the functional activity of TSPO may depend on a pretest session and that using this procedure is necessary to detect antidepressant activity of fluoxetine-like drugs.

Productivity growth, case mix and optimal size of hospitals. A 16-year study of the Norwegian hospital sector.

Science.gov (United States)

Anthun, Kjartan Sarheim; Kittelsen, Sverre Andreas Campbell; Magnussen, Jon

2017-04-01

This paper analyses productivity growth in the Norwegian hospital sector over a period of 16 years, 1999-2014. This period was characterized by a large ownership reform with subsequent hospital reorganizations and mergers. We describe how technological change, technical productivity, scale efficiency and the estimated optimal size of hospitals have evolved during this period. Hospital admissions were grouped into diagnosis-related groups using a fixed-grouper logic. Four composite outputs were defined and inputs were measured as operating costs. Productivity and efficiency were estimated with bootstrapped data envelopment analyses. Mean productivity increased by 24.6% points from 1999 to 2014, an average annual change of 1.5%. There was a substantial growth in productivity and hospital size following the ownership reform. After the reform (2003-2014), average annual growth was case mix between hospitals, and thus provides a framework for future studies. The study adds to the discussion on optimal hospital size. Copyright © 2017 Elsevier B.V. All rights reserved.

45 CFR 702.16 - Attendance of news media at public sessions.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Attendance of news media at public sessions. 702... Attendance of news media at public sessions. Reasonable access for coverage of public sessions shall be provided to the various communications media, including newspapers, magazines, radio, newsreels, and...

76 FR 42112 - Specialty Crop Committee Stakeholder Listening Sessions

Science.gov (United States)

2011-07-18

... Specialty Crop Committee Stakeholder Listening Sessions AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder listening sessions. SUMMARY: In accordance with the Federal Advisory Committee Act, 5 U.S.C. App 2, the United States Department of Agriculture announces two stakeholder...

Comparative analysis of a client's verbal responses in counseling sessions: quantitative case study.

Science.gov (United States)

Lee, Han-Jong

2011-04-01

This study investigated how the in-session change in a client's verbal behavior might influence the effectiveness of counseling sessions. 10 sessions of counseling with a male undergraduate suffering from depressive mood were conducted by a humanistically oriented counselor. The two most effective and the two least effective sessions were identified according to the client's evaluation of the effectiveness of counseling sessions. Results indicated that over the three segments of the most effective sessions, the client gradually increased responses that indicated exploration of his own emotions, thoughts, and behaviors. By contrast, the client continued talking mainly about past events in a storytelling manner throughout the least effective sessions.

Nurses' medication administration practices at two Singaporean acute care hospitals.

Science.gov (United States)

Choo, Janet; Johnston, Linda; Manias, Elizabeth

2013-03-01

This study examined registered nurses' overall compliance with accepted medication administration procedures, and explored the distractions they faced during medication administration at two acute care hospitals in Singapore. A total of 140 registered nurses, 70 from each hospital, participated in the study. At both hospitals, nurses were distracted by personnel, such as physicians, radiographers, patients not under their care, and telephone calls, during medication rounds. Deviations from accepted medication procedures were observed. At one hospital, the use of a vest during medication administration alone was not effective in avoiding distractions during medication administration. Environmental factors and distractions can impact on the safe administration of medications, because they not only impair nurses' level of concentration, but also add to their work pressure. Attention should be placed on eliminating distractions through the use of appropriate strategies. Strategies that could be considered include the conduct of education sessions with health professionals and patients about the importance of not interrupting nurses while they are administering medications, and changes in work design. © 2013 Wiley Publishing Asia Pty Ltd.

A Study of the Impact of an Educational Intervention on Nurse Attitudes and Behaviours toward Mobile Device Use in Hospital Settings

Directory of Open Access Journals (Sweden)

Lori Giles-Smith

2017-04-01

Full Text Available Introduction: Mobile applications (apps provide nurses with evidence-based information at the bedside. Librarians encourage app use by purchasing licenses and promoting their features. While many high-quality nursing apps exist, there is inconsistency in published reports on whether nurses use them in patient care. The aim of this research is to describe the use of mobile apps by nurses at two urban hospitals and to examine the impact of educational sessions led by hospital librarians and educators on nurse usage, attitudes and behaviour as they relate to mobile apps. Methods: Phase I consisted of a descriptive, cross-sectional survey of in-patient nurses to determine mobile app use and attitudes. Phase II involved a one-group pre/post-test design to examine the impact of education sessions led by librarians and hospital educators on nurse attitudes, usage and behaviours. A post-intervention focus group captured thoughts on using mobile apps at the bedside. Results: Results indicate that most nurses who have a personal mobile device are interested in using them at the bedside though few are currently doing so. While nurses cite many conveniences and uses, they also highlight a number of barriers associated with using mobile devices that must be addressed in order to realize the benefits in patient-centred care. Discussion: Hospital librarians and educators should work together to provide the education and support nurses require to realize the benefits of using apps at the bedside. Larger studies are needed to determine the impact of educational sessions on patient and health provider satisfaction with mobile device use.

Curtailing: handling the complexity of body care in people hospitalized with severe COPD

DEFF Research Database (Denmark)

Lomborg, Kirsten; Kirkevold, Marit

2005-01-01

that requires substantial efforts on the part of both patients and nurses. The aim of this study was to report on the complex pattern of APBC in hospitalized patients with severe COPD and highlight significant characteristics that should be considered in clinical practice in order to support patients' comfort...... interviews with patients and nurses after the sessions. Findings show that APBC in hospitalized patients with severe COPD is a complex integrated pattern of body care activities that can proceed with a greater or lesser degree of success. The main problem is how to keep the patient's breathing under control...

Resume and discussion of session on direct heavy ion reactions

International Nuclear Information System (INIS)

Hansen, O.

1983-01-01

A conference divides into sessions, but the physics does not always respect such divisions. I found the subject of barrier penetrabilities viewed in a coupled channels picture new, exciting and central to all heavy-ion reaction dynamics. The subject was discussed in bits and pieces over three different sessions, partly in the talks by Winther, Landowne, Braun-Munzinger and Broglia, and partly from the floor by the same people and by Smilanski, I have concentrated on that subject alone and I therefore must apologize to the speakers in my session who covered different material, that definitely merited further discussions. Also, I apologize to other session chairmen, whose territory I have invaded. (orig.)

24 CFR 242.26 - Agreed interest rate.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Agreed interest rate. 242.26... MORTGAGE INSURANCE FOR HOSPITALS Mortgage Requirements § 242.26 Agreed interest rate. (a) The mortgage shall bear interest at the rate or rates agreed upon by the mortgagee and the mortgagor. (b) The amount...

[Experience of liaison psychiatry in Morocco: transversal study over 24 months].

Science.gov (United States)

Barrimi, M; Elghazouani, F; Aarab, C; Tliji, A; Rharrabti, S; Lahlou, F; Rammouz, I; Aalouane, R

2014-10-01

Liaison psychiatry is a discipline caring for psychiatric disorders in patients of general hospitals. It involves clinical, educational, and research aspects. The liaison psychiatry supports patients hospitalized for full-time in medical and surgical departments, patients admitted in day-hospital and patients treated in the emergency department. In this transversal study, we assessed the liaison psychiatry impact that is still in development stage in Morocco. This study lasted 24 months, and was conducted at the University Hospital in Fez, Morocco. The goal of this work was to evaluate the prevalence of psychiatric disorders managed by liaison psychiatry, identify those requiring medical and surgical departments of such psychiatric support, and classify the motivations involved in their needs. This transversal study was initiated in January 2010 and has lasted 24 months. The study recruited 180 patients requiring psychiatric consultation from different medical and surgical departments at the University Hospital in Fes, Morocco. The psychiatric assessment was based on a psychiatric interview using the MINI. The data were collected by a certified psychiatrist using a questionnaire containing 24 items. After initial psychiatric assessment, the follow-up was proposed to the patient in the psychiatric department. During this study, 22 medical and surgical departments of our University Hospital had requested a psychiatric assessment for their patients. Most demands were respectively emitted by the Department of Dermatology (16%) and Nephrology (11%). The most common motivations for psychiatric consultations were respectively psychomotor agitation (17%) and an evaluation of suicide attempts (17%). Depressive and psychotic disorders were the most diagnosed disorders with 47% and 11% respectively. The psychiatric support was based on pharmacological treatment in 60% of cases. Finally, the outcome was favourable in 80% of followed cases. Hospitalized patients in different

Dissecting the role of sessional anatomy teachers: A systematic literature review.

Science.gov (United States)

Rhodes, Danielle; Fogg, Quentin A; Lazarus, Michelle D

2017-12-04

Worldwide there is a growing reliance on sessional teachers in universities. This has impacted all disciplines in higher education including medical anatomy programs. The objective of this review was to define the role and support needs of sessional anatomy teachers by reporting on the (1) qualifications, (2) teaching role, (3) training, and (4) performance management of this group of educators. A systematic literature search was conducted on the 27 July 2017 in Scopus, Web of Science, and several databases on the Ovid, ProQuest and EBSCOhost platforms. The search retrieved 5,658 articles, with 39 deemed eligible for inclusion. The qualifications and educational distance between sessional anatomy teachers and their students varied widely. Reports of cross-level, near-peer and reciprocal-peer teaching were identified, with most institutes utilizing recent medical graduates or medical students as sessional teachers. Sessional anatomy teachers were engaged in the full spectrum of teaching-related duties from assisting students with cadaveric dissection, to marking student assessments and developing course materials. Fourteen institutes reported that training was provided to sessional anatomy teachers, but the specific content, objectives, methods and effectiveness of the training programs were rarely defined. Evaluations of sessional anatomy teacher performance primarily relied on subjective feedback measures such as student surveys (n = 18) or teacher self-assessment (n = 3). The results of this systematic review highlight the need for rigorous explorations of the use of sessional anatomy teachers in medical education, and the development of evidence-based policies and training programs that regulate and support the use of sessional teachers in higher education. Anat Sci Educ. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Effect of Nigella sativa supplementation over a one-year period on lipid levels, blood pressure and heart rate in type-2 diabetic patients receiving oral hypoglycemic agents: nonrandomized clinical trial.

Science.gov (United States)

Badar, Ahmed; Kaatabi, Huda; Bamosa, Abdullah; Al-Elq, Abdulmohsen; Abou-Hozaifa, Bodour; Lebda, Fatma; Alkhadra, Akram; Al-Almaie, Sameeh

2017-01-01

Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications. To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA). Single-blind, nonrandomized. Diabetes clinic of a university hospital in Saudi Arabia. Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups. Lipid and cardiovascular parameters, and BMI. Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group. N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents. There were 9 subjects in each group lost to follow up

Cold-water immersion after training sessions: Effects on fiber type-specific adaptations in muscle K+ transport proteins to sprint-interval training in men.

Science.gov (United States)

Christiansen, Danny; Bishop, David John; Broatch, James R; Bangsbo, Jens; McKenna, Michael John; Murphy, Robyn M

2018-05-10

Effects of regular use of cold-water immersion (CWI) on fiber type-specific adaptations in muscle K + transport proteins to intense training, along with their relationship to changes in mRNA levels after the first training session, were investigated in humans. Nineteen recreationally-active men (24{plus minus}6 y, 79.5{plus minus}10.8 kg, 44.6{plus minus}5.8 mL∙kg -1 ∙min -1 ) completed six weeks of sprint-interval cycling either without (passive rest; CON) or with training sessions followed by CWI (15 min at 10{degree sign}C; COLD). Muscle biopsies were obtained before and after training to determine abundance of Na + ,K + -ATPase isoforms (α 1-3 , β 1-3 ) and FXYD1, and after recovery treatments (+0h and +3h) on the first day of training to measure mRNA content. Training increased (ptraining (p>0.05). CWI after each session did not influence responses to training (p>0.05). However, α 2 mRNA increased after the first session in COLD (+0h, p0.05). In both conditions, α 1 and β 3 mRNA increased (+3h; p 0.05) after the first session. In summary, Na + ,K + -ATPase isoforms are differently regulated in type I and II muscle fibers by sprint-interval training in humans, which for most isoforms do not associate with changes in mRNA levels after the first training session. CWI neither impairs nor improves protein adaptations to intense training of importance for muscle K + regulation.

Design and Baseline Findings of a Multi-site Non-randomized Evaluation of the Effect of a Health Programme on Microfinance Clients in India

OpenAIRE

Saha, Somen

2013-01-01

Microfinance is the provision of financial services for the poor. Health program through microfinance has the potential to address several access barriers to health. We report the design and baseline findings of a multi-site non-randomized evaluation of the effect of a health program on the members of two microfinance organizations from Karnataka and Gujarat states of India. Villages identified for roll-out of health services with microfinance were pair-matched with microfinance only villages...

76 FR 50224 - Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center...

Science.gov (United States)

2011-08-12

...] Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for... (CMS). This two-day training session is the second Accelerated Development Learning Session (ADLS.... Through Accelerated Development Learning Sessions (ADLS), the Innovation Center will test whether...

Multiple sclerosis and alcohol use disorders: In-hospital mortality, extended hospital stays, and overexpenditures.

Science.gov (United States)

Gili-Miner, M; López-Méndez, J; Vilches-Arenas, A; Ramírez-Ramírez, G; Franco-Fernández, D; Sala-Turrens, J; Béjar-Prado, L

2016-10-22

The objective of this study was to analyse the impact of alcohol use disorders (AUD) in patients with multiple sclerosis (MS) in terms of in-hospital mortality, extended hospital stays, and overexpenditures. We conducted a retrospective observational study in a sample of MS patients obtained from minimal basic data sets from 87 Spanish hospitals recorded between 2008 and 2010. Mortality, length of hospital stays, and overexpenditures attributable to AUD were calculated. We used a multivariate analysis of covariance to control for such variables as age and sex, type of hospital, type of admission, other addictions, and comorbidities. The 10,249 patients admitted for MS and aged 18-74 years included 215 patients with AUD. Patients with both MS and AUD were predominantly male, with more emergency admissions, a higher prevalence of tobacco or substance use disorders, and higher scores on the Charlson comorbidity index. Patients with MS and AUD had a very high in-hospital mortality rate (94.1%) and unusually lengthy stays (2.4 days), and they generated overexpenditures (1,116.9euros per patient). According to the results of this study, AUD in patients with MS results in significant increases in-hospital mortality and the length of the hospital stay and results in overexpenditures. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Effect of Play-based Occupational Therapy on Symptoms of Hospitalized Children with Cancer: A Single-subject Study.

Science.gov (United States)

Mohammadi, Ahmad; Mehraban, Afsoon Hassani; Damavandi, Shahla A

2017-01-01

Cancer is one of the four leading causes of death in children. Its courses of diagnosis and treatment can cause physiologic symptoms and psychological distress that secondarily affect children's quality of life and participation in daily activities. The aim of this study was to investigate the effect of play-based occupational therapy on pain, anxiety, and fatigue in hospitalized children with cancer who were receiving chemotherapy. Two hospitalized children with acute lymphoblastic leukemia at least 4 months after diagnoses who received two courses of chemotherapy participated in this pilot study. Takata Play History and Iranian Children Participation Assessment Scale were used to develop intervention protocol. Nine, 30-45 min play-based occupational therapy sessions took place for each child. Children filled out the Faces Pain Scale, Visual Fatigue Scale, and Faces Anxiety Scale before and after each intervention session. Pain, anxiety, and fatigue levels decreased in both participants. Furthermore, the results showed a relationship between pain, anxiety, and fatigue variables in these children. Play-based occupational therapy can be effective in improving pain, anxiety, and fatigue levels in hospitalized children with cancer receiving chemotherapy.

Effect of play-based occupational therapy on symptoms of hospitalized children with cancer: A single-subject study

Directory of Open Access Journals (Sweden)

Ahmad Mohammadi

2017-01-01

Full Text Available Objective: Cancer is one of the four leading causes of death in children. Its courses of diagnosis and treatment can cause physiologic symptoms and psychological distress that secondarily affect children's quality of life and participation in daily activities. The aim of this study was to investigate the effect of play-based occupational therapy on pain, anxiety, and fatigue in hospitalized children with cancer who were receiving chemotherapy. Methods: Two hospitalized children with acute lymphoblastic leukemia at least 4 months after diagnoses who received two courses of chemotherapy participated in this pilot study. Takata Play History and Iranian Children Participation Assessment Scale were used to develop intervention protocol. Nine, 30–45 min play-based occupational therapy sessions took place for each child. Children filled out the Faces Pain Scale, Visual Fatigue Scale, and Faces Anxiety Scale before and after each intervention session. Results: Pain, anxiety, and fatigue levels decreased in both participants. Furthermore, the results showed a relationship between pain, anxiety, and fatigue variables in these children. Conclusions: Play-based occupational therapy can be effective in improving pain, anxiety, and fatigue levels in hospitalized children with cancer receiving chemotherapy.

