Leading and leadership: Reflections on a case study.

OpenAIRE

Joyce, Pauline

2010-01-01

Aim: The aim of this case study was to explore if observing leaders in the context of their day-to-day work can provide an insight into how they lead in particular circumstances. Background: The study was carried out in small organisation which was set up five years ago. Methods: A case study methodology was used. Data was collected by field notes of non-participant and participant observations. Follow-up interviews were transcribed and analysed to contextualise the observations. A refl...

A rare case of haboob in Tehran: Observational and numerical study

Science.gov (United States)

Karami, S.; Ranjbar, A.; Mohebalhojeh, A. R.; Moradi, M.

2017-03-01

A great dust storm occurred in Tehran on 2 June 2014 and caused severe damage to properties and involved loss of human life. From the visual evidence available, it can be regarded as a case of haboob. As a lower latitude phenomenon, its occurrence in Tehran was unprecedented in the last 50 years. This paper aims to present a detailed analysis of the weather conditions, the pathways by which dust particles were ingested by the haboob, as well as the impact of the urban boundary layer on the intensity and propagation of the dust storm. Using numerical simulation carried out by the WRF-Chem model and various observational techniques, the coupling of a low-level small-scale deformation field with a lower-tropospheric cold pool produced by precipitating mid-tropospheric clouds is identified as the main process involved in shaping this rare dust storm.

Case Study: Testing with Case Studies

Science.gov (United States)

Herreid, Clyde Freeman

2015-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

Family Presence During Resuscitation (FPDR): Observational case studies of emergency personnel in Victoria, Australia.

Science.gov (United States)

Porter, Joanne E; Miller, Nareeda; Giannis, Anita; Coombs, Nicole

2017-07-01

Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR. One rural and one metropolitan emergency department in the state of Victoria, Australia were observed and data was collected on FPDR events. The participants consisted of resuscitation team members, including; emergency trained nurses, senior medical officers, general nurses and doctors. The participants were not told that the data would be recorded around interactions with family members or team discussions regarding family involvement in the resuscitation, following ethical approval involving limited disclosure of the aims of the study. Seventeen adult presentations (Metro n=9, Rural n=8) were included in this study and will be presented as resuscitation case studies. The key themes identified included ambiguity around resuscitation status, keeping the family informed, family isolation and inter-professional communication. During 17 adult resuscitation cases, staff were witnessed communicating with family, which was often limited and isolation resulted. Family were often uninformed or separated from their family member, however when a family liaison person was available it was found to be beneficial. This research indicated that staff could benefit from a designated family liaison role, formal policy and further education. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Expressive Bodily Movement Repertoire for Marimba Performance, Revealed through Observers' Laban Effort-Shape Analyses, and Allied Musical Features: Two Case Studies.

Science.gov (United States)

Broughton, Mary C; Davidson, Jane W

2016-01-01

Musicians' expressive bodily movements can influence observers' perception of performance. Furthermore, individual differences in observers' music and motor expertise can shape how they perceive and respond to music performance. However, few studies have investigated the bodily movements that different observers of music performance perceive as expressive, in order to understand how they might relate to the music being produced, and the particular instrument type. In this paper, we focus on marimba performance through two case studies-one solo and one collaborative context. This study aims to investigate the existence of a core repertoire of marimba performance expressive bodily movements, identify key music-related features associated with the core repertoire, and explore how observers' perception of expressive bodily movements might vary according to individual differences in their music and motor expertise. Of the six professional musicians who observed and analyzed the marimba performances, three were percussionists and experienced marimba players. Following training, observers implemented the Laban effort-shape movement analysis system to analyze marimba players' bodily movements that they perceived as expressive in audio-visual recordings of performance. Observations that were agreed by all participants as being the same type of action at the same location in the performance recording were examined in each case study, then across the two studies. A small repertoire of bodily movements emerged that the observers perceived as being expressive. Movements were primarily allied to elements of the music structure, technique, and expressive interpretation, however, these elements appeared to be interactive. A type of body sway movement and more localized sound generating actions were perceived as expressive. These movements co-occurred and also appeared separately. Individual participant data revealed slightly more variety in the types and locations of actions

Stroke risk and NSAIDs: A systematic review of observational studies

NARCIS (Netherlands)

C. Varas-Lorenzo (Cristina); N. Riera-Guardia (Nuria); B. Calingaert (Brian); J. Castellsague (Jordi); A. Pariente (Antoine); L. Scotti (Lorenza); M.C.J.M. Sturkenboom (Miriam); S. Perez-Gutthann (Susana)

2011-01-01

textabstractAims: To perform a quantitative systematic review of observational studies on the risk of stroke associated with the use of individual NSAIDs. Methods and results: Searches were conducted using the Medline database within PubMed (1990-2008). Observational cohort or case-control studies

REFLECTIVE PRACTICE THROUGH JOURNAL WRITING AND PEER OBSERVATION: A Case Study

Directory of Open Access Journals (Sweden)

B. Samrajya LAKSHMI

2014-10-01

Full Text Available Journal writing and Peer Observation in an educational context have become popular techniques, with several different types of applications. They have now been used quite widely in both language teaching and in teacher training. However, despite its reported advantages in both teaching and research, there are not many Peer Observation and Diary studies available based on the writing of experienced language teachers. The Teacher participants maintain Journal writing and Peer Observation as a means of reflective practice. They consider these practices as a mirror, which reflects the teacher’s own image as a practioner. The post-reflection discussion reveals that the teacher participants believe in reflective practice as an effective means of self-evaluation and of developing sensitivity to students’ learning. This paper examines Peer Observation and journal writing of two teachers working on the same language programme in terms of a variety of topic headings, and suggests that reflective practice can be a useful tool for both classroom research and teachers’ professional development.

An Expressive Bodily Movement Repertoire for Marimba Performance, Revealed through Observers' Laban Effort-Shape Analyses, and Allied Musical Features: Two Case Studies

Science.gov (United States)

Broughton, Mary C.; Davidson, Jane W.

2016-01-01

Musicians' expressive bodily movements can influence observers' perception of performance. Furthermore, individual differences in observers' music and motor expertise can shape how they perceive and respond to music performance. However, few studies have investigated the bodily movements that different observers of music performance perceive as expressive, in order to understand how they might relate to the music being produced, and the particular instrument type. In this paper, we focus on marimba performance through two case studies—one solo and one collaborative context. This study aims to investigate the existence of a core repertoire of marimba performance expressive bodily movements, identify key music-related features associated with the core repertoire, and explore how observers' perception of expressive bodily movements might vary according to individual differences in their music and motor expertise. Of the six professional musicians who observed and analyzed the marimba performances, three were percussionists and experienced marimba players. Following training, observers implemented the Laban effort-shape movement analysis system to analyze marimba players' bodily movements that they perceived as expressive in audio-visual recordings of performance. Observations that were agreed by all participants as being the same type of action at the same location in the performance recording were examined in each case study, then across the two studies. A small repertoire of bodily movements emerged that the observers perceived as being expressive. Movements were primarily allied to elements of the music structure, technique, and expressive interpretation, however, these elements appeared to be interactive. A type of body sway movement and more localized sound generating actions were perceived as expressive. These movements co-occurred and also appeared separately. Individual participant data revealed slightly more variety in the types and locations of actions

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement

DEFF Research Database (Denmark)

von Elm, Erik; Altman, Douglas G; Egger, Matthias

2014-01-01

Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed...... recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists...... and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case...

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)

DEFF Research Database (Denmark)

Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G

2014-01-01

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical...... to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how...

Hematological observations on two cases of acute radiation syndrome

International Nuclear Information System (INIS)

Jiang Benrong; Wang Guilin; Huang Shimin

1990-01-01

The hematological changes of two cases of acute radiation syndrome were observed. The physical doses of patients Liang and Yan were 3.5 Gy and 2.6 Gy respectively. According to the changes in WBC and platelet counts and the absolute count of lymphocytes and in comparison with the hematological data of the victims of Y-12 accident in USA in 1958 and those of previous accidents in China, Liang suffered from a moderate or moderate to severe degree, and Yan suffered from a moderate or moderate mild degree of hemopoietic form of acute radiation syndrome. This estimation was consistent with their clinical course and physical doses. Some blood cells appeared in the cytoplasm of megakaryocytes in bone marrow smears of those two cases. The mechanism of this phenomenon is discussed and its clinical significance remains to be studied

Rigour in qualitative case-study research.

Science.gov (United States)

Houghton, Catherine; Casey, Dympna; Shaw, David; Murphy, Kathy

2013-03-01

To provide examples of a qualitative multiple case study to illustrate the specific strategies that can be used to ensure the credibility, dependability, confirmability and transferability of a study. There is increasing recognition of the valuable contribution qualitative research can make to nursing knowledge. However, it is important that the research is conducted in a rigorous manner and that this is demonstrated in the final research report. A multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Multiple sources of evidence were collected: semi-structured interviews (n=58), non-participant observations at five sites and documentary sources. Strategies to ensure the rigour of this research were prolonged engagement and persistent observation, triangulation, peer debriefing, member checking, audit trail, reflexivity, and thick descriptions. Practical examples of how these strategies can be implemented are provided to guide researchers interested in conducting rigorous case study research. While the flexible nature of qualitative research should be embraced, strategies to ensure rigour must be in place.

Improving observational study estimates of treatment effects using joint modeling of selection effects and outcomes: the case of AAA repair.

Science.gov (United States)

O'Malley, A James; Cotterill, Philip; Schermerhorn, Marc L; Landon, Bruce E

2011-12-01

When 2 treatment approaches are available, there are likely to be unmeasured confounders that influence choice of procedure, which complicates estimation of the causal effect of treatment on outcomes using observational data. To estimate the effect of endovascular (endo) versus open surgical (open) repair, including possible modification by institutional volume, on survival after treatment for abdominal aortic aneurysm, accounting for observed and unobserved confounding variables. Observational study of data from the Medicare program using a joint model of treatment selection and survival given treatment to estimate the effects of type of surgery and institutional volume on survival. We studied 61,414 eligible repairs of intact abdominal aortic aneurysms during 2001 to 2004. The outcome, perioperative death, is defined as in-hospital death or death within 30 days of operation. The key predictors are use of endo, transformed endo and open volume, and endo-volume interactions. There is strong evidence of nonrandom selection of treatment with potential confounding variables including institutional volume and procedure date, variables not typically adjusted for in clinical trials. The best fitting model included heterogeneous transformations of endo volume for endo cases and open volume for open cases as predictors. Consistent with our hypothesis, accounting for unmeasured selection reduced the mortality benefit of endo. The effect of endo versus open surgery varies nonlinearly with endo and open volume. Accounting for institutional experience and unmeasured selection enables better decision-making by physicians making treatment referrals, investigators evaluating treatments, and policy makers.

Perioperative Management of Pregnant Women With Idiopathic Pulmonary Arterial Hypertension: An Observational Case Series Study From China.

Science.gov (United States)

Zhang, Jinglan; Lu, Jiakai; Zhou, Xiaorui; Xu, Xuefeng; Ye, Qing; Ou, Qitan; Li, Yanna; Huang, Jiapeng

2018-03-07

The mortality of pregnant women with idiopathic pulmonary arterial hypertension (PAH) is very high. There are limited data on the management of idiopathic PAH during pregnancy. The authors aimed to examine systematically the characteristics of parturient women with idiopathic PAH, to explore the adverse effects of idiopathic PAH on pregnancy outcomes, and to report the multidisciplinary perioperative management strategy from the largest comprehensive cardiac hospital in China. Observational case series study. Tertiary referral acute care hospital in Beijing, China. The cases of 17 consecutive pregnant idiopathic PAH patients undergoing abortion or parturition at Anzhen Hospital were reviewed retrospectively. Preoperative characteristics, anesthesia method, intensive care management, PAH-specific therapy, and maternal and neonatal outcomes were analyzed in this case series study. Maternal and neonatal outcomes were the main measures. The mean ages of the 17 parturient women with idiopathic PAH were 28.3 ± 5.4 years, and the mean systolic pulmonary arterial pressure was 97.9 ± 18.6 mmHg. Fifteen patients (88.2%) received PAH-specific therapy before delivery, including sildenafil, iloprost, and treprostinil. All except 1 parturient received epidural anesthesia for surgery due to an emergency Caesarean section. Three patients experienced pulmonary hypertension crisis that necessitated conversion to general anesthesia. Ten parturients underwent Caesarean delivery at a median gestational age of 31 weeks. Three patients developed acute pulmonary hypertensive crisis intraoperatively. Two patients underwent cardiopulmonary resuscitation and extracorporeal membrane oxygenation support. The maternal mortality was 17.6% (3/17). Of the 10 delivered neonates, 9 (90.0%) survived. The maternal mortality of the idiopathic PAH parturient was high in this case series from China. The authors applied epidural anesthesia, early management with multidisciplinary approaches, PAH

Higher blood 25(OHD level may reduce the breast cancer risk: evidence from a Chinese population based case-control study and meta-analysis of the observational studies.

Directory of Open Access Journals (Sweden)

Peizhan Chen

Full Text Available Experimental data suggest a protective effect of vitamin D on breast cancer; however, epidemiologic results remain inclusive. With a Chinese population-based case-control study and meta-analysis of the observational studies, we here systematically evaluated the association of blood 25(OHD level and breast cancer risk. With 593 breast cancer cases and 580 cancer-free controls from Shanghai, China, we found that 80% of the normal women had severe vitamin D deficiency (less than 20 ng/mL and 15.2% had mild deficiency (20 to 30 ng/mL and only 4.8% of women had sufficient vitamin D level (>30 ng/mL while the proportion was 96.1%, 3.2% and 0.7% respectively for the breast cancer patients. Compared to those with the lowest quartile of plasma 25(OHD level, women with highest quartile 25(OHD level showed a significant decreased breast cancer risk (Q4 vs.Q1: OR = 0.10, 95% CI = 0.06-0.15 and every 1 ng/ml increment of plasma 25(OHD level led to a 16% lower odds of breast cancer (OR = 0.84, 95% CI = 0.81-0.87; P<0.001. From the meta-analysis of the observational studies, we found that women with highest quantile of blood 25(OHD level was associated with a significantly reduced breast cancer risk compared to those with lowest quantile of blood 25(OHD level for the 11 nested case-control and retrospective studies (pooled OR = 0.86, 95% CI = 0.75-1.00 and 10 case-control studies (7 population based, OR = 0.35, 95% CI = 0.24-0.52; 3 hospital based, OR = 0.08, 95% CI = 0.02-0.33. These results suggest that vitamin D may have a chemo-preventive effect against breast cancer.

Case-Cohort Studies: Design and Applicability to Hand Surgery.

Science.gov (United States)

Vojvodic, Miliana; Shafarenko, Mark; McCabe, Steven J

2018-04-24

Observational studies are common research strategies in hand surgery. The case-cohort design offers an efficient and resource-friendly method for risk assessment and outcomes analysis. Case-cohorts remain underrepresented in upper extremity research despite several practical and economic advantages over case-control studies. This report outlines the purpose, utility, and structure of the case-cohort design and offers a sample research question to demonstrate its value to risk estimation for adverse surgical outcomes. The application of well-designed case-cohort studies is advocated in an effort to improve the quality and quantity of observational research evidence in hand and upper extremity surgery. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Observational studies and the difficult quest for causality

DEFF Research Database (Denmark)

Lipsitch, Marc; Jha, Ayan; Simonsen, Lone

2016-01-01

be answered once the vaccine is in use, from observational studies. However, such studies are inherently at risk for bias. Using a causal framework and illustrating with examples, we review newer approaches to detecting and avoiding confounding and selection bias in three major classes of observational study...... design: cohort, case-control and ecological studies. Studies of influenza VE, especially in seniors, are an excellent demonstration of the challenges of detecting and reducing such bias, and so we use influenza VE as a running example. We take a fresh look at the time-trend studies often dismissed...... as 'ecological'. Such designs are the only observational study design that can measure the overall effect of a vaccination programme [indirect (herd) as well as direct effects], and are in fact already an important part of the evidence base for several vaccines currently in use. Despite the great strides towards...

Evaluation of Multiclass Model Observers in PET LROC Studies

Science.gov (United States)

Gifford, H. C.; Kinahan, P. E.; Lartizien, C.; King, M. A.

2007-02-01

A localization ROC (LROC) study was conducted to evaluate nonprewhitening matched-filter (NPW) and channelized NPW (CNPW) versions of a multiclass model observer as predictors of human tumor-detection performance with PET images. Target localization is explicitly performed by these model observers. Tumors were placed in the liver, lungs, and background soft tissue of a mathematical phantom, and the data simulation modeled a full-3D acquisition mode. Reconstructions were performed with the FORE+AWOSEM algorithm. The LROC study measured observer performance with 2D images consisting of either coronal, sagittal, or transverse views of the same set of cases. Versions of the CNPW observer based on two previously published difference-of-Gaussian channel models demonstrated good quantitative agreement with human observers. One interpretation of these results treats the CNPW observer as a channelized Hotelling observer with implicit internal noise

Collaborative Assessment: Middle School Case Study

Science.gov (United States)

Parkison, Paul T.

2014-01-01

Utilizing a participant observer research model, a case study of the efficacy of a collaborative assessment methodology within a middle school social studies class was conducted. A review of existing research revealed that students' perceptions of assessment, evaluation, and accountability influence their intrinsic motivation to learn. A…

Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study.

Directory of Open Access Journals (Sweden)

Bryan A Loy

Full Text Available Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011 and after (2013 the payment method introduction using relative risks (RR. After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05. For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008 from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20. These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study.

Science.gov (United States)

Loy, Bryan A; Shkedy, Clive I; Powell, Adam C; Happe, Laura E; Royalty, Julie A; Miao, Michael T; Smith, Gary L; Long, James W; Gupta, Amit K

2016-01-01

Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05). For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008) from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20). These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

Improvement of Students’ Ability to Analyzing Cases on Case Studies Through Journal and Learning Log

Directory of Open Access Journals (Sweden)

Riska Ahmad

2017-08-01

Full Text Available The purpose of this research is to improve the ability of students in guidance and counseling  to  analyzing the case through journals and learning logs This research is classroom action research consists of two cycles. The research phase consisted of planning, implementation, observation and reflection. The research subject are students in guidance and counseling while they are in sixth semester, totaling 20 people who were taking courses in Case Study. The research instrument is the observation guidelines, assessment rubrics and documentation of case studies in the form of journals and learning logs, and case study reports. The study was conducted collaboratively with student magister’s program guidance and counseling. The results showed that in cycle 1 students are able to identify cases, to develop ideas about the case, select and use instruments to analyze the cause of the problem. The results of the research cycle 2, showed 17 of the 20 students were able to analyze the cause of the problem, select the type of service and provide appropriate assistance in accordance with problem cases. Overall value obtained by the students in the subject of Case Studies also increased. In terms of the ability of explanation of the concept, the concept of truth and creativity, based on the ratings given by fellow students of average ability students were in either category, although there is less good, as are associated with the activity of the opinion and the quality of the opinions expressed.

Methodology Series Module 2: Case-control Studies.

Science.gov (United States)

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

Science.gov (United States)

Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study

Science.gov (United States)

Loy, Bryan A.; Shkedy, Clive I.; Powell, Adam C.; Happe, Laura E.; Royalty, Julie A.; Miao, Michael T.; Smith, Gary L.; Long, James W.; Gupta, Amit K.

2016-01-01

Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, ppayment model and assess implications in other populations. PMID:26870963

[Localized scleroderma: a retrospective study about 92 cases].

Science.gov (United States)

El Fékih, Nadia; Réjaibi, Iménc; Kamoun, Hajer; Zéglaoui, Faten; Fazaa, Bécima; Kharfi, Monia; Kamoun, Mohamed Ridha

2009-09-01

Sclerodermas are rare affections which can be located or generalized. Localized form is the most frequent. The purpose of this study was to describe epidemiologic, clinics, biological, immunological, therapeutic, evolutionary characteristics of the localized scleroderma through a personal series and the data of the literature. We have performed a retrospective study on all patients followed in the department of dermatology of the Hospital Charles Nicole during 14 years period. Our study was about 92 cases of localized scleroderma (73 were females and 19 males). The mean age was 35 years (between 2 and 72 years). The majority of localised sclerodermas (66.2% of the cases) appeared before 40 years with a maximum of frequency between 10 and 30 years (41.6%). Only 11.9% of the cases were observed before 10 years. They were 51 cases (55%) of morphea, 35 cases (38%) of scleroderma in bands including 32 linear scleroderma and 3 scleroderma en coup de sabre, 5 cases (5.5%) of generalized morphea and 1 case (0.15%) of deep morphea. Average therapeutic was specified among 63 patients (87%), and the evolution could be appreciated among 45 patients. The epidemiologic data observed in our series are comparable with those reported in the literature. Therapeutic difficulties and risks of functional after-effects, particular in scleroderma in bands, remain the principal concern for all the authors.

Observing Trip Chain Characteristics of Round-Trip Carsharing Users in China: A Case Study Based on GPS Data in Hangzhou City

Directory of Open Access Journals (Sweden)

Ying Hui

2017-06-01

Full Text Available Carsharing as a means to provide individuals with access to automobiles to complete a personal trip has grown significantly in recent years in China. However, there are few case studies based on operational data to show the role carsharing systems play in citizens’ daily trips. In this study, vehicle GPS data of a round-trip carsharing system in Hangzhou, China was used to describe the trip chain characteristics of users. For clearer delineation of carshare usage, the car use time length of all observations chosen in the study was within 24 h or less. Through data preprocessing, a large pool (26,085 of valid behavior samples was obtained, and several trip chaining attributes were selected to describe the characteristics. The pool of observations was then classified into five clusters, with each cluster having significant differences in one or two trip chain characteristics. The cluster results reflected that different use patterns exist. By a comparative analysis with trip survey data in Hangzhou, differences in trip chain characteristics exist between carsharing and private cars, but in some cases, shared vehicles can be a substitute for private cars to satisfy motorized travel. The proposed method could facilitate companies in formulating a flexible pricing strategy and determining target customers. In addition, traffic administration agencies could have a deeper understanding of the position and function of various carsharing modes in an urban transportation system.

Observing the effect of a policy: a maintenance case

NARCIS (Netherlands)

Rijsdijk, Chris; Tinga, Tiedo

2016-01-01

Purpose – The purpose of this paper is to show that maintenance performance is potentially better predictable from recording routines. Design/methodology/approach – An attempt is made to observe an effect of a policy. Maintenance cases seem exceptional because of the efficiently obtainable evidence

A Case Study on Idiopathic Orbital Pseudotumor: Surgery and ...

African Journals Online (AJOL)

This is a case study of five isolated orbital nerve inflammatory pseudotumor cases ... Optic disk edema was observed by ophthalmoscopy. ... The patients on clinical examination were found to have protrusion, reduced visual acuity of the right ...

Urea cycle disorders in Spain: an observational, cross-sectional and multicentric study of 104 cases.

Science.gov (United States)

Martín-Hernández, Elena; Aldámiz-Echevarría, Luis; Castejón-Ponce, Esperanza; Pedrón-Giner, Consuelo; Couce, María Luz; Serrano-Nieto, Juliana; Pintos-Morell, Guillem; Bélanger-Quintana, Amaya; Martínez-Pardo, Mercedes; García-Silva, María Teresa; Quijada-Fraile, Pilar; Vitoria-Miñana, Isidro; Dalmau, Jaime; Lama-More, Rosa A; Bueno-Delgado, María Amor; Del Toro-Riera, Mirella; García-Jiménez, Inmaculada; Sierra-Córcoles, Concepción; Ruiz-Pons, Mónica; Peña-Quintana, Luis J; Vives-Piñera, Inmaculada; Moráis, Ana; Balmaseda-Serrano, Elena; Meavilla, Silvia; Sanjurjo-Crespo, Pablo; Pérez-Cerdá, Celia

2014-11-30

Advances in the diagnosis and treatment of urea cycle disorders (UCDs) have led to a higher survival rate. The purpose of this study is to describe the characteristics of patients with urea cycle disorders in Spain. Observational, cross-sectional and multicenter study. Clinical, biochemical and genetic data were collected from patients with UCDs, treated in the metabolic diseases centers in Spain between February 2012 and February 2013, covering the entire Spanish population. Heterozygous mothers of patients with OTC deficiency were only included if they were on treatment due to being symptomatic or having biochemistry abnormalities. 104 patients from 98 families were included. Ornithine transcarbamylase deficiency was the most frequent condition (64.4%) (61.2% female) followed by type 1 citrullinemia (21.1%) and argininosuccinic aciduria (9.6%). Only 13 patients (12.5%) were diagnosed in a pre-symptomatic state. 63% of the cases presented with type intoxication encephalopathy. The median ammonia level at onset was 298 μmol/L (169-615). The genotype of 75 patients is known, with 18 new mutations having been described. During the data collection period four patients died, three of them in the early days of life. The median current age is 9.96 years (5.29-18), with 25 patients over 18 years of age. Anthropometric data, expressed as median and z-score for the Spanish population is shown. 52.5% of the cases present neurological sequelae, which have been linked to the type of disease, neonatal onset, hepatic failure at diagnosis and ammonia values at diagnosis. 93 patients are following a protein restrictive diet, 0.84 g/kg/day (0.67-1.10), 50 are receiving essential amino acid supplements, 0.25 g/kg/day (0.20-0.45), 58 arginine, 156 mg/kg/day (109-305) and 45 citrulline, 150 mg/kg/day (105-199). 65 patients are being treated with drugs: 4 with sodium benzoate, 50 with sodium phenylbutyrate, 10 with both drugs and 1 with carglumic acid. Studies like this make it

Towards More Case Study Research in Entrepreneurship

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Tom Duxbury

2012-03-01

Full Text Available Entrepreneurship as an emerging discipline has made good strides, but according to some, has fallen short of bringing its theory and literature up to the standards of others in the management sciences. Rich with the descriptive detail needed for insightful theory building in entrepreneurship, scholars have called for more case study research, particularly those incorporating non-retrospective and longitudinal observations. At the same time however, it has become rare to find such research published in A-level journals dedicated to entrepreneurship. A survey presented here of major entrepreneurship journals over the past six years revealed a publication rate of only 3% using the case study method. This presents a major impediment for developing fresh research in this field based upon the study of real cases. The author explores how the case study method has been applied to entrepreneurship research and provides recommendations for improved publication rates.

Cultural change in telecommunications companies: a case study

OpenAIRE

Anacleto, Cristiane Alves; Irion, Crishna; Paladini, Edson Pacheco

2014-01-01

This work aims to propose a model for the conduct of cultural change in the IT department of a company in the telecommunications industry. To achieve the goal proposed exploratory, technical procedures used were the case study and literature review. The techniques of data collection in the case study were: participant observation, unstructured interview and document analysis. The proposed model consists of five steps: analysis of the company's strategic planning, cultural diagnosis of the IT ...

SUDDEN NATURAL DEATHS IN MEDICOLEGAL CASES- AN AUTOPSY BASED STUDY

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C. S. Sreedevi

2017-01-01

Full Text Available BACKGROUND Death occurring in apparently healthy individual in a case of natural death may arise suspicion of foul play. In these circumstances these cases may be subjected to medicolegal autopsy. The disease condition may be unknown to the individual and the relatives. This study was done to review the exact cause of death in sudden unexpected deaths, and enabling or assisting the legal authorities in detection of crime, to prove or disprove the foul play. Body mass index is the most frequently used indicator of body fatness. An attempt is made to find out whether there is any significant relationship between BMI and the risk for sudden cardiac death. MATERIALS AND METHODS Data of 50 cases of sudden unexpected death brought for medicolegal autopsy at govt. T.D. medical college Alappuzha in the year 2010 were studied and information were collected from the postmortem records. Data was entered in the proforma. The histopathological examination findings of relevant cases were studied. Analysis was done using MS EXCEL and Chi-square test was used as the test of significance in the comparison between two categorical variables. RESULTS In 50 cases, male predominance was observed and 88% were males in which 50% of males died of atherosclerotic occlusive coronary artery disease and among females 33% died of myocardial infarction. While considering the systemic distribution of cause of death, the cardiovascular system was found to be most commonly affected, 33 cases (66% followed by respiratory system 7 cases (14%. In 4 (8% cases gastrointestinal system was affected. In Two cases (4% central nervous system was affected and others were generalized infection, which constituted 2 cases. Out of 33 cases observed in cardiovascular system the commonest cause being the atherosclerotic occlusive coronary artery diseases involving 27 cases (81.81% in which the predominant involvement was seen in left anterior descending artery 21 cases (77.77% followed by right

[Monkeypox: second human case observed in Ivory Coast (rural health sector of Daloa].

Science.gov (United States)

Merouze, F; Lesoin, J J

1983-01-01

A second case of human monkeypox (world fifty-forth case) has been observed in Ivory Coast (rural health sector of Daloa). A three years old girl presented a major pox-like eruption which evolved to recovery. The authors describe the eruption, the evolution of the sickness, and the scars observed at the fourth month after recovery. It has not been possible to prove neither animal-human nor interhuman contagion.

An Observational Case Study of Near-peer Teaching in Medical and Pharmacy Experiential Training.

Science.gov (United States)

Sharif-Chan, Bayan; Tankala, Dipti; Leong, Christine; Austin, Zubin; Battistella, Marisa

2016-09-25

Objective. To compare peer teaching in a medical and a pharmacy clinical teaching unit and to provide suggestions for future research in pharmacy near-peer teaching. Methods. This exploratory observational study used principles of ethnographic methodology for data collection and analysis. Observations were collected in a large downtown teaching hospital. An average of 4-6 hours per day were spent observing a team of medical trainees from the Faculty (School) of Medicine in the general internal medicine (unit for two weeks, followed by a team of pharmacy trainees in an ambulatory hemodialysis (HD) unit for two weeks. Data was collected through field notes and informal interviews that were audiotaped and subsequently transcribed. Data was interpreted by the observer and reviewed weekly by two impartial pharmacists. Results. Five major themes emerged: (1) influence of peer teaching hierarchy; (2) educational distance between peer learners and teachers; (3) effect of the clinical teaching unit size on peer learning; (4) trainees' perception of their teaching role in the clinical teaching unit; and (5) influence of daily schedule and workload on peer teaching. As opposed to pharmacy, a hierarchy and pyramidal structure of peer teaching was observed in medical experiential training. There appeared to be no effect of educational distance on near peer teaching; however, perception of teaching role and influence of daily schedule affected near-peer teaching. Conclusion. Through initial comparisons of medical and pharmacy clinical teaching units, this study provides a reflection of elements that may be necessary to successfully implement near-peer teaching in pharmacy experiential training. Future studies in this area should assess learning outcomes and participant satisfaction, preceptor workload, and impact on patient care.

Case-based Learning in Microbiology: Observations from a North West Indian Medical College.

Science.gov (United States)

Singhal, Anita

2017-12-01

Microbiology is usually taught by conventional lectures, and its retention and application is observed to be poor among medical graduates/practitioners. Introduction of case-based learning (CBL) in microbiology for second-year professional MBBS students. Students were divided into two groups of fifty each. Four clinical cases were used for CBL. One group had two CBL sessions whereas the other had didactic lectures (DLs) and then the groups were crossed over. Case scenario handouts were given to students a week before the session, and smaller groups were formed for discussions and presentations in CBL sessions. Posttest, in multiple choice questions format, was conducted in two phases: First, immediately after the completion of the four CBL and DL sessions, and second, 6 weeks after the first posttest. Student and faculty feedback was taken about CBL sessions. Hundred MBBS students of the fourth semester voluntarily participated in the CBL study. The CBL scores were significantly higher than DL session scores ( P = 0.015). This difference was more marked in scoring done after 6 weeks of session completion ( P < 0.001). Student reported satisfaction in being taught by CBL method in 5-point Likert scale feedback form. Faculty feedback was positive for CBL. CBL helped in retention of knowledge and its application better than DL in our observation. More sessions on commonly encountered case scenarios will be useful for students in recalling basic science knowledge in their later years as practitioners.

A clinico-pathological study of 70 cases of pemphigus

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Arya S

1999-01-01

Full Text Available A clinicopalhological study of 70 cases of pemphigus observed over a span of four and a half years from January 1992 to June 1996 at the Sir J.J. Group of Hospitals and Grant Medical College, Mumbai is reported. Pemphigus vulgaris constituted the single largest group of 43 cases, followed by pemphigus foliaceus (25 cases and pemphigus vegetans (2 cases. Majority of the cases were seen in the age group of 21-60 years, with a slight male predominance. The youngest patient was 14 years while the eldest was aged 75 years. Mucosal involvement was seen in 31 cases of pemphigus vulgaris, as opposed to only 5 cases of pemphigus foliaceus. Flaccid bullae were present in 100% cases. Pruritus was complained of in 14 cases, though it was more common in pemphigus vegetans and vulgaris. Salient histopathological features of pemphigus vulgaris observed were (I intraepidermal suprabasal blisters (35 cases, (2 presence of acantholytic cells (40 cases, (3 "Row of tombstone appearance" (I8 cases and (4 acantholysis involving follicular sheath (20 cases. Main histopathological features of pemphigus foliaceus were (1 subcorneal blister (15 case, (2 acantholysis (24 cases and (3 bulla cavity containing inflammatory infiltrate (12 cases. Both cases of pemphigus vegetans showed hyperkeratosis, papillomatosis and irregular acanthosis with intra-epidermal eosinophilic abscesses besides suprabasal lacunae.

A Prospective Observation Study of Medical Toxicology Consultation in a U.S. Combat Theater.

Science.gov (United States)

Maddry, Joseph K; Ng, Patrick C; Sessions, Daniel; Bebarta, Vikhyat S

2016-11-01

Since 2001, U.S. military personnel and active duty, uniformed physicians providing medical support have been deployed to Afghanistan. Medical toxicologists are among the physicians deployed. There is a paucity of information present in the literature that has documented cases treated by toxicologists in theater. This prospective observational study describes 15 male patients treated in theater by a military medical toxicologist. We performed a prospective observational study in which a medical toxicologist consulted and reported on deployed toxicology cases occurring during a 5-month deployment to Bagram, Afghanistan. Fifteen toxicology cases were collected during the 5-month period. The patients included three Afghan civilians, three U.S. civilians, and nine U.S. military personnel. Eight cases were attempts at recreational euphoria, two were self-harm attempts, two were from performance-enhancing supplements, two were accidental occupational exposures and one was alcohol withdrawal. Methanol was the most common exposure followed by dextromethorphan, supplements, opiates, and chlorine gas. In our study, we found that toxic alcohols and nonprescription medications were the most common exposures. In addition, this is the first study to describe bedside toxicology consults for U.S. combat forces in theater and the use of an observation unit for critically ill patients. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Relationship between the Prediction Accuracy of Tsunami Inundation and Relative Distribution of Tsunami Source and Observation Arrays: A Case Study in Tokyo Bay

Science.gov (United States)

Takagawa, T.

2017-12-01

A rapid and precise tsunami forecast based on offshore monitoring is getting attention to reduce human losses due to devastating tsunami inundation. We developed a forecast method based on the combination of hierarchical Bayesian inversion with pre-computed database and rapid post-computing of tsunami inundation. The method was applied to Tokyo bay to evaluate the efficiency of observation arrays against three tsunamigenic earthquakes. One is a scenario earthquake at Nankai trough and the other two are historic ones of Genroku in 1703 and Enpo in 1677. In general, rich observation array near the tsunami source has an advantage in both accuracy and rapidness of tsunami forecast. To examine the effect of observation time length we used four types of data with the lengths of 5, 10, 20 and 45 minutes after the earthquake occurrences. Prediction accuracy of tsunami inundation was evaluated by the simulated tsunami inundation areas around Tokyo bay due to target earthquakes. The shortest time length of accurate prediction varied with target earthquakes. Here, accurate prediction means the simulated values fall within the 95% credible intervals of prediction. In Enpo earthquake case, 5-minutes observation is enough for accurate prediction for Tokyo bay, but 10-minutes and 45-minutes are needed in the case of Nankai trough and Genroku, respectively. The difference of the shortest time length for accurate prediction shows the strong relationship with the relative distance from the tsunami source and observation arrays. In the Enpo case, offshore tsunami observation points are densely distributed even in the source region. So, accurate prediction can be rapidly achieved within 5 minutes. This precise prediction is useful for early warnings. Even in the worst case of Genroku, where less observation points are available near the source, accurate prediction can be obtained within 45 minutes. This information can be useful to figure out the outline of the hazard in an early

Clinical observations associated with proven and unproven cases in the ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery.