Music Education and Music Therapy. Introduction to Plenary Session 3

DEFF Research Database (Denmark)

Bonde, Lars Ole

2002-01-01

Chairman's introduction to plenary session on the relationship between music therapy and music pedagogics......Chairman's introduction to plenary session on the relationship between music therapy and music pedagogics...

Helix Nebula Science Cloud pilot phase open session

CERN Multimedia

CERN. Geneva

2018-01-01

This Helix Nebula Science Cloud (HNSciCloud) public session is open to everyone and will be webcast. The session will provide the audience with an overview of the HNSciCloud pre-commercial procurement project and the innovative cloud platforms that have been developed. A number of practical use-cases from the physics community will be presented as well as the next steps to be undertaken.

Parameterized Concurrent Multi-Party Session Types

Directory of Open Access Journals (Sweden)

Minas Charalambides

2012-08-01

Full Text Available Session types have been proposed as a means of statically verifying implementations of communication protocols. Although prior work has been successful in verifying some classes of protocols, it does not cope well with parameterized, multi-actor scenarios with inherent asynchrony. For example, the sliding window protocol is inexpressible in previously proposed session type systems. This paper describes System-A, a new typing language which overcomes many of the expressiveness limitations of prior work. System-A explicitly supports asynchrony and parallelism, as well as multiple forms of parameterization. We define System-A and show how it can be used for the static verification of a large class of asynchronous communication protocols.

Transitioning to a Data Driven Mental Health Practice: Collaborative Expert Sessions for Knowledge and Hypothesis Finding.

Science.gov (United States)

Menger, Vincent; Spruit, Marco; Hagoort, Karin; Scheepers, Floor

2016-01-01

The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard Process for Data Mining (CRISP-DM), suitable for conducting expert sessions that focus on finding new knowledge and hypotheses in collaboration with local workforce. Our proposed specification that we name CRISP-IDM is evaluated in a case study at the psychiatry department of the University Medical Center Utrecht. Expert interviews were conducted to identify seven research themes in the psychiatry department, which were researched in cooperation with local health care professionals using data visualization as a modeling tool. During 19 expert sessions, two results that were directly implemented and 29 hypotheses for further research were found, of which 24 were not imagined during the initial expert interviews. Our work demonstrates the viability and benefits of involving work floor people in the analyses and the possibility to effectively find new knowledge and hypotheses using our CRISP-IDM method.

An improved anti-leech mechanism based on session identifier

Science.gov (United States)

Zhang, Jianbiao; Zhu, Tong; Zhang, Han; Lin, Li

2012-01-01

With the rapid development of information technology and extensive requirement of network resource sharing, plenty of resource hotlinking phenomenons appear on the internet. The hotlinking problem not only harms the interests of legal websites but also leads to a great affection to fair internet environment. The anti-leech technique based on session identifier is highly secure, but the transmission of session identifier in plaintext form causes some security flaws. In this paper, a proxy hotlinking technique based on session identifier is introduced firstly to illustrate these security flaws; next, this paper proposes an improved anti-leech mechanism based on session identifier, the mechanism takes the random factor as the core and detects hotlinking request using a map table that contains random factor, user's information and time stamp; at last the paper analyzes the security of mechanism in theory. The result reveals that the improved mechanism has the merits of simple realization, high security and great flexibility.

Disruption to radiation therapy sessions due to anxiety among patients receiving radiation therapy to the head and neck area can be predicted using patient self-report measures.

Science.gov (United States)

Clover, Kerrie; Oultram, Sharon; Adams, Catherine; Cross, Laraine; Findlay, Naomi; Ponman, Leah

2011-12-01

This analysis sought to determine whether patient self-report measures were associated with disruption to radiation therapy sessions due to anxiety among cancer patients undergoing radiation therapy to the head and neck region. A cohort of patients undergoing radiation therapy to the head and neck region at a major regional radiation oncology treatment centre (ROTC) in Australia completed self-report measures of anxiety, history of panic and fears relevant to use of an immobilising mask. The treating Radiation Therapist (RT) rated the level of session disruption due to patient anxiety during the Computerised Tomography/Simulation (CT/Sim) (baseline) session and first treatment session. Complete data were obtained for 90 patients. RTs rated 11 and 24% of patients as having some level of session disruption session due to anxiety at baseline and Treatment 1, respectively. Five factors were significantly associated with session disruption at baseline in bivariate analyses: currently taking psycho-active medication (p=0.008); fear of enclosed spaces (p=0.006); fear of face being covered up (p=0.006); fear of movement restriction (p=0.041) and ever had an anxiety attack (p=0.034). Sensitivity ranged from 0.57 to 0.75 and specificity ranged from 0.68 to 0.90. Only session disruption at baseline predicted disruption at Treatment 1 (pdisruption and patient self-report measures which might be used to flag patients for prophylactic treatment. Further development and replication in a larger sample is warranted before introduction of these measures into routine practice. Copyright © 2010 John Wiley & Sons, Ltd.

Steps Toward Creating A Therapeutic Community for Inpatients Suffering from Chronic Ulcers: Lessons from Allada Buruli Ulcer Treatment Hospital in Benin.

Directory of Open Access Journals (Sweden)

Arnaud Setondji Amoussouhoui

2016-07-01

Full Text Available Reducing social distance between hospital staff and patients and establishing clear lines of communication is a major challenge when providing in-patient care for people afflicted by Buruli ulcer (BU and chronic ulcers. Research on hospitals as therapeutic communities is virtually non-existent in Africa and is currently being called for by medical anthropologists working in the field of health service and policy planning. This paper describes a pioneering attempt to establish a therapeutic community for patients suffering from BU and other chronic ulcers requiring long term hospital care in Benin.A six-month pilot project was undertaken with the objectives of establishing a therapeutic community and evaluating its impact on practitioner and patient relations. The project was designed and implemented by a team of social scientists working in concert with the current and previous director of a hospital serving patients suffering from advanced stage BU and other chronic ulcers. Qualitative research initially investigated patients' understanding of their illness and its treatment, identified questions patients had about their hospitalization, and ascertained their level of social support. Newly designed question-answer health education sessions were developed. Following these hospital wide education sessions, open forums were held each week to provide an opportunity for patients and hospital staff to express concerns and render sources of discontent transparent. Patient group representatives then met with hospital staff to problem solve issues in a non-confrontational manner. Psychosocial support for individual patients was provided in a second intervention which took the form of drop-in counseling sessions with social scientists trained to serve as therapy facilitators and culture brokers.Interviews with patients revealed that most patients had very little information about the identity of their illness and the duration of their treatment. This

Type Inference for Session Types in the Pi-Calculus

DEFF Research Database (Denmark)

Graversen, Eva Fajstrup; Harbo, Jacob Buchreitz; Huttel, Hans

2014-01-01

In this paper we present a direct algorithm for session type inference for the π-calculus. Type inference for session types has previously been achieved by either imposing limitations and restriction on the π-calculus, or by reducing the type inference problem to that for linear types. Our approach...

Foodborne listeriosis acquired in hospitals.

Science.gov (United States)

Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M

2014-08-15

Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Relationship between healthcare worker surface contacts, care type and hand hygiene: an observational study in a single-bed hospital ward.

Science.gov (United States)

King, M-F; Noakes, C J; Sleigh, P A; Bale, S; Waters, L

2016-09-01

This study quantifies the relationship between hand hygiene and the frequency with which healthcare workers (HCWs) touch surfaces in patient rooms. Surface contacts and hand hygiene were recorded in a single-bed UK hospital ward for six care types. Surface contacts often formed non-random patterns, but hygiene before or after patient contact depends significantly on care type (P=0.001). The likelihood of hygiene correlated with the number of surface contacts (95% confidence interval 1.1-5.8, P=0.002), but not with time spent in the room. This highlights that a potential subconscious need for hand hygiene may have developed in HCWs, which may support and help focus future hygiene education programmes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Shopping around for hospital services: a comparison of the United States and Canada.

Science.gov (United States)

Bell, C M; Crystal, M; Detsky, A S; Redelmeier, D A

1998-04-01

Historical comparisons indicate that US hospitals are more expensive than Canadian hospitals, but health care system reform might have changed the relative costs and timeliness of health care in the 2 countries. To estimate the price and convenience of selected hospital services in the United States and Canada for patients in 1997 had they paid out-of-pocket. Cross-sectional telephone survey conducted May 1996 to April 1997. The 2 largest acute care general hospitals from every city in the United States and Canada with a population greater than 500000. Each hospital was telephoned and asked their price and waiting time for 7 services: magnetic resonance imaging of the head without gadolinium; a screening mammogram; a 12-lead electrocardiogram; a prothrombin time measurement; a session of hemodialysis; a screening colonoscopy; and a total knee replacement. Waiting times were measured in days until earliest appointment and charges were converted to American currency. Overall, 48 US and 18 Canadian hospitals were surveyed. Median waiting times were significantly shorter in American hospitals for 4 services, particularly a magnetic resonance imaging of the head (3 days vs 150 days; Preplacement ($26805 vs $10651; Preplacement in the United States. US hospitals still provide higher prices and faster care than Canadian hospitals for patients who pay out-of-pocket.

CERN Technical Training 2006: Office Software Curriculum Scheduled Course Sessions (October-December 2006)

CERN Multimedia

2006-01-01

The Office Software Curriculum of the CERN Technical Training Programme currently offers comprehensive training in Microsoft Office (Word, Excel, Powerpoint, Access, Outlook), MS Project, Frontpage, Dreamweaver, Indesign, LaTeX, and CERN EDMS. There are some places available on the following Microsoft Office 2003 course sessions, currently scheduled until December 2007: EXCEL 2003 - niveau 2 : ECDL - 16-17 October (2 days, session in French) WORD 2003 (Short Course II) - HowTo... Mail merge - 2 November (morning, bilingual session) WORD 2003 (Short Course IV) - HowTo... Work with master document - 2 November (afternoon, bilingual session) OUTLOOK 2003 (Short Course III) - Meetings and Delegation - 3 November (morning, bilingual session) EXCEL 2003 (Short Course IV) - HowTo... Link cells, worksheets and workbooks - 3 November (afternoon, bilingual session) EXCEL 2003 - Level 1: ECDL - 13-14 November (2 days, session in English) ACCESS 2003 - Level 2: ECDL - 5-6 December (2 days, session in English) The abo...

Laparoscopic Complete Mesocolic Excision versus Open Complete Mesocolic Excision for Transverse Colon Cancer: Long-Term Survival Results of a Prospective Single Centre Non-Randomized Study.

Science.gov (United States)

Storli, Kristian Eeg; Eide, Geir Egil

2016-01-01

Laparoscopic complete mesocolic excision (CME) used in the treatment of transverse colon cancer has been questioned on the basis of the technical challenges. The aim of this study was to evaluate the medium- and long-term clinical and survival outcomes after laparoscopic and open CME for transverse colon cancer and to compare the 2 approaches. This study was a retrospective non-randomized study of patients with prospectively registered data on open and laparoscopic CME for transverse colon cancer tumour-node-metastasis stages I-III operated on between 2007 and 2014. This was a single-centre study in a community teaching hospital. A total of 56 patients with transverse colon cancer were included, excluding those with tumours in the colonic flexures. The outcome aims were 4-year time to recurrence (TTR) and cancer-specific survival (CSS). Morbidity was also measured. The 4-year TTR was 93.9% in the laparoscopic group and 91.3% in the open group (p = 0.71). The 4-year CSS was 97.0% in the laparoscopic group and 91.3% in the open group (p = 0.42). This was a prospective single-institution study with a small sample size. Results of the study suggest that the laparoscopic CME approach might be the preferred approach for transverse colon cancer, especially regarding its benefits in terms of short-term morbidity, length of stay and oncological outcome. © 2016 S. Karger AG, Basel.

Organization of infection control in European hospitals.

Science.gov (United States)

Hansen, S; Zingg, W; Ahmad, R; Kyratsis, Y; Behnke, M; Schwab, F; Pittet, D; Gastmeier, P

2015-12-01

The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) survey was initiated to investigate the status of healthcare-associated infection (HCAI) prevention across Europe. This paper presents the methodology of the quantitative PROHIBIT survey and outlines the findings on infection control (IC) structure and organization including management's support at the hospital level. Hospitals in 34 countries were invited to participate between September 2011 and March 2012. Respondents included IC personnel and hospital management. Data from 309 hospitals in 24 countries were analysed. Hospitals had a median (interquartile range) of four IC nurses (2-6) and one IC doctor (0-2) per 1000 beds. Almost all hospitals (96%) had defined IC objectives, which mainly addressed hand hygiene (87%), healthcare-associated infection reduction (84%), and antibiotic stewardship (66%). Senior management provided leadership walk rounds in about half of hospitals, most often in Eastern and Northern Europe, 65% and 64%, respectively. In the majority of hospitals (71%), sanctions were not employed for repeated violations of IC practices. Use of sanctions varied significantly by region (P hospitals should be a public health priority. Copyright © 2015. Published by Elsevier Ltd.

Rock climbing and acute emotion regulation in patients with major depressive disorder in the context of a psychological inpatient treatment: a controlled pilot trial

Directory of Open Access Journals (Sweden)

Kleinstäuber M

2017-08-01

Full Text Available Maria Kleinstäuber,1,2 Merle Reuter,3 Norbert Doll,4 Andreas J Fallgatter4 1Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, Philipps University, Marburg, Germany; 2Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 3Department of Educational Psychology, Faculty of Psychology, Eberhard Karls University, Tübingen, Germany, 4Department of General Psychiatry and Psychotherapy, University Hospital for Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany Background: Major depressive disorder is characterized by deficits in emotion regulation. This study examined associations between rock climbing and acute emotion regulating effects in patients with major depression. Patients and methods: In a nonrandomized, controlled study, 40 major depressive disorder inpatients were assigned to either a climbing session (n=20 or a relaxation session (n=20. Positive and negative affect, depressiveness, and coping emotions were assessed immediately before and after the session. Results: Mixed analyses of variance and covariance revealed significant time × group interaction effects for all assessed outcomes (p≤0.012: positive affect and coping emotions significantly increased and negative affect and depressiveness significantly decreased after the climbing session (1.04≤ Cohen’s d ≤1.30, in contrast to a relaxation session (0.16≤ Cohen’s d ≤0.36. Conclusion: The results show that rock climbing is associated with acute emotion regulatory effects. These findings have to be replicated with a randomized design, and future research should pay attention to possible mechanisms of rock climbing in regard to emotion regulation. Keywords: physical activity, controlled trial, relaxation, inpatient treatment

USING SESSION RPE TO MONITOR DIFFERENT METHODS OF RESISTANCE EXERCISE

Directory of Open Access Journals (Sweden)

Alison D. Egan

2006-06-01

Full Text Available The purpose of this study was to compare session rating of perceived exertion for different resistance training techniques in the squat exercise. These techniques included traditional resistance training, super slow, and maximal power training. Fourteen college-age women (Mean ± SD; age = 22 ± 3 years; height = 1.68 ± 0. 07 m completed three experimental trials in a randomized crossover design. The traditional resistance training protocol consisted of 6 sets of 6 repetitions of squats using 80% of 1-RM. The super slow protocol consisted of 6 sets of 6 repetitions using 55% of 1-RM. The maximal power protocol consisted of 6 sets of 6 repetitions using 30% of 1-RM. Rating of perceived exertion (RPE measures were obtained following each set using Borg's CR-10 scale. In addition, a session RPE value was obtained 30 minutes following each exercise session. When comparing average RPE and session RPE, no significant difference was found. However, power training had significantly lower (p < 0.05 average and session RPE (4.50 ± 1.9 and 4.5 ± 2.1 compared to both super slow training (7.81 ± 1.75 and 7.43 ± 1.73 and traditional training (7.33 ± 1.52 and 7.13 ± 1.73. The results indicate that session RPE values are not significantly different from the more traditional methods of measuring RPE during exercise bouts. It does appear that the resistance training mode that is used results in differences in perceived exertion that does not relate directly to the loading that is used. Using session RPE provides practitioners with the same information about perceived exertion as the traditional RPE measures. Taking a single measure following a training session would appear to be much easier than using multiple measures of RPE throughout a resistance training workout. However, practitioners should also be aware that the RPE does not directly relate to the relative intensity used and appears to be dependent on the mode of resistance exercise that is used

Long-Term Effects of Neurofeedback Treatment in Autism

Science.gov (United States)

Kouijzer, Mirjam E. J.; de Moor, Jan M. H.; Gerrits, Berrie J. L.; Buitelaar, Jan K.; van Schie, Hein T.

2009-01-01

Previously we demonstrated significant improvement of executive functions and social behavior in children with autism spectrum disorders (ASD) treated with 40 sessions of EEG neurofeedback in a nonrandomized waiting list control group design. In this paper we extend these findings by reporting the long-term results of neurofeedback treatment in…

7 years of MacGyver sessions at EGU and AGU: what happened?