LENUS (Irish Health Repository)

Barry, Peter

2012-02-01

PURPOSE: To describe cases of postoperative endophthalmitis in the European Society of Cataract & Refractive Surgeons (ESCRS) study of the prophylaxis of endophthalmitis, compare characteristics of unproven cases and cases proven by culture or polymerase chain reaction, and compare the characteristics with those in other reported series. SETTING: Twenty-four ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, and the United Kingdom. METHODS: Univariable and multivariable logistic regression models were used to analyze data for statistical association of signs and symptoms in cases with proven or unproven endophthalmitis. Specific data describing characteristics of the cases were compared between the 2 types of cases. RESULTS: Data from 29 endophthalmitis cases were analyzed. Swollen lids and pain were statistically associated with proven cases of endophthalmitis on univariable regression analysis. Multivariable analysis indicated that swollen lids and an opaque vitreous were associated with proven cases. Five cases of endophthalmitis occurred in the cefuroxime-treated groups. No case of streptococcal infection occurred in the cefuroxime-treated groups. However, cases of infection due to streptococci showed striking differences in visual acuity and were associated with earlier onset. Characteristics in the 29 cases parallel results in previous studies, such as the Endophthalmitis Vitrectomy Study, although the addition of a control group in the ESCRS study elicited additional findings. CONCLUSION: Swollen lids, pain, and an opaque vitreous were statistically associated with proven endophthalmitis cases in the ESCRS study.

Intensive Case Management for Addiction to promote engagement with care of people with severe mental and substance use disorders: an observational study.

Science.gov (United States)

Morandi, Stéphane; Silva, Benedetta; Golay, Philippe; Bonsack, Charles

2017-05-25

Co-occurring severe mental and substance use disorders are associated with physical, psychological and social complications such as homelessness and unemployment. People with severe mental and substance use disorders are difficult to engage with care. The lack of treatment worsens their health and social conditions and increases treatment costs, as emergency department visits arise. Case management has proved to be effective in promoting engagement with care of people with severe mental and substance use disorders. However, this impact seemed mainly related to the case management model. The Intensive Case Management for Addiction (ICMA) aimed to improve engagement with care of people with severe mental and substance use disorders, insufficiently engaged with standard treatment. This innovative multidisciplinary mobile team programme combined Assertive Community Treatment and Critical Time Intervention methodologies. The aim of the study was to observe the impact of ICMA upon service use, treatment adherence and quality of support networks. Participants' psychosocial and mental functioning, and substance use were also assessed throughout the intervention. The study was observational. Eligible participants were all the people entering the programme during the first year of implementation (April 2014-April 2015). Data were collected through structured questionnaires and medical charts. Assessments were conducted at baseline and at 12 months follow-up or at the end of the programme if completed earlier. McNemar-Bowker's Test, General Linear Model repeated-measures analysis of variance and non-parametric Wilcoxon Signed Rank tests were used for the analysis. A total of 30 participants took part in the study. Results showed a significant reduction in the number of participants visiting the general emergency department compared to baseline. A significantly decreased number of psychiatric emergency department visits was also registered. Moreover, at follow-up participants

Observer Variation in Computed Tomography of the Sacroiliac Joints: A Retrospective Analysis of 1383 Cases

International Nuclear Information System (INIS)

Geijer, M.; Gadeholt Goethlin, G.; Goethlin, J.H.

2007-01-01

Background: Computed tomography (CT) for evaluation of sacroiliitis has a higher diagnostic accuracy than radiography. There is a high degree of interobserver variation in evaluating sacroiliitis on radiographs. Purpose: To evaluate interobserver variation in CT of the sacroiliac joints for evaluation of sacroiliitis in a large number of patients. Material and Methods: 1383 CT examinations of the sacroiliac joints were reviewed by two observers. The outcomes as originally reported and the findings from the reviews were classified as no sacroiliitis, equivocal, unilateral sacroiliitis, or bilateral sacroiliitis. The unweighted kappa statistic was used for assessment of observer agreement. Results: The interobserver agreement between the two reviewers was good (0.6724), with excellent agreement on cases of bilateral sacroiliitis and moderate agreement on cases of unilateral sacroiliitis. Excellent agreement was also reached in normal cases. Compared to the original reports, there were moderate interobserver agreements between both reviewers' findings and the original reports 0.4651 and 0.4481, respectively). Conclusion: The interobserver variation for the diagnosis of sacroiliitis on CT between two reviewers in a study setting showed good agreement, with moderate agreement between each of the observers and the original clinical reports. CT is a reliable method for evaluating the sacroiliac joints for changes of sacroiliitis

Observer Variation in Computed Tomography of the Sacroiliac Joints: A Retrospective Analysis of 1383 Cases

Energy Technology Data Exchange (ETDEWEB)

Geijer, M.; Gadeholt Goethlin, G.; Goethlin, J.H. [Dept. of Diagnostic Radiology, Sahlgrenska Univ. Hospital, Goeteborg (Sweden)

2007-08-15

Background: Computed tomography (CT) for evaluation of sacroiliitis has a higher diagnostic accuracy than radiography. There is a high degree of interobserver variation in evaluating sacroiliitis on radiographs. Purpose: To evaluate interobserver variation in CT of the sacroiliac joints for evaluation of sacroiliitis in a large number of patients. Material and Methods: 1383 CT examinations of the sacroiliac joints were reviewed by two observers. The outcomes as originally reported and the findings from the reviews were classified as no sacroiliitis, equivocal, unilateral sacroiliitis, or bilateral sacroiliitis. The unweighted kappa statistic was used for assessment of observer agreement. Results: The interobserver agreement between the two reviewers was good (0.6724), with excellent agreement on cases of bilateral sacroiliitis and moderate agreement on cases of unilateral sacroiliitis. Excellent agreement was also reached in normal cases. Compared to the original reports, there were moderate interobserver agreements between both reviewers' findings and the original reports 0.4651 and 0.4481, respectively). Conclusion: The interobserver variation for the diagnosis of sacroiliitis on CT between two reviewers in a study setting showed good agreement, with moderate agreement between each of the observers and the original clinical reports. CT is a reliable method for evaluating the sacroiliac joints for changes of sacroiliitis.

Vitamin D Intake and Risk of Type 1 Diabetes: A Meta-Analysis of Observational Studies

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Li-Qiang Qin

2013-09-01

Full Text Available Vitamin D is suggested to have protective effects against type 1 diabetes. However, the results from observational studies have been inconsistent. We aimed to examine their association by conducting a meta-analysis of observational studies. Multiple databases were searched in June 2013 to identify relevant studies including both case-control and cohort studies. Either a fixed- or random-effects model was used to calculate the pooled risk estimate. We identified eight studies (two cohort studies and six case-control studies on vitamin D intake during early life and three studies (two cohort studies and one case-control study on maternal vitamin D intake during pregnancy. The pooled odds ratio for type 1 diabetes comparing vitamin D supplementation with non-supplementation during early life was 0.71 (95% confidence interval [CI], 0.51–0.98. Similar results were observed in the case-control subgroup analysis but not in the cohort subgroup analysis. The pooled odds ratio with maternal intake of vitamin D during pregnancy was 0.95 (95% CI, 0.66–1.36. In conclusion, vitamin D intake during early life may be associated with a reduced risk of type 1 diabetes. However, there was not enough evidence for an association between maternal intake of vitamin D and risk of type 1 diabetes in the offspring.

Epidemiological follow-up study of Japanese Thorotrast cases

International Nuclear Information System (INIS)

Mori, T.; Maruyama, T.; Kato, Y.; Takahashi, S.

1979-01-01

The authors conducted a follow-up study on 243 Thorotrast-administered war-wounded ex-servicemen in 1975, after a lapse of 30 to 38 years from Thorotrast injections, and found 18 cases of malignant hepatic tumor, 15 cases of other malignant tumors, 2 cases of blood diseases, and 9 cases of liver cirrhosis in 224 cases who had been given Thorotrast intravascularly. The incidence of hepatic and other malignant tumors, blood diseases, and liver cirrhosis was significantly higher than in the controls. The total number of deaths in the Thorotrast-administered cases was also significantly higher than in the controls. In the remaining 19 cases who had been given Thorotrast by a route other than intravascularly, no fatal case related to Thorotrast administration was discovered. In the living cases, however, one sarcoma was observed to have developed at the site of the Thorotrast injection

The role of the observational approach in RI planning: WAG 5 case study

International Nuclear Information System (INIS)

Brill, A.K.; Kuhaida, A.J. Jr.

1992-10-01

A Remedial Investigation (RI) Plan was developed for the Oak Ridge National Laboratory (ORNL) Waste Area Grouping (WAG) 5 in March 1988 and submitted to the Environmental Protection Agency (EPA) Region IV and the State of Tennessee for review and approval. The observational approach was evaluated by the ORNL Environmental Restoration (ER) Program and accepted by EPA as an accelerated and cost-effective approach to the RI/Feasibility Study (FS) process for remediation of WAG 5. The traditional approach used in preparing the 1988 RI Plan focused on data completeness, included a typical range of RI data-gathering activities for determining the nature and extent of contamination at WAG 5, and used multiple iterations of sampling activities to deal with uncertainties without consideration of potential deviations. In fall 1991, a revised Field Sampling Plan (FSP) was developed that used the observational approach to integrate site characterization with site remediation needs. This approach recognized the uncertainties of site characterization/remedial planning and developed contingency plans for dealing with them. The observational approach emphasizes data sufficiency to support remedial planning decisions for WAG 5

An alternative approach for socio-hydrology: case study research

Science.gov (United States)

Mostert, Erik

2018-01-01

Currently the most popular approach in socio hydrology is to develop coupled human-water models. This article proposes an alternative approach, qualitative case study research, involving a systematic review of (1) the human activities affecting the hydrology in the case, (2) the main human actors, and (3) the main factors influencing the actors and their activities. Moreover, this article presents a case study of the Dommel Basin in Belgium and the Netherlands, and compares this with a coupled model of the Kissimmee Basin in Florida. In both basins a pendulum swing from water resources development and control to protection and restoration can be observed. The Dommel case study moreover points to the importance of institutional and financial arrangements, community values, and broader social, economic, and technical developments. These factors are missing from the Kissimmee model. Generally, case studies can result in a more complete understanding of individual cases than coupled models, and if the cases are selected carefully and compared with previous studies, it is possible to generalize on the basis of them. Case studies also offer more levers for management and facilitate interdisciplinary cooperation. Coupled models, on the other hand, can be used to generate possible explanations of past developments and quantitative scenarios for future developments. The article concludes that, given the limited attention they currently get and their potential benefits, case studies deserve more attention in socio-hydrology.

Magnetic clouds' structure in the magnetosheath as observed by Cluster and Geotail: four case studies

Directory of Open Access Journals (Sweden)

L. Turc

2014-10-01

Full Text Available Magnetic clouds (MCs are large-scale magnetic flux ropes ejected from the Sun into the interplanetary space. They play a central role in solar–terrestrial relations as they can efficiently drive magnetic activity in the near-Earth environment. Their impact on the Earth's magnetosphere is often attributed to the presence of southward magnetic fields inside the MC, as observed in the upstream solar wind. However, when they arrive in the vicinity of the Earth, MCs first encounter the bow shock, which is expected to modify their properties, including their magnetic field strength and direction. If these changes are significant, they can in turn affect the interaction of the MC with the magnetosphere. In this paper, we use data from the Cluster and Geotail spacecraft inside the magnetosheath and from the Advanced Composition Explorer (ACE upstream of the Earth's environment to investigate the impact of the bow shock's crossing on the magnetic structure of MCs. Through four example MCs, we show that the evolution of the MC's structure from the solar wind to the magnetosheath differs largely from one event to another. The smooth rotation of the MC can either be preserved inside the magnetosheath, be modified, i.e. the magnetic field still rotates slowly but at different angles, or even disappear. The alteration of the magnetic field orientation across the bow shock can vary with time during the MC's passage and with the location inside the magnetosheath. We examine the conditions encountered at the bow shock from direct observations, when Cluster or Geotail cross it, or indirectly by applying a magnetosheath model. We obtain a good agreement between the observed and modelled magnetic field direction and shock configuration, which varies from quasi-perpendicular to quasi-parallel in our study. We find that the variations in the angle between the magnetic fields in the solar wind and in the magnetosheath are anti-correlated with the variations in the

CULTURAL CHANGE IN TELECOMMUNICATIONS COMPANIES: A CASE STUDY

Directory of Open Access Journals (Sweden)

Cristiane Alves Anacleto

2014-09-01

Full Text Available This work aims to propose a model for the conduct of cultural change in the IT department of a company in the telecommunications industry. To achieve the goal proposed exploratory, technical procedures used were the case study and literature review. The techniques of data collection in the case study were: participant observation, unstructured interview and document analysis. The proposed model consists of five steps: analysis of the company's strategic planning, cultural diagnosis of the IT department, brainstorming with the staff and managers, compared to the case studies surveyed and proposed actions for the conduct of cultural change. We conclude that a receptive environment, employees not only understand why the changes are necessary, but engage with the process and faithfully executes the steps required, favoring the strategic positioning of the company.

Case Study Research Methodology

Directory of Open Access Journals (Sweden)

Mark Widdowson

2011-01-01

Full Text Available Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before providing a summary of types of case studies including clinical, experimental and naturalistic. Suggestions are included for developing systematic case studies and brief descriptions are given of a range of research resources relating to outcome and process measures. Examples of a pragmatic case study design and a hermeneutic single-case efficacy design are given and the paper concludes with some ethical considerations and an exhortation to the TA community to engage more widely in case study research.

Project management case studies

CERN Document Server

Kerzner, Harold R

2013-01-01

A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

Association Between the Mediterranean Diet and Cancer Risk: A Review of Observational Studies

NARCIS (Netherlands)

Verberne, L.D.M.; Bach-Faig, A.; Buckland, G.; Serra-Majem, L.

2010-01-01

The aim of this article was to summarize the evidence concerning the association between Mediterranean dietary pattern and cancer risk in observational epidemiological studies. All the studies that met the following criteria were reviewed: human cohort and case-control studies that examined the

Properties, propagation, and excitation of EMIC waves observed by MMS: A case study

Science.gov (United States)

Zhang, J.; Boardsen, S. A.; Coffey, V. N.; Chandler, M. O.; Saikin, A.; Mello, E. M.; Russell, C. T.; Torbert, R. B.; Fuselier, S. A.; Giles, B. L.; Gershman, D. J.

2017-12-01

Electromagnetic ion cyclotron (EMIC) waves (0.1-5 Hz) play an important role in particle dynamics in the Earth's magnetosphere. EMIC waves are preferentially excited in regions where hot anisotropic ions and cold dense plasma populations spatially overlap. While the generation region of EMIC waves is usually on or near the magnetic equatorial plane in the inner magnetosphere, EMIC waves have both equatorial and off-equator source regions on the dayside in the compressed outer magnetosphere. Using field and plasma measurements from the Magnetospheric Multiscale (MMS) mission, we perform a case study of EMIC waves and associated local plasma conditions observed on 19 October 2015. From 0315 to 0810 UT, before crossing the magnetopause into the magnetosheath, all four MMS spacecraft detected long-lasting He+-band EMIC wave emissions around local noon (MLT = 12.7 - 14.0) at high L-shells (L = 8.8 - 15.2) and low magnetic latitudes (MLAT = -21.8º - -30.3º). Energetic (> 1 keV) and anisotropic ions were present throughout this event that was in the recovery phase of a weak geomagnetic storm (min. Dst = -48 nT at 1000 UT on 18 October 2015). The testing of linear theory suggests that the EMIC waves were excited locally. Although the wave event is dominated by small normal angles, its polarization is mixed with right- and left-handedness and its propagation is bi-directional with regard to the background magnetic field. The short inter-spacecraft distances (as low as 15 km) of the MMS mission make it possible to accurately determine the k vector of the waves using the phase difference technique. Preliminary analysis finds that the k vector magnitude, phase speed, and wavelength of the 0.3-Hz wave packet at 0453:55 UT are 0.005 km-1, 372.9 km/s, and 1242.9 km, respectively. We will discuss the characteristics of the wave and particle measurements and their significance in this locale.

[Case and studies].

Science.gov (United States)

Schubert, András

2015-11-15

Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

Case Study of Ion Beams Observed By Cluster At Perigee

Science.gov (United States)

Sergeev, V.; Sauvaud, J.-A.; Perigee Beam Team

During substorms the short beams of ions in the keV-to-tens keV energy range are injected into the auroral flux tubes from the magnetotail (sometimes extending up to >100 keV energy) carrying the information on the source distance, scale-size and temporal history of plasma acceleration. We present observations with the CLUSTER crossing inward the auroral zone flux tubes at ~4Re distance near its perigee during the substorm activity on February 14, 2001. The ion beams cover the same region (poleward half) of the auroral oval where the low-energy ions are extracted from the ionosphere, and where the small-scale transient transverse Alfven waves are observed which carry predominantly the downward parallel Poynting flux into the ionosphere. The multiple beams were basically confirmed to be the transient effects, although some effects including the (spatial) velocity filter and the parallel electric fields (im- posed by quasineutrality requirement) may complicate the interpretation. The gener- ation region of ion beams is not limited to most poleward, newly-reconnected flux tubes; the beam generation region could extend across magnetic field inward by as much as >100km (if mapped to the ionosphere). Surprising variety of injection dis- tances observed nearly simultaneously (ranging between >60 Re and ~10 Re) have been inferred when using the full available energy and time resolution, with shorter injection distances be possibly associated with the flow braking process. The beam multiplicity often displays the apparent ~3 min quasiperiodicity inherent to the basic dissipation process, it was not yet explained by any substorm theory.

Classroom Observation Practice in Career Schools: A Multiple Case Study

Science.gov (United States)

Withers, Marya G.

2017-01-01

Post-secondary career school educational leaders are charged with formulating sufficient, ongoing, and effective faculty development programming to ensure the delivery of quality education in their unique trade-expert led institutions. Classroom observations, which include substantive feedback exchanges from trained personnel are well documented…

Building theories from case study research: the progressive case study

NARCIS (Netherlands)

Steenhuis, H.J.; de Bruijn, E.J.

2006-01-01

Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior

IVHS Institutional Issues and Case Studies, Analysis and Lessons Learned, Final Report

Science.gov (United States)

1994-04-01

This 'Analysis and Lessons Learned' report contains observations, conclusions, and recommendations based on the performance of six case studies of Intelligent Vehicle-Highway Systems (IVHS) projects. Information to support the development of the case...

Censored Hurdle Negative Binomial Regression (Case Study: Neonatorum Tetanus Case in Indonesia)

Science.gov (United States)

Yuli Rusdiana, Riza; Zain, Ismaini; Wulan Purnami, Santi

2017-06-01

Hurdle negative binomial model regression is a method that can be used for discreate dependent variable, excess zero and under- and overdispersion. It uses two parts approach. The first part estimates zero elements from dependent variable is zero hurdle model and the second part estimates not zero elements (non-negative integer) from dependent variable is called truncated negative binomial models. The discrete dependent variable in such cases is censored for some values. The type of censor that will be studied in this research is right censored. This study aims to obtain the parameter estimator hurdle negative binomial regression for right censored dependent variable. In the assessment of parameter estimation methods used Maximum Likelihood Estimator (MLE). Hurdle negative binomial model regression for right censored dependent variable is applied on the number of neonatorum tetanus cases in Indonesia. The type data is count data which contains zero values in some observations and other variety value. This study also aims to obtain the parameter estimator and test statistic censored hurdle negative binomial model. Based on the regression results, the factors that influence neonatorum tetanus case in Indonesia is the percentage of baby health care coverage and neonatal visits.

Pharmacotherapy for primary delusional jealousy, a retrospective observational study of 32 cases with Othello syndrome.

Science.gov (United States)

Liu, Chen-Chung; Wang, Yen-Chin; Hwang, Tzung-Jeng

2018-03-01

To determine whether primary delusional jealousy can be treated effectively with antipsychotics or antidepressants, and whether any clinical variables are associated with response to pharmacotherapy, we carried out a retrospective case series observational study by reviewing clinical records of patients with an International Classification of Disease, 9th ed., diagnostic code of 297 (delusional disorders) who were treated at the Department of Psychiatry of a university affiliated hospital from January 2010 to December 2015. Only those records showing obvious delusional jealousy not secondary to other medical conditions, dementia, or schizophrenia were scrutinized thoroughly with respect to types of pharmacotherapy, treatment response, and other demographic and clinical variables likely to be associated with clinical outcomes. All except one of 32 patients, 16 men and 16 women, between 37 and 79 (60.9±10.6) years of age, were treated with low-dose antipsychotics. The general response was favorable as 19 (59.4%) were rated as good and 13 as inadequate responders (seven partial and six limited). Compared with antipsychotic monotherapy, concomitant therapy with antidepressants had a higher rate of good response, although statistically insignificant (75 vs. 53%, P=0.21). Younger age (P=0.01) and presentation at the index visit with their suspected unfaithful spouse were associated with a good response (P=0.036); comorbidity with delusions other than the jealous type was associated with a poor response (P=0.006). The overall outcome for delusional jealousy looks promising if the patients can accept pharmacotherapy in an outpatient setting.

Misclassification of Case-Control Studies in Neurosurgery and Proposed Solutions.

Science.gov (United States)

Esene, Ignatius Ngene; Mbuagbaw, Lawrence; Dechambenoit, Gilbert; Reda, Wael; Kalangu, Kazadi K

2018-04-01

Case-control studies (CCS) and cohort studies (CS) are common research designs in neurosurgery. But the term case-control study is frequently misused in the neurosurgical literature, with many articles reported as CCS, even although their methodology does not respect the basic components of a CCS. We sought to estimate the extent of these discrepancies in neurosurgical literature, explore factors contributing to mislabeling, and shed some light on study design reporting. We identified 31 top-ranking pure neurosurgical journals and searched them for articles reported as CCS, either in the title or in the abstract. The articles were read to determine if they really were CCS according to STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Article assessment was conducted in duplicate (agreement [κ statistics] = 99.82%). Two hundred and twenty-four articles met our inclusion criteria, 133 of which (59.38%) correctly labeled the case-control design, whereas 91 (40.62%) misclassified this study design. Cohort studies (CS) were the most common design mislabeled as case-control studies in 76 articles (33.93%), 57 of which (25.45%) were retrospective CS. The mislabeling of CCS impairs the appropriate indexing, classification, and sorting of evidence. Mislabeling CS for CCS leads to a downgrading of evidence as CS represent the highest level of evidence for observational studies. Odds ratios instead of relative risk are reported for these studies, resulting in a distortion of the measurement of the effect size, compounded when these are summarized in systematic reviews and pooled in meta-analyses. Many studies reported as CCS are not true CCS. Reporting guidelines should include items that ensure that studies are labeled correctly. STROBE guidelines should be implemented in assessment of observational studies. Researchers in neurosurgery need better training in research methods and terminology. We also recommend accrued vigilance from

Role of observation of live cases done by Japanese experts in the acquisition of ESD skills by a western endoscopist.

Science.gov (United States)

Draganov, Peter V; Chang, Myron; Coman, Roxana M; Wagh, Mihir S; An, Qi; Gotoda, Takuji

2014-04-28

To evaluate the role of observation of experts performing endoscopic submucosal dissection (ESD) in the acquisition of ESD skills. This prospective study is documenting the learning curve of one Western endoscopist. The study consisted of three periods. In the first period (pre-observation), the trainee performed ESDs in animal models in his home institution in the United States. The second period (observation) consisted of visit to Japan and observation of live ESD cases done by experts. The observation of cases occurred over a 5-wk period. During the third period (post-observation), the trainee performed ESD in animal models in a similar fashion as in the first period. Three animal models were used: live 40-50 kg Yorkshire pig, explanted pig stomach model, and explanted pig rectum model. The outcomes from the ESDs done in the animal models before and after observation of live human cases (main study intervention) were compared. Statistical analysis of the data included: Fisher's exact test to compare distributions of a categorical variable, Wilcoxon rank sum test to compare distributions of a continuous variable between the two groups (pre-observation and post-observation), and Kruskal-Wallis test to evaluate the impact of lesion location and type of model (ex-vivo vs live pig) on lesion removal time. The trainee performed 38 ESDs in animal model (29 pre-observation/9 post-observation). The removal times post-observation were significantly shorter than those pre-observation (32.7 ± 15.0 min vs 63.5 ± 9.8 min, P < 0.001). To minimize the impact of improving physician skill, the 9 lesions post-observation were compared to the last 9 lesions pre-observation and the removal times remained significantly shorter (32.7 ± 15.0 min vs 61.0 ± 7.4 min, P = 0.0011). Regression analysis showed that ESD observation significantly reduced removal time when controlling for the sequence of lesion removal (P = 0.025). Furthermore, it was also noted a trend towards decrease in

A model of scientific attitudes assessment by observation in physics learning based scientific approach: case study of dynamic fluid topic in high school

Science.gov (United States)

Yusliana Ekawati, Elvin

2017-01-01

This study aimed to produce a model of scientific attitude assessment in terms of the observations for physics learning based scientific approach (case study of dynamic fluid topic in high school). Development of instruments in this study adaptation of the Plomp model, the procedure includes the initial investigation, design, construction, testing, evaluation and revision. The test is done in Surakarta, so that the data obtained are analyzed using Aiken formula to determine the validity of the content of the instrument, Cronbach’s alpha to determine the reliability of the instrument, and construct validity using confirmatory factor analysis with LISREL 8.50 program. The results of this research were conceptual models, instruments and guidelines on scientific attitudes assessment by observation. The construct assessment instruments include components of curiosity, objectivity, suspended judgment, open-mindedness, honesty and perseverance. The construct validity of instruments has been qualified (rated load factor > 0.3). The reliability of the model is quite good with the Alpha value 0.899 (> 0.7). The test showed that the model fits the theoretical models are supported by empirical data, namely p-value 0.315 (≥ 0.05), RMSEA 0.027 (≤ 0.08)

Observations of tropospheric trace gases and meteorology in rural Virginia using an unattended monitoring system: Hurricane Hugo (1989), A case study

Science.gov (United States)

Doddridge, Bruce G.; Dickerson, Russell R.; Holland, Joshua Z.; Cooper, James N.; Wardell, R. Glenn; Poulida, Olga; Watkins, James G.

1991-05-01

Tropospheric trace gases such as ozone and reactive nitrogen compounds exert a strong influence on global climate, but observations of these species are limited by the necessity of having a trained observer on site to monitor instruments. A technique using modern communications technology has been developed to transport and review data collected at a remote site. The site was equipped with a PAM II station and satellite data link so that raw, real-time data and equipment status were available for inspection readily on a workstation at the University of Maryland campus through a combination of wide and local area networks. CO, NO, NOy, O3, UV radiative flux, and meteorological parameters were measured in rural Virginia for a full year. The cleanest air observed over the year was associated with the passage of Hurricane Hugo over the mid-Atlantic region on September 22, 1989. Hourly average data for concentrations of CO, NOy, and O3 observed during this particular case study were as low as 90 ppbv, 570 pptv, and 11 ppbv, respectively. Within this period, daytime NO was highly variable, ranging between the detection limit of the instrument, ˜ 20 pptv, and 2.4 ppbv. These concentrations are well below the hourly concentration average at this site for these species during September 1989. Equivalent potential temperature, θe, in conjunction with the trace gas concentrations and geostrophic back-trajectories, illustrates how this hurricane influenced air parcel history; observed concentrations of CO and NOy increased with the time the air parcel spent over land. Observations at this site were consistent with current hurricane models based on mean soundings and aircraft flights. Hurricanes over land also appear to redistribute air vertically throughout the troposphere, creating the potential for substantial post-storm tropospheric column O3 increase.

Inference for Ecological Dynamical Systems: A Case Study of Two Endemic Diseases

Directory of Open Access Journals (Sweden)

Daniel A. Vasco

2012-01-01

Full Text Available A Bayesian Markov chain Monte Carlo method is used to infer parameters for an open stochastic epidemiological model: the Markovian susceptible-infected-recovered (SIR model, which is suitable for modeling and simulating recurrent epidemics. This allows exploring two major problems of inference appearing in many mechanistic population models. First, trajectories of these processes are often only partly observed. For example, during an epidemic the transmission process is only partly observable: one cannot record infection times. Therefore, one only records cases (infections as the observations. As a result some means of imputing or reconstructing individuals in the susceptible cases class must be accomplished. Second, the official reporting of observations (cases in epidemiology is typically done not as they are actually recorded but at some temporal interval over which they have been aggregated. To address these issues, this paper investigates the following problems. Parameter inference for a perfectly sampled open Markovian SIR is first considered. Next inference for an imperfectly observed sample path of the system is studied. Although this second problem has been solved for the case of closed epidemics, it has proven quite difficult for the case of open recurrent epidemics. Lastly, application of the statistical theory is made to measles and pertussis epidemic time series data from 60 UK cities.

Topical session proceedings of the 5. IGSC meeting on: observations regarding the safety case in recent safety assessment studies

International Nuclear Information System (INIS)

Hooper, Alan J.; Voinis, Sylvie; Van Luik, Abraham E.

2004-01-01

Within the NEA, the IGSC (Integration Group for the Safety Case) has, as an essential role, to develop common views on such key aspects of the safety case. Therefore, since the inauguration of the IGSC in 2000, four meetings were organised with topical sessions to explore various of these key aspects. This is a report on the fifth such topical session, held as part of the 5. plenary meeting of the IGSC. The session was attended by 36 participants, representing waste management organisations and regulatory authorities from 16 NEA member countries, the IAEA and the European Commission. The purpose of this topical session was to provide support to the finalising of the IGSC safety case brochure by getting a description of the safety case content of the IAEA Draft Safety Requirements document and by getting an overview of progress that could be observed from national organisations on developing their cases for system safety and/or developing the required methodologies. The objective was that the IGSC safety case brochure should be supportive of the IAEA/NEA document, and be reflective of the experience of the IGSC member programmes and organisations. The topical session was mainly aimed at exchanging information on: - The safety case related content of the proposed IAEA/NEA document (currently titled: 'IAEA Safety Standards Series, Geological Disposal of Radioactive Waste, Draft Safety Requirements (DS-154)'). - National programmes where safety assessments have recently been completed, e.g. ONDRAF/NIRAS, Nagra and Andra. - Feedback from international peer reviews, e.g. the Andra Dossier 2001 Argile, the Belgian SAFIR 2 report, the SR 97 report and the US-DOE Yucca Mountain TSPA. - The evolution of some national assessment methods and approaches e.g. SKB and Nagra. - The content of the draft IGSC safety case brochure entitled: 'The Nature and Purpose of the Post-closure Safety Case in Geological Disposal'. This document presents the various

Probiotics and gut health in infants: A preliminary case-control observational study about early treatment with Lactobacillus reuteri DSM 17938.

Science.gov (United States)

Savino, Francesco; Fornasero, Stefania; Ceratto, Simone; De Marco, Angela; Mandras, Narcisa; Roana, Janira; Tullio, Vivian; Amisano, Gabriella

2015-12-07

We performed this case-control observational study to evaluate the effects of early administration of Lactobacillus reuteri DSM 17938 on microbial composition in infants' gastrointestinal tract. Early fecal microbiota composition was analyzed by using selective and differential cultural methods. Genomic DNA from positive Escherichia coli and Cronobacter sakazakii colonies was extracted and DNA was processed by multiplex PCR assay. Fecal samples of 30 hospitalized infants who previously received probiotics and 30 not receiving probiotics were analyzed. We find that the two groups showed differences in gut microbial strains composition and richness. Infant treated with probiotics have a lower total anaerobic gram negative counts (p=0.03) and a higher total anaerobic gram-positive counts (p=0.02). Enterobacteriaceae and enterococci were significantly higher (p=0.04) in the control group. No significant differences were observed for total aerobic counts, lactobacilli and bifidobacteria. C. sakazaki was found only in one infant recruited in the control group. Infants not previously treated with probiotics showed a higher colonization by diarrheagenic E. coli (EPEC) (p=0.04). Our findings enhanced our understanding of the effects of probiotics on gut health in pediatric subjects. Early administration of L. reuteri in infancy could improve gut health by reducing pathogens colonization. Copyright © 2015 Elsevier B.V. All rights reserved.

Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

Science.gov (United States)

van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

2015-07-01

Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

Final report on case studies

DEFF Research Database (Denmark)

Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

2012-01-01

Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

Inter-observer reproducibility in reporting on renal drainage in children with hydronephrosis: a large collaborative study

International Nuclear Information System (INIS)

Tondeur, Marianne; Piepsz, Amy; De Palma, Diego; Roca, Isabel; Ham, Hamphrey

2008-01-01

The goal of this study was to evaluate the inter-observer reproducibility in reporting on renal drainage obtained during 99m Tc MAG3 renography in children, when already processed data are offered to the observers. Because web site facilities were used for communication, 57 observers from five continents participated in the study. Twenty-three renograms, including furosemide stimulation and posterect postmicturition views, covering various patterns of drainage, were submitted to the observers. Images, curves and quantitative parameters were provided. Good or almost good drainage, partial drainage and poor or no drainage were the three possible responses for each kidney. An important bias was observed among the observers, some of them more systematically reporting the drainage as being good, while others had a general tendency to consider the drainage as poor. This resulted in rather poor inter-observer reproducibility, as for more than half of the kidneys, less than 80% of the observers agreed on one of the three responses. Analysis of the individual cases identified some obvious causes of discrepancy: the absence of a clear limit between partial and good or almost good drainage, the fact of including or neglecting the effect of micturition and change of patient's position, the underestimation of drainage in the case of a flat renographic curve, and the difficulties of interpretation in the case of a small, not well functioning kidney. There is an urgent need for better standardisation in estimating the quality of drainage. (orig.)

Inter-observer reproducibility in reporting on renal drainage in children with hydronephrosis: a large collaborative study

Energy Technology Data Exchange (ETDEWEB)

Tondeur, Marianne; Piepsz, Amy [CHU Saint-Pierre, Departement des Radio-Isotopes, Brussels (Belgium); De Palma, Diego [Ospedale di Circolo, Nuclear Medicine, Varese (Italy); Roca, Isabel [Vall d' Hebron Hospital, Nuclear Medicine, Barcelona (Spain); Ham, Hamphrey [University Hospital, Department Nuclear Medicine, Ghent (Belgium)

2008-03-15

The goal of this study was to evaluate the inter-observer reproducibility in reporting on renal drainage obtained during {sup 99m}Tc MAG3 renography in children, when already processed data are offered to the observers. Because web site facilities were used for communication, 57 observers from five continents participated in the study. Twenty-three renograms, including furosemide stimulation and posterect postmicturition views, covering various patterns of drainage, were submitted to the observers. Images, curves and quantitative parameters were provided. Good or almost good drainage, partial drainage and poor or no drainage were the three possible responses for each kidney. An important bias was observed among the observers, some of them more systematically reporting the drainage as being good, while others had a general tendency to consider the drainage as poor. This resulted in rather poor inter-observer reproducibility, as for more than half of the kidneys, less than 80% of the observers agreed on one of the three responses. Analysis of the individual cases identified some obvious causes of discrepancy: the absence of a clear limit between partial and good or almost good drainage, the fact of including or neglecting the effect of micturition and change of patient's position, the underestimation of drainage in the case of a flat renographic curve, and the difficulties of interpretation in the case of a small, not well functioning kidney. There is an urgent need for better standardisation in estimating the quality of drainage. (orig.)

Literacy Skills Development for Tertiary Institutions: A Case Study of ...

African Journals Online (AJOL)

Literacy Skills Development for Tertiary Institutions: A Case Study of the University of Calabar. ... These were drawn from five faculties, namely Education, Social Sciences, Law, Arts and Agriculture. The study observed that there is a ... more literacy skills. Key Words: Literacy skills, university, Nigeria, tertiary institution ...

An Observational Analysis of Coaching Behaviors for Career Development Event Teams: A Mixed Methods Study

Science.gov (United States)

Ball, Anna L.; Bowling, Amanda M.; Sharpless, Justin D.

2016-01-01

School Based Agricultural Education (SBAE) teachers can use coaching behaviors, along with their agricultural content knowledge to help their Career Development Event (CDE) teams succeed. This mixed methods, collective case study observed three SBAE teachers preparing multiple CDEs throughout the CDE season. The teachers observed had a previous…

Fatal poisonings in Oslo: a one-year observational study.

Science.gov (United States)

Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

2010-06-06

Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

Dermoscopic features of onychotillomania: A study of 36 cases.

Science.gov (United States)

Maddy, Austin John; Tosti, Antonella

2018-04-13

Onychotillomania is a nail-picking disorder characterized by nail dystrophy and abnormal morphology of the nail plate, nail bed, and periungual skin. The purpose of this study was to describe the dermoscopic features of onychotillomania. A retrospective study of the dermoscopy images of 36 patients affected by onychotillomania. The images were reviewed independently by both authors and a list of dermatoscopic findings was established. Scales were observed in 34 cases (94.4%); absence of nail plate was seen in 30 (83.3%); wavy lines were observed in 25 (69.4%); hemorrhages were observed in 23 (63.9%); crusts were seen in 22 (61.1%); nail bed pigmentation was observed in 17 (47.2%); speckled dots were observed in 14 (38.9%); nail plate melanonychia was observed in 4 (11.1%). Limitations included small sample size and retrospective study. Absence of the nail plate with multiple obliquely oriented nail bed hemorrhages, nail bed gray pigmentation, and presence of wavy lines are characteristic findings of onychotillomania and not seen in other nail diseases. Copyright © 2018. Published by Elsevier Inc.

Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

Science.gov (United States)

Sartelli, Massimo; Baiocchi, Gian L; Di Saverio, Salomone; Ferrara, Francesco; Labricciosa, Francesco M; Ansaloni, Luca; Coccolini, Federico; Vijayan, Deepak; Abbas, Ashraf; Abongwa, Hariscine K; Agboola, John; Ahmed, Adamu; Akhmeteli, Lali; Akkapulu, Nezih; Akkucuk, Seckin; Altintoprak, Fatih; Andreiev, Aurelia L; Anyfantakis, Dimitrios; Atanasov, Boiko; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Bellanova, Giovanni; Beltran, Marcelo; Melo, Renato Bessa; Bini, Roberto; Bouliaris, Konstantinos; Brunelli, Daniele; Castillo, Adrian; Catani, Marco; Che Jusoh, Asri; Chichom-Mefire, Alain; Cocorullo, Gianfranco; Coimbra, Raul; Colak, Elif; Costa, Silvia; Das, Koray; Delibegovic, Samir; Demetrashvili, Zaza; Di Carlo, Isidoro; Kiseleva, Nadezda; El Zalabany, Tamer; Faro, Mario; Ferreira, Margarida; Fraga, Gustavo P; Gachabayov, Mahir; Ghnnam, Wagih M; Giménez Maurel, Teresa; Gkiokas, Georgios; Gomes, Carlos A; Griffiths, Ewen; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S; Hodonou, Adrien; Hutan, Martin; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kauhanen, Saila; Kaushik, Robin; Kavalakat, Alfie; Kenig, Jakub; Khokha, Vladimir; Khor, Desmond; Kim, Dennis; Kim, Jae I; Kong, Victor; Lasithiotakis, Konstantinos; Leão, Pedro; Leon, Miguel; Litvin, Andrey; Lohsiriwat, Varut; López-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Maciel, James; Major, Piotr; Dimova, Ana; Manatakis, Dimitrios; Marinis, Athanasio; Martinez-Perez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesina, Cristian; Pędziwiatr, Michał; Michalopoulos, Nickos; Misiakos, Evangelos; Mohamedahmed, Ali; Moldovanu, Radu; Montori, Giulia; Mysore Narayana, Raghuveer; Negoi, Ionut; Nikolopoulos, Ioannis; Novelli, Giuseppe; Novikovs, Viktors; Olaoye, Iyiade; Omari, Abdelkarim; Ordoñez, Carlos A; Ouadii, Mouaqit; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M; Partecke, Lars I; Pata, Francesco; Pędziwiatr, Michał; Pereira Júnior, Gerson A; Pintar, Tadeja; Pisarska, Magdalena; Ploneda-Valencia, Cesar F; Pouggouras, Konstantinos; Prabhu, Vinod; Ramakrishnapillai, Padmakumar; Regimbeau, Jean-Marc; Reitz, Marianne; Rios-Cruz, Daniel; Saar, Sten; Sakakushev, Boris; Seretis, Charalampos; Sazhin, Alexander; Shelat, Vishal; Skrovina, Matej; Smirnov, Dmitry; Spyropoulos, Charalampos; Strzałka, Marcin; Talving, Peep; Teixeira Gonsaga, Ricardo A; Theobald, George; Tomadze, Gia; Torba, Myftar; Tranà, Cristian; Ulrych, Jan; Uzunoğlu, Mustafa Y; Vasilescu, Alin; Occhionorelli, Savino; Venara, Aurélien; Vereczkei, Andras; Vettoretto, Nereo; Vlad, Nutu; Walędziak, Maciej; Yilmaz, Tonguç U; Yuan, Kuo-Ching; Yunfeng, Cui; Zilinskas, Justas; Grelpois, Gérard; Catena, Fausto

2018-01-01

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

Sustaining Latina Student Organizations: An Exploratory Instrumental Case Study

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Castellanos, Michelle

2016-01-01

Utilizing the exploratory case study methodology, the author examines the conditions that support and limit a Latina-based student organization at a predominately White institution of higher education. Seven organizational structures were found to influence the organization's ability to advance its aims, from interviews, documents, observations,…

A Case Study of Horizontal Reuse in a Project-Driven Organisation

DEFF Research Database (Denmark)

Christensen, Henrik Bærbak; Røn, Henrik

2000-01-01

This experience paper presents observations, lessons learned, and recommendations based on a case study of reuse. The case study is concerned with the development, maturation, and reuse of a business domain independent software component (horizontal reuse) in a project-driven organisation that has...... knowledge is transferred within an organisation; (c) design patterns can be as risky as they can be beneficial; and (d) there is more to architectural mismatch than “merely ” packaging mismatch....

[Case-non case studies: Principles, methods, bias and interpretation].

Science.gov (United States)

Faillie, Jean-Luc

2017-10-31

Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Observation of Clouds Using the CSIR Transportable LIDAR: A Case Study over Durban, South Africa

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Lerato Shikwambana

2016-01-01

Full Text Available The Council for Scientific and Industrial Research (CSIR transportable Light Detection And Ranging (LIDAR was used to collect data over Durban (29.9°S, 30.9°E during 20–23 November 2012. Aerosol measurements have been carried out in the past over Durban; however, no cloud measurements using LIDAR have ever been performed. Therefore, this study further motivates the continuation of LIDAR for atmospheric research over Durban. Low level clouds were observed on 20–22 November 2012 and high level clouds were observed on 23 November 2012. The low level cloud could be classified as stratocumulus clouds, whereas the high level clouds could be classified as cirrus clouds. Low level cloud layers showed high extinction coefficients values ranging between 0.0009 and 0.0044 m−1, whereas low extinction coefficients for high level clouds were observed at values ranging between 0.000001 and 0.000002 m−1. Optical depth showed a high variability for 20 and 21 November 2012. This indicates a change in the composition and/or thickness of the cloud. For 22 and 23 November 2012, almost similar values of optical depth were observed. Cloud-Aerosol LIDAR and Infrared Pathfinder Satellite Observations (CALIPSO revealed high level clouds while the CSIR LIDAR could not. However, the two instruments complement each other well to describe the cloudy condition.

AN OBSERVATIONAL STUDY ON COMPLICATIONS OF CHRONIC DIABETES ENCOUNTERED IN A PULMONOLOGIST CLINIC

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V. Vinod Kumar Viswanathan

2017-07-01

Full Text Available BACKGROUND With the ever increasing prevalence of diabetes, complications of diabetes are encountered across all specialities. Hence, it is imperative that all specialists should have a working knowledge of diabetes mellitus. This study was done to understand the prevalence and complications of diabetes among patients attending a pulmonologist OPD. Knowledge of diabetes and its complications will help pulmonary medicine specialists to identify and manage the complications of diabetes better. MATERIALS AND METHODS All patients attending a pulmonologist’s clinic for a period of one month were enquired regarding their diabetes status and patients with known history of diabetes were questioned using a standard questionnaire and their available records examined regarding their complications pertaining to diabetes and the results analysed. RESULTS In this study, 18.7% of patients attending pulmonologist clinic had diabetes mellitus and 13.5% of patients had diabetes of more than 10 years duration. Most of the patients were in the age group of 40 to 60 years and were predominantly male. Among the diabetic patients, 71.9% had complications due to diabetes. Infections were the most commonly associated complication followed by pulmonary and cardiovascular complications. Many cases of pulmonary tuberculosis were observed among these patients. Other respiratory infections observed included pneumonias and flu. Cardiovascular complications like systemic hypertension, coronary artery disease and dyslipidaemia were observed. CONCLUSION With the rising prevalence of diabetes mellitus, such cases are frequently observed across all medical specialities. Hence, it is vital that all specialists should be trained in a management of diabetes, which is a frequent comorbidity observed by all specialists. Knowledge of diabetes, identifying diabetes early and management of complications will go a long way in reducing the morbidity and mortality due to diabetes and also

Pedagogical Content Knowledge: A Case Study of ESL Teacher Educator

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Liu, Siping

2013-01-01

This single-case study focuses on the pedagogical content knowledge (PCK) of a university faculty member teaching Second Language Acquisition to elementary teacher candidates. The research questions address the pattern and development of PCK for ESL teaching. Based on data from classroom observation, interviews and document review, the study finds…

Successful Minority Pedagogy in Mathematics: US and Japanese Case Studies

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Ahn, Ruth; Catbagan, Paula; Tamayo, Kristin; I, Ji Yeong; Lopez, Mario; Walker, Pamela

2015-01-01

This study examines best practices in teaching mathematics to minority students through two case studies conducted at high-minority junior high schools in the USA and Japan. Observations, interviews, and conversations with the teachers in both countries focused on the research question: how do teachers successfully teach mathematics to minority…

Monitoring soil wetness variations by means of satellite passive microwave observations: the HYDROPTIMET study cases

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T. Lacava

2005-01-01

Full Text Available Soil moisture is an important component of the hydrological cycle. In the framework of modern flood warning systems, the knowledge of soil moisture is crucial, due to the influence on the soil response in terms of infiltration-runoff. Precipitation-runoff processes, in fact, are related to catchment's hydrological conditions before the precipitation. Thus, an estimation of these conditions is of significant importance to improve the reliability of flood warning systems. Combining such information with other weather-related satellite products (i.e. rain rate estimation might represent a useful exercise in order to improve our capability to handle (and possibly mitigate or prevent hydro-geological hazards. Remote sensing, in the last few years, has supported several techniques for soil moisture/wetness monitoring. Most of the satellite-based techniques use microwave data, thanks to the all-weather and all-time capability of these data, as well as to their high sensitivity to water content in the soil. On the other hand, microwave data are unfortunately highly affected by the presence of surface roughness or vegetation coverage within the instantaneous satellite field of view (IFOV. Those problems, consequently, strongly limit the efficiency and the reliability of traditional satellite techniques. Recently, using data coming from AMSU (Advanced Microwave Sounding Unit, flying aboard NOAA (National Oceanic and Atmospheric Administration satellites, a new methodology for soil wetness estimation has been proposed. The proposed index, called Soil Wetness Variation Index (SWVI, developed by a multi-temporal analysis of AMSU records, seems able to reduce the problems related to vegetation and/or roughness effects. Such an approach has been tested, with promising results, on the analysis of some flooding events which occurred in Europe in the past. In this study, results achieved for the HYDROPTIMET test cases will be analysed and discussed in detail

[The management of 126 cases of posterior cracked crown of tooth and its effective observation].

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Chen, L L

2000-06-01

To detect the treatment and effect of posterior cracked tooth. 162 posterior cracked teeth of 158 cases, including enamel fissure and dentin fissure, all there cases undergone the synthetical treatment and follow up in different period, the longest observation period was 2.5 years. The healing and improved rate of 162 cracked teeth 90.74%. Among cases of failure, we have founded 6 cases of acute pulpitis (3.7%), 3 cases of alveodental abscess (1.85%), 2 cases of chronic apical periodontitis (1.24%), 4 cases of tooth fracture (2.4%). Cracked tooth was caused by multiple factors. Early diagnosis, synthetical treatment, and follow up in different period are 3 main factors in treatment.

Case-Based Instructional Practices: A Multiple-Case Study from Torts, Marketing, and Online Instructional Design Classes

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Jung, Ji yoon

2017-01-01

The purpose of this study is to provide a comprehensive account on case-based instructional practices. Semester-long participant observation records in torts, marketing, and online instructional design classes, instructor interviews, course syllabi and teaching materials were used to describe the within-class complexity of the practices in terms…

Observations of plasma vortices in the vicinity of flow-braking: a case study

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K. Keika

2009-08-01

Full Text Available We examine fast plasma flows and magnetic field fluctuations observed by THEMIS at 03:00–03:30 UT on 12 December 2007. All THEMIS probes are situated in the near-Earth plasma sheet (XSM>−10 RE with 1–2 RE spacecraft separations in azimuthal and radial directions. We focus on the observations of plasma convective flows made simultaneously by more than one THEMIS probe. At about 03:10 UT and 03:14 UT, the THEMIS P2 probe observed earthward flows of >100 km/s. The THEMIS P1 probe, located duskward and earthward of P2, observed tailward flows under a positive Bz. The inner most probe THEMIS P4, located at almost the same MLT as THEMIS P1 and P2, did not see any clear flow. We examine the convective flow patterns for the THEMIS observations. We conclude that plasma vortices are formed near the region where the earthward flows slow down and turn in azimuthal directions.

An Observation Capability Semantic-Associated Approach to the Selection of Remote Sensing Satellite Sensors: A Case Study of Flood Observations in the Jinsha River Basin.

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Hu, Chuli; Li, Jie; Lin, Xin; Chen, Nengcheng; Yang, Chao

2018-05-21

Observation schedules depend upon the accurate understanding of a single sensor’s observation capability and the interrelated observation capability information on multiple sensors. The general ontologies for sensors and observations are abundant. However, few observation capability ontologies for satellite sensors are available, and no study has described the dynamic associations among the observation capabilities of multiple sensors used for integrated observational planning. This limitation results in a failure to realize effective sensor selection. This paper develops a sensor observation capability association (SOCA) ontology model that is resolved around the task-sensor-observation capability (TSOC) ontology pattern. The pattern is developed considering the stimulus-sensor-observation (SSO) ontology design pattern, which focuses on facilitating sensor selection for one observation task. The core aim of the SOCA ontology model is to achieve an observation capability semantic association. A prototype system called SemOCAssociation was developed, and an experiment was conducted for flood observations in the Jinsha River basin in China. The results of this experiment verified that the SOCA ontology based association method can help sensor planners intuitively and accurately make evidence-based sensor selection decisions for a given flood observation task, which facilitates efficient and effective observational planning for flood satellite sensors.

An Observation Capability Semantic-Associated Approach to the Selection of Remote Sensing Satellite Sensors: A Case Study of Flood Observations in the Jinsha River Basin

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Chuli Hu

2018-05-01

Full Text Available Observation schedules depend upon the accurate understanding of a single sensor’s observation capability and the interrelated observation capability information on multiple sensors. The general ontologies for sensors and observations are abundant. However, few observation capability ontologies for satellite sensors are available, and no study has described the dynamic associations among the observation capabilities of multiple sensors used for integrated observational planning. This limitation results in a failure to realize effective sensor selection. This paper develops a sensor observation capability association (SOCA ontology model that is resolved around the task-sensor-observation capability (TSOC ontology pattern. The pattern is developed considering the stimulus-sensor-observation (SSO ontology design pattern, which focuses on facilitating sensor selection for one observation task. The core aim of the SOCA ontology model is to achieve an observation capability semantic association. A prototype system called SemOCAssociation was developed, and an experiment was conducted for flood observations in the Jinsha River basin in China. The results of this experiment verified that the SOCA ontology based association method can help sensor planners intuitively and accurately make evidence-based sensor selection decisions for a given flood observation task, which facilitates efficient and effective observational planning for flood satellite sensors.

Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras.

Science.gov (United States)

Kaminsky, Rina Girard; Lagos, Javier; Raudales Santos, Gabriela; Urrutia, Samuel

2016-02-04

Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras. Retrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts. A total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036-0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r(2) = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura. Results suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.

Quality of care in integrated community case management services in Bugoye, Uganda: a retrospective observational study.

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Miller, James S; English, Lacey; Matte, Michael; Mbusa, Rapheal; Ntaro, Moses; Bwambale, Shem; Kenney, Jessica; Siedner, Mark J; Reyes, Raquel; Lee, Patrick T; Mulogo, Edgar; Stone, Geren S

2018-02-27

Village health workers (VHWs) in five villages in Bugoye subcounty (Kasese District, Uganda) provide integrated community case management (iCCM) services, in which VHWs evaluate and treat malaria, pneumonia, and diarrhoea in children under 5 years of age. VHWs use a "Sick Child Job Aid" that guides them through the evaluation and treatment of these illnesses. A retrospective observational study was conducted to measure the quality of iCCM care provided by 23 VHWs in 5 villages in Bugoye subcounty over a 2-year period. Patient characteristics and clinical services were summarized using existing aggregate programme data. Lot quality assurance sampling of individual patient records was used to estimate adherence to the iCCM algorithm, VHW-level quality (based on adherence to the iCCM protocol), and change over time in quality of care (using generalized estimating equations regression modelling). For each of 23 VHWs, 25 patient visits were randomly selected from a 2-year period after iCCM care initiation. In these visits, 97% (150) of patients with diarrhoea were treated with oral rehydration and zinc, 95% (216) of patients with pneumonia were treated with amoxicillin, and 94% (240) of patients with malaria were treated with artemisinin-based combination therapy or rectal artesunate. However, only 44% (44) of patients with a negative rapid test for malaria were appropriately referred to a health facility. Overall, 75% (434) of patients received all the correct evaluation and management steps. Only 9 (39%) of the 23 VHWs met the pre-determined LQAS threshold for high-quality care over the 2-year observation period. Quality of care increased significantly in the first 6 months after initiation of iCCM services (p = 0.003), and then plateaued during months 7-24. Quality of care was high for uncomplicated malaria, pneumonia and diarrhoea. Overall quality of care was lower, in part because VHWs often did not follow the guidelines to refer patients with fever who tested

Robustness analysis of geodetic networks in the case of correlated observations

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Mevlut Yetkin

Full Text Available GPS (or GNSS networks are invaluable tools for monitoring natural hazards such as earthquakes. However, blunders in GPS observations may be mistakenly interpreted as deformation. Therefore, robust networks are needed in deformation monitoring using GPS networks. Robustness analysis is a natural merger of reliability and strain and defined as the ability to resist deformations caused by the maximum undetecle errors as determined from internal reliability analysis. However, to obtain rigorously correct results; the correlations among the observations must be considered while computing maximum undetectable errors. Therefore, we propose to use the normalized reliability numbers instead of redundancy numbers (Baarda's approach in robustness analysis of a GPS network. A simple mathematical relation showing the ratio between uncorrelated and correlated cases for maximum undetectable error is derived. The same ratio is also valid for the displacements. Numerical results show that if correlations among observations are ignored, dramatically different displacements can be obtained depending on the size of multiple correlation coefficients. Furthermore, when normalized reliability numbers are small, displacements get large, i.e., observations with low reliability numbers cause bigger displacements compared to observations with high reliability numbers.

Effects of donepezil on behavioural manifestations of thalamic infarction: a single case observation

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Rodrigo eRiveros

2011-03-01

Full Text Available Objective: To examine the effect of donepezil for the treatment of cognitive and behavioural disorders associated with thalamic lesions in a 45 years old male who suffered an infarct in the left thalamus. Background: Recent studies suggest that donepezil may improve executive functions impairments due to subcortical ischemic lesionsMethod: The crossover effects of donepezil were analyzed in a single case of thalamic infarction with cognitive and behavioural alterations. Results: Significant behavioural modifications related to improved performances in executive functions were observed with the treatment. Conclusions: The results suggest that donepezil may have significant effect on executive functions that can alter behavioural outcomes after thalamic infarctions

Urea cycle disorders in Spain: an observational, cross-sectional and multicentric study of 104 cases

OpenAIRE

Martín-Hernández, Elena; Aldámiz-Echevarría, Luis; Castejón-Ponce, Esperanza; Pedrón-Giner, Consuelo; Couce, María Luz; Serrano-Nieto, Juliana; Pintos-Morell, Guillem; Bélanger-Quintana, Amaya; Martínez-Pardo, Mercedes; García-Silva, María Teresa; Quijada-Fraile, Pilar; Vitoria-Miñana, Isidro; Dalmau, Jaime; Lama-More, Rosa A; Bueno-Delgado, María Amor

2014-01-01

Background Advances in the diagnosis and treatment of urea cycle disorders (UCDs) have led to a higher survival rate. The purpose of this study is to describe the characteristics of patients with urea cycle disorders in Spain. Methods Observational, cross-sectional and multicenter study. Clinical, biochemical and genetic data were collected from patients with UCDs, treated in the metabolic diseases centers in Spain between February 2012 and February 2013, covering the entire Spanish populatio...

An Epidemiological Study of Accidents in a Construction Industry: A Case-Control Study

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Malakouti J.

2013-01-01

Full Text Available Background and Objectives: Despite science and technology development and their application in various industries, accidents continue to occur in many workplaces. This study was designed and carried out with the aim of epidemiological survey of accident among workers of a tunneling industry.Methods: This study was conducted on 144 out of a total of 440 employees of a tunneling project who were at risk of occupational accidents. 48 workers with a history of occupational accident over the past two years were selected as case group and 96 workers of the same project were selected as control group. The data were collected through a designed checklist and analyzed using logistic regression, chi-square and independent t tests.Results: A significant association was observed between accident rate and different age groups (p<0.05. There was a significant relationship (p=0.016 in the case of sport activities between case and control groups, and significant relationships were observed between two groups regarding education (p=0.057 and smoking (p=0.06, but there was no significant relationships between accident occurrence with marital status, residence in workplace, job related education, job experience, chronic diseases and obesity.Conclusion: The results of this study clarify the necessity of the use of epidemiological data in preventive and control measures in workplaces. Therefore, Developing programs for determination of physical and mental capacity of workers are essential to employ them in jobs commensurate with their abilities, especially in older workers.

Brain fag: New perspectives from case observations.

Science.gov (United States)

Ebigbo, Peter O; Lekwas, Elekwachi Chimezie; Chukwunenyem, Nweze Felix

2015-06-01

Brain fag was originally described as a culture-bound syndrome among West African students. The term "brain fag" literally means "brain fatigue." Available literature indicates that brain fag symptoms usually present in formal academic settings when African students are required to transit to a reliance on written literature (as opposed to more traditional oral forms of information transmission) and to adapt to westernized, individualistic systems of education that, at times, oppose the values of relatively collectivistic African societies. Based on detailed observation of two typical and two nontypical cases of brain fag, the authors suggest that the syndrome may not be solely related to tensions in the academic sphere, but may function more generally as an expression of psychological distress that results from societal pressures that exceed the coping capacity of the individual. The brain fag symptoms, including lack of concentration, sensations of internal heat in the head and body, heaviness, and multiple somatic complaints, may constitute a defensive process which helps prevent a full-fledged decompensation. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Mining Temporal Patterns to Improve Agents Behavior: Two Case Studies

Science.gov (United States)

Fournier-Viger, Philippe; Nkambou, Roger; Faghihi, Usef; Nguifo, Engelbert Mephu

We propose two mechanisms for agent learning based on the idea of mining temporal patterns from agent behavior. The first one consists of extracting temporal patterns from the perceived behavior of other agents accomplishing a task, to learn the task. The second learning mechanism consists in extracting temporal patterns from an agent's own behavior. In this case, the agent then reuses patterns that brought self-satisfaction. In both cases, no assumption is made on how the observed agents' behavior is internally generated. A case study with a real application is presented to illustrate each learning mechanism.

Identifying key components for an effective case report poster: an observational study.

Science.gov (United States)

Willett, Lisa L; Paranjape, Anuradha; Estrada, Carlos

2009-03-01

Residents demonstrate scholarly activity by presenting posters at academic meetings. Although recommendations from national organizations are available, evidence identifying which components are most important is not. To develop and test an evaluation tool to measure the quality of case report posters and identify the specific components most in need of improvement. Faculty evaluators reviewed case report posters and provided on-site feedback to presenters at poster sessions of four annual academic general internal medicine meetings. A newly developed ten-item evaluation form measured poster quality for specific components of content, discussion, and format (5-point Likert scale, 1 = lowest, 5 = highest). Evaluation tool performance, including Cronbach alpha and inter-rater reliability, overall poster scores, differences across meetings and evaluators and specific components of the posters most in need of improvement. Forty-five evaluators from 20 medical institutions reviewed 347 posters. Cronbach's alpha of the evaluation form was 0.84 and inter-rater reliability, Spearman's rho 0.49 (p words. Our evaluation tool provides empirical data to guide trainees as they prepare posters for presentation which may improve poster quality and enhance their scholarly productivity.

Foreign body ingestion in Iranian children: a 4 years observational study

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S. Amini-Ranjbar

2012-12-01

Full Text Available Objective – Foreign body ingestion is common in children due to playing with everything. This study was done to identify type, site, and complication, as well as knowledge about the state of foreign body ingestion in children in Kerman/Iran. Methods – In this prospective study, during 4 years, 85 children less than 14 years old presented to the Emergency Department of Afzalipour Hospital in Kerman were studied. All children, regardless of their clinical symptoms, underwent total radiography (from neck to Pelvic within the first hour of admission. In symptomatic patients, or sharp, long objects, and narcotic substances ingestion, prompt endoscopy was performed and in the case of foreign body lodging in the subglottic area, the patient was being referred to an ear, nose and throat specialist. For asymptomatic patients or far-access foreign body; lactulose, polyethylene glycol solution and high-fiber substances (for ingestion of diskette batteries, heroine and sharp objects respectively were administered as medical treatments. Asymptomatic subjects who had ingested sharp objects or narcotic substances were hospitalized and observed, but other cases were followed out patiently (by phone call or face to face observation. Results – Mean age of subjects was 3.7 years with no significant difference between the two sexes. Mean age was 3.7 year. The most frequent ingested foreign body was diskette battery (28.2% followed by coin (21.2%. The majority of subjects had no symptom (67%. the most frequent endoscopic location (21.8% was subglot. Most complications occurred after battery ingestion. Endoscopic intervention was required in 31.8% that mostly in cases with ingestion of organic substances (77.8% and coin (61.1%. There was a significant relationship between age and the type of foreign body (p=0.033 and its location (p= 0.012. Medical treatment was completely successful in 68.2%. There was no mortality. Conclusion – Manufacturing clockwork toys

Lichen sclerosis: clinicopathological study of 60 cases from Lebanon.

Science.gov (United States)

Knio, Zeina; Kurban, Mazen; Abbas, Ossama

2016-10-01

Lichen sclerosus (LS) is an uncommon idiopathic chronic inflammatory debilitating disease with predilection for the genital region. Our recent encounter with an LS case exhibiting perineural inflammation microscopically prompted us to assess the features of all patients diagnosed with LS at our institution. All cases of LS diagnosed between 1990 and 2014 were retrospectively reviewed. Diagnosis was confirmed with demonstration of microscopic features typical of LS. Sixty patients (42 women and 18 men) with 65 biopsy specimens of LS were identified, of which 41 were extragenital, 16 genital, and three had both. Histopathologically, significantly higher proportions of follicular plugging, atrophy, and vacuolar interface changes were observed in extragenital LS cases, while angiokeratoma-like, mycosis fungoides-like, and pseudoepitheliomatous changes were only seen in genital LS. Perineural inflammation was observed as a novel finding in 22 cases (33.8%) of LS. Features of patients with LS in this study are generally comparable to those published in the literature, with some differences. In contrast to the literature, extragenital LS was more frequently encountered. Histopathologically, perineural inflammation was not an uncommon feature of LS and thus may serve as a clue in the differentiation of LS from its mimickers. © 2016 The International Society of Dermatology.

Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

Science.gov (United States)

Carloye, Lisa

2017-01-01

In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

BioFleet case studies

International Nuclear Information System (INIS)

2007-01-01

These six case studies examined the use of different biodiesel blends as fuel supply sources for businesses in British Columbia (BC). In the first case study, 6 municipalities participated in a pilot program designed to compare the performance of biodiesel and diesel fuels. Each municipality operated 2 base vehicles running on conventional diesel along with 2 similar vehicles which used biodiesel. Real time emissions tests and analyses of the vehicles using biodiesel were also conducted by 2 of the participating municipalities. All municipalities participating in the study agreed to purchase significant volumes of biodiesel. The second case study described a pilot study conducted by the City of Vancouver's equipment services branch in 2004. As a result of the study, the city now has over 530 types of equipment that use biodiesel. The third case study described a program designed by TSI Terminals in Vancouver to assess the emission reduction impact of using biodiesel at its port facility. Six different pieces of equipment were used to confirm that biodiesel could be used throughout the terminal. Test results confirmed that biodiesel blends could be used to reduce emissions. Overall emissions were reduced by 30 per cent. The fourth case study described a waste renderer that used a fleet of 36 trucks to deliver raw products to its plants. The company made the decision to use only biodiesel for its entire fleet of trucks. Since July 2005, the company has logged over 1.7 million km using biodiesel blends. The fifth case study described a salmon hatchery that switched from diesel to biodiesel in order to reduce emissions. The biodiesel blends are used to fuel the hatchery's 2 diesel generators. The hatchery has reduced emissions of greenhouse gases (GHGs) by an estimated 1800 tonnes annually. The sixth case study described how the Township of Langley has started using biodiesel for its entire fleet of of approximately 250 pieces of equipment. The township has not

Multiple Case Study of STEM in School-Based Agricultural Education

Science.gov (United States)

Stubbs, Eric A.; Myers, Brian E.

2015-01-01

This multiple case study investigated the integration of science, technology, engineering, and mathematics (STEM) in three Florida high school agriculture programs. Observations, interviews, documents, and artifacts provided qualitative data that indicated the types of STEM knowledge taught. Variables of interest included student and teacher…

Homoeopathic management of Schizophrenia: A prospective, non-comparative, open-label observational study

Directory of Open Access Journals (Sweden)

Praveen Oberai

2016-01-01

Full Text Available Objectives: To evaluate the usefulness of homoeopathic intervention in Schizophrenia, in untreated cases and antipsychotic treatment resistant cases, to verify indications of medicines, and to assess relapse, if any. Materials and Methods: A prospective, non-comparative, open-label observational study was carried out from October 2005-September 2010 by CCRH at Central Research Institute (H, Kottayam, Kerala, India. Patients between 20 and 60 years of age, presenting with symptoms of Schizophrenia were screened for inclusion and exclusion criteria. The patients who were on antipsychotic drugs were allowed to continue the same along with homoeopathic medicine, the dose of antipsychotics was monitored by the Psychiatrist. The symptoms of each patient were repertorized, and medicine was initially prescribed in 30C potency after consulting Materia Medica. Patients were followed up for 12 months. Outcome of treatment was assessed with Brief Psychiatric Rating Scales (BPRS. Analysis was done using Statistical Package for the Social Sciences  SPSS Version 20.0. Results: Out of 188 enrolled patients, 17 cases did not complete the baseline information. Total 171 patients were analysed as per modified Intention to Treat Principle. Significant difference (P = 0.0001, P < 0.05 in the mean scores of BPRS, using paired t test was observed at end of the study. Sulphur, Lycopodium, Natrum muriaticum, Pulsatilla and Phosphorus were found to be the most useful medicines in treating schizophrenic patients. Conclusion: The study reflects the positive role of homoeopathic medicines in the management of patients suffering from schizophrenia as measured by BPRS.

Progressing the state of knowledge on the human influence on hydrological droughts through case studies

Science.gov (United States)

Rangecroft, Sally; Van Loon, Anne; Bosman, Marianne; Wanders, Niko; Di Baldassarre, Giuliano; AghaKouchak, Amir

2017-04-01

Human activities can have a large influence on changes in the hydrological system and hydrological extremes, more than climate variability and climate change in some cases. However, there are currently only a limited number of studies which aim to quantify the human impact on hydrological droughts. Here we present a synthesis study of existing and new results that aims to summarize and quantify the anthropogenic impact on hydrological drought from case studies and observations. By combining a large number of case studies, we allow conclusions to be drawn about the effects of different human activities. This work suggests ways forward to increase our understanding on how human activities are influencing drought characteristics; invaluable information for water resource management and adaptation. During this project, the impact of different human activities (e.g. water abstraction, reservoir building, urbanisation, etc) on drought frequency, duration and deficit has been calculated in a consistent manner, allowing for an improved understanding to how they have impacted droughts. This consistent methodology is a necessary element for this comparative hydrology exercise, yet we use one which is flexible and applicable to different case study set ups and data availability. The methodology used here depends on available observation data, with three possible approaches: i) paired catchment approach; ii) upstream-downstream comparison; iii) observation modelling framework. The synthesised results of the existing and new case studies cover a number of human activities, hydro-climatic and socio-economic contexts. In particular, we remove the climate dependency in the results by using case studies from multiple climatic regions, including UK, Italy, US, Australia, Mexico and Chile. For groundwater abstraction, it is clear across all the relevant case studies that abstraction activities worsen drought events. This is especially prominent in the deficit volumes, with nearly all

Creating Your Own Case Studies: A Guide for Early Field Experience.

Science.gov (United States)

Florio-Ruane, Susan

1990-01-01

A guide for creating case studies is provided for teacher educators to share with students. Suggestions are offered for becoming a participant observer in a classroom. The appendix contains sample appropriate and inappropriate field notes. (SM)

Describing Case Study Method and Identifying the Factors that Contribute to the Successful Conduct of Case Studies

OpenAIRE

Ahmad H. Juma'h; Mustafa Cavus

2001-01-01

This article has attempted to describe case study, the limitations and critiques on case study methodology and how the proponents have responded to these. Our special focus have been on the debate on theory building from case study research, and a framework for conducting case study research as well as the factors for a successful case study research. The overall conclusion is that the case study has been inappropriately used to generate theories.

Student Self-Perceptions of Leadership in Two Missouri FFA Chapters: A Collective Case Study

Science.gov (United States)

Kagay, Rachel Bartholomew; Marx, Adam A.; Simonsen, Jon C.

2015-01-01

The focus of this study is the self-perceptions of leadership engagement of FFA members in two FFA chapters in Missouri. This multiple case study used documentation of student self-perceptions, researcher observations, and focus groups. The two cases included 24 high school students comprised of FFA officers and members, who provided their…

Splenic lesions observed in 71 splenectomized dogs: a retrospective study

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Elisângela Olegário da Silva

2016-10-01

Full Text Available The spleen of dogs is frequently affected by disorders that vary from local and systemic origin. The difficulty in associating clinical and gross findings contributes for the choice of total splenectomy as the main treatment, leading to an impairment of the immune and hematopoietic functions. The aim of this study was to evaluate the pathological findings in the spleen of splenectomized dogs during 2008 to 2014 at a Veterinary Teaching Hospital. From the 71 cases analyzed, 97% (69/71 of the dogs were submitted to total splenectomy and 3% (2/71 to partial splenectomy. In 45 (63.4% of these cases, the histopathological diagnosis was non-neoplastic alterations; only 36.6% (26/71 had a splenic neoplasia. The main non-neoplastic lesions observed were nodular hyperplasia 24.4% (11/45, infarction 22.3% (10/45, and hematoma 20% (9/45. The most frequent tumors were hemangiosarcoma 50% (13/26, histiocytic sarcoma 23% (6/26, and lymphoma 11.5% (3/26. The clinical methods used to diagnose splenic lesions were ultrasonography 88% (63/71, radiography 2.8% (2/71 and exploratory laparotomy 4.2% (3/71. In 4.2% (3/71 the spleen changes were observed during the therapeutic ovariohysterectomy. The results of the present study showed a prevalence of benign disorders in the spleen of splenectomized dogs associated with a high incidence of total splenectomy performed, indicating a difficulty in recognizing the different lesions that can affect the spleen by the veterinarian medical.

[Extra skeletal Ewing's sarcoma. Report of two cases. Ultrastructural study of one case (author's transl)].

Science.gov (United States)

Krulik, M; Brechot, J M; de Saint-Maur, P; Lecomte, D; Mougeot-Martin, M; Audebert, A A; Zylberait, D; Debray, J

The authors report two cases of extra skeletal Ewing's sarcoma. The first case concerns a 26 years old woman presenting a tumor at the level of the sacrum area, locally recurrent, metastazing to the lungs and the lumbar column, despite of radiotherapy and chemotherapy and leading to death after a course of 18 months. The second one is that of a 30 years old man bearing a tumor of the shoulder area probably already metastazed to bones, rapidly recurrent and metastazing to the lungs and cause of death after 9 months in spite of intensive therapy. About these 2 observations a review of the literature of the cases of extra skeletal Ewing's sarcoma is done. Whatever nosologic discussion it seems that Ewing's sarcoma may present essentially as a tumor of soft tissues. An ultrastructural study has been performed in the second case. The findings are similar to those reported in Ewing's sarcoma.

An observational study of defensible space in the neighbourhood park

Science.gov (United States)

Marzukhi, M. A.; Afiq, M. A.; Zaki, S. Ahmad; Ling, O. H. L.

2018-02-01

The planning of neighborhood park is important to provide space for interaction, leisure, and recreation among residents in any neighbourhood area. However, on an almost daily basis, newspapers report inappropriate incidents such as snatch theft, robbery and street attack that occurred in the neighborhood park. These cases reflect the significance of physical planning and design of neighborhood park that directly affect the safety and comfort of the users. Thus, this study attempts to engage with the defensible space concept in ensuring the security elements be applied in the planning of the recreational area. This study adopts a qualitative method form of research that is retrofitted to an observational study. The observational study is significant for revealing the condition of a neighbourhood park in the ‘real-world,’ in which direct observation is conducted on Taman Tasik Puchong Perdana. The observer focused on four elements or variables of defensible space concept including the provision of facilities in the neighborhood park, territoriality, surveillance, image and milieu. The findings revealed that the planning of Taman Tasik Puchong Perdana does not deliberate the defensible space elements, which may contribute to the crime activities in the park. In these circumstances, the planning of neighbourhood park needs to include proposals for the implementation of defensible space in response to the challenges underpinned by crime problems. Besides, the awareness among the residents needs to be emphasized with the support from local authorities and other organizations to manage and sustain the safety environment in the neighborhood park.

How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

Science.gov (United States)

Fallek, Max

This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

Driving under the influence of khat--alkaloid concentrations and observations in forensic cases.

Science.gov (United States)

Toennes, Stefan W; Kauert, Gerold F

2004-02-10

The use of the herbal stimulant khat (Catha edulis FORSK) is maintained by immigrants from countries where it is part of their cultural life (Arabian Peninsula and eastern Africa). In western countries the drug and its effects are largely unknown and no experience in evaluating impairment symptoms due to the khat-alkaloids, e.g. cathinone, cathine and norephedrine exists. Blood and urine samples from khat users involved in 19 cases of suspected driving under the influence of drugs were analysed and correlated with the results of medical examination and police officer reports. In 3 cases impaired driving and in 10 cases marked impairment of psychophysical functions was observed such as effects on the nervous system (slow pupil reaction to light, dry mouth, increased heart-rate), trembling, restlessness/nervousness, daze/apathy/dullness, impairment of attention, walking and standing on one leg. However, the alkaloid concentrations assayed in blood did not correlate with the impairment symptoms. Apart from an acute phase of indirect sympathomimetic action the development of habituation and withdrawal symptoms must also be considered in explaining the diversity of effects observed. From these results it can be concluded that chewing khat may severely impair driving ability, but may also be without noticeable effects.

Theory Testing Using Case Studies

DEFF Research Database (Denmark)

Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

2014-01-01

The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different...... research paths....

ISTSOS, SENSOR OBSERVATION MANAGEMENT SYSTEM: A REAL CASE APPLICATION OF HYDRO-METEOROLOGICAL DATA FOR FLOOD PROTECTION

Directory of Open Access Journals (Sweden)

M. Cannata

2014-01-01

Full Text Available istSOS (Istituto scienze della Terra Sensor Observation Service is an implementation of the Sensor Observation Service standard from Open Geospatial Consortium (OGC. The development of istSOS started in 2009 in order to provide a simple implementation of the Sensor Observation Service (SOS standard for the management, provision and integration of hydro-meteorological data collected in Canton Ticino (Southern Switzerland. istSOS is entirely written in Python and is based on reliable open source software like PostgreSQL/PostGIS and Apache/mod_wsgi. The authors during this presentation want to illustrate the latest software enhancements together with a real case in a production environment. Latest software enhancement includes the development of a RESTful service and of a Web-based graphical user interface that allows hydrologists a better interaction with measurements. This includes the ability of new services creation, addition of new sensors and relative metadata, visualization and manipulation of stored observations, registration of new measures and setting of system properties like observable properties and data quality codes. The study will show a real case application of the system for the provision of data to interregional partners and to a hydrological model for lake level forecasting and flooding hazard assessment. The hydrological model uses a combination of WPS (Web Processing Service and SOS for the generation of model input data. This system is linked with a dedicated geo-portal used by the civil protection for the management, alert and protection of population and assets of the Locarno area (Verbano Lake flooding. Practical considerations and technical issues will be presented and discussed.

A methodological review of qualitative case study methodology in midwifery research.

Science.gov (United States)

Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

2016-10-01

To explore the use and application of case study research in midwifery. Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. A methodological review of midwifery case study research using recognized templates, frameworks and reporting guidelines facilitated comprehensive analysis. An electronic database search using the date range January 2005-December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting. © 2016 John Wiley & Sons Ltd.

STUDY ON MATERNAL MORTALITY AND NEAR MISS CASE

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Ritanjali Behera

2017-12-01

Full Text Available BACKGROUND Maternal mortality traditionally has been the indicator of maternal health. More recently the review of cases of near miss obstetric event is found to be useful to investigate maternal mortality. Cases of near miss are those, where a woman nearly died but survived a complication that occur during pregnancy or child birth. Aim and Objective 1. To analyse near miss cases and maternal deaths. 2. To determine maternal near miss indicator and to analyse the cause and contributing factors for both of them. MATERIALS AND METHODS This prospective observational study conducted in M.K.C.G. medical college, Berhampur from 1st October 2015 to 30th September 2017. All the cases of maternal deaths and near miss cases defined by WHO criteria are taken. Information regarding demographic profile and reproductive parameters are collected and results are analysed using percentage and proportion. RESULTS Out of 17977 deliveries 201 were near miss cases and 116 were maternal deaths. MMR was 681, near miss incidence 1.18, maternal death to near miss ratio was 1:1.73. Hypertensive disorder of pregnancy (37.4% was the leading cause followed by haemorrhage (17.4%. For near miss cases 101 cases fulfilled clinical criteria, 61 laboratory criteria and 131 cases management based criteria. CONCLUSION Hypertensive disorder of pregnancy and haemorrhage are the leading cause of maternal death and for near miss cases most common organ system involved was cardiovascular system. All the near miss cases should be interpreted as opportunities to improve the health care services.

Risk of Infective Endocarditis After Invasive Dental Treatments: A Case-Only Study.

Science.gov (United States)

Chen, Tzu-Ting; Yeh, Yi-Chun; Chien, Kuo-Liong; Lai, Mei-Shu; Tu, Yu-Kang

2018-04-19

Background -Invasive dental treatments (IDTs) can yield temporary bacteremia and has therefore been considered a potential risk factor of infective endocarditis (IE). It is hypothesized that, through the trauma caused by IDTs, bacteria gain entry to the bloodstream and may attach to abnormal heart valves or damaged heart tissue, giving rise to IE. However, the association between IDTs and IE remains controversial. The aim of this study is to estimate the association between IDTs and IE. Methods -The data in this study were obtained from the Health Insurance Database in Taiwan. We selected two case-only study designs, case-crossover and self-controlled case series, to analyze the data. The advantage of these methods is that confounding factors which do not vary with time are adjusted for implicitly. In the case-crossover design, conditional logistic regression model with exposure to IDTs was used to estimate the risks of IE following an IDT with 4, 8, 12, and 16 weeks delay, respectively. In the self-controlled case series design, conditional Poisson regression model was used to estimate the risk of IE for the risk periods of 1-4, 5-8, 9-12, and 13-16 weeks following an IDT. Results -In total, 9120 and 8181 IE patients were included in case-crossover design and self-controlled case series design, respectively. In case-crossover design, 277 cases and 249 controls received IDTs during the exposure period, and the odds ratio was 1.12 (95% Confidence Interval (CI): 0.94-1.34) for 4 weeks. In self-controlled case series design, we observed that 407 IE occurred during the first four weeks after IDTs, and the age-adjusted incidence rate ratio was 1.14 (95% CI: 1.02-1.26) for 1-4 weeks after IDTs. Conclusions -In both study designs, we did not observe a clinically larger risk for IE in the short periods after IDTs. We also found no association between IDTs and IE among high-risk patients. Therefore, antibiotic prophylaxis for prevention of IE is not required for the

Five Misunderstandings About Case-Study Research

DEFF Research Database (Denmark)

Flyvbjerg, Bent

2006-01-01

This article examines five common misunderstandings about case-study research: (a) theoretical knowledge is more valuable than practical knowledge; (b) one cannot generalize from a single case, therefore, the single-case study cannot contribute to scientific development; (c) the case study is most...... useful for generating hypotheses, whereas other methods are more suitable for hypotheses testing and theory building; (d) the case study contains a bias toward verification; and (e) it is often difficult to summarize specific case studies. This article explains and corrects these misunderstandings one...

[Observational studies in the era of evidence based medicine: short review on their relevance, taxonomy and designs].

Science.gov (United States)

Fronteira, Ines

2013-01-01

In this review of the literature, we distinguish between experimental and observational studies, highlighting the importance that the later have gained in the era of evidence-based medicine. We further analyze the value of observational studies in light of experimental studies. We present a taxonomy for observational studies based on units of observation and measurement (cross-sectional or longitudinal). We distinguish between descriptive studies and analytical studies. Then, and given its specificity, we define and present a classification for ecological studies. We define and consider the advantages and disadvantages of cross-sectional, case control and cohort studies. We analyze the strength of the evidence given by each study design. We finished by examining what should guide the choice of a study design.

Qat use and esophageal cancer in Ethiopia: A pilot case-control study.

Directory of Open Access Journals (Sweden)

Maria E Leon

Full Text Available Qat (Catha edulis chewing is reported to induce lesions in the buccal mucosa, irritation of the esophagus, and esophageal reflux. Case series suggest a possible etiological role in oral and esophageal cancers. This pilot study aimed to generate preliminary estimates of the magnitude and direction of the association between qat use and esophageal cancer (EC risk and to inform the logistics required to conduct a multi-center case-control study.Between May 2012 and May 2013, 73 EC cases (including 12 gastro-esophageal junction cases and 133 controls matched individually on sex, age, and residence were enrolled at two endoscopy clinics and a cancer treatment hospital in Addis Ababa. A face-to-face structured questionnaire was administered. Qat use was defined as ever having chewed qat once a week or more frequently for at least one year. Odds ratios were calculated using conditional logistic regression.Only 8% of cases resided in Addis Ababa. Qat use was more frequent in cases (36% than in controls (26%. A 2-fold elevation in EC risk was observed in ever qat chewers compared with never users in unadjusted conditional logistic regression (OR = 2.12; 95% CI = 0.94, 4.74, an association that disappeared after adjusting for differences in tobacco use, consumption of alcohol and green vegetables, education level, and religion (OR = 0.95; 0.22, 4.22. Among never tobacco users, however, a non-significant increase in EC risk was suggested in ever qat users also after adjustment. Increases in EC risk were observed with ever tobacco use, alcohol consumption, low consumption of green vegetables, a salty diet, illiteracy, and among Muslims; the four latter associations were significant.This pilot study generated EC risk estimates in association with a habit practiced by millions of people and never before studied in a case-control design. Results must be interpreted cautiously in light of possible selection bias, with some demographics such as education level

Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

Science.gov (United States)

Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

2012-01-01

Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral

The Management of Training in Multinational Corporations: Comparative Case Studies.

Science.gov (United States)

Noble, Charles

1997-01-01

Case studies of British and Australian multinational corporations in the food and drink industry investigated how training and development are managed. Competency-based education and industry boards are important elements in both countries. Lack of a training culture in the industry and little innovation in training were observed. (SK)

Palliative care team visits. Qualitative study through participant observation.

Science.gov (United States)

Alfaya Góngora, Maria Del Mar; Bueno Pernias, Maria José; Hueso Montoro, César; Guardia Mancilla, Plácido; Montoya Juárez, Rafael; García Caro, Maria Paz

2016-03-30

To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants. A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room) were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed. The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources. Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources.

The impact of science teachers' epistemological beliefs on authentic inquiry: A multiple-case study

Science.gov (United States)

Jackson, Dionne Bennett

The purpose of this study was to examine how science teachers' epistemological beliefs impacted their use of authentic inquiry in science instruction. Participants in this multiple-case study included a total of four teachers who represented the middle, secondary and post-secondary levels. Based on the results of the pilot study conducted with a secondary science teacher, adjustments were made to the interview questions and observation protocol. Data collection for the study included semi-structured interviews, direct observations of instructional techniques, and the collection of artifacts. The cross case analysis revealed that the cases epistemological beliefs were mostly Transitional and the method of instruction used most was Discussion. Two of the cases exhibited consistent beliefs and instructional practices, whereas the other two exhibited beliefs beyond their instruction. The findings of this study support the literature on the influence of contextual factors and professional development on teacher beliefs and practice. The findings support and contradict literature relevant to the consistency of teacher beliefs with instruction. This study's findings revealed that the use of reform-based instruction, or Authentic Inquiry, does not occur when science teachers do not have the beliefs and experiences necessary to implement this form of instruction.

Fuzzy-Set Case Studies

Science.gov (United States)

Mikkelsen, Kim Sass

2017-01-01

Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

RACORO continental boundary layer cloud investigations: 1. Case study development and ensemble large-scale forcings

Science.gov (United States)

Vogelmann, Andrew M.; Fridlind, Ann M.; Toto, Tami; Endo, Satoshi; Lin, Wuyin; Wang, Jian; Feng, Sha; Zhang, Yunyan; Turner, David D.; Liu, Yangang; Li, Zhijin; Xie, Shaocheng; Ackerman, Andrew S.; Zhang, Minghua; Khairoutdinov, Marat

2015-06-01

Observation-based modeling case studies of continental boundary layer clouds have been developed to study cloudy boundary layers, aerosol influences upon them, and their representation in cloud- and global-scale models. Three 60 h case study periods span the temporal evolution of cumulus, stratiform, and drizzling boundary layer cloud systems, representing mixed and transitional states rather than idealized or canonical cases. Based on in situ measurements from the Routine AAF (Atmospheric Radiation Measurement (ARM) Aerial Facility) CLOWD (Clouds with Low Optical Water Depth) Optical Radiative Observations (RACORO) field campaign and remote sensing observations, the cases are designed with a modular configuration to simplify use in large-eddy simulations (LES) and single-column models. Aircraft measurements of aerosol number size distribution are fit to lognormal functions for concise representation in models. Values of the aerosol hygroscopicity parameter, κ, are derived from observations to be 0.10, which are lower than the 0.3 typical over continents and suggestive of a large aerosol organic fraction. Ensemble large-scale forcing data sets are derived from the ARM variational analysis, European Centre for Medium-Range Weather Forecasts, and a multiscale data assimilation system. The forcings are assessed through comparison of measured bulk atmospheric and cloud properties to those computed in "trial" large-eddy simulations, where more efficient run times are enabled through modest reductions in grid resolution and domain size compared to the full-sized LES grid. Simulations capture many of the general features observed, but the state-of-the-art forcings were limited at representing details of cloud onset, and tight gradients and high-resolution transients of importance. Methods for improving the initial conditions and forcings are discussed. The cases developed are available to the general modeling community for studying continental boundary clouds.

RACORO Continental Boundary Layer Cloud Investigations: 1. Case Study Development and Ensemble Large-Scale Forcings

Science.gov (United States)

Vogelmann, Andrew M.; Fridlind, Ann M.; Toto, Tami; Endo, Satoshi; Lin, Wuyin; Wang, Jian; Feng, Sha; Zhang, Yunyan; Turner, David D.; Liu, Yangang;

Tomographic findings of gastric gastrointestinal stromal tumor: a 14-case study

International Nuclear Information System (INIS)

Pelandre, Gustavo Lemos; Djahjah, Maria Celia; Nobre, Luiz Felipe; Gasparetto, Emerson Leandro; Marchiori, Edson; Pereira, Bruno Vilhena; Valadao, Marcus; Linhares, Eduardo

2008-01-01

Objective: The purpose of this study was to describe the tomographic findings of gastric gastrointestinal stromal tumor. Materials and methods: Fourteen patients with histopathologically and immunohistochemically confirmed gastric gastrointestinal stromal tumors, who had already been submitted to computed tomography scans before the treatment, were evaluated in the period between January 1999 and December 2006. The following tomographic variables were analyzed: lesion topography, size/dimensions, homogeneity, contour, margins, morphology, pattern and intravenous contrast-enhancement intensity, growth pattern, invasion of adjacent organs, presence of ulceration, fistula, calcifications, mesenteric fat infiltration, lymphadenomegaly and presence of distant metastasis. Results: Tumors were found in the body (57.1%) or in the gastric fundus (42.9%), with sizes ranging between 6.0 cm and 23.0 cm (mean, 11.5 cm). Predominantly extra luminal growth was observed in 57.1% of cases and intra/extra luminal in 35.7%. Subtle contrast-enhancement was observed in 50%, moderate in 50%, and heterogeneous in 64.3% of cases. Additionally, central hypodensity was observed in 64.3%, invasion of adjacent organs in 42.9%, and hepatic metastasis in 7.2% of cases. Conclusion: In the present study, the majority of tumors were found in the gastric body, with an average size of 11.5 cm, presenting with central hypodensity, heterogeneous contrast-enhancement and predominantly extraluminal growth. (author)

Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

Science.gov (United States)

Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

2017-01-01

Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

Clinicopathological study of 81 cases of localized and systemic scleroderma.

Science.gov (United States)

Succaria, F; Kurban, M; Kibbi, A-G; Abbas, O

2013-02-01

Scleroderma is a connective tissue disease that includes localized and systemic forms. Our recent encounter with a morphea case exhibiting prominent perineural inflammation microscopically prompted us to assess the features of all patients diagnosed with morphea/scleroderma at our institution. To describe the clinicopathological features of all patients diagnosed with morphea/scleroderma at American University of Beirut Medical Center (AUB-MC) between 1999 and 2010, and compare our findings with those published in the literature. A total of 81 cases (63 women and 18 men) were identified, of which 73 were localized (morphea) and eight were systemic scleroderma. Clinically, plaque type morphea was the most common variant both in adults and children, and seven (9%) cases of morphea were associated with lichen sclerosis et atrophicus (LSA). Histopathologically, perineural inflammation was observed in 49% of cases, and may serve, in addition to other features including lichen sclerosis-like changes (observed in exclusively nine cases of morphea), more diffuse dermal and less subcutaneous sclerosis, and intense inflammation, as clues favouring diagnosis of morphea over systemic sclerosis. The features of morphea/scleroderma patients in this study are generally comparable to those published in the literature, with few differences. Clinically, plaque type morphea was the most common variant both in adults and children and LSA was a frequent association. Histopathologically, perineural inflammation was commonly observed and may serve in addition to lichen sclerosis-like changes and intense inflammation as clues favouring diagnosis of morphea over systemic sclerosis. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Process quality of decision-making in multidisciplinary cancer team meetings: a structured observational study.

Science.gov (United States)

Hahlweg, Pola; Didi, Sarah; Kriston, Levente; Härter, Martin; Nestoriuc, Yvonne; Scholl, Isabelle

2017-11-17

The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation. An adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) was used to assess the quality of the presented information and team processes in MDTMs. Data was analyzed using descriptive statistics and mixed logistic regression analysis. N = 249 cases were observed in N = 29 MDTMs. While cancer-specific medical information was judged to be of high quality, psychosocial information and information regarding patient views were considered to be of low quality. In 25% of the cases no, in 64% one, and in 10% more than one treatment recommendations were given (1% missing data). Giving no treatment recommendation was associated with duration of case discussion, duration of the MDTM session, quality of case history, quality of radiological information, and specialization of the MDTM. Higher levels of medical and treatment uncertainty during discussions were found to be associated with a higher probability for more than one treatment recommendation. The quality of different aspects of information was observed to differ greatly. In general, we did not find MDTMs to be in line with the principles of patient-centered care. Recommendation outcome varied substantially between different specializations of MDTMs. The quality of certain information was associated with the recommendation outcome. Uncertainty during discussions was related to more than one recommendation being considered. Time constraints

Study of Seismic Activity Using Geophysical and Radio Physical Equipment for Observation

Science.gov (United States)

Kvavadze, N.; Tsereteli, N. S.

2015-12-01

One of the most dangerous and destructive natural hazards are earthquakes, which is confirmed by recent earthquakes such as Nepal 2015, Japan and Turkey 2011. Because of this, study of seismic activity is important. Studying any process, it is necessary to use different methods of observation, which allows us to increase accuracy of obtained data. Seismic activity is a complex problem and its study needs different types of observation methods. Two main problems of seismic activity study are: reliable instrumental observations and earthquake short-term predictions. In case of seismic risks it is necessary to have reliable accelerometer data. One of the most promising field in earthquake short-term prediction is very low frequency (VLF) electromagnetic wave propagation in ionosphere observation. To study Seismic activity of Caucasus region, was created observation complex using Accelerometer, Velocimeter and VLF electromagnetic waves received from communication stations (located in different area of the world) reflected from low ionosphere. System is created and operates at Tbilisi State University Ionosphere Observatory, near Tbilisi in Tabakhmela 42.41'70 N, 44.80'92 E, Georgia. Data obtained is sent to a local server located at M. Nodia Institute of Geophysics, TSU, for storage and processing. Diagram for complex is presented. Also data analysis methods were created and preliminary processing was done. In this paper we present some of the results: Earthquake data from ionosphere observations as well as local earthquakes recorded with accelerometer and velocimeter. Complex is first in 6 that will be placed around Georgia this year. We plan on widening network every year.

Five misunderstandings about case study research

DEFF Research Database (Denmark)

Flyvbjerg, Bent

2004-01-01

This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without exemplars is an ineffective one. Social science may be strengthened by the execution of more...

The taxation of unhealthy energy-dense foods (EDFs) and sugar-sweetened beverages (SSBs): An overview of patterns observed in the policy content and policy context of 13 case studies.

Science.gov (United States)

Hagenaars, Luc Louis; Jeurissen, Patrick Paulus Theodoor; Klazinga, Niek Sieds

2017-08-01

Taxation of energy-dense foods (EDFs) and sugar-sweetened beverages (SSBs) is increasingly of interest as a novel public health and fiscal policy instrument. However academic interest in policy determinants has remained limited. We address this paucity by comparing the policy content and policy context of EDF/SSB taxes witnessed in 13 case studies, of which we assume the tax is sufficiently high to induce behavioural change. The observational and non-randomized studies published on our case studies seem to indicate that the EDF/SSB taxes under investigation generally had the desired effects on prices and consumption of targeted products. The revenue collection of EDF/SSB taxes is minimal yet significant. Administrative practicalities in tax levying are important, possibly explaining why a drift towards solely taxing SSBs can be noted, as these can be demarcated more easily, with levies seemingly increasing in more recent case studies. Despite the growing body of evidence suggesting that EDF/SSB taxes have the potential to improve health, fiscal needs more often seem to lay their policy foundation rather than public health advocacy. A remarkable amount of conservative/liberal governments have adopted these taxes, although in many cases revenues are earmarked for benefits compensating regressive income effects. Governments voice diverse policy rationales, ranging from explicitly describing the tax as a public health instrument, to solely explicating revenue raising. Copyright © 2017 Elsevier B.V. All rights reserved.

The development of Haze Events observed by multi-satellite retrievals and Meteorological Analysis: A Case Study over Eastern China in December 2013

Science.gov (United States)

Zhang, Xiaoyu; Jiang, Binbin; Du, Yong; Yao, Lingling; Huang, Dasong

2015-04-01

With the rapid development of national economy and urbanization, the haze has been one of the environment disasters in eastern China. It is necessary that building a model of monitoring the haze for preventing and solving it in the future. In this study, NPP/AOT(550nm) >1and GOCI/AOT(555nm) >1 are adopted to dynamically monitor severe haze events in December 2013 over eastern China. Meanwhile, wind field data from CDAS-NCEP/DOE Reanalysis data and air temperature data from CDAS-NCEP/FNL are adopted to study the mechanism of the occurrence, migration and decay of the haze events. The haze event is composed of two consecutive cases. The first case occurred during 4-9 December is an exogenous haze for Yangtze River Delta, whereas the second case appeared during 11-15 December is an endogenous haze. This result shows:1) With the improved two-stream approximation model, GOCI is successful used to retrieve AOT with compared AERONET AOT, which demonstrates to be feasible in monitoring severe haze events. 2)Because of the large-scale observation capacity of NPP/AOT(550nm) product (×6km) and the high temporal resolution of GOCI/AOT(555nm), this study establishes a framework that detect the large-scale haze events using both data sets. 3)Weak wind speed of less than 5 m*s-1 is important for the development of the haze but the inversion is not a necessary condition for the haze. The strong cold air mass from the northern Siberia area and from East China Sea is the main force for the immigration, diffusion and decay of this haze event. 4)The air quality around Yangtze River Delta in winter is apt to suffer widely divergent influences including exogenous hazes carried by winter northwestward monsoon flows from northern Asia, and endogenous hazes induced by the rapid development of urbanization. The hit of multiple hazes over Yangtze River Delta lead to one of the most severe polluted regions of haze in China. Key words: NPP/AOT；GOCI/AOT; Haze；dynamic monitoring�

Effectiveness of inactivated quadrivalent influenza vaccine in the 2015/2016 season as assessed in both a test-negative case-control study design and a traditional case-control study design.

Science.gov (United States)

Kimiya, Takahisa; Shinjoh, Masayoshi; Anzo, Makoto; Takahashi, Hiroki; Sekiguchi, Shinichiro; Sugaya, Norio; Takahashi, Takao

2018-04-21

Both traditional case-control studies (TCCSs) and test-negative case-control studies (TNCCSs) are commonly used to assess influenza vaccine effectiveness (VE). To compensate for the fact that observational studies are susceptible to bias, we combined both methods to assess VE in one geographical area during the 2015/2016 season, when influenza A (H1N1)pdm was dominant. Our TNCCS covered 331 children aged 6 months to 15 years who visited our hospital with fever, including 182 with influenza, and our TCCS covered 812 pediatric outpatients aged 6 months to 15 years, including 214 with influenza. Influenza infection and vaccination history were reviewed, and VE was calculated as (1 - odds ratio) × 100. In the TNCCS, VE against influenza A was 68% (95% CI 47-81) overall, and 70% (48-83) for those given two doses; against influenza B, VE was 37% (- 12-64) overall and 49% (2-74) for two doses. In the TCCS, VE against influenza A was 44% (15-63) overall and 44% (13-64) for two doses, and VE against influenza B was 24% (- 19-52) overall and 41% (3-64) for two doses. Both studies confirmed significant VE against influenza A, significant two-dose VE against influenza B, and better two-dose VE than one-dose VE. What is Known: • Influenza vaccine effectiveness (VE) varies from year to year. • Observational studies are conventionally used for VE assessment. However, they are inherently susceptible to bias and confounding. What is New: • This is the first report of influenza VE assessment using more than one observational study and performed in a specific area during the same season. • VE estimates obtained in our traditional case-control study were lower than those in our test-negative case-control study, but both studies found significant VE against influenza.

Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

Science.gov (United States)

Pai, Aditi

2014-01-01

A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

Constructing Affective Security in Children: Case Study in Educational Environments

Science.gov (United States)

Margenat, Montserrat; Dalmau, Mariona; Vendrell, Roser; Ibarz, Lidia

2016-01-01

In line with Bowlby's theoretical approach, where he established a relationship between the quality of experiences lived in the first relationships and subsequent behaviours, we are carrying out a case study research project. The objectives are as follows: (1) To describe interactive patterns as observed in natural contexts and focusing on the…

Lichen planus and Hepatitis C: A case-control study | Elagraa ...

African Journals Online (AJOL)

Background The exact cause of LP is not known. However, the association of lichen planus with hepatitis C virus (HCV) infection has been reported in literature. A wide variation in the reported prevalence of HCV infection in patients with lichen planus in different geographical areas was observed. This case – control study ...

Five misunderstandings about Case-study Research

DEFF Research Database (Denmark)

Flyvbjerg, Bent

This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without  exemplars is an ineffective one. Social science may be strengthened by the execution of more...

A case-control study: occupational cooking and the risk of uveal melanoma

Directory of Open Access Journals (Sweden)

Marr Anja

2010-10-01

Full Text Available Abstract Background A European-wide population based case-control study (European rare cancer study undertaken in nine European countries examined risk factors for uveal melanoma. They found a positive association between cooks and the risk of uveal melanoma. In our study we examine whether cooks or people who worked in cook related jobs have an increased uveal melanoma risk. Methods We conducted a case-control study during 2002 and 2005. Overall, 1653 eligible subjects (age range: 20-74 years, living in Germany participated. Interviews were conducted with 459 incident uveal melanoma cases, 827 population controls, 180 ophthalmologist controls and 187 sibling controls. Data on occupational exposure were obtained from a self-administered postal questionnaire and a computer-assisted telephone interview. We used conditional logistic regression to estimate odds ratios adjusting for the matching factors. Results Overall, we did not observe an increased risk of uveal melanoma among people who worked as cooks or who worked in cook related jobs. When we restricted the source population of our study to the population of the Federal State of Northrhine-Westphalia, we observed an increased risk among subjects who were categorized as cooks in the cases-control analysis. Conclusion Our results are in conflict with former results of the European rare cancer study. Considering the rarity of the disease laboratory in vitro studies of human uveal melanoma cell lines should be done to analyze potential exposure risk factors like radiation from microwaves, strong light from incandescent ovens, or infrared radiation.

Effectiveness of Three Case Studies and Associated Teamwork in Stimulating Freshman Interest in an Introduction to Engineering Course

Science.gov (United States)

McIntyre, Joseph S.

2011-01-01

The effectiveness of three case studies and associated teamwork to stimulate interest of college freshman in engineering was investigated by observing students. Case studies were assigned as laboratory team exercises in an introduction to engineering course at Auburn University. Student interest in the case studies was evaluated qualitatively…

Becoming Blended. A Case Study in Teacher Identity

OpenAIRE

Rentería, Victoria

2014-01-01

This case-study explores the identities of two teachers in the English Blended Program of a Mexican University during a four month period. The aim is to discover how agency creates different kinds of impacts on teacher's identity in the context of a blended program. Through an interpretive and sociocultural perspective an analysis was conducted by examining data gathered from face-to-face class observations, teacher's Moodle pages, teacher's journals and interviews, as well as questionnaires ...

An observational and modeling study of the August 2017 Florida climate extreme event.

Science.gov (United States)

Konduru, R.; Singh, V.; Routray, A.

2017-12-01

A special report on the climate extremes by the Intergovernmental Panel on Climate Change (IPCC) elucidates that the sole cause of disasters is due to the exposure and vulnerability of the human and natural system to the climate extremes. The cause of such a climate extreme could be anthropogenic or non-anthropogenic. Therefore, it is challenging to discern the critical factor of influence for a particular climate extreme. Such kind of perceptive study with reasonable confidence on climate extreme events is possible only if there exist any past case studies. A similar rarest climate extreme problem encountered in the case of Houston floods and extreme rainfall over Florida in August 2017. A continuum of hurricanes like Harvey and Irma targeted the Florida region and caused catastrophe. Due to the rarity of August 2017 Florida climate extreme event, it requires the in-depth study on this case. To understand the multi-faceted nature of the event, a study on the development of the Harvey hurricane and its progression and dynamics is significant. Current article focus on the observational and modeling study on the Harvey hurricane. A global model named as NCUM (The global UK Met office Unified Model (UM) operational at National Center for Medium Range Weather Forecasting, India, was utilized to simulate the Harvey hurricane. The simulated rainfall and wind fields were compared with the observational datasets like Tropical Rainfall Measuring Mission rainfall datasets and Era-Interim wind fields. The National Centre for Environmental Prediction (NCEP) automated tracking system was utilized to track the Harvey hurricane, and the tracks were analyzed statistically for different forecasts concerning the Harvey hurricane track of Joint Typhon Warning Centre. Further, the current study will be continued to investigate the atmospheric processes involved in the August 2017 Florida climate extreme event.

Committed to Differentiation and Engagement: A Case Study of Two American Secondary Social Studies Teachers

Directory of Open Access Journals (Sweden)

Derek Anderson

2014-05-01

Full Text Available This case study examines two 10th-grade US History teachers who collaborated to create and implement an integrated, thematic eight-week unit on war with an emphasis differentiated instruction. Drawing on the National Council for the Social Studies (2010 framework for powerful and purposeful social studies instruction, the case study uses multiple sources of data, including 38 lesson observations, analyses of the teachers’ lesson plans and student work, and interviews of teachers. Initially, the teachers were successful at engaging students in simulations, small-group discussions, and higher-order thinking. As the unit progressed, however, the teachers reverted to transmission-style teaching with an emphasis on breadth over depth. Changing teaching practice requires overcoming barriers associated with prior experiences and deeply-held beliefs about teaching and learning.

Dietary patterns are associated with disease risk among participants in the women's health initiative observational study

Science.gov (United States)

Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infar...

Design Fixation and Cooperative Learning in Elementary Engineering Design Project: A Case Study

Science.gov (United States)

Luo, Yi

2015-01-01

This paper presents a case study examining 3rd, 4th and 5th graders' design fixation and cooperative learning in an engineering design project. A mixed methods instrument, the Cooperative Learning Observation Protocol (CLOP), was adapted to record frequency and class observation on cooperative learning engagement through detailed field notes.…

Homeopathic drug therapy. Homeopathy in Chikungunya Fever and Post-Chikungunya Chronic Arthritis: an observational study.

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Wadhwani, Gyandas G

2013-07-01

To observe the effect of homeopathic therapy in Chikungunya Fever (CF) and in Post-Chikungunya Chronic Arthritis (PCCA) in a primary health care setting. A prospective observational study was conducted at Delhi Government Homeopathic Dispensary, Aali Village, New Delhi, India, for a period of 6 months, from 1st October 2010 to 31st March 2011. 126 patients (75 CF, 51 PCCA) were enrolled based on predefined inclusion criteria. A single homeopathic medicine was prescribed for each patient after case taking with the help of Materia Medica and/or Repertory. Results were evaluated on the basis of visual analogue scale and symptom scores. Complete recovery was seen in 84.5% CF cases in a mean time of 6.8 days. 90% cases of PCCA recovered completely in a mean time of 32.5 days. Homeopathic therapy may be effective in CF and PCCA. A randomized controlled trial should be considered. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

Theoretical pluralism in psychoanalytic case studies.

Science.gov (United States)

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

Theoretical pluralism in psychoanalytic case studies

Science.gov (United States)

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study.

Science.gov (United States)

Cornelis, Shana; Desmet, Mattias; Van Nieuwenhove, Kimberly L H D; Meganck, Reitske; Willemsen, Jochem; Inslegers, Ruth; Feyaerts, Jasper

2017-01-01

The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed.

Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

Directory of Open Access Journals (Sweden)

Shana Cornelis

2017-06-01

Full Text Available The classical symptom specificity hypothesis (Blatt, 1974 particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2 documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009. Similar to the first empirical case study (Chapter 1, Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed.

A PROSPECTIVE OBSERVATIONAL STUDY REGARDING PREVALENCE OF DRY EYE DISEASE IN POST-OPERATIVE CATARACT SURGERY PATIENTS OF 140 CASES.

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S. Srinivasan

2017-02-01

Full Text Available BACKGROUND Dry eye disease is one of the most common ocular surface disorder with large number of studies carried out in various countries estimate the prevalence of dry eye disease to be between 5-34%. The prevalence of dry eye increases with age. As per Breaver Dam study regarding dry eye the prevalence of DED 13.3%. Dry eye was apparently higher in women than men. Studies have shown that cataract surgery worsen dry eye symptoms in patients with preexisting dry eye symptoms as well as without preexisting DES, mostly dry eye symptoms last for two months of post cataract surgery period. MATERIALS AND METHODS The prospective observational study was conducted in Department of Ophthalmology, Government Vellore Medical College and Hospital, Vellore. The total number of cataract surgery performed cases were 140 in number. The study period was four months, conducted in tertiary eye center. The Cataract patients were preoperatively at normal tear secretions. Post cataract surgery period from first POD, one week POD, four weeks, six weeks, two months and three months POD examined by slit lamp, Schirmer's test I, TBUT and corneal sensitivity test were performed. RESULTS Our study revealed that increased prevalence in female sex with increased age group range from 51-70 years showed post cataract surgery period dryness of eye. The ratio of Post cataract surgery DED in male and female is 13:29. This shows increased female sex prevalence of postoperative DED. In our study, the prevalence of post cataract surgery dry eye disease was 30%. CONCLUSION 73% cataract surgeries is now clear corneal cataract surgery and this procedure cuts a large part of corneal nerves. The nerve essential for tear production gets disturbed leading to dryness and hence decreased visual function. The corneal nerves are important in self-regulation of tears since they provide the sensation in the feedback loop that signals tear production. When the functions of the nerves get blocked

Periodontal disease and spontaneous preterm birth: a case control study

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Eley Barry

2006-07-01

Full Text Available Abstract Background Several studies have suggested an association between periodontal disease and prematurity but this finding has not been consistently observed. Methods Case control study. Cases (n = 50 were women who had delivered after spontaneous preterm labor at Results There was no difference in the proportion of sites with significant attachment loss (≥3 mm: Cases-3.2%, Controls-2.2% p = 0.21. The gingival crevicular fluid concentrations of elastase and gingipain were elevated in cases vs. controls 238.8 uU/ul vs. 159.6 uU/ul p = .007 and 2.70 uU/ul vs. 1.56 uU/ul p = .001. On multivariate analysis, the mean log concentration of elastase, but not of gingipain, remained a significant predictor of preterm labor p = .0.015. Conclusion We found no evidence that clinical periodontal disease is associated with spontaneous preterm birth. Elevated gingival crevicular fluid levels of elastase were associated with preterm birth but further research is needed before this can be assumed to be a causal relationship.