Science.gov (United States)

Hut, Rolf; Selker, John; Weijs, Steven; Luxemburg, Wim; Wickert, Andy; Blume, Theresa; Bamburger, Jan; Stoof, Cathelijne; Tauro, Flavia

2016-04-01

The session that this poster is in, the: "Self-made sensors and unintended use of measurement equipment", also known as the "MacGyver-session" has had 7 years of scientists contributing their self made devices, hacks and solutions with the hydrological community. In 2009, the first session was held at the AGU fall meeting and since 2011 a session is also organised at the EGU General Assembly. On this poster, and in the accompanying review paper, we will present an overview of the work presented in the last 7 years, cataloging the work of the inventive scientists who have contributed to these successful, and above all: fun, sessions.

Electron and muon physics sessions: Summary

International Nuclear Information System (INIS)

Montgomery, H.E.

1988-06-01

The electromagnetic interaction needs no introduction as a probe of the structure of systems on many scales. The continued use of this technique dominated the sessions on Electron and Muon Physics at the Samoset Meeting. The experimental results continue to stimulate large numbers of theorists and the results on polarized deep inelastic muon scattering and their various interpretations permeated beyond these sessions. The breadth of physics attacked with electrons and muons makes a summary such as this rather peculiar. As one of my nuclear physics friends (I think) commented after my summary, ''it was interesting to see Nuclear Physics from a long distance with the telescope inverted.'' The comment may well be applied to this written version of the summary talk. 21 refs

Association of Resident Coverage with Cost, Length of Stay, and Profitability at a Community Hospital

Science.gov (United States)

Shine, Daniel; Beg, Sumbul; Jaeger, Joseph; Pencak, Dorothy; Panush, Richard

2001-01-01

OBJECTIVE The effect of care by medical residents on hospital length of stay (LOS), indirect costs, and reimbursement was last examined across a range of illnesses in 1981; the issue has never been examined at a community hospital. We studied resource utilization and reimbursement at a community hospital in relation to the involvement of medical residents. DESIGN This nonrandomized observational study compared patients discharged from a general medicine teaching unit with those discharged from nonteaching general medical/surgical units. SETTING A 620-bed community teaching hospital with a general medicine teaching unit (resident care) and several general medicine nonteaching units (no resident care). PATIENTS All medical discharges between July 1998 and February 1999, excluding those from designated subspecialty and critical care units. MEASUREMENTS AND MAIN RESULTS Endpoints included mean LOS in excess of expected LOS, mean cost in excess of expected mean payments, and mean profitability (payments minus total costs). Observed values were obtained from the hospital's database and expected values from a proprietary risk–cost adjustment program. No significant difference in LOS between 917 teaching-unit patients and 697 nonteaching patients was demonstrated. Costs averaged $3,178 (95% confidencence interval (CI) ± $489) less than expected among teaching-unit patients and $4,153 (95% CI ± $422) less than expected among nonteaching-unit patients. Payments were significantly higher per patient on the teaching unit than on the nonteaching units, and as a result mean, profitability was higher: $848 (95% CI ± $307) per hospitalization for teaching-unit patients and $451 (95% CI ± $327) for patients on the nonteaching units. Teaching-unit patients of attendings who rarely admitted to the teaching unit (nonteaching attendings) generated an average profit of $1,299 (95% CI ± $613), while nonteaching patients of nonteaching attendings generated an average profit of $208

Pre-Hospital and Hospital Management Practices and Circumstances behind Venomous Snakebite in Northwestern Part of Bangladesh

Directory of Open Access Journals (Sweden)

Ratindra Mondal

2012-12-01

Full Text Available Background: Snakebite is the most important cause of envenomation in South Asia particularly in Bangladesh, though there is lack of data from the rural part of the country. About 82 species of snakes (28 venomous exist in Bangladesh. In this study, demographic characteristics of the victim, circumstances behind the bite along with pre-hospital and hospital managements and outcomes were evaluated. Methods: It was a cross-sectional study during January 2010 to June 2012 at Rangpur Medical College Hospital. Only venomous snakebite cases were included and diagnosis was made on clinical syndrome. Descriptive statistics were presented using percentage and proportion. Results: Out of 28 patients (mean age: 31.7 years, 20 (71.4% were males with a significant male-female ratio (2.5:1. Majority were farmers (46.4% and most (50% of the bites happened during household activities. Lag period between bite and hospitalization was ≤5 hours in 50% patients; 6 to 10 hours in 39.2% and >10 hours in 10.7% cases. 82.1% patients received ligature as pre-hospital first aid. Total 21 patients received anti-snake venom (ASV in different dose regimens. 15 (53.5% patients recovered while 13 (46.4% died. Among 13 patients who died, 53.8% died within 2 hours, 15.3% within 3-24 hours and 30.7% after 24 hours post-bite. Conclusion: Snakebite has a significant impact on human health and economy through treatment-related expenditures and loss of productivity. Policy makers of Bangladesh should prioritize the issue to reduce future mortality and morbidity. Keywords: Poisoning, Snakebite, Bangladesh, Envenomation, Management        

Radiation Protection Society of Serbia and Montenegro. Proceedings of 24. Symposium

International Nuclear Information System (INIS)

Kovacevic, M.

2007-09-01

The Proceedings are a collection of papers presented at the 24. Symposium of the Radiation Protection Society of Serbia and Montenegro, held in Zlatibor, Serbia, 3-5 October 2007. The papers are organised into following sessions: Radioecology, Radiotoxicology, Radiation Protection in Medicine, Dosimetry, Radiobiology, Radioactive Waste, Measuring Instrumentation, Regulations and Standards, Education and Public Information, Nonionizing radiation, Other topics. The papers represent the scientific contributions of 156 authors. The Proceedings were printed in 120 hard copies

75 FR 34418 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

Science.gov (United States)

2010-06-17

... Notice of the Specialty Crop Committee's Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder listening session. SUMMARY: The notice announces the Specialty Crop Committee's Stakeholder Listening Session. The document contained the wrong date for the...

Reiki training for caregivers of hospitalized pediatric patients: A pilot program☆

OpenAIRE

Kundu, Anjana; Dolan-Oves, Rebecca; Dimmers, Martha A.; Towle, Cara B.; Doorenbos, Ardith Z.

2012-01-01

To explore the feasibility of a Reiki therapy-training program for the caregivers of pediatric medical or oncology inpatients, at a large pediatric hospital, a series of Reiki training classes were offered by a Reiki Master. At completion of the training, an interview was conducted to elicit participant’s feedback regarding the effectiveness and feasibility of the training program. Seventeen of the 18 families agreed to participate. Most families (65%) attended three Reiki training sessions, ...

[Changes in hospitality workers' expectations and attitudes after the implementation of the Spanish smoking law].

Science.gov (United States)

Martínez-Sánchez, Jose M; Fenández, Esteve; Fu, Marcela; Pérez-Ríos, Mónica; Schiaffino, Anna; López, María J; Alonso, Begoña; Saltó, Esteve; Nebot, Manel; Borràs, Josep M

2010-01-01

To assess changes in hospitality workers' expectations and attitudes towards the Spanish smoking law before and 2 years after the smoking ban. We performed a longitudinal study of a cohort (n=431) of hospitality workers in five regions in Spain before the law came into effect and 24 months later. Expectations and attitudes towards the ban and knowledge about the effect of second-hand smoke on health were compared before and after the ban. We recruited 431 hospitality workers in the baseline survey and 219 were followed-up 24 months later (overall follow-up rate of 50.8%). The percentage of hospitality workers who knew the law was 79.0% before it was passed and was 94.1% 24 months later (phospitality workers increased 2 years after the implementation of the ban. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

76 FR 4412 - Commercial Space Transportation Advisory Committee-Closed Session

Science.gov (United States)

2011-01-25

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Special Closed Session. SUMMARY: Pursuant to Section 10(a... Commercial Space Transportation Advisory Committee (COMSTAC). The special closed session will be an...

Coping with the challenges of early disaster response: 24 years of field hospital experience after earthquakes.

Science.gov (United States)

Bar-On, Elhanan; Abargel, Avi; Peleg, Kobi; Kreiss, Yitshak

2013-10-01

To propose strategies and recommendations for future planning and deployment of field hospitals after earthquakes by comparing the experience of 4 field hospitals deployed by The Israel Defense Forces (IDF) Medical Corps in Armenia, Turkey, India and Haiti. Quantitative data regarding the earthquakes were collected from published sources; data regarding hospital activity were collected from IDF records; and qualitative information was obtained from structured interviews with key figures involved in the missions. The hospitals started operating between 89 and 262 hours after the earthquakes. Their sizes ranged from 25 to 72 beds, and their personnel numbered between 34 and 100. The number of patients treated varied from 1111 to 2400. The proportion of earthquake-related diagnoses ranged from 28% to 67% (P earthquakes, patient caseload and treatment requirements varied widely. The variables affecting the patient profile most significantly were time until deployment, total number of injured, availability of adjacent medical facilities, and possibility of evacuation from the disaster area. When deploying a field hospital in the early phase after an earthquake, a wide variability in patient caseload should be anticipated. Customization is difficult due to the paucity of information. Therefore, early deployment necessitates full logistic self-sufficiency and operational versatility. Also, collaboration with local and international medical teams can greatly enhance treatment capabilities.

75 FR 27536 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

Science.gov (United States)

2010-05-17

... Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder... United States Department of Agriculture announces a stakeholder listening session of the Specialty Crop... Advisory Board (NAREEE). DATES: The Specialty Crop Committee will hold the stakeholder listening session on...

75 FR 32735 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

Science.gov (United States)

2010-06-09

... Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder... United States Department of Agriculture announces a stakeholder listening session of the Specialty Crop... Advisory Board (NAREEE). DATES: The Specialty Crop Committee will hold the stakeholder listening session on...

Multimorbidity Patterns in Hospitalized Older Patients: Associations among Chronic Diseases and Geriatric Syndromes.

Directory of Open Access Journals (Sweden)

Mercedes Clerencia-Sierra

Full Text Available The clinical status of older individuals with multimorbidity can be further complicated by concomitant geriatric syndromes. This study explores multimorbidity patterns, encompassing both chronic diseases and geriatric syndromes, in geriatric patients attended in an acute hospital setting.Retrospective observational study.Unit of Social and Clinical Assessment (UVSS, Miguel Servet University Hospital (HUMS, Zaragoza (Spain. Year, 2011.A total of 924 hospitalized patients aged 65 years or older.Data on patients' clinical, functional, cognitive and social statuses were gathered through comprehensive geriatric assessments. To identify diseases and/or geriatric syndromes that cluster into patterns, an exploratory factor analysis was applied, stratifying by sex. The factors can be interpreted as multimorbidity patterns, i.e., diseases non-randomly associated with each other within the study population. The resulting patterns were clinically assessed by several physicians.The mean age of the study population was 82.1 years (SD 7.2. Multimorbidity burden was lower in men under 80 years, but increased in those over 80. Immobility, urinary incontinence, hypertension, falls, dementia, cognitive decline, diabetes and arrhythmia were among the 10 most frequent health problems in both sexes, with prevalence rates above 20%. Four multimorbidity patterns were identified that were present in both sexes: Cardiovascular, Induced Dependency, Falls and Osteoarticular. The number of conditions comprising these patterns was similar in men and women.The existence of specific multimorbidity patterns in geriatric patients, such as the Induced Dependency and Falls patterns, may facilitate the early detection of vulnerability to stressors, thus helping to avoid negative health outcomes such as functional disability.

Length of stay, hospitalization cost, and in-hospital mortality in US adult inpatients with immune thrombocytopenic purpura, 2006-2012.

Science.gov (United States)

An, Ruopeng; Wang, Peizhong Peter

2017-01-01

In this study, we examined the length of stay, hospitalization cost, and risk of in-hospital mortality among US adult inpatients with immune thrombocytopenic purpura (ITP). We analyzed nationally representative data obtained from Nationwide/National Inpatient Sample database of discharges from 2006 to 2012. In the US, there were an estimated 296,870 (95% confidence interval [CI]: 284,831-308,909) patient discharges recorded for ITP from 2006 to 2012, during which ITP-related hospitalizations had increased steadily by nearly 30%. The average length of stay for an ITP-related hospitalization was found to be 6.02 days (95% CI: 5.93-6.10), which is 28% higher than that of the overall US discharge population (4.70 days, 95% CI: 4.66-4.74). The average cost of ITP-related hospitalizations was found to be US$16,594 (95% CI: US$16,257-US$16,931), which is 48% higher than that of the overall US discharge population (US$11,200; 95% CI: US$11,033-US$11,368). Gender- and age-adjusted mortality risk in inpatients with ITP was 22% (95% CI: 19%-24%) higher than that of the overall US discharge population. Across diagnosis related groups, length of stay for ITP-related hospitalizations was longest for septicemia (7.97 days, 95% CI: 7.55-8.39) and splenectomy (7.40 days, 95% CI: 6.94-7.86). Splenectomy (US$25,262; 95% CI: US$24,044-US$26,481) and septicemia (US$18,430; 95% CI: US$17,353-US$19,507) were associated with the highest cost of hospitalization. The prevalence of mortality in ITP-related hospitalizations was highest for septicemia (11.11%, 95% CI: 9.60%-12.63%) and intracranial hemorrhage (9.71%, 95% CI: 7.65%-11.77%). Inpatients with ITP had longer hospital stay, bore higher costs, and faced greater risk of mortality than the overall US discharge population.

On SIP Session setup delay for VoIP services over correlated fading channels

DEFF Research Database (Denmark)

Fathi, Hanane; Chakraborty, Shyam S.; Prasad, Ramjee

2006-01-01

In this paper, the session setup delay of the session initiation protocol (SIP) is studied. The transmissions on both the forward and reverse channel are assumed to experience Markovian errors. The session setup delay is evaluated for different transport protocols, and with the use of the radio...... link protocol (RLP). An adaptive retransmission timer is used to optimize SIP performances. Using numerical results, we find that SIP over user datagram protocol (UDP) instead of transport control protocol (TCP) can make the session setup up to 30% shorter. Also, RLP drastically reduces the session...... setup delay down to 4 to 5 s, even in environments with high frame error rates (10%) and significant correlation in the fading process (fDT=0.02). SIP is compared with its competitor H.323. SIP session setup delay with compressed messages outperforms H.323 session setup delay....

Summary of Session 5 and 6 'Long Shutdown 1'

Energy Technology Data Exchange (ETDEWEB)

Bordry, F; Foraz, K [European Organization for Nuclear Research, Geneva (Switzerland)

2012-07-01

This paper summarizes the sessions devoted to Long Shutdown 1 (LS1) in the LHC, injectors and experiments. The time frame and start date were discussed, with the main activities from powering tests prior to warm-up up to physics were presented. The session finished with a discussion on the maximum reasonable energy. (author)

Technical training: Comprehensive VHDL for FPGA Design' and 'Introduction au VHDL et utilisation du simulateur NCVHDL de CADENCE' course sessions, May-June 2006

CERN Multimedia

Davide Vitè

2006-01-01

The next session of the course 'Comprehensive VHDL for FPGA Design'given in English by Doulos Ltd (UK) will take place at CERN from May 29 through June 2nd (5 days), for a maximum of 14 participants. It will be preceded by an optional, refresher session of the two-day course 'Introduction au VHDL et utilisation du simulateur NCVHDL de CADENCE', given on 23-24 May, in French, by Serge Brobecker of IT/DES. For more information, please visit the Technical Training CTA website, http://cta.cern.ch/cta2/f?p=300, to consult the detailed course descriptions and to apply via EDH. Organiser: Davide Vitè / HR-PMD / 75141 Davide.Vite@cern.ch ENSEIGNEMENT TECHNIQUE TECHNICAL TRAINING technical.training@cern.ch

The relationship between session frequency and psychotherapy outcome in a naturalistic setting.

Science.gov (United States)

Erekson, David M; Lambert, Michael J; Eggett, Dennis L

2015-12-01

The dose-response relationship in psychotherapy has been examined extensively, but few studies have included session frequency as a component of psychotherapy "dose." Studies that have examined session frequency have indicated that it may affect both the speed and the amount of recovery. No studies were found examining the clinical significance of this construct in a naturalistic setting, which is the aim of the current study. Using an archival database of session-by-session Outcome Questionnaire 45 (OQ-45) measures over 17 years, change trajectories of 21,488 university counseling center clients (54.9% female, 85.0% White, mean age = 22.5) were examined using multilevel modeling, including session frequency at the occasion level. Of these clients, subgroups that attended therapy approximately weekly or fortnightly were compared to each other for differences in speed of recovery (using multilevel Cox regression) and clinically significant change (using multilevel logistic regression). Results indicated that more frequent therapy was associated with steeper recovery curves (Cohen's f2 = 0.07; an effect size between small and medium). When comparing weekly and fortnightly groups, clinically significant gains were achieved faster for those attending weekly sessions; however, few significant differences were found between groups in total amount of change in therapy. Findings replicated previous session frequency literature and supported a clinically significant effect, where higher session frequency resulted in faster recovery. Session frequency appears to be an impactful component in delivering more efficient psychotherapy, and it is important to consider in individual treatment planning, institutional policy, and future research. (c) 2015 APA, all rights reserved).

Tenth Workshop on Crystalline Silicon Solar Cell Materials and Processes: A Summary of Discussion Sessions

Energy Technology Data Exchange (ETDEWEB)

Tan, T.; Swanson, D.; Sinton, R.; Sopori, B.

2001-01-22

The 10th Workshop on Silicon Solar Cell Materials and Processes was held in Copper Mountain, Colorado, on August 13-16, 2000. The workshop was attended by 85 scientists and engineers from 15 international photovoltaic (PV) companies and 24 research institutions. Review and poster presentations were augmented by discussion sessions to address the recent progress and critical issues in meeting the goals for Si in the PV Industry Roadmap. The theme of the workshop was Si Photovoltaics: 10 Years of Progress and Opportunities for the Future. Two special sessions were held: Advanced Metallization and Interconnections - covering recent advances in solar cell metallization, printed contacts and interconnections, and addressing new metallization schemes for low-cost cell interconnections; and Characterization Methods - addressing the growing need for process monitoring techniques in the PV industry. The following major issues emerged from the discussion sessions: (1) Mechanical breakage in the P V industry involves a large fraction, about 5%-10%, of the wafers. (2) The current use of Al screen-printed back-contacts appears to be incompatible with the PV Industry Roadmap requirements. (3) The PV manufacturers who use hydrogen passivation should incorporate the plasma-enhanced chemical vapor deposited (PECVD) nitride for antireflection coating and hydrogenation. (4) There is an imminent need to dissolve metallic precipitates to minimize the electrical shunt problem caused by the ''bad'' regions in wafers. (5) Industry needs equipment for automated, in-line monitoring and testing. There are simply not many tools available to industry. (6) In the Wrap-Up Session of the workshop, there was consensus to create four industry/university teams that would address critical research topics in crystalline silicon. (7) The workshop attendees unanimously agreed that the workshop has served well the PV community by promoting the fundamental understanding of industrial

78 FR 70093 - Commercial Space Transportation Advisory Committee-Closed Session

Science.gov (United States)

2013-11-22

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Special Closed Session. SUMMARY: Pursuant to Section 10(a...), notice is hereby given of a special closed session of the Commercial Space Transportation Advisory...

78 FR 53497 - Commercial Space Transportation Advisory Committee; Closed Session

Science.gov (United States)

2013-08-29

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Special Closed Session. SUMMARY: Pursuant to Section 10(a...), notice is hereby given of a special closed session of the Commercial Space Transportation Advisory...

The number of bleaching sessions influences pulp tissue damage in rat teeth.

Science.gov (United States)

Cintra, Luciano Tavares Angelo; Benetti, Francine; da Silva Facundo, Aguinaldo Cândido; Ferreira, Luciana Louzada; Gomes-Filho, João Eduardo; Ervolino, Edilson; Rahal, Vanessa; Briso, André Luiz Fraga

2013-12-01

Hydrogen peroxide tooth bleaching is claimed to cause alterations in dental tissue structures. This study investigated the influence of the number of bleaching sessions on pulp tissue in rats. Male Wistar rats were studied in 5 groups (groups 1S-5S) of 10 each, which differed by the number (1-5) of bleaching sessions. In each session, the animals were anesthetized, and 35% hydrogen peroxide gel was applied to 3 upper right molars. Two days after the experimental period, the animals were killed, and their jaws were processed for light microscope evaluation. Pulp tissue reactions were scored as follows: 1, no or few inflammatory cells and no reaction; 2, session, necrotic tissue in the pulp horns and underlying inflammatory changes were observed. The extent and intensity of these changes increased with the number of bleaching sessions. After 5 sessions, the changes included necrotic areas in the pulp tissue involving the second third of the radicular pulp and intense inflammation in the apical third. The number of bleaching sessions directly influenced the extent of pulp damage. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

2011 annual meeting on nuclear technology. Pt. 4. Topical sessions

International Nuclear Information System (INIS)

Schoenfelder, Christian; Dams, Wolfgang

2011-01-01

Summary report on the Topical Session of the Annual Conference on Nuclear Technology held in Berlin, 17 to 19 May 2011: - Nuclear Competence in Germany and Europe. The Topical Session: - Sodium Cooled Fast Reactors -- will be covered in a report in a further issue of atw. The reports on the Topical Sessions: - CFD-Simulations for Safety Relevant Tasks; and - Final Disposal: From Scientific Basis to Application; - Characteristics of a High Reliability Organization (HRO) Considering Experience Gained from Events at Nuclear Power Stations -- have been covered in atw 7, 8/9, and 10 (2011). (orig.)

[Mortality in the first 24h of very low birth weight preterm infants in the Northeast of Brazil].

Science.gov (United States)

Castro, Eveline Campos Monteiro de; Leite, Álvaro Jorge Madeiro; Guinsburg, Ruth

2016-01-01

To evaluate factors associated with neonatal death within 24 hours after birth in very low birth weight preterm newborns. Prospective cohort of live births with gestational age of 23(0/7)-31(6/7) weeks, birth weight of 500-1499g without malformations, in 19 public maternity hospitals in nine capitals in northeastern Brazil from July to December 2007. The 19 hospitals were assessed in relation to physical resources, equipment, human resources and aiming at quality in care initiatives. Hospital, maternal and neonatal characteristics, neonatal morbidity, neonatal procedures and interventions were compared between preterm newborns that died or survived up to 24 hours of life. The variables associated with death within 24 hours after birth were determined by logistic regression. Of the 627 newborns enrolled in the study, 179 (29%) died within 168 hours after birth, of which 59 (33%) up to 24 hours and 97 (54%) up to 48 hours after birth. The variables associated with death vitality at birth and a worse infrastructure of the hospital where the birth occurred. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Divergence of Scientific Heuristic Method and Direct Algebraic Instruction

Science.gov (United States)

Calucag, Lina S.

2016-01-01

This is an experimental study, made used of the non-randomized experimental and control groups, pretest-posttest designs. The experimental and control groups were two separate intact classes in Algebra. For a period of twelve sessions, the experimental group was subjected to the scientific heuristic method, but the control group instead was given…

An examination of within-session responding following access to reinforcing stimuli.

Science.gov (United States)

Rispoli, Mandy; O'Reilly, Mark; Lang, Russell; Machalicek, Wendy; Kang, Soyeon; Davis, Tonya; Neely, Leslie

2016-01-01

Previous research has shown tangibly maintained challenging behavior can be temporarily decreased by providing presession access to the relevant tangible. However, the duration of this beneficial effect is unknown. We measured the subsequent duration of behavior reduction effects following presession access during extended classroom observation sessions by analyzing within-session patterns of responding in three children with autism. An alternating treatments design was used to analyze within- and across-session responding following presession access and presession restriction conditions. The cumulative frequency of challenging behavior was higher following the presession restriction condition for all participants and lower following presession access. Within-session analysis revealed the same basic pattern of responding across participants. Specifically, the first half of the sessions contained very little, if any, challenging behavior; however, after 60 min, the rate of challenging behavior began to increase rapidly for two of the three participants. Results are discussed in terms of implications for practitioners, satiation, habituation, and behavioral contrast. Copyright © 2015 Elsevier Ltd. All rights reserved.

Proceedings of the topical session on stakeholder involvement in decommissioning projects

International Nuclear Information System (INIS)

Santiago, Juan Luis; Chandler, Steve; Metcalfe, Doug; Le Bars, Yves

2006-01-01

Set up by the Radioactive Waste Management Committee (RWMC), the WPDD brings together senior representatives of national organisations who have a broad overview of Decommissioning and Dismantling (D and D) issues through their work as regulators, implementers, R and D experts or policy makers. These include representatives from regulatory authorities, industrial decommissioners from the NEA Co-operative Programme on Exchange of Scientific and Technical Information on Nuclear Installation Decommissioning Projects (CPD), and cross-representation from the other NEA Committees. The EC is a member of the WPDD and the IAEA is participating as an observer. This broad participation provides good possibilities for the co-ordination efforts amongst activities in the international programmes. At its sixth meeting, in Paris, 14-16 November 2005, the WPDD held a topical session on the 'Stakeholder Involvement in Decommissioning Projects'. The topical session was jointly planned and run with members of the NEA Forum on Stakeholder Confidence (FSC). This report documents the topical session. The main text summarises the lessons learnt and includes the rapporteurs reports. Appendix 1 and 2 provide the agenda of the topical session and all contributed papers respectively. The Topical session also provided a stimuli to review all the contributions in the area of stakeholder involvement that the WPDD has received since its inception. A list of references is provided in Appendix 3. The topical session was meant to provide an exchange of information and experience on the following issues: - Views from Stakeholders Regarding Stakeholder Involvement and Their Own Role. - Case Studies on Stakeholders Confidence. At the end of each session time was allotted for a plenary discussion. The Rapporteur reviewed the main points and the lessons learnt at the end of the whole Topical Session. (authors)

The impact of high intensity physical training on motor and non-motor symptoms in patients with Parkinson's disease (PIP)

DEFF Research Database (Denmark)

Morberg, Bo M; Jensen, Joakim; Bode, Matthias

2014-01-01

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disease caused by loss of dopaminergic nigrostriatal neurons. Several studies have investigated various physical interventions on PD. The effects of a high intensity exercise program with focus on resistance; cardio; equilibrium......; and flexibility training have not been evaluated previously. OBJECTIVE: The aim of this study was to investigate the effects of a complex, high intensity physical training program, with a long duration, on motor and non-motor symptoms in patients with PD. METHOD: 24 patients with PD Hoehn and Yahr stage 1-3 were...... non-randomly allocated to an intervention group (n = 12) and a control group (n = 12). The intervention group underwent 32 weeks of high intensity personalized physical training twice a week, with an optional extra training session once a week. The control group received general recommendations...

Training laypersons and hospital personnel in basic resuscitation techniques: an approach to impact the global trauma burden in Mozambique.

Science.gov (United States)

Merchant, Amina; Outhay, Malena; Gonzaléz-Calvo, Lazáro; Moon, Troy D; Sidat, Mohsin; Taibo, Catia Luciana Abdulfattáhe; McQueen, Kelly

2015-06-01

Over half of prehospital deaths in low-income countries are the result of airway compromise, respiratory failure, or uncontrolled hemorrhage; all three conditions can be addressed using simple first-aid measures. For both hospital personnel and laypersons, a basic trauma resuscitation training in modified ABCD (airway, breathing, circulation, disability) techniques can be easily learned and applied to increase the number of first responders in Mozambique, a resource-challenged country. A trauma training session was administered to 100 people in Mozambique: half were hospital personnel from 7 district medical centers and the other half were selected laypersons. This session included a pre-test, intervention, and post-test to evaluate and demonstrate first response skills. Eighty-eight people completed both the pre- and post-tests. Following the education intervention, both groups demonstrated an improvement in test scores. Hospital personnel had a mean post-test score of 60% (SD = 17, N = 43) and community laypeople had a mean score of 51% (SD = 16, N = 45). A t test for equal variances demonstrated significant difference between the post-intervention scores for the two groups (p = 0.01). All 100 participants were able to open an airway, externally control hemorrhage, and transport a patient with appropriate precautions. The trauma training session served as new information that improved knowledge as well as skills for both groups, and increased the number of capable responders in Mozambique. This study supports WHO recommendations to utilize the strengths of a developing nation-population-as the first step in establishing an organized trauma triage system.

Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures

International Nuclear Information System (INIS)

Akhan, Okan; Islim, Filiz; Balci, Sinan; Erbahceci, Aysun; Akpınar, Burcu; Ciftci, Turkmen; Akinci, Devrim

2016-01-01

PurposeThe purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.Materials and MethodsWe retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 months (median: 38 months).ResultsAll patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.ConclusionsFor patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.

Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures

Energy Technology Data Exchange (ETDEWEB)

Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University Faculty of Medicine, Department of Radiology (Turkey); Islim, Filiz, E-mail: fislim@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Radiology (Turkey); Balci, Sinan, E-mail: snnbalci@gmail.com [Hacettepe University Faculty of Medicine, Department of Radiology (Turkey); Erbahceci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Radiology (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com; Ciftci, Turkmen, E-mail: turkmenciftci@yahoo.com; Akinci, Devrim, E-mail: akincid@hotmail.com [Hacettepe University Faculty of Medicine, Department of Radiology (Turkey)

2016-06-15

PurposeThe purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.Materials and MethodsWe retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 months (median: 38 months).ResultsAll patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.ConclusionsFor patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.

A Video Recall Study of In-session Changes in Sentiment Override.

Science.gov (United States)

Johnson, Lee N; Tambling, Rachel B; Anderson, Shayne R

2015-09-01

This study examines in-session changes in sentiment override over the first three sessions of couple therapy. Couples viewed a video recording of therapy sessions immediately after each of the first three sessions and continuously rated their level of sentiment override. Ninety-eight changes were randomly chosen for analysis. Three talk turns prior to each change was coded using the Family Relational Communication Control Coding System. Results show that changes in sentiment override occur frequently. Repeated incidents of communication control were related to negative change in sentiment override for females. Repeated incidents of being left out of the conversation were related to negative changes in sentiment override for females and positive changes for males. © 2014 Family Process Institute.

Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia.

Science.gov (United States)

Havers, Fiona; Bramley, Anna M; Finelli, Lyn; Reed, Carrie; Self, Wesley H; Trabue, Christopher; Fakhran, Sherene; Balk, Robert; Courtney, D Mark; Girard, Timothy D; Anderson, Evan J; Grijalva, Carlos G; Edwards, Kathryn M; Wunderink, Richard G; Jain, Seema

2016-06-15

Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI], .88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI, .88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Further experience with radiotherapy by multiple daily sessions

Energy Technology Data Exchange (ETDEWEB)

Svoboda, V H.J. [Saint Mary' s Hospital, Portsmouth (UK). Dept. of Radiotherapy and Oncology

1978-05-01

Since 1972 over 100 patients have been treated by frequent daily sessions of radiotherapy with a short overall time. Cobalt 60 teletherapy and 250 kV X-ray beams have been used with radical or palliative dosage. The tolerance to these regimes of the skin, breast, chest wall, neck, lung and pelvis is discussed and the tumour responses described. Radiotherapy by multiple daily sessions is clinically possible and often an advantage. Its therapeutic ratio is not inferior to comparable regimes using longer intervals.

Quantification of training load using session RPE method and performance in futsal. DOI: 10.5007/1980-0037.2012v14n1p73

Directory of Open Access Journals (Sweden)

Victor Hugo Freitas

2011-12-01

Full Text Available There is a need of studies about training load (TL quantification using session rating of perceived exertion (session-RPE and its relation to athlete’s performance in futsal. The objective of this study was to describe training load behavior using session-RPE method and to analyze futsal athlete´s performance during a preparatory period and its relation to TL. Twelve male futsal players (age 24,92 ± 5,20 year, weight 73,42 ± 5,70 kg, height 175,83 ± 5,05 cm were submitted to 14 weeks of training quantified by the session-RPE method. It was measured maximum volume of oxygen (VO₂max, velocity, agility and vertical jump (VJ before and after the training period and also the VJ every week. Using the Wilcoxon test, it was observed an increase in VO₂max (p=0,004, VJ (p=0,003, velocity (p=0,003 and agility (p=0,002 after the training period. Using the ANOVA to repeated measures (Tukey post-hoc, it was observed a greater training load (TL in the first mesocycle compared to the others and a greater CT in the second compared to the third mesocycle. It was not found a relation between VJ and TL. It was concluded that the session RPE allowed an effective TL quantification through the training period and the athlete’s performance increased along with the progressive TL reduction description. There wasn’t correlation between the TL and performance.

Quantification of training load using session RPE method and performance in futsal. DOI: 10.5007/1980-0037.2012v14n1p73

Directory of Open Access Journals (Sweden)

Maurício Gattas Bara Filho

2012-01-01

Full Text Available There is a need of studies about training load (TL quantification using session rating of perceived exertion (session-RPE and its relation to athlete’s performance in futsal. The objective of this study was to describe training load behavior using session-RPE method and to analyze futsal athlete´s performance during a preparatory period and its relation to TL. Twelve male futsal players (age 24,92 ± 5,20 year, weight 73,42 ± 5,70 kg, height 175,83 ± 5,05 cm were submitted to 14 weeks of training quantified by the session-RPE method. It was measured maximum volume of oxygen (VO₂max, velocity, agility and vertical jump (VJ before and after the training period and also the VJ every week. Using the Wilcoxon test, it was observed an increase in VO₂max (p=0,004, VJ (p=0,003, velocity (p=0,003 and agility (p=0,002 after the training period. Using the ANOVA to repeated measures (Tukey post-hoc, it was observed a greater training load (TL in the first mesocycle compared to the others and a greater CT in the second compared to the third mesocycle. It was not found a relation between VJ and TL. It was concluded that the session RPE allowed an effective TL quantification through the training period and the athlete’s performance increased along with the progressive TL reduction description. There wasn’t correlation between the TL and performance.