Using direct clinical observation to assess the quality of cesarean delivery in Afghanistan: an exploratory study

Science.gov (United States)

2014-01-01

Background As part of a National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment, a special study was undertaken in July 2010 to examine the quality of cesarean deliveries in Afghanistan and examine the utility of direct clinical observation as an assessment method in low-resource settings. Methods This cross-sectional assessment of the quality of cesareans at 14 facilities in Afghanistan included a survey of surgeons regarding their routine cesarean practices, direct observation of 29 cesarean deliveries and comparison of observations with facility records for 34 additional cesareans conducted during the 3 days prior to the observation period at each facility. For both observed cases and record reviews, we assessed time intervals between specified points of care-arrival to the ward, first evaluation, detection of a complication, decision for cesarean, incision, and birth. Results All time intervals with the exception of “decision to skin incision” were longer in the record reviews than in observed cases. Prior cesarean was the most common primary indication for all cases. All mothers in both groups observed survived through one hour postpartum. Among newborns there were two stillbirths (7%) in observed births and seven (21%) record reviews. Although our sample is too small to show statistical significance, the difference is noteworthy. In six of the reviewed cesareans resulting in stillbirth, a fetal heart rate was recorded in the operating theater, although four were recorded as macerated. For the two fresh stillbirths, the cesarean surgeries were recorded as scheduled and not urgent. Conclusions Direct observation of cesarean deliveries enabled us to assess a number of preoperative, postoperative, and intraoperative procedures that are often not described in medical records in low resource settings. Comparison of observations with findings from provider interviews and facility records allowed us to infer whether observed practices were typical

Bioremediation case studies: Abstracts. Final report

International Nuclear Information System (INIS)

Devine, K.

1992-03-01

The report contains abstracts of 132 case studies of bioremediation technology applied to hazardous waste clean-up. It was prepared to compile bioremediation studies in a variety of locations and treating diverse contaminants, most of which were previously undocumented. All data are based on vendor-supplied information and there was no opportunity to independently confirm its accuracy. These 132 case studies, from 10 different biotechnology companies, provide users with reference information about on-going and/or completed field applications and studies. About two-thirds of the cases were at full-scale clean-up level with the remainder at pilot or laboratory scale. In 74 percent of the cases, soil was at least one of the media treated. Soil alone accounts for 46 percent of the cases. Petroleum-related wastes account for the largest contaminant with 82 cases. Thirty-one states are represented in the case studies

Learning in the Making: A Comparative Case Study of Three Makerspaces

Science.gov (United States)

Sheridan, Kimberly M.; Halverson, Erica Rosenfeld; Litts, Breanne K.; Brahms, Lisa; Jacobs-Priebe, Lynette; Owens, Trevor

2014-01-01

Through a comparative case study, Sheridan and colleagues explore how makerspaces may function as learning environments. Drawing on field observations, interviews, and analysis of artifacts, videos, and other documents, the authors describe features of three makerspaces and how participants learn and develop through complex design and making…

451 Case studies Cardiac

African Journals Online (AJOL)

Marinda

Case Studies. 29 ... A case of a 26-year-old ASA I physical status male undergoing septoplasty had an abrupt ... myocardial infarction, severe hypertensive crisis, cerebral .... or no formal management is required in an ASA I patient.8 One.

Comparing Case Study and Ethnography as Qualitative Research Approaches

OpenAIRE

Suryani, Anne

2008-01-01

Abstract: This article reviews several differences between case study and ethnography in terms of definitions, characteristics, strengths and limitations. It provides current information by comparing these approaches from various social researchers’ perspectives. Although each method has strong points, they both have differences in conducting observation and interview as data collection techniques; choosing the length of time of data gathering and reporting details of a particular reality....

Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

Directory of Open Access Journals (Sweden)

Jane N Mutanga

Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early

A case study of gravity waves in noctilucent clouds

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P. Dalin

2004-06-01

Full Text Available We present a case study of a noctilucent cloud (NLC display appearing on 10-11 August 2000 over Northern Sweden. Clear wave structures were visible in the clouds and time-lapse photography was used to derive the parameters characterising the gravity waves which could account for the observed NLC modulation. Using two nearby atmospheric radars, the Esrange MST Radar data and Andoya MF radar, we have identified gravity waves propagating upward from the upper stratosphere to NLC altitudes. The wave parameters derived from the radar measurements support the suggestion that gravity waves are responsible for the observed complex wave dynamics in the NLC.

A case-control study assessing depression in patients with periodontitis

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Shiyamali Sundararajan

2017-01-01

Full Text Available Background: Chronic periodontitis is an inflammatory disease of the supporting structures of the tooth. One of the important non-oral risk factors for periodontitis is psychosocial stress and depression. Depression affects oral health by affecting the immune system through its effects on hypothalamic pituitary axis system. Periodontal inflammatory surface area (PISA is a system used to assess inflammatory burden in the periodontal tissue. Aim: The aim of this study is to assess the relationship between PISA and depression. Settings and Design: The design of the study is case-control study. Materials and Methods: The study design is a case-control study with forty patients each in case and control groups. The periodontal inflammatory level was assessed by PISA system and the levels of depression was assessed by using Beck's Depression Inventory (BDI. Statistical Analysis: Student's t-test was used to compare PISA and BDI scores. The BDI score (mean ± standard deviation [SD] for controls was 12.75 ± 6.82 compared to 22.73 ± 4.40 for the cases. The comparison (t = 7.78 was statistically significant at P < 0.0001. The PISA score (mean ± SD for controls was 210.47 ± 76.80 compared to the PISA score of 1069.50 ± 204.21 for cases which was statistically significant (t = 24.90; P < 0.0001. Results: Significantly higher BDI scores were observed in patients with chronic periodontitis than healthy controls. Conclusion: This study clearly reveals a significant association between the severity of depression and inflammatory burden.

Study of the Effects of Total Modulation Transfer Function Changes on Observer Performance Using Clinical Mammograms.

Science.gov (United States)

Bencomo, Jose Antonio Fagundez

The main goal of this study was to relate physical changes in image quality measured by Modulation Transfer Function (MTF) to diagnostic accuracy. One Hundred and Fifty Kodak Min-R screen/film combination conventional craniocaudal mammograms obtained with the Pfizer Microfocus Mammographic system were selected from the files of the Department of Radiology, at M.D. Anderson Hospital and Tumor Institute. The mammograms included 88 cases with a variety of benign diagnosis and 62 cases with a variety of malignant biopsy diagnosis. The average age of the patient population was 55 years old. 70 cases presented calcifications with 30 cases having calcifications smaller than 0.5mm. 46 cases presented irregular bordered masses larger than 1 cm. 30 cases presented smooth bordered masses with 20 larger than 1 cm. Four separated copies of the original images were made each having a different change in the MTF using a defocusing technique whereby copies of the original were obtained by light exposure through different thicknesses (spacing) of transparent film base. The mammograms were randomized, and evaluated by three experienced mammographers for the degree of visibility of various anatomical breast structures and pathological lesions (masses and calicifications), subjective image quality, and mammographic interpretation. 3,000 separate evaluations were anayzed by several statistical techniques including Receiver Operating Characteristic curve analysis, McNemar test for differences between proportions and the Landis et al. method of agreement weighted kappa for ordinal categorical data. Results from the statistical analysis show: (1) There were no statistical significant differences in the diagnostic accuracy of the observers when diagnosing from mammograms with the same MTF. (2) There were no statistically significant differences in diagnostic accuracy for each observer when diagnosing from mammograms with the different MTF's used in the study. (3) There statistical

Observing documentary reading by verbal protocol

Directory of Open Access Journals (Sweden)

Fujita Mariangela Spotti Lopes

2003-01-01

Full Text Available Verifies the applicability to research on indexers' reading strategies of the process observing technique known as Verbal Protocol or Thinking Aloud. This interpretative-qualitative data collecting technique allows the observation of different kinds of process during the progress of different kinds of tasks. Presents a theoretical investigation into "reading" and into formal methodological procedures to observe reading processes. Describes details of the methodological procedures adopted in five case studies with analysis of samples of data. The project adopted three kinds of parameters for data analysis: theoretical, normative, empirical (derived from observations made in the first case study. The results are compared, and important conclusions regarding documentary reading are drawn.

Mechanism of case processing in the brain: an fMRI study.

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Satoru Yokoyama

Full Text Available In sentence comprehension research, the case system, which is one of the subsystems of the language processing system, has been assumed to play a crucial role in signifying relationships in sentences between noun phrases (NPs and other elements, such as verbs, prepositions, nouns, and tense. However, so far, less attention has been paid to the question of how cases are processed in our brain. To this end, the current study used fMRI and scanned the brain activity of 15 native English speakers during an English-case processing task. The results showed that, while the processing of all cases activates the left inferior frontal gyrus and posterior part of the middle temporal gyrus, genitive case processing activates these two regions more than nominative and accusative case processing. Since the effect of the difference in behavioral performance among these three cases is excluded from brain activation data, the observed different brain activations would be due to the different processing patterns among the cases, indicating that cases are processed differently in our brains. The different brain activations between genitive case processing and nominative/accusative case processing may be due to the difference in structural complexity between them.

CASE STUDY

African Journals Online (AJOL)

2011-06-02

Jun 2, 2011 ... immunosuppression associated with HIV/AIDS puts them at a higher risk of developing oesophageal cancer. 47. CASE STUDY. A 49-year-old man was diagnosed as HIV infected, with a CD4 count of 60 cells/µl. He was started on an antiretroviral treatment regimen comprising zidovudine, lamivudine and ...

Critical role of bioanalytical strategies in investigation of clinical PK observations, a Phase I case study

Science.gov (United States)

Peng, Kun; Xu, Keyang; Liu, Luna; Hendricks, Robert; Delarosa, Reginald; Erickson, Rich; Budha, Nageshwar; Leabman, Maya; Song, An; Kaur, Surinder; Fischer, Saloumeh K

2014-01-01

RG7652 is a human immunoglobulin 1 (IgG1) monoclonal antibody (mAb) targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) and is designed for the treatment of hypercholesterolemia. A target-binding enzyme-linked immunosorbent assay (ELISA) was developed to measure RG7652 levels in human serum in a Phase I study. Although target-binding assay formats are generally used to quantify free therapeutic, the actual therapeutic species being measured are affected by assay conditions, such as sample dilution and incubation time, and levels of soluble target in the samples. Therefore, in the presence of high concentrations of circulating target, the choice of reagents and assay conditions can have a significant effect on the observed pharmacokinetic (PK) profiles. Phase I RG7652 PK analysis using the ELISA data resulted in a nonlinear dose normalized exposure. An investigation was conducted to characterize the ELISA to determine whether the assay format and reagents may have contributed to the PK observation. In addition, to confirm the ELISA results, a second orthogonal method, liquid chromatography tandem mass spectrometry (LC-MS/MS) using a signature peptide as surrogate, was developed and implemented. A subset of PK samples, randomly selected from half of the subjects in the 6 single ascending dose (SAD) cohorts in the Phase I clinical study, was analyzed with the LC-MS/MS assay, and the data were found to be comparable to the ELISA data. This paper illustrates the importance of reagent characterization, as well as the benefits of using an orthogonal approach to eliminate bioanalytical contributions when encountering unexpected observations. PMID:25484037

Casing study

Energy Technology Data Exchange (ETDEWEB)

Roche, P.

2000-12-01

An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.

Exploring Teacher Beliefs and Classroom Practices through Reflective Practice: A Case Study

Science.gov (United States)

Farrell, Thomas S. C.; Ives, Jessica

2015-01-01

This article presents a case study that explored and reflected on the relationship between the stated beliefs and observed classroom practices of one second language reading teacher. The findings of this study revealed that this particular teacher holds complex beliefs about teaching reading that were evident to some extent in many of his…

Exploring ESL Teacher Beliefs and Classroom Practices of CLT: A Case Study

Science.gov (United States)

Rahman, Mohammad Mosiur; Singh, Manjet Kaur Mehar; Pandian, Ambigapathy

2018-01-01

This paper presents a case study that investigated and compared the stated beliefs and observed classroom practices relating to Communicative Language Teaching (CLT) of two ESL teachers. The findings of the study revealed that both the teachers hold similar complex beliefs that mostly contradict the philosophy of CLT. The practices were not in…

The Implementation of Lesson Study in English Language Learning: A Case Study

Directory of Open Access Journals (Sweden)

Wakhid Nashruddin

2016-12-01

Full Text Available Lesson Study as a growing interest in the education world has attracted educators, experts, and professionals in the area to make use of it in improving the lessons—it also happens in Indonesia. Originally applied in the teaching of mathematics in Japan, now it turns to be used in other fields, and English is one of them. This paper highlights the guideline on Lesson Study and pictures its application in a private senior high school in Malang, East Java, Indonesia. The adaptation of Lesson Study is interesting since Japan and Indonesia have different cultural background. How Lesson Study is usually implemented in Japan and the US and how it is applied in Indonesia will be seen here. As this is a case study, it will only focus on a school and the result should not be used to generalize Lesson Study applications in Indonesia. Interview and observation were instruments used in this study. The interview was used to gain information on how Lesson Study was normally conducted and observation (and the researchers’ involvements was used to see the real implementation of Lesson Study. What happened during the implementation of Lesson Study and during the teaching and learning process become a great attention here.

TU-FG-209-11: Validation of a Channelized Hotelling Observer to Optimize Chest Radiography Image Processing for Nodule Detection: A Human Observer Study

International Nuclear Information System (INIS)

Sanchez, A; Little, K; Chung, J; Lu, ZF; MacMahon, H; Reiser, I

2016-01-01

Purpose: To validate the use of a Channelized Hotelling Observer (CHO) model for guiding image processing parameter selection and enable improved nodule detection in digital chest radiography. Methods: In a previous study, an anthropomorphic chest phantom was imaged with and without PMMA simulated nodules using a GE Discovery XR656 digital radiography system. The impact of image processing parameters was then explored using a CHO with 10 Laguerre-Gauss channels. In this work, we validate the CHO’s trend in nodule detectability as a function of two processing parameters by conducting a signal-known-exactly, multi-reader-multi-case (MRMC) ROC observer study. Five naive readers scored confidence of nodule visualization in 384 images with 50% nodule prevalence. The image backgrounds were regions-of-interest extracted from 6 normal patient scans, and the digitally inserted simulated nodules were obtained from phantom data in previous work. Each patient image was processed with both a near-optimal and a worst-case parameter combination, as determined by the CHO for nodule detection. The same 192 ROIs were used for each image processing method, with 32 randomly selected lung ROIs per patient image. Finally, the MRMC data was analyzed using the freely available iMRMC software of Gallas et al. Results: The image processing parameters which were optimized for the CHO led to a statistically significant improvement (p=0.049) in human observer AUC from 0.78 to 0.86, relative to the image processing implementation which produced the lowest CHO performance. Conclusion: Differences in user-selectable image processing methods on a commercially available digital radiography system were shown to have a marked impact on performance of human observers in the task of lung nodule detection. Further, the effect of processing on humans was similar to the effect on CHO performance. Future work will expand this study to include a wider range of detection/classification tasks and more

Organisational culture and learning: a case study.

Science.gov (United States)

Bell, Elaine

2013-11-01

To explore the impact organisational cultures have on the learning experience of student nurses and identify the influencing factors. A case study approach was used. The single case being a Defence School of Health Care Studies (DSHCS) and the multiple units of analysis: student nurses, the lecturers and Student Standing Orders. An in depth three dimensional picture was achieved using multiple data collection methods: interview, survey, observation and document analysis. The findings suggest that the DSHCS is perceived to be a sub-culture within a dominant civilian learning culture. Generally, the students and staff believed that the DSHCS is an excellent learning environment and that the defence students overall are high achievers. The common themes that appeared from the data were image, ethos, environment, discipline, support, welfare and a civilian versus military way of thinking. The learning experience of defence student nurses is very positive and enhanced by the positive learning culture of the civilian Higher Educational Institution. The factors influencing a positive learning experience that can be impacted by the overarching culture are discipline, image, ethos of adult learning, support and welfare. Copyright © 2013 Elsevier Ltd. All rights reserved.

MRI case studies

International Nuclear Information System (INIS)

Huggett, S.; Barber, J.

1989-01-01

Three case studies are presented to show the value of magnetic resonance imaging used in conjunction with other imaging techniques. In each case MRI proved a vital diagnostic tool and superior to CT in showing firstly the haematoma in a patient with aphasia and right-sided weakness, secondly the size of the disc herniation in a patient with severe leg and ankle pains and thirdly the existence of a metastatic lesion in a patient with a previous history of breast cancer. 11 figs

Case study as a learning opportunity among nursing students in a ...

African Journals Online (AJOL)

research were observed in order to maintain the integrity of the research. The research fi ndings suggest that the case study as a learning opportunity is effective in facilitating learning, as indicated by the following three categories: increase in critical thinking skills, increased theory and practice integration and increased ...

Comparing Case Study and Ethnography as Qualitative Research Approaches

Directory of Open Access Journals (Sweden)

Anne Suryani

2013-12-01

Full Text Available Abstract: This article reviews several differences between case study and ethnography in terms of definitions, characteristics, strengths and limitations. It provides current information by comparing these approaches from various social researchers’ perspectives. Although each method has strong points, they both have differences in conducting observation and interview as data collection techniques; choosing the length of time of data gathering and reporting details of a particular reality.

The structure of high altitude O+ energization and outflow: a case study

Directory of Open Access Journals (Sweden)

H. Nilsson

2004-07-01

Full Text Available Multi-spacecraft observations from the CIS ion spectrometers on board the Cluster spacecraft have been used to study the structure of high-altitude oxygen ion energization and outflow. A case study taken from 12 April 2004 is discussed in more detail. In this case the spacecraft crossed the polar cap, mantle and high-altitude cusp region at altitudes between 4RE and 8RE and 2 of the spacecraft provided data. The oxygen ions were seen as a beam with narrow energy distribution, and increasing field-aligned velocity and temperature at higher altitude further in the upstream flow direction. The peak O+ energy was typically just above the highest energy of observed protons. The observed energies reached the upper limit of the CIS ion spectrometer, i.e. 38keV. Moment data from the spacecraft have been cross-correlated to determine cross-correlation coefficients, as well as the phase delay between the spacecraft. Structures in ion density, temperature and field-aligned flow appear to drift with the observed field-perpendicular drift. This, together with a velocity dispersion analysis, indicates that much of the structure can be explained by transverse heating well below the spacecraft. However, temperature isotropy and the particle flux as a function of field-aligned velocity are inconsistent with a single altitude Maxwellian source. Heating over extended altitude intervals, possibly all the way up to the observation point, seem consistent with the observations.

Red and processed meat consumption and risk of glioma in adults: A systematic review and meta-analysis of observational studies

Directory of Open Access Journals (Sweden)

Parvane Saneei

2015-01-01

Full Text Available Background: These findings from several observational studies, investigated the association between red meat consumption and gliomas, were inconsistent. We conducted a systematic review and meta-analysis of observational studies to summarize available date on the relation between meat intake and risk of glioma. Materials and Methods: A systematic literature search of relevant reports published until May 2014 of the PubMed/Medline, ISI Web of Knowledge, Excerpta Medica database, Ovid database, Google Scholar, and Scopus databases was conducted. From 723 articles yielded in the preliminary literature search, data from eighteen publications (14 case-control, three cohort, and one nested case-control study on unprocessed red meat, processed meat, and/or total red meat consumption in relation to glioma in adults were included in the analysis. Quality assessment of studies was performed. Random effects model was used to conduct the meta-analysis. Results: We found a positive significant association between unprocessed red meat intake and risk of glioma (relative risk [RR] = 1.30; 95% confidence interval [CI]: 1.08-1.58 after excluding three studies with uncertain type of brain cancer. This analysis included only one cohort study which revealed no relation between unprocessed red meat intake and glioma (RR = 1.75; 95% CI: 0.35-8.77. Consumption of processed meats was not related to increased risk of glioma in population-based case-control studies (RR = 1.26; 95% CI: 1.05-1.51 and reduced risk in hospital-based case-controls (RR = 0.79; 95% CI: 0.65-0.97. No significant association was seen between processed red meat intake and risk of glioma in cohort studies (RR: 1.08; 95% CI: 0.84-1.37. Total red meat consumption was not associated with risk of adult glioma in case-control or cohort studies. Conclusion: In this meta-analysis of 18 observational studies, we found a modest positive association between unprocessed red meat intake and risk of gliomas

Qualitative Case Study Guidelines

Science.gov (United States)

2013-11-01

Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

A Prospective Observational Study

African Journals Online (AJOL)

Methods: This was a prospective, questionnaire-based observational study. Printed questionnaires were distributed to the visitors of medical, surgical and neurosurgical ICU patients to determine awareness of basic infection control practices among visitors to an ICU. All the ICU staff, including nurses, doctors, consultant ...

Clinicoepidemiological Observational Study of Acquired Alopecias in Females Correlating with Anemia and Thyroid Function

Directory of Open Access Journals (Sweden)

Kirti Deo

2016-01-01

Full Text Available Alopecia can either be inherited or acquired; the latter, more common, can be diffuse, patterned, and focal, each having cicatricial and noncicatricial forms. This observational study of 135 cases in a semiurban Indian population aimed to detect the prevalence of various forms of acquired alopecia in females and correlate the same with levels of hemoglobin, serum ferritin, triiodothyronine, thyroxin, and thyroid stimulating hormone. The majority (84, 62.2% of our cases of alopecia had telogen effluvium followed by female pattern alopecia (32, 23.7%. Stress (86, 63.7%, topical application of chemicals (72, 53.3%, systemic medications for concurrent illnesses (62, 5%, and pregnancy (14, 10.3% were the common exacerbating factors. Neither low hemoglobin (12 μg/L. Though lack of vitamin B12 testing was a limitation of our study, its deficiency could be the probable cause of iron deficiency as the majority (58, 64.4% of these cases, as indeed majority (89, 65.4% of our study population, were vegetarians. Thyroid disorders (23, 17%, including 9 newly diagnosed were not of significance statistically.

Social Competence Intervention in Autistic Spectrum Disorders (ASDS) - A Case Study

Science.gov (United States)

Amin, Noor A.; Oweini, Ahmad

2013-01-01

The purpose of this case study was to determine the effectiveness of a combined intervention in remediating the social skills in a first-grader with a disorder from the autism spectrum disorders (ASDs). The researcher also aimed to identify the changes observed during the intervention period. The combined intervention consisted of reading…

Selective serotonin reuptake inhibitors and gastrointestinal bleeding: a case-control study.

Directory of Open Access Journals (Sweden)

Alfonso Carvajal

Full Text Available BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs have been associated with upper gastrointestinal (GI bleeding. Given their worldwide use, even small risks account for a large number of cases. This study has been conducted with carefully collected information to further investigate the relationship between SSRIs and upper GI bleeding. METHODS: We conducted a case-control study in hospitals in Spain and in Italy. Cases were patients aged ≥18 years with a primary diagnosis of acute upper GI bleeding diagnosed by endoscopy; three controls were matched by sex, age, date of admission (within 3 months and hospital among patients who were admitted for elective surgery for non-painful disorders. Exposures to SSRIs, other antidepressants and other drugs were defined as any use of these drugs in the 7 days before the day on which upper gastrointestinal bleeding started (index day. RESULTS: 581 cases of upper GI bleeding and 1358 controls were considered eligible for the study; no differences in age or sex distribution were observed between cases and controls after matching. Overall, 4.0% of the cases and 3.3% of controls used an SSRI antidepressant in the week before the index day. No significant risk of upper GI bleeding was encountered for SSRI antidepressants (adjusted odds ratio, 1.06, 95% CI, 0.57-1.96 or for whichever other grouping of antidepressants. CONCLUSIONS: The results of this case-control study showed no significant increase in upper GI bleeding with SSRIs and provide good evidence that the magnitude of any increase in risk is not greater than 2.

Wound healing in pre-tibial injuries--an observation study.

Science.gov (United States)

McClelland, Heather M; Stephenson, John; Ousey, Karen J; Gillibrand, Warren P; Underwood, Paul

2012-06-01

Pre-tibial lacerations are complex wounds affecting a primarily aged population, with poor healing and a potentially significant impact on social well-being. Management of these wounds has changed little in 20 years, despite significant advances in wound care. A retrospective observational study was undertaken to observe current wound care practice and to assess the effect of various medical factors on wound healing time on 24 elderly patients throughout their wound journey. Wound length was found to be substantively and significantly associated with wound healing time, with a reduction in instantaneous healing rate of about 30% for every increase of 1 cm in wound length. Hence, longer wounds are associated with longer wound healing times. Prescription of several categories of drugs, including those for ischaemic heart disease (IHD), hypertension, respiratory disease or asthma; and the age of the patient were not significantly associated with wound healing times, although substantive significance could be inferred in the case of prescription for IHD and asthma. Despite the small sample size, this study identified a clear association between healing and length of wound. Neither the comorbidities nor prescriptions explored showed any significant association although some seem to be more prevalent in this patient group. The study also highlighted other issues that require further exploration including the social and economic impact of these wounds. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Case Study: The Chemistry of Cocaine

Science.gov (United States)

Dewprashad, Brahmadeo

2011-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

The role of radionuclide studies in emergency cases

International Nuclear Information System (INIS)

Nishimura, Tsunehiko; Hayashida, Kohei; Uehara, Toshiisa

1982-01-01

Radionuclide studies have been performed popularly because of its noninvasive and simple method recently. In this study, we applied this technique for the evaluation of emergency cases in cardiovascular diseases. There were 93 cases (1.5%) out of 6163 cases, done during 1981. The subjects were 34 cases of cardiac studies (9 cases of sup(99m)Tc-PYP myocardial imaging, 12 cases of thallium myocardial imaging, 13 cases of cardioangiography), 23 cases of peripheral diseases (12 cases of peripheral angiography, 11 cases of venography), 16 cases of pulmonary imaging, 10 cases of renal studies (6 cases of renal angiography, 9 cases of renal imaging) and 5 cases of brain angiography. These studies were proven to be useful clinically for the evaluation of emergency cases and follow-up studies. In the near future, ''emergency radionuclide studies'' would be benefit for the high-risk patients noninvasively. (author)

eCompetence Case Studies

DEFF Research Database (Denmark)

Jensen, Helle Bækkelund

2006-01-01

In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

Case Study Methodology and Homelessness Research

Directory of Open Access Journals (Sweden)

Jill Pable

2013-10-01

Full Text Available This paper describes the potential suitability of case study methodology for inquiry with the homeless population. It references a research study that uses case study research method to build theory. This study's topic is the lived experience of destitute individuals who reside in homeless shelters, and explores the homeless shelter built environment's potential influence on resident satisfaction and recovery. Case study methodology may be appropriate because it explores real-life contextual issues that characterize homelessness and can also accommodate the wide range of homeless person demographics that make this group difficult to study in a generalized fashion. Further, case study method accommodates the need within research in this area to understand individualized treatments as a potential solution for homelessness.

Assembling a Case Study Tool Kit: 10 Tools for Teaching with Cases

Science.gov (United States)

Prud'homme-Généreux, Annie

2017-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. The author shares the strategies and tools that teachers can use to manage a case study classroom effectively.

On misunderstandings in connection with case-studies

DEFF Research Database (Denmark)

Flyvbjerg, Bent

2005-01-01

This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

Yogic breathing and Ayurveda in aphasia: a case study.

Science.gov (United States)

Mohapatra, Bijoyaa; Marshall, Rebecca Shisler; Laures-Gore, Jacqueline

2014-01-01

We present a case study of a woman who used yogic breathing as Ayurvedic medicine in her recovery from poststroke aphasia. Ayurvedic medicine is one of the most ancient medicines of the world, but it is not widely used for aphasia rehabilitation in many Western countries. The description of this case aims to further the understanding of the benefits that this type of medicine may provide to poststroke patients living with aphasia. After her stroke, the patient received brief conventional language therapy for her aphasia. At 5 weeks post stroke, she received no further conventional rehabilitation; instead, she consulted with a Vedic priest. She followed a regimen of different body manipulations, yogic breathing techniques, and ingestion of coconut oil. Cognitive and language testing was performed throughout a 3-month period while she was involved in this therapy. Overall, improvement was noted in language, visual attention, and some mood measures. Although case studies lead to limited conclusions, changes were observed for this individual using Ayurvedic medicine. Given the changes in language and some aspects of cognition seen in this patient, further exploration of the effectiveness of yogic breathing and Ayurvedic medicine in the treatment of poststroke aphasia is warranted.

Formulating autism systemically: Part 2 - A 12-year prospective case study.

Science.gov (United States)

Brewerton, Nicky; Robson, Katrina; Crittenden, Patricia M

2017-07-01

This prospective case study illustrates the ideas on the developmental origins of some cases of autism that were described in Part 1 of this article. We explored and found support for several systemic hypotheses regarding the experience of 'Graeme' and his mother. Graeme's story is told prospectively from the age of 3 until 15. Three independent sources of information are reported: hypotheses from the literature and case review in Part 1 of this article, the school's experience, and observations from the assessments of attachment when Graeme was turning 6. These three streams of information are integrated here. The review of the literature and clinical cases gives us a wide-angle lens, empirically supporting our focus on danger in relationships. The school's experience describes working with a child with undiagnosed autism. The assessments of attachment both provide information about family members' psychological strategies for protection from danger and also include the mother's childhood history of family threat. Their synthesis permits us to construct a developmental history, from Graeme's mother's childhood history of being triangulated into her parents' hidden marital discord to it's repetition for Graeme in her own marriage. New observations included mum's postural/gestural communication to Graeme and her possible ambivalence about males. Strikingly, Graeme was a case study (Attachment & Family Therapy, ch. 6) before he was diagnosed with autism. That presentation focused on Graeme's feeling of rejection by his father. In the same book, an interpersonal formulation of autism was offered (ch. 3), but it was not connected to Graeme, showing that when one lacks crucial information, the clinical formulation is distorted. The crucial information in this case was the mother's psychological history. Our case suggests that filling the blind spot in the research on autism with information about family functioning over at least two generations might change the

A Case Study in Corporate Social Responsibility

Directory of Open Access Journals (Sweden)

Sharon K. Kendrick

2014-03-01

Full Text Available This case study promotes analysis through a brief investigation into the role of corporate social responsibility (CSR in the operation of a multinational corporation as evidenced by Google, Inc. The study focuses on a transnational company in order to observe the impact of CSR practice on a global level. The study will present implications of CSR for corporate management, corporate employees, state regulators, shareholders, and customers in general. In addition, the study will discuss consequences of poor CSR compliance for a multinational corporation. Questions for analysis include implications of CSR, employee retention, development of corporate culture, and evaluation of advantages and disadvantages of different CSR approaches. Upon conclusion of the study, suggestions are made for future collaborative efforts in corporate social responsibility as applied to psychological, sociological, and economical motives. Recruiting and training possibilities also present partnership opportunities for best practice sharing in regards to community, civic, and service engagement.

Qualitative Case Study Research as Empirical Inquiry

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Ellinger, Andrea D.; McWhorter, Rochell

2016-01-01

This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

Case series and descriptive cohort studies in neurosurgery: the confusion and solution.

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Esene, Ignatius N; Ngu, Julius; El Zoghby, Mohamed; Solaroglu, Ihsan; Sikod, Anna M; Kotb, Ali; Dechambenoit, Gilbert; El Husseiny, Hossam

2014-08-01

Case series (CS) are well-known designs in contemporary use in neurosurgery but are sometimes used in contexts that are incompatible with their true meaning as defined by epidemiologists. This inconsistent, inappropriate and incorrect use, and mislabeling impairs the appropriate indexing and sorting of evidence. Using PubMed, we systematically identified published articles that had "case series" in the "title" in 15 top-ranked neurosurgical journals from January 2008 to December 2012. The abstracts and/or full articles were scanned to identify those with descriptions of the principal method as being "case series" and then classified as "true case series" or "non-case series" by two independent investigators with 100 % inter-rater agreement. Sixty-four articles had the label "case series" in their "titles." Based on the definition of "case series" and our appraisal of the articles using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, 18 articles (28.13 %) were true case series, while 46 (71.87 %) were mislabeled. Thirty-five articles (54.69 %) mistook retrospective (descriptive) cohorts for CS. CS are descriptive with an outcome-based sampling, while "descriptive cohorts" have an exposure-based sampling of patients, followed over time to assess outcome(s). A comparison group is not a defining feature of a cohort study and distinguishes descriptive from analytic cohorts. A distinction between a case report, case series, and descriptive cohorts is absolutely necessary to enable the appropriate indexing, sorting, and application of evidence. Researchers need better training in methods and terminology, and editors and reviewers should scrutinize more carefully manuscripts claiming to be "case series" studies.

The Alberta smoke plume observation study

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K. Anderson

2018-02-01

Full Text Available A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS. Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018 at http://cwfis.cfs.nrcan.gc.ca/datamart.

The Alberta smoke plume observation study

Science.gov (United States)

Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

2018-02-01

A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at http://cwfis.cfs.nrcan.gc.ca/datamart.

Methodology for the case studies

NARCIS (Netherlands)

Smits, M.J.W.; Woltjer, G.B.

2017-01-01

This document is about the methodology and selection of the case studies. It is meant as a guideline for the case studies, and together with the other reports in this work package can be a source of inform ation for policy officers, interest groups and researchers evaluating or performing impact

Performable Case Studies in Ethics Education.

Science.gov (United States)

Robeson, Richard; King, Nancy M P

2017-09-12

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

Detection of lung cancer on the chest radiograph: a study on observer performance

International Nuclear Information System (INIS)

Quekel, Lorentz G.B.A.; Kessels, Alphons G.H.; Goei, Reginald; Engelshoven, Joseph M.A. van

2001-01-01

Study objectives: to study the validity and observers consistency in the detection of lung cancer on the chest radiograph. Materials and methods: the chest radiographs of 100 clinical cases were interpreted by 14 observers. The radiographs were obtained from 30 patients with initially missed but histopathologically proven non-small cell lung cancer (NSCLC), 35 patients with other cardiopulmonary diseases and 35 patients with no abnormalities. The observers consisted of ten experienced radiologists, two-experienced chest physicians and two residents in radiology. All observers were unaware of the study design. The validity and observer consistency was determined for each observer. Results: the mean sensitivity and specificity of the ten radiologists were 0.36 and 0.90. For the two chest physicians, the mean sensitivity and specificity were 0.29 and 0.96. For the two residents in radiology, mean sensitivity and specificity were 0.25 and 0.94. The mean interobserver kappa and mean intraobserver kappa for the radiologists were 0.38 and 0.54. For the two chest physicians, the mean interobserver kappa was 0.43, while the intraobserver kappa was 0.59. For the two residents in radiology, mean interobserver kappa was 0.35 and the intraobserver kappa was 0.42. There was no significant relation between the consistency parameters and validity parameters. The interobserver and intraobserver kappa values showed good correlation. Conclusion: the validity of the chest radiograph and observers consistency in the detection of nodular lung cancer varies widely. The level of experience is likely to influence the diagnostic performance

A suggestion for quality assessment in systematic reviews of observational studies in nutritional epidemiology

Directory of Open Access Journals (Sweden)

Jong-Myon Bae

2016-04-01

Full Text Available OBJECTIVES: It is important to control the quality level of the observational studies in conducting meta-analyses. The Newcastle-Ottawa Scale (NOS is a representative tool used for this purpose. We investigated the relationship between high-quality (HQ defined using NOS and the results of subgroup analysis according to study design. METHODS: We selected systematic review studies with meta-analysis which performed a quality evaluation on observational studies of diet and cancer by NOS. HQ determinations and the distribution of study designs were examined. Subgroup analyses according to quality level as defined by the NOS were also extracted. Equivalence was evaluated based on the summary effect size (sES and 95% confidence intervals computed in the subgroup analysis. RESULTS: The meta-analysis results of the HQ and cohort groups were identical. The overall sES, which was obtained by combining the sES when equivalence was observed between the cohort and case-control groups, also showed equivalence. CONCLUSIONS: The results of this study suggest that it is more reasonable to control for quality level by performing subgroup analysis according to study design rather than by using HQ based on the NOS quality assessment tool.

Emotion, Engagement, and Case Studies

Science.gov (United States)

Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

2014-01-01

Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

Using Correspondence Analysis in Multiple Case Studies

NARCIS (Netherlands)

Kienstra, Natascha; van der Heijden, Peter G.M.

2015-01-01

In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

Using correspondence analysis in multiple case studies

NARCIS (Netherlands)

Kienstra, N.H.H.; van der Heijden, P.G.M.