Effects of the Pilates method on neck pain: a systematic review

Directory of Open Access Journals (Sweden)

Natália Fernanda Cemin

Full Text Available Abstract Introduction: The Pilates method has been used for neck pain reduction. Objective: To systematically review randomized and non-randomized controlled trials that assessed the effects of Pilates on neck pain when compared to other groups (CRD42015025987. Methods: This study involved a systematic review directed by the PRISMA Statement based on the recommendations of the Cochrane Colaboration, registered in PROSPERO under the code CRD42015025987. The following databases were searched: Cochrane CENTRAL, EMBASE, PubMed, Science Direct, Scopus and Web of Science, using the terms “Pilates” AND “Neck pain”, without language and date restrictions. Results: Of a total of 73 identified studies, two were included herein since they fulfilled the eligibility criteria (at least one intervention group applying Pilates, where we evaluated the methodological quality by the Downs and Black scale and evidence strength with the Best Evidence Synthesis. Pain and disability decreased from the sixth session, with gradual improvement in up to 24 sessions. Conclusion: Few studies are available using Pilates to decrease pain, and moderate evidence exists of positive Pilates effects on pain and function in patients with neck pain.

Effectiveness of Training Self-encauragement on the Resiliency and Optimism the Mothers of Children with Mental Retardation

Directory of Open Access Journals (Sweden)

A Afkhami Aqda

2016-07-01

Full Text Available Introduction: a retarded child is considered as a perishing pressure on the parents, hence, teaching these mothers is very important. One of the useful tasks to do for this, is teaching self-encouragement. The aim of the present study was to investigate the effectiveness of self-encouragement on resilience and optimism of mothers with mental retardation. Methods: The method was semi-experimental, pretest-posttest with a control group. The sample group included 24 mothers from Yazd city in 1393-94 with mentally retarded children volunteering (non-randomly for the study and finally divided into control and experimental groups (fifteen people each. The resilience and optimism of the participants were assessed using CD-RISK Connor-Davidson’s resilience questionnaire and life orientation test LOT, respectively LOT and the experiment group was instructed the self-encouragement program for 1 sessions. Results: Covariance analysis MANCOVA, ANCOVA in SPSS (ver. 22 of the data showed that the educational sessions had significant effect on resilience and optimism of the experimental group (p<0/05. Conclusion: Accordingly, it can be concluded that teaching self-encouragement can lead to more resilience and optimism.

Burden, duration and costs of hospital bed closures due to acute gastroenteritis in England per winter, 2010/11-2015/16.

Science.gov (United States)

Sandmann, F G; Jit, M; Robotham, J V; Deeny, S R

2017-09-01

Bed closures due to acute gastroenteritis put hospitals under pressure each winter. In England, the National Health Service (NHS) has monitored the winter situation for all acute trusts since 2010/11. To estimate the burden, duration and costs of hospital bed closures due to acute gastroenteritis in winter. A retrospective analysis of routinely collected time-series data of bed closures due to diarrhoea and vomiting was conducted for the winters 2010/11 to 2015/16. Two key issues were addressed by imputing non-randomly missing values at provider level, and filtering observations to a range of dates recorded in all six winters. The lowest and highest values imputed were taken to represent the best- and worst-case scenarios. Bed-days were costed using NHS reference costs, and potential staff absence costs were based on previous studies. In the best-to-worst case, a median of 88,000-113,000 beds were closed due to gastroenteritis each winter. Of these, 19.6-20.4% were unoccupied. On average, 80% of providers were affected, and had closed beds for a median of 15-21 days each winter. Hospital costs of closed beds were £5.7-£7.5 million, which increased to £6.9-£10.0 million when including staff absence costs due to illness. The median number of hospital beds closed due to acute gastroenteritis per winter was equivalent to all general and acute hospital beds in England being unavailable for a median of 0.88-1.12 days. Costs for hospitals are high but vary with closures each winter. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

State of malnutrition in hospitals of Ecuador.

Science.gov (United States)

Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio

2014-08-01

Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women: 37.5%; Ages ≥ 60 years: 35.1%; Length of stay ≤ 15 days: 91.2%) admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

A Systematic Review of Hospital-to-School Reintegration Interventions for Children and Youth with Acquired Brain Injury

Science.gov (United States)

Lindsay, Sally; Hartman, Laura R.; Reed, Nick; Gan, Caron; Thomson, Nicole; Solomon, Beverely

2015-01-01

Objectives We reviewed the literature on interventions that aimed to improve hospital-to-school reintegration for children and youth with acquired brain injury (ABI). ABI is the leading cause of disability among children and youth. A successful hospital-to-school reintegration process is essential to the rehabilitative process. However, little is known about the effective components of of such interventions. Methods and findings Our research team conducted a systematic review, completing comprehensive searches of seven databases and selected reference lists for relevant articles published in a peer-reviewed journal between 1989 and June 2014. We selected articles for inclusion that report on studies involving: a clinical population with ABI; sample had an average age of 20 years or younger; an intentional structured intervention affecting hospital-to-school transitions or related components; an experimental design; and a statistically evaluated health outcome. Two independent reviewers applied our inclusion criteria, extracted data, and rated study quality. A meta-analysis was not feasible due to the heterogeneity of the studies reported. Of the 6933 articles identified in our initial search, 17 articles (reporting on 350 preadolescents and adolescents, aged 4–19, (average age 11.5 years, SD: 2.21) met our inclusion criteria. They reported on interventions varying in number of sessions (one to 119) and session length (20 minutes to 4 hours). The majority of interventions involved multiple one-to-one sessions conducted by a trained clinician or educator, homework activities, and parental involvement. The interventions were delivered through different settings and media, including hospitals, schools, and online. Although outcomes varied (with effect sizes ranging from small to large), 14 of the articles reported at least one significant improvement in cognitive, social, psychological, or behavioral functioning or knowledge of ABI. Conclusions Cognitive, behavioral

Reiki training for caregivers of hospitalized pediatric patients: a pilot program.

Science.gov (United States)

Kundu, Anjana; Dolan-Oves, Rebecca; Dimmers, Martha A; Towle, Cara B; Doorenbos, Ardith Z

2013-02-01

To explore the feasibility of a Reiki therapy-training program for the caregivers of pediatric medical or oncology inpatients, at a large pediatric hospital, a series of Reiki training classes were offered by a Reiki Master. At completion of the training, an interview was conducted to elicit participant's feedback regarding the effectiveness and feasibility of the training program. Seventeen of the 18 families agreed to participate. Most families (65%) attended three Reiki training sessions, reporting that Reiki benefitted their child by improving their comfort (76%), providing relaxation (88%), and pain relief (41%). All caregivers identified becoming an active participant in their child's care as a major gain from participation in the Reiki training. A hospital-based Reiki training program for caregivers of hospitalized pediatric patients is feasible and can positively impact patients and their families. More rigorous research regarding the benefits of Reiki in the pediatric population is needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reiki training for caregivers of hospitalized pediatric patients: A pilot program☆

Science.gov (United States)

Kundu, Anjana; Dolan-Oves, Rebecca; Dimmers, Martha A.; Towle, Cara B.; Doorenbos, Ardith Z.

2013-01-01

To explore the feasibility of a Reiki therapy-training program for the caregivers of pediatric medical or oncology inpatients, at a large pediatric hospital, a series of Reiki training classes were offered by a Reiki Master. At completion of the training, an interview was conducted to elicit participant’s feedback regarding the effectiveness and feasibility of the training program. Seventeen of the 18 families agreed to participate. Most families (65%) attended three Reiki training sessions, reporting that Reiki benefitted their child by improving their comfort (76%), providing relaxation (88%), and pain relief (41%). All caregivers identified becoming an active participant in their child’s care as a major gain from participation in the Reiki training. A hospital-based Reiki training program for caregivers of hospitalized pediatric patients is feasible and can positively impact patients and their families. More rigorous research regarding the benefits of Reiki in the pediatric population is needed. PMID:23337565

Interleukin-6 and procalcitonin as biomarkers in mortality prediction of hospitalized patients with community acquired pneumonia

Directory of Open Access Journals (Sweden)

Ilija Andrijevic

2014-01-01

Full Text Available Introduction: Community acquired pneumonia (CAP may present as life-threatening infection with uncertain progression and outcome of treatment. Primary aim of the trial was determination of the cut-off value of serum interleukin-6 (IL-6 and procalcitonin (PCT above which, 30-day mortality in hospitalized patients with CAP, could be predicted with high sensitivity and specificity. We investigated correlation between serum levels of IL-6 and PCT at admission and available scoring systems of CAP (pneumonia severity index-PSI, modified early warning score-MEWS and (Confusion, Urea nitrogen, respiratory rate, Blood pressure, ≥65 years of age-CURB65. Methods: This was prospective, non-randomized trial which included 101 patients with diagnosed CAP. PSI, MEWS and CURB65 were assessed on first day of hospitalization. IL-6 and PCT were also sampled on the first day of hospitalization. Results: Based on ROC curve analysis (AUC ± SE = 0.934 ± 0.035; 95%CI(0.864-1.0; P = 0.000 hospitalized CAP patients with elevated IL-6 level have 93.4% higher risk level for lethal outcome. Cut-off value of 20.2 pg/ml IL-6 shows sensitivity of 84% and specificity of 87% in mortality prediction. ROC curve analysis confirmed significant role of procalcitonin as a mortality predictor in CAP patients (AUC ± SE = 0.667 ± 0.062; 95%CI(0.546-0.789; P = 0.012. Patients with elevated PCT level have 66.7% higher risk level for lethal outcome. As a predictor of mortality at the cut-off value of 2.56 ng/ml PCT shows sensitivity of 76% and specificity of 61.8%. Conclusions: Both IL-6 and PCI are significant for prediction of 30-day mortality in hospitalized patients with CAP. Serum levels of IL6 correlate with major CAP scoring systems.

[The paradoxical effect of persuasive communication in health education sessions].

Science.gov (United States)

Piperini, Marie-Christine

2012-01-01

The purpose of this study was to examine the communication dynamics leading to the adoption of new attitudes and cognitions in health education sessions. We examined the verbal interactions at work in persuasive communication in 16 health education sessions. The study found that the medical expertise of the educator and the initial level of commitment of the participants had a positive effect on adherence to recommendations. However, persuasive communication in health education sessions appears to involve a paradoxical process in which criticism of the message can go hand in hand with the expression of an intention to implement new risk-reducing behaviors.

When Does Premature Treatment Termination Occur? Examining Session-by-Session Dropout Among Clients with Gambling Disorder.

Science.gov (United States)

Pfund, Rory A; Peter, Samuel C; Whelan, James P; Meyers, Andrew W

2018-06-01

Premature termination challenges the successful outcomes of psychological treatments for gambling disorder. To date, research has primarily identified clients who are at particular risk for dropping out of treatment. A smaller but growing body of literature has investigated when dropout occurs. Typically, those studies have not considered improvement in psychological distress within their operationalizations of dropout and therefore may have misrepresented when dropout occurs. The current study examined when dropout occurs using an operationalization based on the criteria of attaining reliable change in a naturalistic sample of clients with gambling disorder, and the classification rates yielded from that operationalization were compared to the rates from a more common operationalization. Participants (n = 334) were clients meeting diagnostic criteria for gambling disorder at an outpatient private practice who completed a measure of psychological distress at baseline and prior to each subsequent treatment session. A survival analysis was conducted to determine temporal patterns of treatment dropout (i.e., clients who discontinued treatment before realizing reliable changes in psychological distress) and completion (i.e., clients who discontinued treatment after realizing reliable changes in distress) at each treatment session. Forty-nine percent of clients were classified as dropouts, and the majority of those clients did so in the first few sessions. The more common operationalization of dropout classified clients as dropouts when they had improved in their distress and clients as completers when they had not improved in their distress. Discussion centers on the implications of dropout occurring at various stages of treatment and future directions.

Classroom-based narrative and vocabulary instruction: results of an early-stage, nonrandomized comparison study.

Science.gov (United States)

Gillam, Sandra Laing; Olszewski, Abbie; Fargo, Jamison; Gillam, Ronald B

2014-07-01

This nonrandomized feasibility study was designed to provide a preliminary assessment of the impact of a narrative and vocabulary instruction program provided by a speech-language pathologist (SLP) in a regular classroom setting. Forty-three children attending 2 first-grade classrooms participated in the study. Children in each classroom were divided into high- and low-risk subgroups on the basis of their performance on a narrative test. Narrative and vocabulary instruction was provided by an SLP in 1 classroom for three 30-min periods per week for 6 weeks. The children in the experimental classroom made clinically significant improvements on narrative and vocabulary measures; children in the comparison classroom did not. Within the experimental classroom, children in the high-risk subgroup demonstrated greater gains in narration and fewer gains in vocabulary than children in the low-risk subgroup. There were no subgroup differences in the comparison classroom. These preliminary results provide early evidence of the feasibility of implementing a narrative instruction program in a classroom setting. Children at a high risk for language difficulties appeared to profit more from the narrative instruction than from the embedded vocabulary instruction. More extensive research on this instructional program is warranted.

Assessment of Patient Safety Friendly Hospital Initiative in Three Hospitals Affiliated to Tehran University of Medical Sciences

Directory of Open Access Journals (Sweden)

Firoozeh Bairami

2016-01-01

Full Text Available Introduction: The aim of this study was to assess the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences, based on the critical standards of Patient Safety Friendly Hospital Initiative (PSFHI. Materials and Methods:In this cross-sectional study, conducted in 2014, we used PSFHI assessment tool to evaluate the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences; these general referral hospitals were selected purposefully. PSFHI assessment tool is comprised of 140 patient safety standards in five domains, categorized in 24 sub-domains. The five major domains include leadership and management, patient and public involvement, safe evidence-based clinical practices, safe environment, and lifelong learning. Results: All three hospitals met more than 70% of the critical standards. The highest score in critical standards (> 80% was related to the domain of leadership and management in all hospitals. The average score in the domain of safe evidence-based clinical practices was 70% in the studied hospitals. Finally, all the hospitals met 50% of the critical standards in the domains of patient and public involvement and safe environment. Conclusion: Based on the findings, PSFHI is a suitable program for meeting patient safety goals. The selected hospitals in this survey all had a high managerial commitment to patient safety; therefore, they could obtain high scores on critical standards.

Treatment of age-related subfoveal neovascular membranes by teletherapy. Results of a non-randomized study

Energy Technology Data Exchange (ETDEWEB)

Subasi, M.; Akmansu, M.; Or, M. [Gazi Univ., Ankara (Turkey). Medical Faculty

1999-03-01

This investigation was designed to determine whether low-dose radiation to the macular region could influence the natural course of age-related subfoveal neovascularization. Thirty-one patients with subfoveal membranes due to age-related macular degeneration (ARMD) were treated with 12 Gy of 6 MV X-rays, and 72 patients who were untreated served as a control group. Both groups were followed-up. At six months of follow-up visual acuity was maintained in 54.8% and improved 25.8% of patients treated by radiotherapy. In the control group, visual acuity showed deterioration in 55.5%. There was a significant difference between the treated and untreated groups (p<0.01). Significant neovascular membrane regression or stabilization was recorded in 61.3% of treated patients at six months post-radiation, whereas the membranes in all. 72 control patients showed progressive enlargement. This non-randomized study suggested that low doses of radiation may be an alternative treatment for ARMD without an immediate drop in visual acuity or significant radiation morbidity. (author)

Single High Intensity Focused Ultrasound Session as a Whole Gland Primary Treatment for Clinically Localized Prostate Cancer: 10-Year Outcomes

Directory of Open Access Journals (Sweden)

Ksenija Limani

2014-01-01

Full Text Available Objectives. To assess the treatment outcomes of a single session of whole gland high intensity focused ultrasound (HIFU for patients with localized prostate cancer (PCa. Methods. Response rates were defined using the Stuttgart and Phoenix criteria. Complications were graded according to the Clavien score. Results. At a median follow-up of 94months, 48 (44.4% and 50 (46.3% patients experienced biochemical recurrence for Phoenix and Stuttgart definition, respectively. The 5- and 10-year actuarial biochemical recurrence free survival rates were 57% and 40%, respectively. The 10-year overall survival rate, cancer specific survival rate, and metastasis free survival rate were 72%, 90%, and 70%, respectively. Preoperative high risk category, Gleason score, preoperative PSA, and postoperative nadir PSA were independent predictors of oncological failure. 24.5% of patients had self-resolving LUTS, 18.2% had urinary tract infection, and 18.2% had acute urinary retention. A grade 3b complication occurred in 27 patients. Pad-free continence rate was 87.9% and the erectile dysfunction rate was 30.8%. Conclusion. Single session HIFU can be alternative therapy for patients with low risk PCa. Patients with intermediate risk should be informed about the need of multiple sessions of HIFU and/or adjuvant treatments and HIFU performed very poorly in high risk patients.

Transitioning to a Data Driven Mental Health Practice: Collaborative Expert Sessions for Knowledge and Hypothesis Finding

Directory of Open Access Journals (Sweden)

Vincent Menger

2016-01-01

Full Text Available The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard Process for Data Mining (CRISP-DM, suitable for conducting expert sessions that focus on finding new knowledge and hypotheses in collaboration with local workforce. Our proposed specification that we name CRISP-IDM is evaluated in a case study at the psychiatry department of the University Medical Center Utrecht. Expert interviews were conducted to identify seven research themes in the psychiatry department, which were researched in cooperation with local health care professionals using data visualization as a modeling tool. During 19 expert sessions, two results that were directly implemented and 29 hypotheses for further research were found, of which 24 were not imagined during the initial expert interviews. Our work demonstrates the viability and benefits of involving work floor people in the analyses and the possibility to effectively find new knowledge and hypotheses using our CRISP-IDM method.

Less is more: latent learning is maximized by shorter training sessions in auditory perceptual learning.

Science.gov (United States)

Molloy, Katharine; Moore, David R; Sohoglu, Ediz; Amitay, Sygal

2012-01-01

The time course and outcome of perceptual learning can be affected by the length and distribution of practice, but the training regimen parameters that govern these effects have received little systematic study in the auditory domain. We asked whether there was a minimum requirement on the number of trials within a training session for learning to occur, whether there was a maximum limit beyond which additional trials became ineffective, and whether multiple training sessions provided benefit over a single session. We investigated the efficacy of different regimens that varied in the distribution of practice across training sessions and in the overall amount of practice received on a frequency discrimination task. While learning was relatively robust to variations in regimen, the group with the shortest training sessions (∼8 min) had significantly faster learning in early stages of training than groups with longer sessions. In later stages, the group with the longest training sessions (>1 hr) showed slower learning than the other groups, suggesting overtraining. Between-session improvements were inversely correlated with performance; they were largest at the start of training and reduced as training progressed. In a second experiment we found no additional longer-term improvement in performance, retention, or transfer of learning for a group that trained over 4 sessions (∼4 hr in total) relative to a group that trained for a single session (∼1 hr). However, the mechanisms of learning differed; the single-session group continued to improve in the days following cessation of training, whereas the multi-session group showed no further improvement once training had ceased. Shorter training sessions were advantageous because they allowed for more latent, between-session and post-training learning to emerge. These findings suggest that efficient regimens should use short training sessions, and optimized spacing between sessions.

Pharmacological interference with metabotropic glutamate receptor subtype 7 but not subtype 5 differentially affects within- and between-session extinction of Pavlovian conditioned fear.

Science.gov (United States)

Toth, Iulia; Dietz, Monika; Peterlik, Daniel; Huber, Sabine E; Fendt, Markus; Neumann, Inga D; Flor, Peter J; Slattery, David A

2012-03-01

Fear extinction is defined as the attenuation of a conditioned-fear memory by re-exposing animals to the conditioned stimulus without the aversive stimulus. This process is known to be effectively enhanced via administration of D-cycloserine (DCS), a partial NMDA-receptor agonist. However, other glutamatergic mechanisms, such as interference with metabotropic glutamate receptor (mGluR) subtypes 5 and 7 in the extinction of aversive memories are insufficiently understood. Using the allosteric mGluR5 receptor antagonist 2-methyl-6-(phenylethynyl)-pyridine (MPEP), the mGluR7 allosteric agonist N,N'-dibenzyhydryl-ethane-1,2-diamine dihydrochloride (AMN082), and DCS for comparison, we aimed to study how pharmacological blockade of mGluR5 and activation of mGluR7 influenced within- and between-session conditioned-fear extinction training and extinction retention in rats. We show that when injected before extinction training, mGluR7 activation with AMN082 enhanced freezing and thereby attenuated within-session fear extinction, whereas both DCS and the mGluR5 receptor antagonist MPEP had no effect on this process. However, these differential drug effects were not long lasting, as no difference in extinction retention were observed 24 h later. Therefore, we assessed whether the compounds affect 24 h consolidation of extinction training following incomplete extinction training (between-session extinction). Similar to DCS, AMN082- but not MPEP-treated rats showed facilitated extinction retention, as exhibited by decreased freezing. Finally, using fluoxetine, we provide evidence that the effect of AMN082 on between-session extinction retention is most likely not via increasing 5-HT transmission. These findings demonstrate that mGluR7 activation differentially modulates conditioned-fear extinction, in dependence on the protocol employed, and suggests drugs with AMN082-like mechanisms as potential add-on drugs following exposure-based psychotherapy for fear-related human

Practical session assessments in human anatomy: Weightings and performance.

Science.gov (United States)

McDonald, Aaron C; Chan, Siew-Pang; Schuijers, Johannes A

2016-07-08

Assessment weighting within a given module can be a motivating factor for students when deciding on their commitment level and time given to study a specific topic. In this study, an analysis of assessment performances of second year anatomy students was performed over four years to determine if (1) students performed better when a higher weighting was given to a set of practical session assessments and (2) whether an improved performance in the practical session assessments had a carry-over effect on other assessment tasks within that anatomy module and/or other anatomy modules that follow. Results showed that increasing the weighting of practical session assessments improved the average mark in that assessment and also improved the percentage of students passing that assessment. Further, it significantly improved performance in the written end-semester examination within the same module and had a carry-over effect on the anatomy module taught in the next teaching period, as students performed better in subsequent practical session assessments as well as subsequent end-semester examinations. It was concluded that the weighting of assessments had significant influences on a student's performance in that, and subsequent, assessments. It is postulated that practical session assessments, designed to develop deep learning skills in anatomy, improved efficacy in student performance in assessments undertaken in that and subsequent anatomy modules when the weighting of these assessments was greater. These deep learning skills were also transferable to other methods of assessing anatomy. Anat Sci Educ 9: 330-336. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

The Organization of Behavior Over Time: Insights from Mid-Session Reversal

OpenAIRE

Rayburn-Reeves, Rebecca M.; Cook, Robert G.

2016-01-01

What are the mechanisms by which behavior is organized sequentially over time? The recently developed mid-session reversal (MSR) task offers new insights into this fundamental question. The typical MSR task is arranged to have a single reversed discrimination occurring in a consistent location within each session and across sessions. In this task, we examine the relevance of time, reinforcement, and other factors as the switching cue in the sequential modulation of control in MSR. New analyse...

Perceptions about lung health in Nepal before and after an educational session

Directory of Open Access Journals (Sweden)

Shankar PR

2010-12-01

Full Text Available BackgroundIn Nepal tuberculosis, outdoor and indoor air pollution, cigarette smoking, smoking during pregnancy, poor working and health conditions in industries are common. Perceptions about various aspects of lung health among non-medical personnel working in medical schools in Nepal have not been previously studied. Method The study was carried out during January 2009. Basic demographic information was collected. Participants’ perceptions about various aspects of lung health were studied by noting their agreement with a set of 50 statements using a modified Likert-type scale. The median total score and scores of various subcategories were calculated. The scores were compared among various subgroups of respondents using appropriate non-parametric tests. After noting the deficiencies a structured interactive session to correct them was conducted. Participant perceptions were studied immediately after the session using the same questionnaire and the scores compared to those before the session.ResultsFifty-one respondents completed the questionnaire before the education session and 31 did so post-session. The majority of respondents were female, less than 40 years of age, either Brahmins or Chhetris, belonged to middle socioeconomic group; high school educated and used gas at home for cooking. The median total score was 182 before the session and increased to 218 post-session (maximum possible score 250. There was a significant increase in the scores of different subcategories also. ConclusionNon-medical personnel in a Nepalese medical school had good knowledge and understanding of various aspects of lung health which further improved following an educational session.

One session of partial-body cryotherapy (-110 °C) improves muscle damage recovery.

Science.gov (United States)

Ferreira-Junior, J B; Bottaro, M; Vieira, A; Siqueira, A F; Vieira, C A; Durigan, J L Q; Cadore, E L; Coelho, L G M; Simões, H G; Bemben, M G

2015-10-01

To evaluate the effects of a single session of partial-body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle-damaging protocol that consisted of five sets of 20 drop jumps with 2-min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at -110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P  0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Pre-Session Satiation as a Treatment for Stereotypy During Group Activities.

Science.gov (United States)

Rispoli, Mandy; Camargo, Síglia Hoher; Neely, Leslie; Gerow, Stephanie; Lang, Russell; Goodwyn, Fara; Ninci, Jennifer

2014-05-01

Individuals with developmental disabilities may engage in automatically reinforced behaviors that may interfere with learning opportunities. Manipulation of motivating operations has been shown to reduce automatically maintained behavior in some individuals. Considering behavioral indicators of satiation may assist in identifying the point at which an abolishing operation has begun to effect behavior. The purpose of this study was to evaluate the effects of pre-session satiation of automatic reinforcement on subsequent levels of stereotypy and activity engagement during group activities for three males ages 5 to 13 years with developmental disabilities. Following functional analyses with analogue conditions, an alternating treatment design compared a pre-session access to stereotypy condition with a no-pre-session access condition prior to group activity sessions. Results indicated that pre-session satiation of the putative reinforcer produced by stereotypy was effective in decreasing stereotypy and increasing activity engagement during subsequent group activities for all participants. These findings add to the literature supporting the effectiveness of abolishing operations to decrease automatically maintained stereotypy. © The Author(s) 2013.

Clinical Commentary by Barbara Segal, a Consultant Child and Adolescent Psychotherapist Working in University College London Hospitals

Science.gov (United States)

Segal, Barbara

2010-01-01

This moving clinical account describes the psychotherapeutic work of a child psychotherapist undertaken in a hospital room with 13-year-old Maya, after the sudden onset of a terrifying and serious illness, Guillain-Barre syndrome, leaving her with paralysis and extreme weakness. The first session takes place almost three weeks after Maya's…

Assessing knowledge, performance, and efficiency for hospital waste management-a comparison of government and private hospitals in Pakistan.

Science.gov (United States)

Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong; Ashraf, Uzma

2017-04-01

Proper management of healthcare waste is a critical concern in many countries of the world. Rapid urbanization and population growth rates pose serious challenges to healthcare waste management infrastructure in such countries. This study was aimed at assessing the situation of hospital waste management in a major city of Pakistan. Simple random sampling was used to select 12 government and private hospitals in the city. Field visits, physical measurements, and questionnaire survey method were used for data collection. Information was obtained regarding hospital waste generation, segregation, collection, storage, transportation, and disposal. Data envelopment analysis (DEA) was used to classify the hospitals on the basis of their relative waste management efficiencies. The weighted average total waste generation at the surveyed hospitals was discovered to be 1.53 kg/patient/day of which 75.15% consisted of general waste and the remaining consisted of biomedical waste. Of the total waste, 24.54% came from the public hospital and the remaining came from the private hospitals. DEA showed that seven of the surveyed hospitals had scale or pure technical inefficiencies in their waste management activities. The public hospital was relatively less efficient than most of the private hospitals in these activities. Results of the questionnaire survey showed that none of the surveyed hospitals was carrying out waste management in strict compliance with government regulations. Moreover, hospital staff at all the surveyed hospitals had low level of knowledge regarding safe hospital waste management practices. The current situation should be rectified in order to avoid environmental and epidemiological risks.

Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance

Directory of Open Access Journals (Sweden)

Badia BISBIS

2016-06-01

Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care  indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from  Nador, 2% from Bouarfa, 4% from  Taourirt and 2% from Jerrada. One might question about  the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential  problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.

Summary of session D2: quantum aspects of cosmology

International Nuclear Information System (INIS)

Bojowald, Martin

2008-01-01

This is a summary of talks about quantum aspects of cosmology. Topics involve the properties of quantum matter fields on an expanding spacetime as well as issues in the quantization of gravity itself. This session had three parts, one of which was in a joint session with quantum aspects of black holes (D1) and other quantum aspects (D3). The first block of talks was related to quantum aspects of field theories on a classical spacetime (with possible back-reaction), while the second block dealt in several ways with quantizations of gravity itself. The two talks in the combined session discussed issues in quantum theory on de Sitter space and will therefore be included here in the summary of the first block. For each talk, a reference is given for further details

Does a specialist unit improve outcomes for hospitalized patients with Parkinson's disease?

Science.gov (United States)

Skelly, Rob; Brown, Lisa; Fakis, Apostolos; Kimber, Lindsey; Downes, Charlotte; Lindop, Fiona; Johnson, Clare; Bartliff, Caroline; Bajaj, Nin

2014-01-01

Objective Suboptimal management of Parkinson's disease (PD) medication in hospital may lead to avoidable complications. We introduced an in-patient PD unit for those admitted urgently with general medical problems. We explored the effect of the unit on medication management, length of stay and patient experience. Methods We conducted a single-center prospective feasibility study. The unit's core features were defined following consultation with patients and professionals: specially trained staff, ready availability of PD drugs, guidelines, and care led by a geriatrician with specialty PD training. Mandatory staff training comprised four 1 h sessions: PD symptoms; medications; therapy; communication and swallowing. Most medication was prescribed using an electronic Prescribing and Administration system (iSOFT) which provided accurate data on time of administration. We compared patient outcomes before and after introduction of the unit. Results The general ward care (n = 20) and the Specialist Parkinson's Unit care (n = 24) groups had similar baseline characteristics. On the specialist unit: less Parkinson's medication was omitted (13% vs 20%, p < 0.001); of the medication that was given, more was given on time (64% vs 50%, p < 0.001); median length of stay was shorter (9 days vs 13 days, p = 0.043) and patients' experience of care was better (p = 0.01). Discussion If replicated and generalizable to other hospitals, reductions in length of stay would lead to significant cost savings. The apparent improved outcomes with Parkinson's unit care merit further investigation. We hope to test the hypothesis that specialized units are cost-effective and improve patient care using a randomized controlled trial design. PMID:25264022

9. Biennial session of nuclear physics

International Nuclear Information System (INIS)

1987-03-01

As every two years the 9th biennial session of nuclear physics shall try to make a survey of the recent experimental developments as well as the evolution of the theoretical ideas in Nuclear Physics. Communications are indexed and analysed separately

Declarative interpretations of session-based concurrency

DEFF Research Database (Denmark)

Cano, Mauricio; Rueda, Camilo; López-Acosta, Hugo-Andrés

2015-01-01

Session-based concurrency is a type-based approach to the analysis of communication-intensive systems. Correct behavior in these systems may be specified in an operational or declarative style: the former defines how interactions are structured; the latter defines governing conditions...

76 FR 66931 - Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center...

Science.gov (United States)

2011-10-28

...] Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for... Services (CMS). This two-day training session is the third and final Accelerated Development Learning... the quality of care for beneficiaries. Through Accelerated Development Learning Sessions (ADLS), the...

Growth-induced strong pinning sites in laser ablated YBa2Cu3O7-δ films with a non-random distribution

International Nuclear Information System (INIS)

Huijbregtse, J.M.; Klaassen, F.C.; Geest, R.C.F. van der; Dam, B.; Griessen, R.