2015-01-01

In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

Radial dependence of foreshock cavities: a case study

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D. G. Sibeck

2004-12-01

Full Text Available We present a case study of Geotail, Interball-1, IMP-8, and Wind observations of density and magnetic field strength cavities excavated by the enhanced pressures associated with bursts of energetic ions in the foreshock. Consistent with theoretical predictions, the pressure of the energetic ions diminishes rapidly with upstream distance due to a decrease in the flux of energetic ions and a transition from near-isotropic to streaming pitch angle distributions. Consequently, the cavities can only be observed immediately upstream from the bow shock. A comparison of conditions upstream from the pre- and post-noon bow shock demonstrates that foreshock cavities introduce perturbations into the oncoming solar wind flow with dimensions smaller than those of the magnetosphere. Dayside geosynchronous magnetic field strength variations observed by GOES-8 do not track the density variations seen by any of the spacecraft upstream from the bow shock in a one-to-one manner, indicating that none of these spacecraft observed the precise sequence of density variations that actually struck the subsolar magnetopause. Key words. Interplanetary physics (energetic particles; planetary bow shocks – Magnetospheric physics (solar wind-magnetosphere interactions

Radial dependence of foreshock cavities: a case study

Directory of Open Access Journals (Sweden)

D. G. Sibeck

2004-12-01

Full Text Available We present a case study of Geotail, Interball-1, IMP-8, and Wind observations of density and magnetic field strength cavities excavated by the enhanced pressures associated with bursts of energetic ions in the foreshock. Consistent with theoretical predictions, the pressure of the energetic ions diminishes rapidly with upstream distance due to a decrease in the flux of energetic ions and a transition from near-isotropic to streaming pitch angle distributions. Consequently, the cavities can only be observed immediately upstream from the bow shock. A comparison of conditions upstream from the pre- and post-noon bow shock demonstrates that foreshock cavities introduce perturbations into the oncoming solar wind flow with dimensions smaller than those of the magnetosphere. Dayside geosynchronous magnetic field strength variations observed by GOES-8 do not track the density variations seen by any of the spacecraft upstream from the bow shock in a one-to-one manner, indicating that none of these spacecraft observed the precise sequence of density variations that actually struck the subsolar magnetopause.

Key words. Interplanetary physics (energetic particles; planetary bow shocks – Magnetospheric physics (solar wind-magnetosphere interactions

Teaching Business French through Case Studies: Presentation of a Marketing Case.

Science.gov (United States)

Federico, Salvatore; Moore, Catherine

The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

Case Study: Puttin' on the Ritz: How to Put Science into Cases

Science.gov (United States)

Herreid, Clyde Freeman

2017-01-01

There are multiple ways to put science into a case. This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses different ways of presenting science in case studies.

Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

Science.gov (United States)

Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

2017-01-01

Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

Atlanta NAVIGATOR case study. Final report, May 1996--Jun 1997

Energy Technology Data Exchange (ETDEWEB)

Amodei, R.; Bard, E.; Brong, B.; Cahoon, F.; Jasper, K.

1998-11-01

The Atlanta metropolitan region was the location of one of the most ambitious Intelligent Transportation Systems (ITS) deployments in the United States. This deployment included several individual projects--a Central Transportation Management Center (TMC), six Traffic Control Centers (TCC), one Transit Information Center (TIC), the Travel Information Showcase (TIS), and the extension of the Metropolitan Atlanta Rapid Transit Authority (MARTA) rail network and the new high-occupancy vehicle (HOV) lanes on I-85 and I-75. The Atlanta Centennial Olympic Games and Paralympic Games created a focus for these projects. All of these systems were to be brought on line in time for the Olympic Games. This report presents the findings of the NAVIGATOR Case Study and documents the lessons learned from the Atlanta ITS deployment experience in order to improve other ITS deployments in the future. The Case Study focuses on the institutional, programmatic, and technical issues and opportunities from planning and implementing the ITS deployment in Atlanta. The Case Study collected data and information from interviews, observations, focus groups, and documentation reviews. It presents a series of lessons learned and recommendations for enabling successful ITS deployments nationwide.

Sport tourism event impacts on the host community – a case study of ...

African Journals Online (AJOL)

South African Journal for Research in Sport, Physical Education and ... Sport tourism event impacts on the host community – a case study of Red Bull Big Wave Africa ... and direct observations were carried out as methods of obtaining data.

Service platforms management strategy: case study of an interior design firm

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Leonel Del Rey de Melo Filho

2015-03-01

Full Text Available Platform management is a strategic tool for firms of various sizes, although it demands studies in the service sector. The aim of this paper is to investigate a use of platform management, designed to reach flexibility and operational dynamics in service projects. The studied platform is evaluated as a strategic resource in a particular case. The contributions of the service platform were explored from Resource-Based View (RBV and Service Marketing (SM perspectives, to study their effects on firms’ performance. The research strategy used was an exploratory case study in an interior design firm. The data collection techniques included a participant observation, document analysis and a focus group with firm managers. The research demonstrated that platform management is a strategic resource that assists with the planning of internal capabilities, market positioning, and provides better customer service.

[Child abuse in Tlaxcala: a case-control study].

Science.gov (United States)

Herrada-Huidobro, A; Nazar-Beutelspacher, A; Cassaball-Núñez, M; Vega-Ramos, R; Nava-Cruz, C B

1992-01-01

A longitudinal, retrospective and descriptive study about child abuse was carried out in the Hospitals of the Tlaxcala Secretariat of Health, Mexico. The information was obtained from hospitalized children's charts between January first and November 30, 1991. The charts included were those belonging to zero to 14 year old children with injuries, poisoning, and II-III degrees of malnutrition. Four child-abuse criteria were established: physical, sexual, non organic malnutrition and mixed (physical and non organic malnutrition). Two control groups were defined. Different patterns were observed between accidental and non accidental injuries, malnutrition and poisoning among the case and the control groups. The study provides useful information for the integral diagnosis of child abuse in hospitalized children.

CLINICAL OBSERVATION ON TREATMENT OF 61 CASES OF INSOMNIA WITH AURICULAR PLASTER THERAPY

Institute of Scientific and Technical Information of China (English)

张家彤; 王月

2003-01-01

Objective: To observe the therapeutic effect of auricular plaster (otopoint-pressure) therapy in thetreatment of insomnia. Methods: In this paper, 61 cases of insomnia patients including 16 males and 45 females weretreated with Ershenmen (MA-TF 1), Zhen (MA-AT), Yuanzhong (MA-AT), Nao Dian and E (MA-AT), combined withother otopoints according to symptoms. The otopoint was stuck with a piece of plaster adhered with vaccaria seeds andpressured by the patient him- or her-self. The treatment was given twice a week, with 7 times being a therapeuticcourse. Results: After 1 - 2 courses of treatment, 19 (31.15%) cases were cured, 34 (55.74 % ) had improvementand 8 (13.11%) had no changes, with the total effective rate being 86.9%. Conclusion: Auricular plaster therapyworks well in the treatment of insomnia patient.

Clinico-MRI study of hemispheric disorder in long-term follow-up cases of multiple system atrophy

International Nuclear Information System (INIS)

Konagaya, Masaaki; Miwa, Shigeru; Matsuoka, Yukihiko; Konagaya, Yoko

1998-01-01

Twelve cases of multiple system atrophy (MSA) were studied for clinical and MRI findings of the cerebral hemispheric involvement. The subjects consisted of five olivopontocerebellar atrophy (OPCA) type and seven striatonigral degeneration (SND) type. The age at onset was 56.7±8.0 (M±SD) years, duration of illness at the first MRI study 3.2±1.1 years, duration of illness at the last study 8.1±2.2 years, and the following up duration 4.9±2.0 years. The grasping phenomenon was observed in 70% of the cases examined, snout reflex in 80%, slowness of verbal response in 88%, and decrease of spontaneous speech in 100%. Three cases finally fell into the state of mutism. Three out of ten cases were categorized as dementia by HDS-R (Hasegawa Dementia Scale-Revised) test. Besides the progression of the pontocerebellar atrophy and putaminal changes, MRI study revealed progressive frontal lobe atrophy in most cases. At six years after the onset, SND type showed significantly higher incidence of conspicuous frontal lobe atrophy and dilatation of the Sylvian fissure than OPCA type. Cerebral ventricular dilatation was common feature, and atrophy of the temporal and occipital lobes were observed in several cases. We indicated the possible involvement of the cerebral hemisphere, especially the frontal lobe, and higher nervous function in MSA. (author)

Clinico-MRI study of hemispheric disorder in long-term follow-up cases of multiple system atrophy

Energy Technology Data Exchange (ETDEWEB)

Konagaya, Masaaki; Miwa, Shigeru; Matsuoka, Yukihiko [Suzuka National Hospital, Mie (Japan); Konagaya, Yoko

1998-12-01

Twelve cases of multiple system atrophy (MSA) were studied for clinical and MRI findings of the cerebral hemispheric involvement. The subjects consisted of five olivopontocerebellar atrophy (OPCA) type and seven striatonigral degeneration (SND) type. The age at onset was 56.7{+-}8.0 (M{+-}SD) years, duration of illness at the first MRI study 3.2{+-}1.1 years, duration of illness at the last study 8.1{+-}2.2 years, and the following up duration 4.9{+-}2.0 years. The grasping phenomenon was observed in 70% of the cases examined, snout reflex in 80%, slowness of verbal response in 88%, and decrease of spontaneous speech in 100%. Three cases finally fell into the state of mutism. Three out of ten cases were categorized as dementia by HDS-R (Hasegawa Dementia Scale-Revised) test. Besides the progression of the pontocerebellar atrophy and putaminal changes, MRI study revealed progressive frontal lobe atrophy in most cases. At six years after the onset, SND type showed significantly higher incidence of conspicuous frontal lobe atrophy and dilatation of the Sylvian fissure than OPCA type. Cerebral ventricular dilatation was common feature, and atrophy of the temporal and occipital lobes were observed in several cases. We indicated the possible involvement of the cerebral hemisphere, especially the frontal lobe, and higher nervous function in MSA. (author)

Evaluation of Oral Performance in Outsourced Call Centres: An Exploratory Case Study

Science.gov (United States)

Friginal, Eric

2013-01-01

This case study discusses the development and use of an oral performance assessment instrument intended to evaluate Filipino agents' customer service transactions with callers from the United States (US). The design and applications of the instrument were based on a longitudinal, qualitative observation of language training and customer service…

HYDROGEOLOGIC CASE STUDIES

Science.gov (United States)

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

IS supported service work: a case study of global certification

OpenAIRE

Berntsen, Kirsti Elisabeth

2011-01-01

The thesis approaches the issue of IS support for service work, understood as distributed knowledge work taking place as a negotiation between diverse interests. It is based on an ethnographically inspired, longitudinal case study of certification auditing according to a formal generic standard. A handful of certification auditors are followed closely, periodically and comprehensively over three years. Observations are combined with interviews of subjects and colleagues, added by exploration ...

Self-socialization: a case study of a parachute child.

Science.gov (United States)

Newman, Philip R; Newman, Barbara M

2009-01-01

The theoretical concept of self-socialization suggests that an individual is able to reflect on the self, formulate a vision of a future self, set goals, and take actions that create or alter the developmental trajectory. This case study of a parachute child illustrates how a person constructs her life from a very young age, drawing on a profound capacity for personal agency to overcome obstacles, identify resources, and internalize values to build a life structure. A model of the psychosocial process of self-socialization emerges from this case. Following the disruption of a well-defined trajectory, self-socialization is observed as a sequence of actions, reflection, correction, and new actions. Self-socialization is possible when a strong sense of self-efficacy is applied to attaining internalized values and goals.

Training Diaries during Altitude Training Camp in Two Olympic Champions: An Observational Case Study

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Lorenzo Pugliese, Fabio R. Serpiello, Grégoire P. Millet, Antonio La Torre

2014-09-01

Full Text Available Traditionally, Live High-Train High (LHTH interventions were adopted when athletes trained and lived at altitude to try maximising the benefits offered by hypoxic exposure and improving sea level performance. Nevertheless, scientific research has proposed that the possible benefits of hypoxia would be offset by the inability to maintain high training intensity at altitude. However, elite athletes have been rarely recruited as an experimental sample, and training intensity has almost never been monitored during altitude research. This case study is an attempt to provide a practical example of successful LHTH interventions in two Olympic gold medal athletes. Training diaries were collected and total training volumes, volumes at different intensities, and sea level performance recorded before, during and after a 3-week LHTH camp. Both athletes successfully completed the LHTH camp (2090 m maintaining similar absolute training intensity and training volume at high-intensity (> 91% of race pace compared to sea level. After the LHTH intervention both athletes obtained enhancements in performance and they won an Olympic gold medal. In our opinion, LHTH interventions can be used as a simple, yet effective, method to maintain absolute, and improve relative training intensity in elite endurance athletes.

A case study on successful ayurvedic management of a rare case of reiter's syndrome

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Vaishali Kuchewar

2017-01-01

Full Text Available Reiter's syndrome is a clinical syndrome of arthritis, urethritis, conjunctivitis, and mucocutaneous lesions. Skin and mucosal involvement is observed in about 10% of the cases. A 34-year-old male was brought in severe condition. He had red colored foul smelling maculopapular skin lesions all over body, swollen and painful knee and shoulder joints. History revealed that he was suffering from Reiter's syndrome since 2003. He used to get admitted between the months of February and May every year due to aggravation of symptoms. Every time he was treated with systemic antibiotics, corticosteroids, immunosuppressants and non-steroidal anti-inflammatory drugs. He was successfully treated with external application and internal medication with tikta (bitter and kaṣāya (astringent drugs. He got significant relief in skin lesions as well as joint pain and his quality of life was markedly improved. This case study demonstrates that Reiter's syndrome can be well managed with Ayurvedic medicines.

Association between bullous pemphigoid and neurologic diseases: a case-control study.

Science.gov (United States)

Casas-de-la-Asunción, E; Ruano-Ruiz, J; Rodríguez-Martín, A M; Vélez García-Nieto, A; Moreno-Giménez, J C

2014-11-01

In the past 10 years, bullous pemphigoid has been associated with other comorbidities and neurologic and psychiatric conditions in particular. Case series, small case-control studies, and large population-based studies in different Asian populations, mainland Europe, and the United Kingdom have confirmed this association. However, no data are available for the Spanish population. This was an observational, retrospective, case-control study with 1:2 matching. Fifty-four patients with bullous pemphigoid were selected. We compared the percentage of patients in each group with concurrent neurologic conditions, ischemic heart disease, diabetes, chronic obstructive pulmonary disease, and solid tumors using univariate logistic regression. An association model was constructed with conditional multiple logistic regression. The case group had a significantly higher percentage of patients with cerebrovascular accident and/or transient ischemic attack (odds ratio [OR], 3.06; 95% CI, 1.19-7.87], dementia (OR, 5.52; 95% CI, 2.19-13.93), and Parkinson disease (OR, 5; 95% CI, 1.57-15.94). A significantly higher percentage of cases had neurologic conditions (OR, 6.34; 95% CI, 2.89-13.91). Dementia and Parkinson disease were independently associated with bullous pemphigoid in the multivariate analysis. Patients with bullous pemphigoid have a higher frequency of neurologic conditions. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

Periodontal disease and risk of chronic obstructive pulmonary disease: a meta-analysis of observational studies.

Directory of Open Access Journals (Sweden)

Xian-Tao Zeng

Full Text Available BACKGROUND: Many epidemiological studies have found a positive association between periodontal disease (PD and risk of chronic obstructive pulmonary disease (COPD, but this association is varied and even contradictory among studies. We performed a meta-analysis to ascertain the relationship between PD and COPD. METHODS: PubMed and Embase database were searched up to January 10, 2012, for relevant observational studies on the association between PD and risk of COPD. Data from the studies selected were extracted and analyzed independently by two authors. The meta-analysis was performed using the Comprehensive Meta-Analysis software. RESULTS: Fourteen observational studies (one nested case-control, eight case-control, and five cross-sectional involving 3,988 COPD patients were yielded. Based on random-effects meta-analysis, a significant association between PD and COPD was identified (odds ratio = 2.08, 95% confidence interval = 1.48-2.91; P<0.001, with sensitivity analysis showing that the result was robust. Subgroups analyses according to study design, ethnicity, assessment of PD/COPD, and adjusted/unadjusted odds ratios also revealed a significant association. Publication bias was detected. CONCLUSIONS: Based on current evidence, PD is a significant and independent risk factor of COPD. However, whether a causal relationships exists remains unclear. Morever, we suggest performing randomized controlled trails to explore whether periodontal interventions are beneficial in regulating COPD pathogenesis and progression.

The Clinical Observation on one case of Patient with Progressive Muscular Dystrophies

Directory of Open Access Journals (Sweden)

Yoo, Chang-Kil

2000-12-01

Full Text Available After observing a patient diagnosed with Progressive Muscular Dystropies from the August, 31, 2000 to the January, 2001, the following results are obtained. Method and Result: Under our assumption that the Korean Bee Venom Therapy is a good method to treat Progress Muscular Dystropies. Korean Bee Venom Therapy was applied on the following acupuncture points: BL23(Shinsu:腎兪, BL26(Guanyuanshu:關元兪, ST36(Chok-Samni:足三里, LI4(Hapkok:合谷, LV3(Taechung:太, SP10(Hyolhae:血海, SI9(Sojang-Kyonjong:貞. In addition CFC(Carthami Flos;紅花: and Cervi Pantotrichum Cornu; Herbal-Acupuncture is also treated on the other acupuncture points. For herbal medication was given to the patient based on the Sasang Constitution, Taeyangin Ogapijangchuk-tang. Following these treatments in this case of Progressive Muscular Dystropies, the skeletal muscle functions made remarkable improvement. Conclusion: Based on the clinical results, traditional Korean Medical treatment is believed to be effective for treating Progressive Muscular Dystropies, and further studies should be conducted to provide more valuable information.

Objectivist case study research

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner; Fachner, Jörg

2016-01-01

be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive......In order to comprehend the impact of music therapy or music therapy processes, a researcher might look for an approach where the topic under investigation can be understood within a broader context. This calls for a rich inclusion of data and consequently a limited number of participants and may...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

Catalog of NASA-Related Case Studies

Data.gov (United States)

National Aeronautics and Space Administration — The OCKO has developed over 50 case studies to enhance learning at workshops, training, retreats and conferences. Case studies make mission knowledge attractive and...

Paradox of Student Gender: A Case Study of Economic Education from China

Science.gov (United States)

Zhang, Jian; Qiao, Fangbin; Li, Binbin

2016-01-01

In many Chinese universities and colleges, female students outperform male students in social science subjects. This paper presents a case study, which examines gender difference in economic education in a Chinese university. We look at a sample of students from the Chinese university and find that holding constant observed student…

ARCADO - Adding random case analysis to direct observation in workplace-based formative assessment of general practice registrars.

Science.gov (United States)

Ingham, Gerard; Fry, Jennifer; Morgan, Simon; Ward, Bernadette

2015-12-10

Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. Assessment reliability is improved by using multiple assessment methods. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments. A sample of general practice medical educators and matched registrars were recruited. Following the ARCADO workplace assessment, semi-structured qualitative interviews were conducted. The data was analysed thematically. Ten registrars and eight medical educators participated. Four major themes emerged - formative versus summative assessment; strengths (acceptability, flexibility, time efficiency, complementarity and authenticity); weaknesses (reduced observation and integrity risks); and contextual factors (variation in assessment content, assessment timing, registrar-medical educator relationship, medical educator's approach and registrar ability). ARCADO is a well-accepted workplace-based formative assessment perceived by registrars and assessors to be valid and flexible. The use of ARCADO enabled complementary insights that would not have been achieved with direct observation alone. Whilst there are some contextual factors to be considered in its implementation, ARCADO appears to have utility as formative assessment and, subject to further evaluation, high-stakes assessment.

No Need to Wait for Superman: A Case Study of One Unique High School

Science.gov (United States)

Ratcliff, N. J.; Jones, C. R.; Costner, R. H.; Knight, C.; Disney, G.; Savage-Davis, E.; Sheehan, H.; Hunt, G. H.

2012-01-01

Based on a theoretical model developed by Schlechty, this case study focuses on a small high school, located on a college campus and designed to address the educational needs of gifted 9th- through 12th-grade students. Eight teachers who taught 9th- and 12th-grade classes and their 60 students were observed. Each teacher was observed during six…

Organizing pneumonia and occupational and environmental risk factors: a case-control study.

Science.gov (United States)

Jobard, Stéphanie; Chaigne, Benjamin; Marchand-Adam, Sylvain; Lasfargues, Gérard; Diot, Elisabeth

2017-11-01

A single-center case-control study was carried out to investigate the relationship between occupational and environmental exposure and organizing pneumonia (OP). Thirty-seven cases of OP, including 25 cases of cryptogenic OP, and 111 controls were included. Occupational exposure was assessed retrospectively by an industrial hygienist and an occupational physician, through semi-quantitative estimates of exposure. An exposure score was calculated for each subject, based on probability, intensity, daily frequency, and duration of exposure for each period of employment. The final cumulative exposure score was obtained by summing exposure scores for all periods of employment. Significant associations with all-cause OP were observed for exposure to tetrachloroethylene (OR 13.33, CI 95% 1.44-123.5) and silica (OR 6.61, CI 95% 1.16-37.71). A significant association with cryptogenic OP was observed only for tetrachloroethylene (OR 31.6, CI 95% 1.64-610.8). No associations were found for environmental exposure. Despite its low statistical power, this work suggests that occupational risk factors could be involved in OP.

Case Study: Let's Get Personal--Putting Personality into Your Cases

Science.gov (United States)

Herreid, Clyde Freeman

2017-01-01

In this case study, the subject for discussion is the need to use teaching notes in order to add personality to case studies. Personality, it is said, is more important than policy, than demographics, than finances, or amorous peccadillos. Personality is essential. It is the interaction of people that capture our interest, yet, the question is…

Case Study of 'moral injury' : Format Dutch Case Studies Project

NARCIS (Netherlands)

Korver, Sjaak; Walton, Martin N.; van Loenen, Guus

2017-01-01

The case study ‘Moral Injury’ traces care provided by a chaplain in a mental health institution to a former military marksman named Hans. Hans was in care at a specialized unit for military veterans with traumas. He sought contact with a chaplain “to set things right with God” and wanted the

Study of four cases of radiation colitis needed operation therapy

International Nuclear Information System (INIS)

Sasaki, Shigeru; Takesue, Yoshio; Yokoyama, Takashi

1996-01-01

On the 4 cases of operation for the late radiation effect, the process and notes for radiation colitis were described. Case 1; a female of 57 y with cervical carcinoma (IIIb) received 59.8 Gy of external irradiation and 24.0 Gy of intracervical irradiation. About 8 months after the radiotherapy, anemia due to gut bleeding was observed and hemorrhage was seen in the colon with the colon fiber. One year later, colostomy was performed. Case 2; a female of 79 y with cervical carcinoma (IIb) received 50.0 Gy of external irradiation and 18.0 Gy of intracervical irradiation. About 8 months after the therapy, gut bleeding and ileac symptom were observed and ulcer and stenosis in the sigmoid colon were seen. Sigmoidectomy was performed. Case 3; a female of 75 y with cervical carcinoma (IIIb) received external 49.8 Gy irradiation and intracervical 23.0 Gy irradiation. About 4 months after the therapy, anemia and ulcer with hemorrhage in the sigmoidal colon were recognized. Sigmoidectomy and colostomy were performed. Case 4; a female of 68 y with cervical carcinoma (IIb) and chronic renal failure received 50.4 Gy of external irradiation post hysterectomy. About 5 months later, iliac symptom was observed. She received ileectomy and then colostomy but died of MOF due to renal failure. (K.H.)

Study of four cases of radiation colitis needed operation therapy

Energy Technology Data Exchange (ETDEWEB)

Sasaki, Shigeru; Takesue, Yoshio; Yokoyama, Takashi [Hiroshima Univ. (Japan). School of Medicine] [and others

1996-09-01

On the 4 cases of operation for the late radiation effect, the process and notes for radiation colitis were described. Case 1; a female of 57 y with cervical carcinoma (IIIb) received 59.8 Gy of external irradiation and 24.0 Gy of intracervical irradiation. About 8 months after the radiotherapy, anemia due to gut bleeding was observed and hemorrhage was seen in the colon with the colon fiber. One year later, colostomy was performed. Case 2; a female of 79 y with cervical carcinoma (IIb) received 50.0 Gy of external irradiation and 18.0 Gy of intracervical irradiation. About 8 months after the therapy, gut bleeding and ileac symptom were observed and ulcer and stenosis in the sigmoid colon were seen. Sigmoidectomy was performed. Case 3; a female of 75 y with cervical carcinoma (IIIb) received external 49.8 Gy irradiation and intracervical 23.0 Gy irradiation. About 4 months after the therapy, anemia and ulcer with hemorrhage in the sigmoidal colon were recognized. Sigmoidectomy and colostomy were performed. Case 4; a female of 68 y with cervical carcinoma (IIb) and chronic renal failure received 50.4 Gy of external irradiation post hysterectomy. About 5 months later, iliac symptom was observed. She received ileectomy and then colostomy but died of MOF due to renal failure. (K.H.)

Serum Taurine and Stroke Risk in Women: A Prospective, Nested Case-Control Study

Science.gov (United States)

Wu, Fen; Koenig, Karen L.; Zeleniuch-Jacquotte, Anne; Jonas, Saran; Afanasyeva, Yelena; Wójcik, Oktawia P.; Costa, Max; Chen, Yu

2016-01-01

Background Taurine (2-aminoethanesulfonic acid), a conditionally essential sulfur-containing amino acid, is mainly obtained from diet in humans. Experimental studies have shown that taurine’s main biological actions include bile salt conjugation, blood pressure regulation, anti-oxidation, and anti-inflammation. Methods We conducted a prospective case-control study nested in the New York University Women’s Health Study, a cohort study involving 14,274 women enrolled since 1985. Taurine was measured in pre-diagnostic serum samples of 241 stroke cases and 479 matched controls. Results There was no statistically significant association between serum taurine and stroke risk in the overall study population. The adjusted ORs for stroke were 1.0 (reference), 0.87 (95% CI, 0.59–1.28), and 1.03 (95% CI, 0.69–1.54) in increasing tertiles of taurine (64.3–126.6, 126.7–152.9, and 153.0–308.5 nmol/mL, respectively). A significant inverse association between serum taurine and stroke risk was observed among never smokers, with an adjusted OR of 0.66 (95% CI, 0.37–1.18) and 0.50 (95% CI, 0.26–0.94) for the second and third tertile, respectively (p for trend = 0.01), but not among past or current smokers (p for interaction taurine and stroke risk, although a protective effect was observed in never smokers, which requires further investigation. Taurine, Stroke, Epidemiology, Prospective, Case-control study, NYUWHS. PMID:26866594

Observational Case Series Evaluation of the Granisetron Transdermal Patch System (Sancuso) for the Management of Nausea/Vomiting of Pregnancy.

Science.gov (United States)

Le, Tran N; Adler, Michael T; Ouillette, Holly; Berens, Pamela; Smith, Judith A

2017-07-01

Objective  The objective of this study was to observe the efficacy of antiemetic therapy (no emesis/retching episodes and no rescue medication use) when granisetron is administered via a transdermal patch system (TDS) in women who are 6 to 14 weeks pregnant when compared with oral ondansetron by evaluating the frequency of the use of rescue medications for control of nausea/vomiting of pregnancy (NVP). Methods  This was an observational case series study to observe the potential benefits of granisetron TDS compared with oral ondansetron for management of NVP in pregnant patients during the first trimester. Dates of data collection were September 1, 2014, through December 31, 2015. There was no direct contact with patient. The oral ondansetron and granisetron TDS patients were matched by age, 4:1. The proportion of patients who received rescue antiemetics was calculated from those patients who continued to experience NVP. Risk factors for NVP were identified and compared between groups. Descriptive statistics were used to describe study results. Results  Patients were prescribed rescue antiemetics in 0/3 patients in the granisetron TDS group compared with 2/12 patients in the oral ondansetron group. Conclusion  Prospective efficacy studies on the use of granisetron TDS for management of NVP are needed to confirm this clinical observation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Study on individual stochastic model of GNSS observations for precise kinematic applications

Science.gov (United States)

Próchniewicz, Dominik; Szpunar, Ryszard

2015-04-01

The proper definition of mathematical positioning model, which is defined by functional and stochastic models, is a prerequisite to obtain the optimal estimation of unknown parameters. Especially important in this definition is realistic modelling of stochastic properties of observations, which are more receiver-dependent and time-varying than deterministic relationships. This is particularly true with respect to precise kinematic applications which are characterized by weakening model strength. In this case, incorrect or simplified definition of stochastic model causes that the performance of ambiguity resolution and accuracy of position estimation can be limited. In this study we investigate the methods of describing the measurement noise of GNSS observations and its impact to derive precise kinematic positioning model. In particular stochastic modelling of individual components of the variance-covariance matrix of observation noise performed using observations from a very short baseline and laboratory GNSS signal generator, is analyzed. Experimental test results indicate that the utilizing the individual stochastic model of observations including elevation dependency and cross-correlation instead of assumption that raw measurements are independent with the same variance improves the performance of ambiguity resolution as well as rover positioning accuracy. This shows that the proposed stochastic assessment method could be a important part in complex calibration procedure of GNSS equipment.

Periodontal disease and risk of preeclampsia: a meta-analysis of observational studies.

Directory of Open Access Journals (Sweden)

Ben-Juan Wei

Full Text Available BACKGROUND: Many epidemiological studies have found a positive association between periodontal disease (PD and the risk of preeclampsia, but the magnitude of this association varies and independent studies have reported conflicting findings. We performed a meta-analysis to ascertain the relationship between PD and preeclampsia. METHODS: The PubMed database was searched up to January 12, 2013, for relevant observational studies on an association between PD and the risk of preeclampsia. Data were extracted and analyzed independently by two authors. The meta-analysis was performed using comprehensive meta-analysis software. RESULTS: Thirteen observational case-control studies and two cohort studies, involving 1089 preeclampsia patients, were identified. Based on a random-effects meta-analysis, a significant association between PD and preeclampsia was identified (odds ratio = 2.79, 95% confidence interval CI, 2.01-3.01, P<0.0001. CONCLUSIONS: Although the causality remains unclear, the association between PD and preeclampsia may reflect the induction of PD by the preeclamptic state, or it may be part of an overall exaggerated inflammatory response to pregnancy. Larger randomized controlled trials with preeclampsia as the primary outcome and pathophysiological studies are required to explore causality and to dissect the biological mechanisms involved.

Schematic representation of case study research designs.

Science.gov (United States)

Rosenberg, John P; Yates, Patsy M

2007-11-01

The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods.

Echolalia versus Inclusion: A Case Study of a Child Who Is Blind.

Science.gov (United States)

Zoniou-Sideri, Athina; Karayianni, Panagiota

2000-01-01

A case study of a Greek child (age 5) with visual impairment and echolalia is presented to illustrate the symptoms of echolalia in inclusive settings, the forms that echolalia can take, and how echolalia is differentiated from the kinds of speech repetitions observed in conditions of normal language acquisition. (Contains references.) (CR)

Remote Sensing based multi-temporal observation of North Korea mining activities : A case study of Rakyeon mine

Science.gov (United States)

Lim, J. H.; Yu, J.; Koh, S. M.; Lee, G.

2017-12-01

Mining is a major industrial business of North Korea accounting for significant portion of an export for North Korean economy. However, due to its veiled political system, details of mining activities of North Korea is rarely known. This study investigated mining activities of Rakyeon Au-Ag mine, North Korea based on remote sensing based multi-temporal observation. To monitor the mining activities, CORONA data acquired in 1960s and 1970s, SPOT and Landsat data acquired in 1980s and 1990s and KOMPSAT-2 data acquired in 2010s are utilized. The results show that mining activities of Rakyeon mine continuously carried out for the observation period expanding tailing areas of the mine. However, its expanding rate varies between the period related to North Korea's economic and political situations.

Questionnaire-based assessment of executive functioning: Case studies.

Science.gov (United States)

Kronenberger, William G; Castellanos, Irina; Pisoni, David B

2018-01-01

Delays in the development of executive functioning skills are frequently observed in pediatric neuropsychology populations and can have a broad and significant impact on quality of life. As a result, assessment of executive functioning is often relevant for the development of formulations and recommendations in pediatric neuropsychology clinical work. Questionnaire-based measures of executive functioning behaviors in everyday life have unique advantages and complement traditional neuropsychological measures of executive functioning. Two case studies of children with spina bifida are presented to illustrate the clinical use of a new questionnaire measure of executive and learning-related functioning, the Learning, Executive, and Attention Functioning Scale (LEAF). The LEAF emphasizes clinical utility in assessment by incorporating four characteristics: brevity in administration, breadth of additional relevant content, efficiency of scoring and interpretation, and ease of availability for use. LEAF results were consistent with another executive functioning checklist in documenting everyday behavior problems related to working memory, planning, and organization while offering additional breadth of assessment of domains such as attention, processing speed, and novel problem-solving. These case study results demonstrate the clinical utility of questionnaire-based measurement of executive functioning in pediatric neuropsychology and provide a new measure for accomplishing this goal.

Peace Corps Water/Sanitation Case Studies and Analyses. Appropriate Technologies for Development. Case Study CS-4.

Science.gov (United States)

Talbert, Diana E., Comp.

This document provides an overview of Peace Corps water and sanitation activities, five case studies (Thailand, Yemen, Paraguay, Sierra Leone, and Togo), programming guidelines, and training information. Each case study includes: (1) background information on the country's geography, population, and economics; (2) information on the country's…

Explaining the Evolution of Performance Measures - A Dual Case-Study Approach

Directory of Open Access Journals (Sweden)

Mohammed Salloum

2013-07-01

Full Text Available Few empirical studies have examined how performance measures change in practice and the driving forces behind this change. The existing body of literature has taken a prescriptive approach to how managers and organisations ought to manage change in performance measures without any concern for studying the phenomenon itself and thus a theoretical gap exists. With this gap in mind, the purpose of this paper is to outline how and why the performance measures have changed at two case companies over the time period 2008-2011. In order to fulfil the purpose of this paper two case studies at two different case companies have been conducted. The choice of data collection method is justified by the ambition to attain an in-depth and holistic understanding of the phenomenon. For each case, the data collection was based on four components: an interview study, analysis of archived data, documentation and direct observations. In total, 28 interviews were conducted, 14 at each case company. The empirical findings exhibit that the performance measures are exposed to continuous and considerable change from several perspectives. The measurement scopes at both case companies are steadily expanding, the individual performance measures are constantly replaced and their characteristics are continuously altered. An array of change triggers has been identified in the empirical findings. In contrast to what is advocated in literature, the findings illustrate that the most frequent reason for change is the will to improve the performance measures, the measurement process and the overall performance rather than changing internal and external environments. There are several challenges that need to be addressed in the future research agenda.

Reducing selection bias in case-control studies from rare disease registries.

Science.gov (United States)

Cole, J Alexander; Taylor, John S; Hangartner, Thomas N; Weinreb, Neal J; Mistry, Pramod K; Khan, Aneal

2011-09-12

In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry were used as an example. A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN) and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals) were calculated for each variable before and after matching. The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN) and controls (i.e., patients without AVN) who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age), treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

Five case studies of multifamily weatherization programs

Energy Technology Data Exchange (ETDEWEB)

Kinney, L; Wilson, T.; Lewis, G. [Synertech Systems Corp. (United States); MacDonald, M. [Oak Ridge National Lab., TN (United States)

1997-12-31

The multifamily case studies that are the subject of this report were conducted to provide a better understanding of the approach taken by program operators in weatherizing large buildings. Because of significant variations in building construction and energy systems across the country, five states were selected based on their high level of multifamily weatherization. This report summarizes findings from case studies conducted by multifamily weatherization operations in five cities. The case studies were conducted between January and November 1994. Each of the case studies involved extensive interviews with the staff of weatherization subgrantees conducting multifamily weatherization, the inspection of 4 to 12 buildings weatherized between 1991 and 1993, and the analysis of savings and costs. The case studies focused on innovative techniques which appear to work well.

Effectiveness of Using Online Discussion Forum for Case Study Analysis

Directory of Open Access Journals (Sweden)

Ravi Seethamraju

2014-01-01

Full Text Available Business schools are exploring new pedagogical approaches to learning in order to deal with challenges such as increased class sizes, limited funding support, and difficulties in facilitating and encouraging active participation and learning among a diverse cohort of students. This paper reports on a study of the effectiveness of a pedagogical approach that blends online discussion board and case study. Analysing quantity and quality of online postings and comparing accounting students’ performance with previous cohort, this study observes a significant improvement in student learning. Appropriate design and delivery strategies and clear assessment criteria for assessment and use have provided an effective learning vehicle for students, helped them overcome their own language related barriers, and encouraged them to participate in a nonthreatening environment. This approach further complemented the benefits of peer-to-peer learning and case study pedagogy. Reported increase in workload for students and marking load for academics and measuring the value of learning, however, are some of the challenges that need further attention by researchers.

A Case Study to Evaluate Balance Training with Movement Test Items and through Teaching Observation: Beyond Specificity and Transfer of Learning

Science.gov (United States)

Kluwe, Margret; Miyahara, Motohide; Heveldt, Kate

2012-01-01

Background: Specificity and transfer of learning have been examined in experimental studies. However, their findings may not be relevant to practitioners because of the difference between the experiment conditions and teaching situations. This case study investigates the theoretical issue of specificity vs. transfer of learning by conducting…

[Pregnancy-Associated Breast Cancer: An analytical observational study].

Science.gov (United States)

Baulies, Sonia; Cusidó, Maite; Tresserra, Francisco; Rodríguez, Ignacio; Ubeda, Belén; Ara, Carmen; Fábregas, Rafael

2014-03-04

Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy and up to one year postpartum. A retrospective, analytical, observational study comparing 56 cases of breast cancer and pregnancy (PABC) diagnosed 1976-2008 with 73 patients with breast cancer not associated with pregnancy (non-PABC) was performed. Demographic data, prognostic factors, treatment and survival were reviewed and compared. The prevalence of PABC in our center is 8.3/10,000. The highest frequency (62%) appeared during the postpartum period. The stages are higher in PABC, being 31.3% advanced (EIII and EIV) in PABC versus 13.3% in non-PABC (P < .05). Regarding prognostic factors, 27.3% in PABC had a tumoral grade 3 versus 15.8% of non-PABC. Among women with PABC, 33.3% had negative estrogen receptors, 48.7% negative progesterone receptors and 34.5% positive Her2Neu compared with 22.2, 24.1 and 31%, respectively of non-PABC patients. Finally, positive lymph nodes were found in 52.8% of PABC, versus 33.8% non-PABC (P < .05). Overall and disease-free survival rate at 5 years for PABC was 63.7 and 74.2%, respectively. The poorer survival observed is possibly due to the presence of adverse prognostic features such as lymph node metastases, negative hormone receptors, tumoral grade iii, as well as a delay in diagnosis with a higher rate of advanced stages. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Summary of case studies for cooperation mechanisms

DEFF Research Database (Denmark)

Longa, Francesco Dalla; Klinge Jacobsen, Henrik; Hansen, Lise-Lotte Pade

2012-01-01

This document is a summary report highlighting the main aspect analyzed in the RES4LESS case studies. The document starts with an introductory chapter where the background that led to the selection of the case studies is outlined. In the following three chapters the case studies are presented, hi...

Implementing Product Platforms: A Case Study

DEFF Research Database (Denmark)

Nielsen, Ole Fiil; Mortensen, Niels Henrik

2006-01-01

The paper describes a case study dealing with the process of creating and implementing a product platform. The paper espessially deals with the fact that to obtain the benefits of platforms a permanent change in behaviour in product development must be ensured. This change in behaviour requires...... acceptance and approval from the organisation in general and the commitment from management to enforce agreed-upon decisions. The case study itself was performed in the Danish company LEGO Group. The case study had two objectives: To create a technical architecture and align this architecture...

MR imaging of alar ligament in whiplash-associated disorders: an observer study

Energy Technology Data Exchange (ETDEWEB)

Wilmink, J.T. [Dept. of Neuroradiology, University of Maastricht (Netherlands); Patijn, J. [Dept. of Anesthesiology, University Hospital Maastricht (Netherlands)

2001-10-01

Rotational CT studies have been previously used in whiplash-associated disorders (WAD) to document rotatory instability of the upper cervical spine thought to be due to alar ligamentous injury. More recently MR imaging has been employed to image such injury more directly. Our study aimed to assess the reliability and reproducibility of such MRI findings. In 12 WAD patients and six asymptomatic controls the alar ligaments were imaged in the coronal plane with an 0.5-T MRI system using a quadrature neck coil and applying a fast spin echo proton density/T2-weighted sequence P(TR/TE/ETL 2,500/18 ms/16, FOV 140 mm, matrix 200 x 256, 16 x 3 mm slices, scan time 25 min). Images were graded for symmetry of imaging plane using a 3-point scale and also for presence of ligamentous injury with a 4-point scale, by two independent observers on two separate occasions. The alar ligaments could be identified in all cases. Asymmetry of the imaging plane was found to some degree in over half of the cases. Such images were much more likely to be graded as indicating injury. Of a total of 72 assessments, clearly and probably normal grades were given in 75 %, and clearly or probably abnormal grades in 25 %. Kappa values for intra- and inter-observer agreement were moderate to very poor, however, and the grading system could not reliably distinguish between patients and controls. It was concluded that with MRI techniques presently employed, alar ligamentous damage as a causative factor in WAD has not been proven. (orig.)

MR imaging of alar ligament in whiplash-associated disorders: an observer study

International Nuclear Information System (INIS)

Wilmink, J.T.; Patijn, J.

2001-01-01

Rotational CT studies have been previously used in whiplash-associated disorders (WAD) to document rotatory instability of the upper cervical spine thought to be due to alar ligamentous injury. More recently MR imaging has been employed to image such injury more directly. Our study aimed to assess the reliability and reproducibility of such MRI findings. In 12 WAD patients and six asymptomatic controls the alar ligaments were imaged in the coronal plane with an 0.5-T MRI system using a quadrature neck coil and applying a fast spin echo proton density/T2-weighted sequence P(TR/TE/ETL 2,500/18 ms/16, FOV 140 mm, matrix 200 x 256, 16 x 3 mm slices, scan time 25 min). Images were graded for symmetry of imaging plane using a 3-point scale and also for presence of ligamentous injury with a 4-point scale, by two independent observers on two separate occasions. The alar ligaments could be identified in all cases. Asymmetry of the imaging plane was found to some degree in over half of the cases. Such images were much more likely to be graded as indicating injury. Of a total of 72 assessments, clearly and probably normal grades were given in 75 %, and clearly or probably abnormal grades in 25 %. Kappa values for intra- and inter-observer agreement were moderate to very poor, however, and the grading system could not reliably distinguish between patients and controls. It was concluded that with MRI techniques presently employed, alar ligamentous damage as a causative factor in WAD has not been proven. (orig.)

MR imaging of alar ligament in whiplash-associated disorders: an observer study.

Science.gov (United States)

Wilmink, J T; Patijn, J

2001-10-01

Rotational CT studies have been previously used in whiplash-associated disorders (WAD) to document rotatory instability of the upper cervical spine thought to be due to alar ligamentous injury. More recently MR imaging has been employed to image such injury more directly. Our study aimed to assess the reliability and reproducibility of such MRI findings. In 12 WAD patients and six asymptomatic controls the alar ligaments were imaged in the coronal plane with an 0.5-T MRI system using a quadrature neck coil and applying a fast spin echo proton density/T2-weighted sequence (TR/TE/ETL 2,500/18 ms/16, FOV 140 mm, matrix 200 x 256, 16 x 3 mm slices, scan time 25 min). Images were graded for symmetry of imaging plane using a 3-point scale and also for presence of ligamentous injury with a 4-point scale, by two independent observers on two separate occasions. The alar ligaments could be identified in all cases. Asymmetry of the imaging plane was found to some degree in over half of the cases. Such images were much more likely to be graded as indicating injury. Of a total of 72 assessments, clearly and probably normal grades were given in 75%, and clearly or probably abnormal grades in 25%. Kappa values for intra- and inter-observer agreement were moderate to very poor, however, and the grading system could not reliably distinguish between patients and controls. It was concluded that with MRI techniques presently employed, alar ligamentous damage as a causative factor in WAD has not been proven.

Uranium miner lung cancer. A study about two cases

International Nuclear Information System (INIS)

Madelrieux, J.-M.

1977-01-01

The problem of lung cancer in uranium miners is analyzed on the basis of the two cases observed. Epidemiological studies establish conclusively the existence of increased hazards in the case of early working conditions, which gave rise to large accumulated doses of irradiation. Unfortunately these studies have their limits, the most important being inadequacy of sampling, and doubts remain about the low exposure levels prevailing nowadays and which concerns the cases investigated. The absence of certainty over long-term effects of low exposure levels is leading to the development of research to establish the exact nature of the dose-effect relationship and the possible existence of a radiotoxicity threshold on the basis of which the protective measures from the CMA angle could be revised. Biological research has proved the responsibility of α radiation from active radon deposits as a source of lung cancer in uranium miners, but other contributing factors must not be neglected: tobacco for instance, which plays an important part, but also the presence of engine exhaust gases and non-specific lung aggressions connected with dampness and ventilation. The occupational risk examined concerns only 600 miners now working at the bottom of uranium mines in France, and since extraction began a dozen cancers have been detected including 10 in heavy smokers. 2 cases correspond to exposures of 300 WLM, 3 to values between 150 and 100WLM and the rest to very slight exposures, 10 to 50 WLM. Although these figures are not conclusive the fact that exposure in French mines averages 0.3 WL means that the results of the French epidemiological study can be awaited with some optimism [fr

Location of existing Case Studies on Open Education

OpenAIRE

Burke, Siobhan

2014-01-01

Members of the Open Education Special Interest Group have collected a selection of short case studies on Open Education. View all of the case studies at http://repository.alt.ac.uk/view/divisions/CaseStudies/ Location of existing Case Studies on Open Education: The following lists aims to capture and amalgamate the various different case study sources which have been created and developed within the UK around experiences of Open Educational Resources.

Structural abnormalities and persistent complaints after an ankle sprain are not associated: an observational case control study in primary care.

Science.gov (United States)

van Ochten, John M; Mos, Marinka C E; van Putte-Katier, Nienke; Oei, Edwin H G; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke

2014-09-01

Persistent complaints are very common after a lateral ankle sprain. To investigate possible associations between structural abnormalities on radiography and MRI, and persistent complaints after a lateral ankle sprain. Observational case control study on primary care patients in general practice. Patients were selected who had visited their GP with an ankle sprain 6-12 months before the study; all received a standardised questionnaire, underwent a physical examination, and radiography and MRI of the ankle. Patients with and without persistent complaints were compared regarding structural abnormalities found on radiography and MRI; analyses were adjusted for age, sex, and body mass index. Of the 206 included patients, 98 had persistent complaints and 108 did not. No significant differences were found in structural abnormalities between patients with and without persistent complaints. In both groups, however, many structural abnormalities were found on radiography in the talocrural joint (47.2% osteophytes and 45.1% osteoarthritis) and the talonavicular joint (36.5% sclerosis). On MRI, a high prevalence was found of bone oedema (33.8%) and osteophytes (39.5) in the talocrural joint; osteophytes (54.4%), sclerosis (47.2%), and osteoarthritis (55.4%, Kellgren and Lawrence grade >1) in the talonavicular joint, as well as ligament damage (16.4%) in the anterior talofibular ligament. The prevalence of structural abnormalities is high on radiography and MRI in patients presenting in general practice with a previous ankle sprain. There is no difference in structural abnormalities, however, between patients with and without persistent complaints. Using imaging only will not lead to diagnosis of the explicit reason for the persistent complaint. © British Journal of General Practice 2014.

Evaluation of Pediatric Forensic Cases in Emergency Department: A Retrospective Study

Directory of Open Access Journals (Sweden)

Tanzer Korkmaz

2014-12-01

Full Text Available Aim: Our aim was to evaluate the properties of pediatric forensic cases and to discuss the precautions in order to prevent the occurrence of these forensic events. Methods: The patient files and forensic reports of pediatric (age 0-18 years forensic cases, who were referred to the emergency department in our hospital between January 01, 2009 and December 31, 2011 were retrospectively investigated. Results: A total of 421 forensic pediatric cases with a median age of 9.9±5.5 years were included in the study. Off the cases, 61% (n=257 were male and 47.3% were in 5-14 age group. The type of the events were traffic accident (50.4%, fall (18.3%, stab injuries (10.9%, intoxication (5.9%, pounding (5.0% and other incidents (9.5%. There were nine cases of suicide attempt (all of them were above 14 years of age and four cases of physical abuse (three of them were under 15 years of age. After the observation period, 79.8% of the cases were discharged from the emergency department, whilst 20.2% of cases were hospitalized in one of the clinics. Conclusion: Because most of the cases were traffic accident, this situation show us that these injuries are preventable. Prevention and intervention strategies should be developed for providing a safe environment for children.

national Case study

African Journals Online (AJOL)

This national case study reports on the development of a national network, ... system under the new policy), tends to be limited by content on problems and ... 20 credit programme; and within two Post Graduate Certificate of Education contexts, ...... descriptive with an issues focus (empirical) towards awareness production to.

Writing case studies in information systems research

NARCIS (Netherlands)

van der Blonk, H.C.

Case study research can be reported in different ways. This paper explores the various ways in which researchers may choose to write down their case studies and then introduces a subsequent typology of writing case studies. The typology is based on a 2 x 2 matrix, resulting in four forms of writing

Friedreich's ataxia: clinical and molecular study of 25 Brazilian cases

Directory of Open Access Journals (Sweden)

Albano Lilian M. J.

2001-01-01

Full Text Available INTRODUCTION: Friedreich's ataxia is a neurodegenerative disorder whose clinical diagnostic criteria for typical cases basically include: a early age of onset (< 20 or 25 years, b autosomal recessive inheritance, c progressive ataxia of limbs and gait, and d absence of lower limb tendon reflexes. METHODS: We studied the frequency and the size of expanded GAA and their influence on neurologic findings, age at onset, and disease progression in 25 Brazilian patients with clinical diagnosis of Friedreich's ataxia - 19 typical and 6 atypical - using a long-range PCR test. RESULTS: Abnormalities in cerebellar signs, in electrocardiography, and pes cavus occurred more frequently in typical cases; however, plantar response and speech were more frequently normal in this group when the both typical and atypical cases were compared. Homozygous GAA expansion repeats were detected in 17 cases (68% - all typical cases. In 8 patients (32% (6 atypical and 2 typical, no expansion was observed, ruling out the diagnosis of Friedreich's ataxia. In cases with GAA expansions, foot deformity, cardiac abnormalities, and some neurologic findings occurred more frequently; however, abnormalities in cranial nerves and in tomographic findings were detected less frequently than in patients without GAA expansions. DISCUSSION: Molecular analysis was imperative for the diagnosis of Friedreich's ataxia, not only for typical cases but also for atypical ones. There was no genotype-phenotype correlation. Diagnosis based only on clinical findings is limited; however, it aids in better screening for suspected cases that should be tested. Evaluation for vitamin E deficiency is recommended, especially in cases without GAA expansion.

Ground-truth aerosol lidar observations: can the Klett solutions obtained from ground and space be equal for the same aerosol case?

International Nuclear Information System (INIS)

Ansmann, Albert

2006-01-01

Upcoming multiyear satellite lidar aerosol observations need strong support by a worldwide ground-truth lidar network. In this context the question arises as to whether the ground stations can deliver the same results as obtained from space when the Klett formalism is applied to elastic backscatter lidar data for the same aerosol case. This question is investigated based on simulations of observed cases of simple and complex aerosol layering. The results show that the differences between spaceborne and ground-based observations can be as large as20% for the backscatter and extinction coefficients and the optimum estimates of the column lidar ratios. In cases with complex aerosol layering, the application of the two-layer approach can lead to similar results (space, ground) and accurate products provided that horizontally homogeneous aerosol conditions are given

Clinical observed performance evaluation: a prospective study in final year students of surgery.

LENUS (Irish Health Repository)

Markey, G C

2010-06-24

We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series of assessments in a 25-week teaching programme. Over time, several clinicians from a pool of 16 surgical consultants and registrars evaluated each student by direct observation. A structured rating form was used for assessment data. Variance component analysis (VCA), internal consistency and inter-rater agreement were used to estimate reliability. The predictive and convergent validity of COPE in relation to summative OSCE, long case, and overall final examination was estimated. Median number of COPE assessments per student was 7. Generalisability of a mean score over 7 COPE assessments was 0.66, equal to that of an 8 x 7.5 min station final OSCE. Internal consistency was 0.88-0.97 and inter-rater agreement 0.82. Significant correlations were observed with OSCE performance (R = 0.55 disattenuated) and long case (R = 0.47 disattenuated). Convergent validity was 0.81 by VCA. Overall final examination performance was linearly related to mean COPE score with standard error 3.7%. COPE permitted efficient serial assessment of a large cohort of final year students in a real world setting. Its psychometric quality compared well with conventional assessments and with other direct observation instruments as reported in the literature. Effect on learning, and translation to clinical care, are directions for future research.

Distracted Biking: An Observational Study.

Science.gov (United States)

Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

2016-01-01

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

Case of pancreatolithiasis. CT observation of calculus formation

Energy Technology Data Exchange (ETDEWEB)

Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira (Fujita-Gakuen Univ., School of Medicine, Aichi (Japan))

1982-11-01

During 3-year follow-up of a case of pancreatolithiasis localized in the pancreatic head, CT showed sudden new appearance of calculi over an extensive area of the body and tail of the pancreas after acute exacerbation of chronic pancreatitis. This case and the etiology and mechanism of pancreatolithiasis were discussed on the basis of literature.

The Danish National Case Study Report

DEFF Research Database (Denmark)

Brodersen, Søsser; Jørgensen, Michael Søgaard

Three case studies from Danish science shops within the environmental field are analysed with respect to societal background, interaction between the involved actors and the societal impact of the co-operation. The report is one of the seven national case study reports from the EU...

Using Case Studies in Calculus-based Physics

Science.gov (United States)

Katz, Debora M.

2006-12-01

Do your students believe that the physics only works in your classroom or laboratory? Or do they see that physics underlies their everyday experience? Case studies in physics help students connect physics principles to their everyday experience. For decades, case studies have been used to teach law, medicine and biology, but they are rarely used in physics. I am working on a calculus-based physics textbook for scientists and engineers. Case studies are woven into each chapter. Stop by and get a case study to test out in your classroom. I would love to get your feedback.

Modalities of Generalization Through Single Case Studies.

Science.gov (United States)

Zittoun, Tania

2017-06-01

The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

The lack of selection bias in a snowball sampled case-control study on drug abuse.

Science.gov (United States)

Lopes, C S; Rodrigues, L C; Sichieri, R

1996-12-01

Friend controls in matched case-control studies can be a potential source of bias based on the assumption that friends are more likely to share exposure factors. This study evaluates the role of selection bias in a case-control study that used the snowball sampling method based on friendship for the selection of cases and controls. The cases selected fro the study were drug abusers located in the community. Exposure was defined by the presence of at least one psychiatric diagnosis. Psychiatric and drug abuse/dependence diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria. Cases and controls were matched on sex, age and friendship. The measurement of selection bias was made through the comparison of the proportion of exposed controls selected by exposed cases (p1) with the proportion of exposed controls selected by unexposed cases (p2). If p1 = p2 then, selection bias should not occur. The observed distribution of the 185 matched pairs having at least one psychiatric disorder showed a p1 value of 0.52 and a p2 value of 0.51, indicating no selection bias in this study. Our findings support the idea that the use of friend controls can produce a valid basis for a case-control study.

Learning to observe mathematical learning in lesson studies

DEFF Research Database (Denmark)

Rasmussen, Klaus; Østergaard, Camilla Hellsten; Foss, Kristian Kildemoes

2016-01-01

This poster deals with lesson study (LS) in pre-service teacher education. In particular how to prepare for, carry out, and reflect upon, observations of pupil learning. Observation is of crucial importance to the lesson study process, and here we present a study of observation features which ena...... enable or hinder fruitful lesson study. While substantial research has been carried out in the general field of bserving pupils’ learning processes and teachers’ pedagogical practice, little is known about this in the particular setting of lesson study....

The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.

Science.gov (United States)

Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

2013-01-01

Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. To describe the effects of different communication interventions and their problems. Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

Reducing selection bias in case-control studies from rare disease registries

Directory of Open Access Journals (Sweden)

Mistry Pramod K

2011-09-01

Full Text Available Abstract Background In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG Gaucher Registry were used as an example. Methods A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals were calculated for each variable before and after matching. Results The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN and controls (i.e., patients without AVN who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age, treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. Conclusions We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

Using Case Studies to Teach About Global Issues, Bali: A Case Study

Science.gov (United States)

Oswald, James M.

1974-01-01

The South Pacific island of Bali is used as a case study of overpopulation and food shortage. A brief description of the resources, the typical lifestyle of the Balinese farmer, and possible teaching techniques are given. (DE)

A Case Study of Knowledge Exchange in a Hierarchical Mechanism

Directory of Open Access Journals (Sweden)

Indria Handoko

2017-04-01

Full Text Available This research investigates knowledge exchange in an organization applying hierarchical mechanisms, and the influence of social interactions on knowledge flow across different levels of analysis. The research uses a qualitative case study method of an Indonesian automotive component-making company, applying semi-structured interviews, observations, and focus groups at interorganizational, internal company, and shop floor levels. The research main finding is that in an organization applying hierarchical mechanisms, social interactions that exist at one level are able to influence interactions at other levels, and that the interactions can both facilitate and inhibit knowledge exchange across levels and boundaries. The application of any formal mechanism at interorganizational level needs to consider both the dynamics operating at social level and the potentially disparate and contradictory effects it may have if its aim is to promote knowledge flow across levels. The application of in-depth exploratory case study research contributes to the conceptualization of relationships between knowledge exchange, social interactions, and governance mechanism.

Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study.

Science.gov (United States)

Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

2015-01-01

Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. This was an observational study. Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6-232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2-142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere's disease among the 76 PVD patients. We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo.

Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study

Science.gov (United States)

Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

2015-01-01

Objective Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design This was an observational study. Setting and participants Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. Outcome The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere’s disease among the 76 PVD patients. Conclusion We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo. PMID:25931828

Carotenoids and risk of fracture: a meta-analysis of observational studies.

Science.gov (United States)

Xu, Jiuhong; Song, Chunli; Song, Xiaochao; Zhang, Xi; Li, Xinli

2017-01-10

To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture.

THE MANY FACES OF PNEUMOMEDIASTINUM: AN OBSERVATIONAL STUDY

Directory of Open Access Journals (Sweden)

Narendra Kumar Narahari

2016-06-01

Full Text Available Pneumomediastinum is an uncommon condition which is defined by the presence of air in the mediastinum. It may result from a number of causes, but at times the underlying aetiology remains obscure. The present study aims to review the clinical and imaging features in patients who presented with pneumomediastinum alone or in association with other findings in order to establish the aetiological diagnosis. We report here, a series of cases with pneumomediastinum of various unusual aetiologies and also the clinical profile, predisposing factors and outcome of these patients along with the associated complications. METHODS We retrospectively reviewed the records of all patients who presented to the respiratory unit of our hospital with the diagnosis of pneumomediastinum over a period of 2 years from 2013-2015. The cases of pneumomediastinum resulting from trauma and iatrogenic causes were excluded from the study. RESULTS A total of six patients (4 males and 2 females with pneumomediastinum were identified during the study period after applying the exclusion criteria. The most common presenting symptom in these cases was shortness of breath followed by dry cough, chest pain and fever. Subcutaneous emphysema and Hamman sign was identified in one patient each. Of the six cases, preexisting lung disease was identified in 3 patients and these included connective tissue disease related interstitial lung disease in two cases and combined pulmonary fibrosis and emphysema in one case. In the remaining three cases, the causes of pneumomediastinum were Pneumocystis carinii pneumonia (PCP in HIV positive patient, pulmonary tuberculosis in another and spontaneous oesophageal perforation in the third. Coexisting pneumothorax was present in 3 out of 6 cases. The mean duration of hospital stay in these six patients was 8 days. No recurrence of pneumomediastinum was seen in any of the six patients during six months of followup. CONCLUSIONS Pneumomediastinum is a

Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

Science.gov (United States)

Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

2017-06-05

Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

Success Despite Socioeconomics: A Case Study of a High-Achieving, High-Poverty School

Science.gov (United States)

Tilley, Thomas Brent; Smith, Samuel J.; Claxton, Russell L.

2012-01-01

This case study of a high-achieving, high-poverty school describes the school's leadership, culture, and programs that contributed to its success. Data were collected from two surveys (the School Culture Survey and the Vanderbilt Assessment of Leadership in Education), observations at the school site, and interviews with school personnel. The…

Translanguaging Practices at a Bilingual University: A Case Study of a Science Classroom

Science.gov (United States)

Mazak, Catherine M.; Herbas-Donoso, Claudia

2015-01-01

The objective of this ethnographic case study is to describe in detail one professor's translanguaging practices in an undergraduate science course at an officially bilingual university. The data-set is comprised of ethnographic field notes of 11 observed classes, audio recordings of those classes, an interview with the professor, and artifacts…

Septic Systems Case Studies

Science.gov (United States)

A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.

Teaching culture in the Japanese language classroom: A NSW case study

Directory of Open Access Journals (Sweden)

Caroline Mahoney

2009-12-01

Full Text Available This study examines, through a qualitative case study approach, how non-native- speaking (NNS Japanese language teachers in New South Wales (NSW teach culture and why. The study seeks to understand the pedagogy used to teach culture, teachers’ attitudes and beliefs on teaching culture and how these attitudes and beliefs have been influenced by past experiences. This study also explores how the NSW K-10 Japanese syllabus and concepts of Intercultural Language Learning (IcLL are being implemented in teachers’ classrooms. Two non-native-speaking (NNS Japanese language teachers from a selective secondary school in NSW were interviewed and their classes observed over three days. Analysis of interview and observation data shows that these teachers teach culture as determined by language content, integrate language and culture teaching and teach culture as observable and factual. The study shows that both teachers view culture teaching as easier than language teaching, however their views on the influence of the syllabus differ. The study explores the teachers’ past experiences and how these affect how they feel towards, and teach culture. Finally, this study looks at how the teachers’ practices reflect concepts of IcLL such as integrating language and culture, student-centered learning and how their status as NNS teachers affects their culture teaching.

Calculation of controllability and observability matrices for special case of continuous-time multi-order fractional systems.

Science.gov (United States)

Hassanzadeh, Iman; Tabatabaei, Mohammad

2017-03-28

In this paper, controllability and observability matrices for pseudo upper or lower triangular multi-order fractional systems are derived. It is demonstrated that these systems are controllable and observable if and only if their controllability and observability matrices are full rank. In other words, the rank of these matrices should be equal to the inner dimension of their corresponding state space realizations. To reduce the computational complexities, these matrices are converted to simplified matrices with smaller dimensions. Numerical examples are provided to show the usefulness of the mentioned matrices for controllability and observability analysis of this case of multi-order fractional systems. These examples clarify that the duality concept is not necessarily true for these special systems. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Contextualising case studies in entrepreneurship: A tandem approach to conducting a longitudinal cross-country case study

DEFF Research Database (Denmark)

Chetty, S. K.; Partanen, J.; Rasmussen, Erik Stavnsager

2014-01-01

Using predictive and effectuation logics as a framework, this research note explains how case study research was conducted to demonstrate rigour and relevance. The study involves a longitudinal cross-country case study on small and medium-sized firm growth and networks undertaken by research teams...... in three countries (Finland, Denmark and New Zealand) involving 33 firms. This research note outlines the implications of this research and provides valuable guidance and reflections upon opportunities for future research regarding the conduct of contextual studies in entrepreneurship without compromising...

Improving case study research in medical education: a systematised review.

Science.gov (United States)

Cheek, Colleen; Hays, Richard; Smith, Janie; Allen, Penny

2018-05-01

Case study research (CSR) is a research approach that guides holistic investigation of a real phenomenon. This approach may be useful in medical education to provide critical analyses of teaching and learning, and to reveal the underlying elements of leadership and innovation. There are variations in the definition, design and choice of methods, which may diminish the value of CSR as a form of inquiry. This paper reports an analysis of CSR papers in the medical education literature. The review aims to describe how CSR has been used and how more consistency might be achieved to promote understanding and value. A systematised review was undertaken to quantify the number of CSR articles published in scholarly medical education journals over the last 10 years. A typology of CSR proposed by Thomas and Myers to integrate the various ways in which CSR is constructed was applied. Of the 362 full-text articles assessed, 290 were excluded as they did not meet the eligibility criteria; 76 of these were titled 'case study'. Of the 72 included articles, 50 used single-case and 22 multi-case design; 46 connected with theory and 26 were atheoretical. In some articles it was unclear what the subject was or how the subject was being analysed. In this study, more articles titled 'case study' failed than succeeded in meeting the eligibility criteria. Well-structured, clearly written CSR in medical education has the potential to increase understanding of more complex situations, but this review shows there is considerable variation in how it is conducted, which potentially limits its utility and translation into education practice. Case study research might be of more value in medical education if researchers were to follow more consistently principles of design, and harness rich observation with connection of ideas and knowledge to engage the reader in what is most interesting. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Is meat consumption associated with depression? A meta-analysis of observational studies.

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Zhang, Yi; Yang, Ye; Xie, Ming-Sheng; Ding, Xiang; Li, Hui; Liu, Zhi-Chen; Peng, Shi-Fang

2017-12-28

A number of epidemiological studies have examined the effect of meat consumption on depression. However, no conclusion has been reached. The aim of this study was to examine the relationship between meat consumption and depression. The electronic databases of PUBMED and EMBASE were searched up to March 2017, for observational studies that examined the relationship between meat consumption and depression. The pooled odds ratio (OR) for the prevalence of depression and the relative risk (RR) for the incidence of depression, as well as their corresponding 95% confidence interval (CI), were calculated respectively (the highest versus the lowest category of meat consumption). A total of eight observational studies (three cross-sectional, three cohort and two case-control studies) were included in this meta-analysis. Specifically, six studies were related to the prevalence of depression, and the overall multi-variable adjusted OR suggested no significant association between meat consumption and the prevalence of depression (OR = 0.89, 95% CI: 0.65 to 1.22; P = 0.469). In contrast, for the three studies related to the incidence of depression, the overall multi-variable adjusted RR evidenced an association between meat consumption and a moderately higher incidence of depression (RR = 1.13, 95% CI: 1.03 to 1.24; P = 0.013). Meat consumption may be associated with a moderately higher risk of depression. However, it still warrants further studies to confirm such findings due to the limited number of prospective studies.

Familial colorectal cancer, can it be identified by microsatellite instability and chromosomal instability? - A case-control study

DEFF Research Database (Denmark)

Sunde, Lone; Bisgaard, Marie Luise; Soll-Johanning, Helle

2009-01-01

(Chromosome INstability=LOH (loss of heterozygosity) and/or DNA-aneuploidy (abnormal nuclear DNA contents)) could be used as predictors of familial CRC. Formalin-fixed tissue from 97 patients with CRC (29 patients with 2 or more affected first-degree relatives (="cases"), 29 matched CRC controls without......Colonoscopy is recommended for persons with a familial risk of colorectal cancer (CRC). A familial risk is identified by a family history with CRC and/or predisposing mutation(s). However, such information may not be available. We analysed whether MSI (MicroSatellite Instability) and/or CIN...... a family history, and 39 relatives to cases) were analysed for MSI and CIN. In this small case-control study, no significant differences in the frequencies of MSI and CIN were observed between cases with a family history and their controls without a family history. MSI+;CIN- was observed in 6/29 cases...

Simultaneous Observation of Hybrid States for Cyber-Physical Systems: A Case Study of Electric Vehicle Powertrain.

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Lv, Chen; Liu, Yahui; Hu, Xiaosong; Guo, Hongyan; Cao, Dongpu; Wang, Fei-Yue

2017-08-22

As a typical cyber-physical system (CPS), electrified vehicle becomes a hot research topic due to its high efficiency and low emissions. In order to develop advanced electric powertrains, accurate estimations of the unmeasurable hybrid states, including discrete backlash nonlinearity and continuous half-shaft torque, are of great importance. In this paper, a novel estimation algorithm for simultaneously identifying the backlash position and half-shaft torque of an electric powertrain is proposed using a hybrid system approach. System models, including the electric powertrain and vehicle dynamics models, are established considering the drivetrain backlash and flexibility, and also calibrated and validated using vehicle road testing data. Based on the developed system models, the powertrain behavior is represented using hybrid automata according to the piecewise affine property of the backlash dynamics. A hybrid-state observer, which is comprised of a discrete-state observer and a continuous-state observer, is designed for the simultaneous estimation of the backlash position and half-shaft torque. In order to guarantee the stability and reachability, the convergence property of the proposed observer is investigated. The proposed observer are validated under highly dynamical transitions of vehicle states. The validation results demonstrates the feasibility and effectiveness of the proposed hybrid-state observer.

Ethics and observational studies in medical research: various rules in a common framework

Science.gov (United States)

Claudot, Frédérique; Alla, François; Fresson, Jeanne; Calvez, Thierry; Coudane, Henry; Bonaïti-Pellié, Catherine

2009-01-01

Background Research ethics have become universal in their principles through international agreements. The standardization of regulations facilitates the internationalization of research concerning drugs. However, in so-called observational studies (i.e. from data collected retrospectively or prospectively, obtained without any additional therapy or monitoring procedure), the modalities used for applying the main principles vary from one country to the other. This situation may entail problems for the conduct of multi-centric international studies, as well as for the publication of results if the authors and editors come from countries governed by different regulations. In particular, several French observational studies were rejected or retracted by United States peer reviewed journals, because their protocols have not been submitted to an Institutional Review Board/Independent Ethics Committee (IRB/IEC). Methods national legislation case analysis Results In accordance with European regulation, French observational studies from data obtained without any additional therapy or monitoring procedure, do not need the approval of an IRB/IEC. Nevertheless, these researches are neither exempt from scientific opinion nor from ethical and legal authorization. Conclusion We wish to demonstrate through the study of this example that different bodies of law can provide equivalent levels of protection that respect the same ethical principles. Our purpose in writing this paper was to encourage public bodies, scientific journals, and researchers to gain a better understanding of the various sets of specific national regulations and to speak a common language. PMID:19336436

Modeling of environmentally significant interfaces: Two case studies

International Nuclear Information System (INIS)

Williford, R.E.

2006-01-01

When some parameters cannot be easily measured experimentally, mathematical models can often be used to deconvolute or interpret data collected on complex systems, such as those characteristic of many environmental problems. These models can help quantify the contributions of various physical or chemical phenomena that contribute to the overall behavior, thereby enabling the scientist to control and manipulate these phenomena, and thus to optimize the performance of the material or device. In the first case study presented here, a model is used to test the hypothesis that oxygen interactions with hydrogen on the catalyst particles of solid oxide fuel cell anodes can sometimes occur a finite distance away from the triple phase boundary (TPB), so that such reactions are not restricted to the TPB as normally assumed. The model may help explain a discrepancy between the observed structure of SOFCs and their performance. The second case study develops a simple physical model that allows engineers to design and control the sizes and shapes of mesopores in silica thin films. Such pore design can be useful for enhancing the selectivity and reactivity of environmental sensors and catalysts. This paper demonstrates the mutually beneficial interactions between experiment and modeling in the solution of a wide range of problems

Case Study Research: Foundations and Methodological Orientations

Directory of Open Access Journals (Sweden)

Helena Harrison

2017-01-01

Full Text Available Over the last forty years, case study research has undergone substantial methodological development. This evolution has resulted in a pragmatic, flexible research approach, capable of providing comprehensive in-depth understanding of a diverse range of issues across a number of disciplines. Change and progress have stemmed from parallel influences of historical transformations in approaches to research and individual researcher's preferences, perspectives, and interpretations of this design. Researchers who have contributed to the development of case study research come from diverse disciplines with different philosophical perspectives, resulting in a variety of definitions and approaches. For the researcher new to using case study, such variety can create a confusing platform for its application. In this article, we explore the evolution of case study research, discuss methodological variations, and summarize key elements with the aim of providing guidance on the available options for researchers wanting to use case study in their work. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1701195

Dissociation between facial and bodily expressions in emotion recognition: A case study.

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Leiva, Samanta; Margulis, Laura; Micciulli, Andrea; Ferreres, Aldo

2017-12-21

Existing single-case studies have reported deficit in recognizing basic emotions through facial expression and unaffected performance with body expressions, but not the opposite pattern. The aim of this paper is to present a case study with impaired emotion recognition through body expressions and intact performance with facial expressions. In this single-case study we assessed a 30-year-old patient with autism spectrum disorder, without intellectual disability, and a healthy control group (n = 30) with four tasks of basic and complex emotion recognition through face and body movements, and two non-emotional control tasks. To analyze the dissociation between facial and body expressions, we used Crawford and Garthwaite's operational criteria, and we compared the patient and the control group performance with a modified one-tailed t-test designed specifically for single-case studies. There were no statistically significant differences between the patient's and the control group's performances on the non-emotional body movement task or the facial perception task. For both kinds of emotions (basic and complex) when the patient's performance was compared to the control group's, statistically significant differences were only observed for the recognition of body expressions. There were no significant differences between the patient's and the control group's correct answers for emotional facial stimuli. Our results showed a profile of impaired emotion recognition through body expressions and intact performance with facial expressions. This is the first case study that describes the existence of this kind of dissociation pattern between facial and body expressions of basic and complex emotions.

Participation in population-based case-control studies: does the observed decline vary by socio-economic status?

Science.gov (United States)

Mazloum, Marie; Bailey, Helen D; Heiden, Tamika; Armstrong, Bruce K; de Klerk, Nicholas; Milne, Elizabeth

2012-05-01

An Australian study of childhood leukaemia (Aus-ALL) previously reported that control participation was positively associated with socio-economic status (SES). A similar study of childhood brain tumours (Aus-CBT) was carried out 4 years later, and this paper compares control participation and its relationship with SES in the two studies. To assess the representativeness of controls in terms of SES, the addresses of controls were linked to Australian Bureau of Statistics Census 2006 Collection Districts (CDs), and hence to area-based indices of SES. Independent sample t-tests and chi-squared tests were used to compare the SES indices of CDs where Aus-CBT controls lived with those where Aus-ALL controls lived and with those of all CDs where Australian families lived. The overall percentage of eligible families who agreed to participate was lower in Aus-CBT (53.9%) than in Aus-ALL (70.3%). Control families in both studies were of higher SES than the general population, while the distribution of SES among recruited controls was similar in both studies. These findings provide some reassurance that the observed decline in research participation over time may not be associated with an increasingly unrepresentative participant population. © 2012 Blackwell Publishing Ltd.