1999-01-01

Recently, the authors showed that natural linear defects are the origin of the high critical currents in laser ablated YGBa 2 Cu 3 O 7-δ films. Combining wet-chemical etching and Atomic Force Microscopy, they find that these dislocations are created by island coalescence during growth. Consequently, the defect density can be reproducibly varied by manipulating the density of growth islands, which in turn depends on the substrate temperature. Interestingly, the radial defect distribution function approaches zero at small distances, indicating short range order. Therefore, they are now able to study vortex matter in films with a tailored non-random distribution of natural strong pinning sites

Messengers of the universe: Session IV Summary

International Nuclear Information System (INIS)

Bernardini, Elisa; Serpico, Pasquale Dario

2013-01-01

Being stable, light and neutral weakly interacting particles, neutrinos are ideal messengers of the deep universe and a channel of choice in particular to explore the very high energy Galactic and Extragalactic sky, playing a synergic role most notably with gamma-ray observations. Neutrino astronomy—long after the SN1987A detection in the MeV range—is mature enough for decisive tests of astrophysical paradigms. Its current status constitutes one of the two big pillars of the “Messengers of the universe” session of the Neutrino Oscillation Workshop 2012. Neutrinos may also play a role in some cosmological contexts, such as the early universe and the dark matter problem. We review both aspects in this session summary report

Effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda: results from a non-randomized controlled trial

Directory of Open Access Journals (Sweden)

Michielsen Kristien

2012-09-01

Full Text Available Abstract Background While the HIV epidemic is levelling off in sub-Saharan Africa, it remains at an unacceptably high level. Young people aged 15-24 years remain particularly vulnerable, resulting in a regional HIV prevalence of 1.4% in young men and 3.3% in young women. This study assesses the effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda on young people’s sexual behavior, HIV knowledge and attitudes. Methods In a non-randomized longitudinal controlled trial, fourteen schools were selected in two neighboring districts in Rwanda Bugesera (intervention and Rwamagana (control. Students (n = 1950 in eight intervention and six control schools participated in three surveys (baseline, six and twelve months in the intervention. Analysis was done using linear and logistic regression using generalized estimation equations adjusted for propensity score. Results The overall retention rate was 72%. Time trends in sexual risk behavior (being sexually active, sex in last six months, condom use at last sex were not significantly different in students from intervention and control schools, nor was the intervention associated with increased knowledge, perceived severity or perceived susceptibility. It did significantly reduce reported stigma. Conclusions Analyzing this and other interventions, we identified several reasons for the observed limited effectiveness of peer education: 1 intervention activities (spreading information are not tuned to objectives (changing behavior; 2 young people prefer receiving HIV information from other sources than peers; 3 outcome indicators are not adequate and the context of the relationship in which sex occurs and the context in which sex occurs is ignored. Effectiveness of peer education may increase through integration in holistic interventions and redefining peer educators’ role as focal points for sensitization and referral to experts and services. Finally, we argue that a

Two-stage revision surgery with preformed spacers and cementless implants for septic hip arthritis: a prospective, non-randomized cohort study

Directory of Open Access Journals (Sweden)

Logoluso Nicola

2011-05-01

Full Text Available Abstract Background Outcome data on two-stage revision surgery for deep infection after septic hip arthritis are limited and inconsistent. This study presents the medium-term results of a new, standardized two-stage arthroplasty with preformed hip spacers and cementless implants in a consecutive series of adult patients with septic arthritis of the hip treated according to a same protocol. Methods Nineteen patients (20 hips were enrolled in this prospective, non-randomized cohort study between 2000 and 2008. The first stage comprised femoral head resection, debridement, and insertion of a preformed, commercially available, antibiotic-loaded cement hip spacer. After eradication of infection, a cementless total hip arthroplasty was implanted in the second stage. Patients were assessed for infection recurrence, pain (visual analog scale [VAS] and hip joint function (Harris Hip score. Results The mean time between first diagnosis of infection and revision surgery was 5.8 ± 9.0 months; the average duration of follow up was 56.6 (range, 24 - 104 months; all 20 hips were successfully converted to prosthesis an average 22 ± 5.1 weeks after spacer implantation. Reinfection after total hip joint replacement occurred in 1 patient. The mean VAS pain score improved from 48 (range, 35 - 84 pre-operatively to 18 (range, 0 - 38 prior to spacer removal and to 8 (range, 0 - 15 at the last follow-up assessment after prosthesis implantation. The average Harris Hip score improved from 27.5 before surgery to 61.8 between the two stages to 92.3 at the final follow-up assessment. Conclusions Satisfactory outcomes can be obtained with two-stage revision hip arthroplasty using preformed spacers and cementless implants for prosthetic hip joint infections of various etiologies.

Mortality in the first 24h of very low birth weight preterm infants in the Northeast of Brazil

Directory of Open Access Journals (Sweden)

Eveline Campos Monteiro de Castro

2016-03-01

Full Text Available Abstract Objective: To evaluate factors associated with neonatal death within 24 hours after birth in very low birth weight preterm newborns. Methods: Prospective cohort of live births with gestational age of 230/7–316/7 weeks, birth weight of 500–1499g without malformations, in 19 public maternity hospitals in nine capitals in northeastern Brazil from July to December 2007. The 19 hospitals were assessed in relation to physical resources, equipment, human resources and aiming at quality in care initiatives. Hospital, maternal and neonatal characteristics, neonatal morbidity, neonatal procedures and interventions were compared between preterm newborns that died or survived up to 24 hours of life. The variables associated with death within 24 hours after birth were determined by logistic regression. Results: Of the 627 newborns enrolled in the study, 179 (29% died within 168 hours after birth, of which 59 (33% up to 24 hours and 97 (54% up to 48 hours after birth. The variables associated with death <24h were: weight <1000g (2.94; 1.32–6.53, 5th minute Apgar <7 (7.17; 3.46–14.88, male gender (2.99; 1.39–6.47. A better hospital structure was a protective factor for early neonatal death (odds ratio: 0.34; 95% confidence interval: 0.17–0.71. Conclusions: The high neonatal mortality on the first day of life in capital cities of Northeast Brazil is associated with biological variables such as weight and gender of the newborn, as well as low vitality at birth and a worse infrastructure of the hospital where the birth occurred.

[Pressure sores in a university hospital].

Science.gov (United States)

Barbut, Frédéric; Parzybut, Bérengère; Boëlle, Pierre-Yves; Neyme, Denis; Farid, Rachida; Kosmann, Marie-Jeanne; Luquel, Laurence

2006-05-01

To determine the prevalence of pressure sores, their risk factors, and the responsible microbial agents in an acute-care hospital and to evaluate their management. A prevalence survey was conducted from 5 July through 9 July 2004. Investigators completed a standardized questionnaire for each hospitalized patient, including demographic data (age, sex, previous hospitalizations, etc.) and Braden scale risk factors (sensory perception, humidity, activity, mobility, nutrition, and friction and shear). Two experts in skin care detected pressure sores by physical examination of the patients. Each pressure sore was swabbed and inoculated on selective media. Management was evaluated by reviewing the clinical charts of each patient with a pressure sore. The study included 535 adult patients (aged 59 +/- 19 years): 75 ulcer sores were observed in 37 patients (prevalence=6.9%). Stage I sores accounted for 24% of the total, stage II for 29%, stage III 31%, and stage IV 16%. The most frequent site was the heel (41%), followed by the sacrum (20%), elbow (11%), back (7%) and ischial tuberosities (7%). Sixty (80%) were acquired while hospitalized. Age-adjusted multivariate analyses found that the risk factors significantly associated with pressure sores were Braden scorepressure sores (OR=5.0 95% CI: 2.2-11.6, psores (24.5%), mostly stage III and IV, were colonized by multiple-drug-resistant bacteria (i.e., methicillin resistant Staphylococcus aureus, extended spectrum beta-lactamase Enterobacteriaceae). Seven (9.3%) of the 75 ulcers were diagnosed only during the survey, by the experts; of the 68 diagnosed before the survey, 57 (83.8%) had been under treatment. Treatment was considered inappropriate according to French guidelines in 31.6% of the cases. This prospective prevalence study resulted in better awareness of the patients at risk for pressure sores. It also made the recently created mobile geriatrics unit better known within the hospital.

Energy and the public: public awareness workshop and plenary session

Energy Technology Data Exchange (ETDEWEB)

1979-07-01

This publication of these two sessions of the conference on February 22 and 23, 1979 was prepared from a verbatim record made by a reporting firm. A separate abstract was prepared for each of the seventeen papers of the public awareness workshops and of the six papers of the plenary session.

STS-32 Commander Brandenstein adjusts IMAX camera during training session

Science.gov (United States)

1989-01-01

STS-32 Commander Daniel C. Brandenstein adjusts IMAX camera setting during briefing and training session as technician looks on. The session was conducted in the JSC Mockup and Integration Laboratory (MAIL) Bldg 9B. The IMAX camera will be used onboard Columbia, Orbiter Vehicle (OV) 102, during the STS-32 mission.

The Organization of Behavior Over Time: Insights from Mid-Session Reversal.

Science.gov (United States)

Rayburn-Reeves, Rebecca M; Cook, Robert G

2016-01-01

What are the mechanisms by which behavior is organized sequentially over time? The recently developed mid-session reversal (MSR) task offers new insights into this fundamental question. The typical MSR task is arranged to have a single reversed discrimination occurring in a consistent location within each session and across sessions. In this task, we examine the relevance of time, reinforcement, and other factors as the switching cue in the sequential modulation of control in MSR. New analyses also highlight some of the potential mechanisms underlying this serially organized behavior. MSR provides new evidence and we offer some ideas about how cues interact to compete for the control of behavior within and across sessions. We suggest that MSR is an excellent preparation for studying the competition among psychological states and their resolution toward action.

Improving communication between staff and disabled children in hospital wards: testing the feasibility of a training intervention developed through intervention mapping.

Science.gov (United States)

Gumm, Rebecca; Thomas, Eleanor; Lloyd, Claire; Hambly, Helen; Tomlinson, Richard; Logan, Stuart; Morris, Christopher

2017-01-01

To develop and test the feasibility of a novel parent-inspired training intervention for hospital ward staff to improve communication with disabled children when inpatients. Training content and delivery strategies were informed by the iterative process of Intervention Mapping and developed in collaboration with parents of disabled children. UK University Hospital children's ward. 80 medical, nursing, allied health professionals, clerical and housekeeping staff on a children's ward. Themes identified in previous qualitative research formed the basis of the training. Learning objectives included prioritising communication, cultivating empathy, improving knowledge and developing confidence. Participant feedback was used to refine content and delivery. Intervention documentation adheres to the Template for Intervention Description and Replication checklist. Highlighting mandated National Health Service policies and involving the hospital Patient and Carer Experience Group facilitated management support for the training. Eighty staff participated in one of four 1-hour sessions. A paediatric registrar and nurse delivered sessions to mixed groups of staff. General feedback was very positive. The intervention, fully documented in a manual, includes videos of parent carers discussing hospital experiences, interactive tasks, small group discussion, personal reflection and intention planning. Generic and local resources were provided. It was feasible to deliver this new communication training to hospital ward staff and it was positively received. Early feedback was encouraging and indicates a commitment to behaviour change. Further piloting is required to establish the transferability of the intervention to other hospitals, followed by consideration of downstream markers to evaluate the effects on disabled children's inpatient experience. Organisational and cultural change is required to support individual behaviour change.

Point prevalence survey of antimicrobial use in Chinese hospitals in 2012.

Science.gov (United States)

Ren, Nan; Zhou, Pengcheng; Wen, Ximao; Li, Chunhui; Huang, Xun; Guo, Yanhong; Meng, Li; Gong, Ruie; Feng, Li; Fu, Chenchao; Wu, Anhua

2016-03-01

In China, several measures have been adopted to decrease unnecessary antimicrobial overuse since 2010. This study aimed to identify characteristics of antimicrobial use in Chinese hospitals after implementing these measures and to explore additional targets for future antimicrobial stewardship. In 2012, point prevalence surveys conducted in Chinese hospitals included inpatients who were admitted for at least 24 hours. Details regarding infection, antimicrobial use, and bacterial cultures were recorded. A survey of 786,028 inpatients in 1,313 hospitals included prevalence of health care-associated (3.22%) and community-acquired infections (22.52%); antimicrobial use prevalence (AUP, 38.39%); bacterial culture rate (BCR, 40.16%); and proportions of administration of a single antimicrobial (75.33%), therapeutic (23.16%), prophylactic (11.99%), and therapeutic plus prophylactic (3.24%) AUP rates. Prophylactic AUP rates of hospitals with AUP rates for surgical patients with classes I, II, and III wounds were 45.19%, 68.18%, and 68.47%, respectively. Prophylactic AUP rates for surgical patients decreased with increasing hospital bed numbers. These indices varied among different hospital departments. More efforts are needed toward small hospitals, prophylactic antimicrobial use for surgical patients, and departments with low BCRs to optimize the clinical antimicrobial use. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Significance of clay art therapy for psychiatric patients admitted in a day hospital

Directory of Open Access Journals (Sweden)

Aquiléia Helena de Morais

2014-04-01

Full Text Available Objective. To understand the significance of clay art therapy for psychiatric patients admitted in a day hospital. Methodology. Qualitative, descriptive and exploratory research, undertaken with 16 patients in a day hospital in Londrina, in the state of Parana, Brazil, who participated in seven clay therapy sessions. Data collection took place from January to July 2012 through interviews guided by a semi structured questionnaire and the data were submitted to content analysis. Results. Three themes emerged: Becoming familiar with clay art therapy; Feeling clay therapy; and Realizing the effect of clay therapy. Conclusion. The use of clay as a therapeutic method by psychiatric patients promoted creativity, self-consciousness, and benefited those who sought anxiety relief.

Early Alliance, Alliance Ruptures, and Symptom Change in a Nonrandomized Trial of Cognitive Therapy for Avoidant and Obsessive–Compulsive Personality Disorders

OpenAIRE

Strauss, Jennifer L.; Hayes, Adele M.; Johnson, Sheri L.; Newman, Cory F.; Brown, Gregory K.; Barber, Jacques P.; Laurenceau, Jean-Philippe; Beck, Aaron T.

2006-01-01

Participants were 30 adult outpatients diagnosed with avoidant personality disorder or obsessive–compulsive personality disorder who enrolled in an open trial of cognitive therapy for personality disorders. Treatment consisted of up to 52 weekly sessions. Symptom evaluations were conducted at intake, at Sessions 17 and 34, and at the last session. Alliance variables were patients’ first alliance rating and “rupture-repair” episodes, which are disruptions in the therapeutic relationship that c...

Offender and offense characteristics of a nonrandom sample of adolescent mass murderers.

Science.gov (United States)

Meloy, J R; Hempel, A G; Mohandie, K; Shiva, A A; Gray, B T

2001-06-01

The authors conducted a descriptive, archival study of adolescent (murderers-subjects who intentionally killed three or more victims in one event-to identify demographic, clinical, and forensic characteristics. A nonrandom sample of convenience of adolescent mass murderers was utilized. Thirty-four subjects, acting alone or in pairs, committed 27 mass murders between 1958 and 1999. The sample consisted of males with a median age of 17. A majority were described as "loners" and abused alcohol or drugs; almost half were bullied by others, preoccupied with violent fantasy, and violent by history. Although 23% had a documented psychiatric history, only 6% were judged to have been psychotic at the time of the mass murder. Depressive symptoms and historical antisocial behaviors were predominant. There was a precipitating event in most cases--usually a perceived failure in love or school--and most subjects made threatening statements regarding the mass murder to third parties. The majority of the sample clustered into three types: the family annihilator, the classroom avenger, and the criminal opportunist. The adolescent mass murderer is often predatorily rather than affectively violent and typically does not show any sudden or highly emotional warning signs. Although the act of mass murder is virtually impossible to predict because of its extremely low frequency, certain clinical and forensic findings can alert the clinician to the need for further, intensified primary care, including family, school, community, law enforcement, and mental health intervention.

Using Videoconferencing Technology to Provide Breastfeeding Support to Low-Income Women: Connecting Hospital-Based Lactation Consultants with Clients Receiving Care at a Community Health Center.

Science.gov (United States)

Friesen, Carol A; Hormuth, Laura J; Petersen, Devan; Babbitt, Tina

2015-11-01

The Tele-Lactation Pilot Project (TLPP), 1 of 13 community-based breastfeeding projects implemented in Indiana in 2013 using Centers for Disease Control and Prevention grant funds, explored the feasibility of using videoconferencing technology to provide breastfeeding education and support to low-income women by a centrally located International Board Certified Lactation Consultant (IBCLC). The IBCLC was housed at the Breastfeeding Center at the hospital where the women would deliver; the women receiving the education and support were located at an inner-city community health center (CHC) where they received their primary care. The videoconferencing sessions were juxtaposed with the women's regularly scheduled prenatal and postnatal visits at the CHC. After delivery, the lactation consultant visited the mother and infant in person at the hospital to offer additional support. Overall, 35 mothers were served by the TLPP during the 9-month project period. A total of 134 visits (30-45 minutes each) were conducted (3.8 sessions per woman). At the conclusion of the project, interviews with key participants indicated that the tele-lactation videoconferencing sessions were easy to implement, allowed the IBCLC to reach a wider client base, and allowed the women to receive expert support that they might not have otherwise received. Comments indicated that, in addition to providing education and increasing the women's confidence, the tele-lactation sessions appeared to have decreased the mothers' anxiety about the birthing process and the hospital experience. The TLPP demonstrated that incorporating videoconferencing technology into routine care can help foster collaboration among health care providers and provide mothers with continuous, easily accessible breastfeeding education and support. © The Author(s) 2015.

Speed Posters: An Alternative to Traditional Poster and Podium Sessions.

Science.gov (United States)

Wagnes, Lisa D

2016-08-01

Speed posters were used as an alternative concurrent session option during a national nursing education conference. The session format was received positively by both participants and presenters, and, as a result, recommendations for use were developed by the conference planners. J Contin Educ Nurs. 2016;47(8):344-346. Copyright 2016, SLACK Incorporated.

Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria.

Science.gov (United States)

Adanikin, Abiodun I; Onwudiegwu, Uche; Loto, Olabisi M

2013-10-01

To determine the influence of multiple contraceptive counselling sessions during antenatal care on use of modern postpartum contraception. A total of 216 eligible pregnant women were randomised into antenatal and postnatal counselling groups. The 'Antenatal group' received one-to-one antenatal contraceptive counselling on several occasions while the 'Postnatal group' received a single one-to-one contraceptive counselling session at the sixth week postnatal check, as is routinely practised. All participants were contacted six months postpartum by telephone or personal visit, and questioned about their contraceptive use, if any. More women who had multiple antenatal contraceptive counselling sessions used modern contraceptive methods than those who had a single postnatal counselling session (57% vs. 35%; p = 0.002). There was also a significantly more frequent use of contraception among previously undecided patients in the Antenatal group (p = 0.014). Multiple antenatal contraceptive counselling sessions improve the use of modern postpartum contraception.

Comparison of Everyday and Every-Fourth-Day Probe Sessions with the Simultaneous Prompting Procedure

Science.gov (United States)

Reichow, Brian; Wolery, Mark

2009-01-01

Simultaneous prompting is a response-prompting procedure requiring two daily sessions: an instructional session in which a controlling prompt is provided on all trials, and a probe session in which no prompt is provided on any trials. In this study, two schedules of conducting the probe sessions (daily vs. every fourth day) were compared using the…

Towards deductive verification of MPI programs against session types

Directory of Open Access Journals (Sweden)

Eduardo R. B. Marques

2013-12-01

Full Text Available The Message Passing Interface (MPI is the de facto standard message-passing infrastructure for developing parallel applications. Two decades after the first version of the library specification, MPI-based applications are nowadays routinely deployed on super and cluster computers. These applications, written in C or Fortran, exhibit intricate message passing behaviours, making it hard to statically verify important properties such as the absence of deadlocks. Our work builds on session types, a theory for describing protocols that provides for correct-by-construction guarantees in this regard. We annotate MPI primitives and C code with session type contracts, written in the language of a software verifier for C. Annotated code is then checked for correctness with the software verifier. We present preliminary results and discuss the challenges that lie ahead for verifying realistic MPI program compliance against session types.

The Physics session at the ATLAS overview week

CERN Multimedia

Takai, H.

The Physics session at the ATLAS overview week at Clermont-Ferrand will be certainly remembered by the presentation of Blaise Pascal's historical experiment repeat. And why not? He is the local hero and by the looks of his primitive measurements it does take a lot of guts to explain his results on the basis of air columns. He was also lucky that he did not have to simulate his results on modern day computers but used the Pascaline. Certainly a man ahead of his time. Of course that wasn't all. Surrounded by a chain of (luckily) extinct volcanoes, rolling hills, and superb views, Clermont-Ferrand provided the perfect backdrop for the physics discussions. It was once more seen that the physics of ATLAS is diverse and that it is healthy and doing well. Many people contributed to the success of the session. Fabiola started the session precisely at 14:00 with a summary of the most recent activities from the physics coordination. Somehow what got stuck in my mind was the very positive statistics on how many prese...

New Session of introductory “E-Groups Training”

CERN Multimedia

2013-01-01

The session provides a short introduction of E-Groups and how to use it to efficiently manage mailing lists at CERN. Alongside a general overview of the E-Groups application, E-Groups specific terminology, the management of dynamic and static groups and the specific settings for mails and archives are discussed in detail.   The course is intended to give newcomers a clear idea of what E-Groups are and how they can be used at CERN. It should enable users to be more efficient when being confronted in particular with: the creation of dynamic and static E-groups and the decision whether the one or the other type is more appropriate, the management of E-group memberships, and the setting of mailing/archiving related properties. The session will also focus on some best practices and give general advice on how to use E-Groups. This introductory training session is given jointly by members of the IT-OIS and GS-AIS groups and is intended for any member at CERN potentially being confronted with the ...

Prediction and validation of the duration of hemodialysis sessions for the treatment of acute ethylene glycol poisoning.

Science.gov (United States)

Iliuta, Ioan-Andrei; Lachance, Philippe; Ghannoum, Marc; Bégin, Yannick; Mac-Way, Fabrice; Desmeules, Simon; De Serres, Sacha A; Julien, Anne-Sophie; Douville, Pierre; Agharazii, Mohsen

2017-08-01

The duration of hemodialysis (HD) sessions for the treatment of acute ethylene glycol poisoning is dependent on concentration, the operational parameters used during HD, and the presence and severity of metabolic acidosis. Ethylene glycol assays are not readily available, potentially leading to undue extension or premature termination of HD. We report a prediction model for the duration of high-efficiency HD sessions based retrospectively on a cohort study of 26 cases of acute ethylene glycol poisoning in 24 individuals treated by alcohol dehydrogenase competitive inhibitors, cofactors and HD. Two patients required HD for more than 14 days, and two died. In 19 cases, the mean ethylene glycol elimination half-life during high-efficiency HD was 165 minutes (95% confidence interval of 151-180 minutes). In a training set of 12 patients with acute ethylene glycol poisoning, using the 90th percentile half-life (195 minutes) and a target ethylene glycol concentration of 2 mmol/l (12.4 mg/dl) allowed all cases to reach a safe ethylene glycol under 3 mmol/l (18.6 mg/dl). The prediction model was then validated in a set of seven acute ethylene glycol poisonings. Thus, the HD session time in hours can be estimated using 4.7 x (Ln [the initial ethylene glycol concentration (mmol/l)/2]), provided that metabolic acidosis is corrected. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

[Day hospital in internal medicine: A chance for ambulatory care].

Science.gov (United States)

Grasland, A; Mortier, E

2018-04-16

Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

75 FR 46948 - Medicare Program; Listening Session Regarding Confidential Feedback Reports and the...

Science.gov (United States)

2010-08-04

...] Medicare Program; Listening Session Regarding Confidential Feedback Reports and the Implementation of a... Services (CMS), HHS. ACTION: Notice of meeting. SUMMARY: This notice announces a listening session being... modifier to the fee- for-service physician fee schedule. The purpose of the listening session is to solicit...

IFESS 2005 Special Session 5 Artifical Vision. Final progress report

Energy Technology Data Exchange (ETDEWEB)

Weiland, James D.

2005-07-05

A special session on visual prostheses was held during the Annual Meeting of the International Functional Electrical Stimulation Society (IFESS), in Montreal, Canada, July 5-9, 2005. IFESS is a meeting that typically attracts researchers in implantable nerve stimulators, functional electrical stimulation, and rehabilitation. All of these areas have significant overlap with the retinal prosthesis, but these areas have decades of research behind them. The special session provided a forum for researchers with vast experience in nerve stimulation to interact with leading research in retinal and cortical visual prostheses. The grant paid for the travel and conference costs of the presenters in the session. The session was chaired by James Weiland (the PI on this grant). The session co-chair was Phil Troyk, Ph.D., from the Illinois Institute of Technology. The Department of Energy was acknowledged at the start of the session as the sponsor. The following talks were delivered: Clinical Trial of a Prototype Retinal Prosthesis James Weiland, Ph.D. Doheny Eye Institute, Los Angeles, California The U.S. Department of Energy's Artificial Sight Program Elias Greenbaum, Ph.D. Oak Ridge National Laboratory, Oak Ridge, Tennessee A 16-Channel stimulator ASIC for use in an intracortical visual prosthesis Phillip R. Troyk, Ph.D. Illinois Institute of Technology, Chicago, Illinois Two approaches to the Optic Nerve Visual Prosthesis Jean Delbeke, M.D. University Cath de Louvain, Louvain, Belgium Design and Implementation of High Power Efficiency Modules for a Cortical Visual Stimulator Mohammad Sawan, Ph.D. Ecole Polytechnique de Montreal, Montreal, Canada Remaining funds from the grant were used to support Dr. Weiland's travel to the Association for Research in Vision and Ophthalmology in May 2006, with DOE approval, where several projects, supported by the DOE artificial retina program, were presented.

Assessment of patient safety culture in private and public hospitals in Peru.

Science.gov (United States)

Arrieta, Alejandro; Suárez, Gabriela; Hakim, Galed

2018-04-01

To assess the patient safety culture in Peruvian hospitals from the perspective of healthcare professionals, and to test for differences between the private and public healthcare sectors. Patient safety is defined as the avoidance and prevention of patient injuries or adverse events resulting from the processes of healthcare delivery. A non-random cross-sectional study conducted online. An online survey was administered from July to August 2016, in Peru. This study reports results from Lima and Callao, which are the capital and the port region of Peru. A total of 1679 healthcare professionals completed the survey. Participants were physicians, medical residents and nurses working in healthcare facilities from the private sector and public sector. Assessment of the degree of patient safety and 12 dimensions of patient safety culture in hospital units as perceived by healthcare professionals. Only 18% of healthcare professionals assess the degree of patient safety in their unit of work as excellent or very good. Significant differences are observed between the patient safety grades in the private sector (37%) compared to the public sub-sectors (13-15%). Moreover, in all patient safety culture dimensions, healthcare professionals from the private sector give more favorable responses for patient safety, than those from the public sub-systems. The most significant difference in support comes from patient safety administrators through communication and information about errors. Overall, the degree of patient safety in Peru is low, with significant gaps that exist between the private and the public sectors.

Comparison between one-session root canal treatment with aPDT and two-session treatment with calcium hydroxide-based antibacterial dressing, in dog's teeth with apical periodontitis.

Science.gov (United States)

Hidalgo, Lidia Regina da Costa; da Silva, Léa Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; de Carvalho, Fabrício Kitazono; Lucisano, Marília Pacífico; Novaes, Arthur Belem

2016-09-01

To evaluate one-session endodontic treatment with aPDT and two-session treatment with calcium hydroxide (CH)-based dressing in dog's teeth with apical periodontitis. After experimental induction of apical periodontitis, 48 teeth were randomly assigned to the following groups: groups OS/aPDT120d and OS/aPDT180d (one-session treatment with aPDT) and groups TS/CH120d and TS/CH180d (two-session treatment with CH-based dressing-control groups). The animals were euthanized after 120 and 180 days. After histotechnical processing, microscopic and radiographic analyses were performed. Data were analyzed by Kruskal-Wallis and Fisher's exact tests (α = 0.05). Groups TS/CHs presented repaired resorbed cemental areas, with collagen bundles and few inflammatory cells. In groups OS/aPDTs, the areas of cemental resorption were not repaired with reduced presence of cells and fibers. In the analysis of the apical closure, fluorescence microscopy and percentage of radiographic reduction of lesions, there was significant difference between groups TS/CH120d and OS/aPDT120d and between TS/CH180d and OS/aPDT180d (p session endodontic treatment using a CH-based dressing in teeth with apical periodontitis.

Effects of the workplace health promotion activities soccer and zumba on muscle pain, work ability and perceived physical exertion among female hospital employees

DEFF Research Database (Denmark)

Barene, Svein; Krustrup, Peter; Holtermann, Andreas

2014-01-01

-randomized into two training groups, and a control group. The training was conducted outside working hours as two-three 1-h sessions per week for the first 12 weeks, and continued as one-two 1-h sessions per week for the last 28 weeks. Muscle pain intensity and duration, work ability, and RPE during work were......Objectives: This 40-week workplace physical training RCT investigated the effect of soccer and Zumba, respectively, on muscle pain intensity and duration, work ability, and rating of perceived exertion (RPE) during work among female hospital employees. Methods: 107 hospital employees were cluster...... group (-1.9, 95% CI, -3.2, -0.7, P=0.002, eta squared=0.092) showed a reduction after 40 weeks referencing the control group. After 40 weeks, both the soccer (-16.4 days, 95% CI, -29.6, -3.2, P4.2, P

Quality Assurance of Assessment and Moderation Discourses Involving Sessional Staff

Science.gov (United States)

Grainger, Peter; Adie, Lenore; Weir, Katie

2016-01-01

Quality assurance is a major agenda in tertiary education. The casualisation of academic work, especially in teaching, is also a quality assurance issue. Casual or sessional staff members teach and assess more than 50% of all university courses in Australia, and yet the research in relation to the role sessional staff play in quality assurance of…

Trends in diarrhea hospitalizations among infants at three hospitals in Tanzania before and after rotavirus vaccine introduction.

Science.gov (United States)

Lyamuya, Faraja; Michael, Fausta; Jani, Bhavin; Fungo, Yohana; Chambo, Alfred; Chami, Inviolatha; Bulali, Regina; Mpamba, Amina; Cholobi, Happy; Kallovya, Dotto; Kamugisha, Christopher; Mwenda, Jason M; Cortese, Margaret M

2018-04-11

The Tanzania Ministry of Health introduced monovalent human rotavirus vaccine in January 2013, to be administered at ages 6 and 10 weeks. Data suggest there was high vaccine uptake. We used hospital ward registers from 3 hospitals to examine trends in diarrhea hospitalizations among infants before and after vaccine introduction. Ward registers from Dodoma Regional Referral Hospital (Central Tanzania), and two hospitals in Mbeya (Southwest area), Mbeya Zonal Referral Hospital and Mbalizi Hospital, were used to tally admissions for diarrhea among children by age group, month and year. Rotavirus surveillance had started at these hospitals in early 2013; the proportion of infants enrolled and rotavirus-EIA positive were examined by month to determine peak periods of rotavirus disease post-vaccine introduction. Registers were available for 2-4 prevaccine years and 2-3 post introduction years. At Dodoma Regional Referral Hospital, compared with the mean of 2011 and 2012, diarrhea hospitalizations among infants were 26% lower in 2015 and 58% lower in 2016. The diarrhea peak shifted later in the year first by 1 and then by 2-3 months from prevaccine. At the Mbeya hospitals, the number of diarrhea admissions in prevaccine period varied substantially by year. At Mbeya Referral Hospital, diarrhea hospitalizations among infants were lower by 25-37% in 2014 and 11-26% in 2015, while at Mbalizi Hospital, these hospitalizations were 4% lower in 2014 and 14% higher in 2015. Rotavirus testing data demonstrated a lowering of the prevaccine peak, a shift in timing of the peak months and indicated that other diarrheal peaks in post-introduction years were not due to rotavirus. In this ecological evaluation, total diarrhea hospitalizations among infants were lower (≥25% lower in ≥1 year) following introduction in 2 of 3 hospitals. There are challenges in using ward registers to ascertain possible impact of rotavirus vaccine introduction on trends in hospitalizations for

IAEA General Conference begins annual session

International Nuclear Information System (INIS)

2001-01-01

The document gives general information about the opening and the programme of the 45th regular session of the IAEA General Conference (17-21 September 2001, Austria Center Vienna). The conference is attended by ministers and high-level governmental representatives from 132 Member States of the IAEA

IAEA General Conference begins annual session

International Nuclear Information System (INIS)

2000-01-01

The document gives general information about the opening and the programme of the 44th regular session of the IAEA General Conference (18 -22 September 2000, Austria Center Vienna). The conference is attended by ministers and high-level governmental representatives from 130 Member States of the IAEA

Cost-identification analysis of total laryngectomy: an itemized approach to hospital costs.

Science.gov (United States)

Dedhia, Raj C; Smith, Kenneth J; Weissfeld, Joel L; Saul, Melissa I; Lee, Steve C; Myers, Eugene N; Johnson, Jonas T

2011-02-01

To understand the contribution of intraoperative and postoperative hospital costs to total hospital costs, examine the costs associated with specific hospital services in the postoperative period, and recognize the impact of patient factors on hospital costs. Case series with chart review. Large tertiary care teaching hospital system. Using the Pittsburgh Head and Neck Organ-Specific Database, 119 patients were identified as having total laryngectomy with bilateral selective neck dissection and primary closure from 1999 to 2009. Cost data were obtained for 112 patients. Costs include fixed and variable costs, adjusted to 2010 US dollars using the Consumer Price Index. Mean total hospital costs were $29,563 (range, $10,915 to $120,345). Operating room costs averaged 24% of total hospital costs, whereas room charges, respiratory therapy, laboratory, pharmacy, and radiology accounted for 38%, 14%, 8%, 7%, and 3%, respectively. Median length of stay was 9 days (range, 6-43), and median Charlson comorbidity index score was 8 (2-16). Patients with ≥1 day in the intensive care unit had significantly higher hospital costs ($46,831 vs $24,601, P cost differences with stratification based on previous radiation therapy ($27,598 vs $29,915 with no prior radiation, P = .62) or hospital readmission within 30 days ($29,483 vs $29,609 without readmission, P = .97). This is one of few studies in surgery and the first in otolaryngology to analyze hospital costs for a relatively standardized procedure. Further work will include cost analysis from multiple centers with investigation of global cost drivers.

The Perilous Road from HIV Diagnosis in the Hospital to Viral Suppression in the Outpatient Clinic.