The Interplay of Virtual Communities: A Multiple Case Study of E-Retailers in Yahoo E-Auctions

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Julia Zhi-Xian Zhao

2012-06-01

Full Text Available This study investigated how businesses operate e-shops in a transaction-oriented virtual community. This research employed a multiple case study approach by observing three cases of e-retailers, as being new e-commerce initiates, operating their businesses on the Yahoo! e-auction website. The results showed that e-shops displaying amusing stories can attract site visitors and “spick and span” e-shop design format can be helpful for converting visitors into buyers.

Guillain-Barré syndrome associated with monosialotetrahexosylganglioside: three cases study and literature review

Directory of Open Access Journals (Sweden)

ZENG Ke-bin

2013-04-01

Full Text Available Background Monosialotetrahexosylganglioside (GM1 is a kind of ganglioside extracted from the neural cells of pig brain, which involves in the pathophysiological processes of neurogenesis, and plays an important role in neural formation, growth and differentiation. GM1 is widely used in the treatment for vascular brain injury and traumatic brain and spinal cord injury, promoting and protecting the recovery of nerve cells. Besides, it can improve the behavior disorders of patients with Parkinson's disease. However, as it is widely used in clinical practice, its adverse reaction has been gradually discovered. There is some evidence to suggest Guillain-Barré syndrome (GBS may occur after GM1 injection intravenously. Both clinical manifestations and possible mechanism of GBS associated with GM1 are unclear, and need further study. Methods Three cases of GBS associated with GM1 were clinically observed including cerebrospinal fluid (CSF testing and nerve conduction studies. These cases were analyzed and subjected to assessment with literature review. Results Three male patients (with the age 39-65 of GBS were observed after injection of GM1 intravenously. At 9-14 days, they developed weakness of all limbs and were unable to stand upright with decreased muscle tone in limbs and absent deep tendon reflexes, accompanied by dyspnea (1 case, albuminocytological dissociation (1 case and axonal degeneration of peripheral nerve (1 case. Conclusion GBS may occur occasionally in patients treated with GM1 injection intravenously for 9-14 days, and the prognosis is not favorable. The possible mechanism is that exogenous gangliosides could be immunogenic and may occasionally result in neural axonal degeneration.

[Study of 103 cases of odontogenic cysts].

Science.gov (United States)

Moctezuma-Bravo, Gustavo Sergio; Magallanes-González, Eduardo

2009-01-01

To describe characteristics of odontogenic cysts in a Mexican population. A retrospective study of 103 odontogenic cysts in 86 patients was done. The data were obtained from files of the Pathology Department of a General Hospital. We observed a frequency of the 8.13 % of odontogenic cysts (103) in 1266 pathological studies. The dentigerous cyst 56 % and odontogenic keratocyst 33 % were the most common odontogenic cysts. Sixty one percent of the cysts appeared in the second and third decades of life. In 71 cysts, 42 % appeared in the posterior region jaw, 29 % in the anterior region of the maxilla and 21 % in the posterior region of the maxilla. A 6.7 % developed a recurrence after treatment and a case of keratocyst of posterior region of the maxilla was associated with epidermoid carcinoma. The study included three women with the syndrome of carcinoma of the basal cell nevus, who presented multiple keratocysts. The dentigerous cysts and odontogenic keratocysts were the most frequent odontogenic cysts. They appeared mainly in the second and third decades of life.

Exploratory case-control study of brain tumors in adults

International Nuclear Information System (INIS)

Burch, J.D.; Craib, K.J.; Choi, B.C.; Miller, A.B.; Risch, H.A.; Howe, G.R.

1987-01-01

An exploratory study of brain tumors in adults was carried out using 215 cases diagnosed in Southern Ontario between 1979 and 1982, with an individually matched, hospital control series. Significantly elevated risks were observed for reported use of spring water, drinking of wine, and consumption of pickled fish, together with a significant protective effect for the regular consumption of any of several types of fruit. While these factors are consistent with a role for N-nitroso compounds in the etiology of these tumors, for several other factors related to this hypothesis, no association was observed. Occupation in the rubber industry was associated with a significant relative risk of 9.0, though no other occupational associations were seen. Two previously unreported associations were with smoking nonfilter cigarettes with a significant trend and with the use of hair dyes or sprays. The data do not support an association between physical head trauma requiring medical attention and risk of brain tumors and indicate that exposure to ionizing radiation and vinyl chloride monomer does not contribute any appreciable fraction of attributable risk in the population studied. The findings warrant further detailed investigation in future epidemiologic studies

Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model.

Science.gov (United States)

Cragun, Deborah L; DeBate, Rita DiGioacchino; Severson, Herbert H; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William D

2012-05-01

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

An observational study of community health care nurses’ knowledge about delirium

Directory of Open Access Journals (Sweden)

Akrour R

2017-03-01

Full Text Available Rachid Akrour,1 Henk Verloo2 1Department of Geriatric Rehabilitation, Lausanne University Hospital, Lausanne, 2Department of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Sion, Switzerland Background: Early detection of delirium among home-dwelling older patients is a substantial challenge for home health care providers. Despite an abundance of literature, recent studies still describe a widespread lack of knowledge about delirium and its underdetection in all types of health care settings.Aims and objectives: This study aimed to assess the knowledge of community health care nurses (CHNs about delirium in the Switzerland’s French-speaking region.Methods: A cross-sectional observational study involving 75 CHNs was conducted between February and July 2015. Data were collected using an autoadministered questionnaire based on the study by Malenfant and Voyer, exploring theoretical knowledge of delirium and its detection using clinical vignette case studies. Outcomes were analyzed using descriptive statistics.
Results: Forty-eight CHNs participated in the study; nearly all of them (44; 94% selected the correct definition of delirium, and most (36; 78% knew its four principal diagnostic criteria. Only 16 (34% participants selected the confusion assessment method (CAM as the recommended best practice delirium detection tool. Only 19 (40% and 23 (49% participants were able to correctly identify hypoactive and hyperactive delirium, respectively, from the clinical vignette case studies. The average score of CHNs on the Malenfant and Voyer’s questionnaire was 12.7 (SD 3.2.Conclusion: Participants showed moderate-to-low knowledge about delirium. The study identified a lack of knowledge on how to recognize the signs and symptoms of delirium and the absence of suitable delirium detection tools. Keywords: delirium knowledge questionnaire, geriatric syndromes, delirium detection tools, clinical vignettes 

A cholera outbreak in Alborz Province, Iran: a matched case-control study.

Science.gov (United States)

Moradi, Ghobad; Rasouli, Mohammad Aziz; Mohammadi, Parvin; Elahi, Elham; Barati, Hojatollah

2016-01-01

A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method. In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72). Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

A cholera outbreak in Alborz Province, Iran: a matched case-control study

Directory of Open Access Journals (Sweden)

Ghobad Moradi

2016-05-01

Full Text Available OBJECTIVES: A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. METHODS: An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs using the logistic regression method. RESULTS: In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41, consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89, and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72. CONCLUSIONS: Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Case studies on age-management in organisations: report on organisational case studies

NARCIS (Netherlands)

Punte, E.; Conen, W.S.; Schippers, J.; Henkens, C.J.I.M.

2011-01-01

The acquisition of case studies was thwarted by the economic crisis and the feeling of being ‘over-researched’ by potential organisations. Although organisations in some sectors (e.g. chemical manufacturing) reported the worst part of the economic crisis was behind, many organisations indicated

Case Study: What Makes a Good Case, Revisited: The Survey Monkey Tells All

Science.gov (United States)

Herried, Clyde Freeman; Prud'homme-Genereux, Annie; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

2016-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the authors provide a more definitive answer to the "What Makes a Good Case?" question based on a just-completed Survey Monkey survey given to NCCSTS teachers.

Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study).

Science.gov (United States)

Mukhopadhyay, Sanjay; Feldman, Michael D; Abels, Esther; Ashfaq, Raheela; Beltaifa, Senda; Cacciabeve, Nicolas G; Cathro, Helen P; Cheng, Liang; Cooper, Kumarasen; Dickey, Glenn E; Gill, Ryan M; Heaton, Robert P; Kerstens, René; Lindberg, Guy M; Malhotra, Reenu K; Mandell, James W; Manlucu, Ellen D; Mills, Anne M; Mills, Stacey E; Moskaluk, Christopher A; Nelis, Mischa; Patil, Deepa T; Przybycin, Christopher G; Reynolds, Jordan P; Rubin, Brian P; Saboorian, Mohammad H; Salicru, Mauricio; Samols, Mark A; Sturgis, Charles D; Turner, Kevin O; Wick, Mark R; Yoon, Ji Y; Zhao, Po; Taylor, Clive R

2018-01-01

Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, -0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide

The value of postmortem computed tomography in paediatric natural cause of death: a Dutch observational study

Energy Technology Data Exchange (ETDEWEB)

Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Emma Children' s Hospital, Amsterdam Zuid-Oost (Netherlands); Beek, Erik J.; Nievelstein, Rutger-Jan A. [University Medical Centre Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Putte, Elise M. van de [University Medical Centre Utrecht, Department of Paediatrics, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Teeuw, Arianne H. [Academic Medical Center Amsterdam, Department of Paediatrics, Emma Children' s Hospital, Amsterdam (Netherlands); Nikkels, Peter G.J. [University Medical Centre Utrecht, Department of Pathology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Duijst, Wilma L.J.M. [Dutch Forensic Medical Association, Rotterdam (Netherlands); Collaboration: on behalf of the Dutch NODO Group

2017-10-15

Postmortem CT is a relatively new field of interest within paediatric radiology. This paper focusses on its value in cases of unexpected natural death. We report on an observational Dutch study regarding the value of postmortem CT in children with an assumed natural unexpected death because postmortem CT is part of the Dutch NODO (additional investigations of cause of death) procedure. We included consecutive children who fulfilled criteria for the NODO procedure and were therefore referred to one of the centres for the procedure. Postmortem CT was performed in all cases and skeletal survey was performed in all children ages <5 years. The cause of death was defined in a consensus meeting. We included a total of 54 children (30 boys, median age 1.1 years, and 24 girls, median age 0.8 years). A definitive cause of death was established in 38 cases. In 7 cases the cause of death could be identified on postmortem CT. In 7 cases imaging findings were clinically relevant but did not lead to a cause of death. In the remaining 40 cases postmortem CT did not add to the diagnostic workup. Our study shows that in a group of children who unexpectedly died of an assumed natural cause of death and in whom a cause of death was found at autopsy, postmortem CT detected the cause of death in a minority of cases (12.9%). In the majority of cases (74.1%) postmortem CT did not add value in diagnosing the cause of death. (orig.)

The value of postmortem computed tomography in paediatric natural cause of death: a Dutch observational study

International Nuclear Information System (INIS)

Rijn, Rick R. van; Beek, Erik J.; Nievelstein, Rutger-Jan A.; Putte, Elise M. van de; Teeuw, Arianne H.; Nikkels, Peter G.J.; Duijst, Wilma L.J.M.

2017-01-01

Postmortem CT is a relatively new field of interest within paediatric radiology. This paper focusses on its value in cases of unexpected natural death. We report on an observational Dutch study regarding the value of postmortem CT in children with an assumed natural unexpected death because postmortem CT is part of the Dutch NODO (additional investigations of cause of death) procedure. We included consecutive children who fulfilled criteria for the NODO procedure and were therefore referred to one of the centres for the procedure. Postmortem CT was performed in all cases and skeletal survey was performed in all children ages <5 years. The cause of death was defined in a consensus meeting. We included a total of 54 children (30 boys, median age 1.1 years, and 24 girls, median age 0.8 years). A definitive cause of death was established in 38 cases. In 7 cases the cause of death could be identified on postmortem CT. In 7 cases imaging findings were clinically relevant but did not lead to a cause of death. In the remaining 40 cases postmortem CT did not add to the diagnostic workup. Our study shows that in a group of children who unexpectedly died of an assumed natural cause of death and in whom a cause of death was found at autopsy, postmortem CT detected the cause of death in a minority of cases (12.9%). In the majority of cases (74.1%) postmortem CT did not add value in diagnosing the cause of death. (orig.)

Cell Phone Video Recording Feature as a Language Learning Tool: A Case Study

Science.gov (United States)

Gromik, Nicolas A.

2012-01-01

This paper reports on a case study conducted at a Japanese national university. Nine participants used the video recording feature on their cell phones to produce weekly video productions. The task required that participants produce one 30-second video on a teacher-selected topic. Observations revealed the process of video creation with a cell…

Associative visual agnosia: a case study.

Science.gov (United States)

Charnallet, A; Carbonnel, S; David, D; Moreaud, O

2008-01-01

We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

The silent salesman: an observational study of personal tobacco pack display at outdoor café strips in Australia.

Science.gov (United States)

Wakefield, Melanie A; Zacher, Meghan; Bayly, Megan; Brennan, Emily; Dono, Joanne; Miller, Caroline; Durkin, Sarah J; Scollo, Michelle M

2014-07-01

We sought to determine the relative frequency and nature of personal display of cigarette packs by smokers in two Australian cities where 30% front-of-pack and 90% back-of-pack health warnings have been used since 2006 and comprehensive tobacco marketing restrictions apply. An observational study counted patrons, active smokers and tobacco packs at cafés, restaurants and bars with outdoor seating. Pack orientation and use of cigarette cases were also noted. Overall, 18954 patrons, 1576 active smokers and 2153 packs were observed, meaning that one out of every 12.0 patrons was actively smoking, and one of every 8.8 patrons displayed a pack. Packs were more frequently observed in lower socio-economic neighbourhoods, reflecting the higher prevalence of smoking in those regions. Packs were displayed less often in venues where children were present, suggesting a greater tendency not to smoke around children. Most packs (81.4%) were oriented face-up, permitting prominent brand display. Only 1.5% of observed packs were cigarette cases, and 4.2% of packs were concealed by another item, such as a phone or wallet. Tobacco packs are frequently seen on table-tops in café strips, providing many opportunities for other patrons and passers-by to be incidentally exposed to cigarette brand names and imagery. Use of cigarette cases is rare, suggesting that smokers eventually habituate to pictorial warnings on branded packs and/or find repeated decanting of each newly purchased branded pack into a case to be inconvenient. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Case Study on Logistics Performance

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Shahryar Sorooshian

2013-05-01

Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.

Roentgenographical observation of impacted teeth

Energy Technology Data Exchange (ETDEWEB)

Choi, Hi Sup; Ahn, Hyung Kyu [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1972-11-15

The author observed on the impacted teeth of 11 cases from 484 full-mouth roentgenograms of dental students S.N.U. (except 3rd molar). These studies are very significant in oral surgery and orthodontic problems. Most of the impacted teeth are located in maxilla and among them 7 cases are impacted central incisors the others are lateral incisors, and cuspids. The form of impactions are vertical, horizontal and inverted positions.

Coffee, caffeine-related genes, and Parkinson's disease: a case-control study.

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Facheris, Maurizio F; Schneider, Nicole K; Lesnick, Timothy G; de Andrade, Mariza; Cunningham, Julie M; Rocca, Walter A; Maraganore, Demetrius M

2008-10-30

An inverse association between coffee and Parkinson's disease (PD) has been reported. However, it remains uncertain why some but not all coffee drinkers are less susceptible to PD. We considered the possibility of a pharmacogenetic effect. In our study, we included 1,208 subjects (446 case-unaffected sibling pairs and 158 case-unrelated control pairs) recruited from an ongoing study of the molecular epidemiology of PD in the Upper Midwest (USA). We collected information on lifetime coffee drinking and we studied two genes: ADORA2A, which encodes the major receptor activity of caffeine in the brain (variants rs5751876 and rs3032740), and CYP1A2, which encodes the major rate-limiting step of caffeine metabolism (variants rs35694136 and rs762551). We did not observe significant associations of coffee drinking or of the genetic variants with PD susceptibility, either independently or jointly, in the sample overall and in most strata. Our study neither supports the hypothesis that coffee protects against PD nor provides evidence for a pharmacogenetic effect. (c) 2008 Movement Disorder Society.

CASE STUDY

African Journals Online (AJOL)

HIV infection has several oral manifestations, including oral candidiasis and oral hairy leucoplakia. Occasionally unusual presentations requiring rigorous investigations are seen, and in these cases the diagnosis sometimes remains a dilemma owing to limited investigation facilities.1-3 We present the case of a patient who.

Case studies in international tobacco surveillance: cigarette smuggling in Brazil.

Science.gov (United States)

Shafey, O; Cokkinides, V; Cavalcante, T M; Teixeira, M; Vianna, C; Thun, M

2002-09-01

This article is the first in a series of international case studies developed by the American Cancer Society to illustrate use of publicly available surveillance data for regional tobacco control. A descriptive analysis of Brazil and Paraguay cigarette production and trade data from official sources. Per capita cigarette consumption for Brazil and its neighbour was calculated from 1970 to 1998 using data on production, imports, and exports from NATIONS, the National Tobacco Information Online System. A 63% decrease was observed in the estimate of per capita consumption of cigarettes in Brazil between 1986 and 1998 (from 1913 cigarettes per person in 1986 to 714 cigarettes per person in 1998) and a 16-fold increase in Paraguay was observed during the same period (from 678 cigarettes per person in 1986 to 10 929 cigarettes per person in 1998). Following Brazil's 1999 passage of a 150% cigarette export tax, cigarette exports fell 89% and Brazil's estimated per capita consumption rose to 1990 levels (based on preliminary data). Per capita consumption in Paraguay also fell to 1990 levels. These trends coincide with local evidence that large volumes of cigarettes manufactured in Brazil for export to Paraguay are smuggled back and consumed as tax-free contraband in Brazil. It is hoped that this case study will draw wider public attention to the problems that smuggling presents for tobacco control, help identify other countries confronting similar issues, and stimulate effective interventions.

Case Studies of Interactive Whole-Class Teaching in Primary Science: Communicative Approach and Pedagogic Purposes

Science.gov (United States)

McMahon, Kendra

2012-01-01

By developing two case studies of expert teaching in action, this study aimed to develop knowledge of talk in whole-class teaching in UK primary science lessons and understand this in relation to both the teachers' interpretations and sociocultural theoretical frameworks. Lessons were observed and video-recorded and the teachers engaged in…

A Psychobiographical Case Study

African Journals Online (AJOL)

man, and cancer fighter. This psychobiographical case study entailed a psychosocial-historical ... does not draw more attention as a research method, as this approach has .... of the applied Levinsonian theory to the life of Jobs against the ...

Observing Privacy, Modesty and Hospitality in the Home Domain: Three Case Studies of Muslim Homes in Brisbane, Australia

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Zulkeplee Othman

2014-12-01

Full Text Available A home embodies a sensorial space that is layered with personal memories and traces of history. The success of a home in providing a strong sense of place depends on various factors such as geographical location, climatic conditions, and occupants’ world-views and perceptions. This paper explores Muslims’ perceptions of privacy, modesty and hospitality within their homes through their lived experiences. This case study focuses on three Muslim families living in Australian designed homes within the same suburb of Brisbane, Australia. The study provides prefatory insight into the ways in which these families perform their daily activities and entertain their guests without jeopardizing their privacy needs. The study examines the significance of modesty in the design of Muslim homes as a means by which family members are able to achieve optimum privacy while simultaneously extending hospitality to guests inside and outside their homes. The findings of this study provide opportunities too, for expanding research into culturally adaptable housing systems to help meet the changing needs of Australian multicultural society.

Associative Visual Agnosia: A Case Study

Directory of Open Access Journals (Sweden)

A. Charnallet

2008-01-01

Full Text Available We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive episodic models of memory [4].

Associative Visual Agnosia: A Case Study

OpenAIRE

Charnallet, A.; Carbonnel, S.; David, D.; Moreaud, O.

2008-01-01

We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4].

Using case study within a sequential explanatory design to evaluate the impact of specialist and advanced practice roles on clinical outcomes: the SCAPE study.

Science.gov (United States)

Lalor, Joan G; Casey, Dympna; Elliott, Naomi; Coyne, Imelda; Comiskey, Catherine; Higgins, Agnes; Murphy, Kathy; Devane, Declan; Begley, Cecily

2013-04-08

The role of the clinical nurse/midwife specialist and advanced nurse/midwife practitioner is complex not least because of the diversity in how the roles are operationalised across health settings and within multidisciplinary teams. This aim of this paper is to use The SCAPE Study: Specialist Clinical and Advanced Practitioner Evaluation in Ireland to illustrate how case study was used to strengthen a Sequential Explanatory Design. In Phase 1, clinicians identified indicators of specialist and advanced practice which were then used to guide the instrumental case study design which formed the second phase of the larger study. Phase 2 used matched case studies to evaluate the effectiveness of specialist and advanced practitioners on clinical outcomes for service users. Data were collected through observation, documentary analysis, and interviews. Observations were made of 23 Clinical Specialists or Advanced Practitioners, and 23 matched clinicians in similar matched non-postholding sites, while they delivered care. Forty-one service users, 41 clinicians, and 23 Directors of Nursing or Midwifery were interviewed, and 279 service users completed a survey based on the components of CS and AP practice identified in Phase 1. A coding framework, and the generation of cross tabulation matrices in NVivo, was used to make explicit how the outcome measures were confirmed and validated from multiple sources. This strengthened the potential to examine single cases that seemed 'different', and allowed for cases to be redefined. Phase 3 involved interviews with policy-makers to set the findings in context. Case study is a powerful research strategy to use within sequential explanatory mixed method designs, and adds completeness to the exploration of complex issues in clinical practice. The design is flexible, allowing the use of multiple data collection methods from both qualitative and quantitative paradigms. Multiple approaches to data collection are needed to evaluate the impact

[Dental agenesis. Results of a prospective study of 30 cases].

Science.gov (United States)

Romieux, G; Bonin, B; Laure, B; Van Hove, A; Goga, D

2000-11-01

We conducted a prospective study to determine the types of bone anomalies observed in different types of dental agenesia. This prospective series included 30 patients who attended our pluridisciplinary clinic since 1988. There were 22 cases of non syndromal agenesia and 8 cases of syndromal agenesia. Patients consulted for a variety of reasons, no specific sign was found. The diagnosis was based on the panoramic x-ray and confirmed at the genetic consultation. Results were systemized by localization of the agenesia. In all cases, the height of the bone crest was preserved compared with the adjacent teeth. In the anterior part of the maxillary, the bone crest was thin showing a water drop aspect. In the posterior maxillary, there was a decrease in the subsinusal height due to invagination of the floor of the sinus. In the anterior part of the mandible, the crest had a knife blade aspect but no loss of height and in the posterior part, a preserved distance between the residual crest rim and the dental canal. In 60% of the solitary agenesias in the anterior part of the maxillary, augmentation was not required. A sinus graft was required in all cases involving the posterior maxillary. Multiple anterior or lateral agenesias were treated with a parietal graft.

How to include the variability of TMS responses in simulations: a speech mapping case study

Science.gov (United States)

De Geeter, N.; Lioumis, P.; Laakso, A.; Crevecoeur, G.; Dupré, L.

2016-11-01

When delivered over a specific cortical site, TMS can temporarily disrupt the ongoing process in that area. This allows mapping of speech-related areas for preoperative evaluation purposes. We numerically explore the observed variability of TMS responses during a speech mapping experiment performed with a neuronavigation system. We selected four cases with very small perturbations in coil position and orientation. In one case (E) a naming error occurred, while in the other cases (NEA, B, C) the subject appointed the images as smoothly as without TMS. A realistic anisotropic head model was constructed of the subject from T1-weighted and diffusion-weighted MRI. The induced electric field distributions were computed, associated to the coil parameters retrieved from the neuronavigation system. Finally, the membrane potentials along relevant white matter fibre tracts, extracted from DTI-based tractography, were computed using a compartmental cable equation. While only minor differences could be noticed between the induced electric field distributions of the four cases, computing the corresponding membrane potentials revealed different subsets of tracts were activated. A single tract was activated for all coil positions. Another tract was only triggered for case E. NEA induced action potentials in 13 tracts, while NEB stimulated 11 tracts and NEC one. The calculated results are certainly sensitive to the coil specifications, demonstrating the observed variability in this study. However, even though a tract connecting Broca’s with Wernicke’s area is only triggered for the error case, further research is needed on other study cases and on refining the neural model with synapses and network connections. Case- and subject-specific modelling that includes both electromagnetic fields and neuronal activity enables demonstration of the variability in TMS experiments and can capture the interaction with complex neural networks.

Nanomaterial Case Studies: Nanoscale Titanium Dioxide ...

Science.gov (United States)

This draft document presents two case studies of nanoscale titanium dioxide (nano-TiO2) used (1) to remove arsenic from drinking water and (2) as an active ingredient in topical sunscreen. The draft case studies are organized around a comprehensive environmental assessment approach that combines a product life cycle framework with the risk assessment paradigm. The document does not draw conclusions about potential risks. Rather, the case studies are intended to help identify what needs to be known in order to conduct a comprehensive environmental assessment of the potential risks related to nano-TiO2. This draft document is part of a process that will inform the development of EPA’s research strategy to support nanomaterial risk assessments. The complex properties of various nanomaterials make evaluating them in the abstract or with generalizations difficult if not impossible. Thus, this document focuses on two specific uses of nano-TiO2, as a drinking water treatment and as topical sunscreen. These case studies do not represent completed or even preliminary assessments; rather, they present the structure for identifying and prioritizing research needed to support future assessments.

What's in a Name? The Incorrect Use of Case Series as a Study Design Label in Studies Involving Dogs and Cats.

Science.gov (United States)

Sargeant, J M; O'Connor, A M; Cullen, J N; Makielski, K M; Jones-Bitton, A

2017-07-01

Study design labels are used to identify relevant literature to address specific clinical and research questions and to aid in evaluating the evidentiary value of research. Evidence from the human healthcare literature indicates that the label "case series" may be used inconsistently and inappropriately. Our primary objective was to determine the proportion of studies in the canine and feline veterinary literature labeled as case series that actually corresponded to descriptive cohort studies, population-based cohort studies, or other study designs. Our secondary objective was to identify the proportion of case series in which potentially inappropriate inferential statements were made. Descriptive evaluation of published literature. One-hundred published studies (from 19 journals) labeled as case series. Studies were identified by a structured literature search, with random selection of 100 studies from the relevant citations. Two reviewers independently characterized each study, with disagreements resolved by consensus. Of the 100 studies, 16 were case series. The remaining studies were descriptive cohort studies (35), population-based cohort studies (36), or other observational or experimental study designs (13). Almost half (48.8%) of the case series or descriptive cohort studies, with no control group and no formal statistical analysis, included inferential statements about the efficacy of treatment or statistical significance of potential risk factors. Authors, peer-reviewers, and editors should carefully consider the design elements of a study to accurately identify and label the study design. Doing so will facilitate an understanding of the evidentiary value of the results. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Training Diaries during Altitude Training Camp in Two Olympic Champions: An Observational Case Study.

Science.gov (United States)

Pugliese, Lorenzo; Serpiello, Fabio R; Millet, Grégoire P; La Torre, Antonio

2014-09-01

Traditionally, Live High-Train High (LHTH) interventions were adopted when athletes trained and lived at altitude to try maximising the benefits offered by hypoxic exposure and improving sea level performance. Nevertheless, scientific research has proposed that the possible benefits of hypoxia would be offset by the inability to maintain high training intensity at altitude. However, elite athletes have been rarely recruited as an experimental sample, and training intensity has almost never been monitored during altitude research. This case study is an attempt to provide a practical example of successful LHTH interventions in two Olympic gold medal athletes. Training diaries were collected and total training volumes, volumes at different intensities, and sea level performance recorded before, during and after a 3-week LHTH camp. Both athletes successfully completed the LHTH camp (2090 m) maintaining similar absolute training intensity and training volume at high-intensity (> 91% of race pace) compared to sea level. After the LHTH intervention both athletes obtained enhancements in performance and they won an Olympic gold medal. In our opinion, LHTH interventions can be used as a simple, yet effective, method to maintain absolute, and improve relative training intensity in elite endurance athletes. Key PointsElite endurance athletes, with extensive altitude training experience, can maintain similar absolute intensity during LHTH compared to sea level.LHTH may be considered as an effective method to increase relative training intensity while maintaining the same running/walking pace, with possible beneficial effects on sea level performance.Training intensity could be the key factor for successful high-level LHTH camp.

Teaching Kindergartners Racial Diversity through Multicultural Literature: A Case Study in a Kindergarten Classroom in Korea

Science.gov (United States)

Kim, So Jung; Wee, Su-Jeong; Lee, Young Mi

2016-01-01

Research Findings: This qualitative case study examines Korean kindergartners' literary discussions about racial/cultural diversity during a whole-group read-aloud. Using multiple sources of data, including observations, open-ended interviews, and written materials and children's artifacts, this study found that (a) the children exhibited a biased…

Case-control studies in diabetes. Do they really use a case-control design?

Science.gov (United States)

Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

2017-07-01

Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

Educational Potential of Case-Study Technology

OpenAIRE

Fedorinova, Zoya; Vorobeva, Victoria; Malyanova, Marina

2015-01-01

This article presents the results of phenomenological and typological analysis of case-study technology educational potential. The definition “educational potential of case-study technology” is given, the main characteristics of which are changed in communication and collaborative activity quality, appearance of educational initiatives, change of participants’ position in learning process, formation of “collective subject” in collaborative activity, increase of learning (subject) results. Dep...

Case Studies - Cervical Cancer

Centers for Disease Control (CDC) Podcasts

Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.

Nuclear forensics case studies

International Nuclear Information System (INIS)

Fedchenko, Vitaly

2016-01-01

The objective of this presentation is to share three case studies from the Institute of Transuranium Elements (ITU) which describe the application of nuclear forensics to events where nuclear and other radioactive material was found to be out of regulatory control

In the Belly of the Beast: A Case Study of Social Work in a Managed Care Organization

Directory of Open Access Journals (Sweden)

Lisa S. Patchner

2002-05-01

Full Text Available The employment of social workers within managed care organizations is a new phenomenon. As such, this case study utilized an exploratory-descriptive design that assessed social workers as case managers within a Medicaid HMO. The semi-structured interviews, focus groups, and participant observation suggested that the use of case management services, delivered primarily by social workers,was effective in addressing the bio-psychosocial needs of Medicaid consumers within a provider-driven HMO. Study findings recommend specific knowledge and skills that social workers need in order to prepare for practice within managed care environments.

Scintigraphy in the diagnosis of liver cancers. Study of 54 observations with anatomical confrontation

International Nuclear Information System (INIS)

Labro, R.D.A.

1976-01-01

This study attempts to judge the reliability of scintigraphy in the diagnosis of liver cancers. It concerns 54 observations with anatomical confrontation (laparoscopy, biopsy, laparotomy and/or autopsy). Technetium 99m scintigraphy gives a correct diagnosis in 81.5% of the cases, whether cirrhosis is present or not. Scintigraphy is only one stage in the investigation of neoplasic liver disease. This study shows that all too often it is practised alone since of 201 observations only 54 include another examination, and of these only 21 a laparoscopy. The simultaneous use of scintigraphy and laparoscopy eliminates false positives and reduces the percentage of false negatives from 7.5% to 4%. The two methods combined are therefore reliable to 96% (i.e. 96% of successful diagnosis in liver cancer tests. This work was performed with the techniques available in 1973. The quality of the scintigraphic image should be improved by technical progress in the form of new isotopic products, cameras with better definition and computerized data processing. With these new techniques it will certainly be possible to detect very small lacunae and to observe in more detail their diffusion in the liver parenchyma [fr

Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

Energy Technology Data Exchange (ETDEWEB)

Takahara, O; Toyoda, S; Tsuno, S; Mukai, H; Uemura, S [Nagasaki Atomic Bomb Hospital (Japan)

1976-09-01

Statistical observation was made as to autopsy cases of atomic-bomb survivors in Nagasaki. The total of autopsy cases at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital from the opening of the hospital, 1968, to December in 1975 was 1,486 cases (autopsy rate, 65.1%) in which 880 cases of atomic bomb survivors (autopsy rate, 68.0%) were contained. Cases of malignancy totaled 829 and 528 cases of those were atomic bomb survivors. Cases of malignancy were divided into three groups, that is, group exposured to atomic bomb at place within 2 km from the explosion place, group exposured at place from more than 2 km or entering after explosion into the city, and not-exposured group. Relationship between main malignancies and exposure was discussed, and the following results were obtained. 1) Obvious relationship was found to exist between exposure and acute and chronic medullary leukemia. 2) Malignant lymphoma was scarcely correlated with exposure, but its occurrence rate was higher than the mean rate in Japan in reflection the region where this disease occurs much geographically. 3) Relationship between exposure and stomach cancer, lung cancer, cancer of the large intestine, and double cancer was not found obviously, but occurrence rate of hepatic cancer was higher than the mean rate in Japan in three groups. The reason was supposed to be geographical factor. 4) Cases of thyroid gland cancer were a small number in female of the group exposured within 2 km, and cases of prostate cancer were a small number in the group within 2 km, but their occurrence rate was high specifically.

Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

International Nuclear Information System (INIS)

Takahara, Osamu; Toyoda, Shigeki; Tsuno, Sumio; Mukai, Hideaki; Uemura, Seiji

1976-01-01

Statistical observation was made as to autopsy cases of atomic-bomb survivors in Nagasaki. The total of autopsy cases at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital from the opening of the hospital, 1968, to December in 1975 was 1,486 cases (autopsy rate, 65.1%) in which 880 cases of atomic bomb survivors (autopsy rate, 68.0%) were contained. Cases of malignancy totaled 829 and 528 cases of those were atomic bomb survivors. Cases of malignancy were divided into three groups, that is, group exposured to atomic bomb at place within 2 km from the explosion place, group exposured at place from more than 2 km or entering after explosion into the city, and not-exposured group. Relationship between main malignancies and exposure was discussed, and the following results were obtained. 1) Obvious relationship was found to exist between exposure and acute and chronic medullary leukemia. 2) Malignant lymphoma was scarecely correlated with exposure, but its occurrence rate was higher than the mean rate in Japan in reflection the region where this disease occurs much geographically. 3) Relationship between exposure and stomach cancer, lung cancer, cancer of the large intestine, and double cancer was not found obviously, but occurrence rate of hepatic cancer was higher than the mean rate in Japan in three groups. The reason was supposed to be geographical factor. 4) Cases of thyroid gland cancer were a small number in female of the group exposured within 2 km, and cases of prostate cancer were a small number in the group within 2 km, but their occurrence rate was high specifically. (Tsunoda, M.)

The Campaign: a case study in identity construction through performance

Directory of Open Access Journals (Sweden)

Matthew D. Riddle

2009-12-01

Full Text Available This article undertakes a detailed case study of The Campaign, a teaching and learning innovation in media and communications that uses an online educational role-play. The case study draws on the qualitative analysis of classroom observations, online communications and semi-structured interviews, employing an interpretive approach informed by models drawn from social theory and sociotechnical theory. Educational authors argue that online educational role-plays engage students in authentic learning, and represent an improvement over didactic teaching strategies. According to this literature, online role-play systems afford students the opportunity of acting and doing instead of only reading and listening. Literature in social theory and social studies of technology takes a different view of certain concepts such as performance, identity and reality. Models such as performative self constitution and actor network theory ask us to consider the constructed nature of identity and the roles of all of the actors, including the system itself. This article examines these concepts by addressing a series of research questions relating to identity formation and mediation, and suggests certain limitations of the situationist perspective in explaining the educational value of role-play systems.

Implementation of a mechanical CPR device in a physician staffed HEMS - a prospective observational study.

Science.gov (United States)

Rauch, Simon; Strapazzon, Giacomo; Brodmann, Monika; Fop, Ernst; Masoner, Christian; Rauch, Lydia; Forti, Alessandro; Pietsch, Urs; Mair, Peter; Brugger, Hermann

2018-04-28

In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR. Two (11.1%) of the 18 patients survived long term with full neurologic recovery. In seven of eight patients transferred to hospital with ongoing CPR, CPR was ceased in the emergency room without further intervention. Retrospectively, all HEMS-assisted OHCA cases were screened for proposed indication criteria for prolonged CPR. Thirteen patients fulfilled these criteria, but only two of them were transported to hospital. Based on these results, we propose a standard operating procedure for HEMS-assisted patients with refractory OHCA in a region without hospitals with ECLS capacity.

Magnetic resonance imaging of knee osteonecrosis: a study of 19 cases

Energy Technology Data Exchange (ETDEWEB)

Cunha, Daniel Leme da; Ribeiro, Elisio Jose Salgado; Domingues, Romeu Cortes, E-mail: danielc@predialnet.com.b [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil); Pires Carvalho, Antonio Carlos [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Faculdade de Medicina

2010-04-15

Objective: to describe epidemiological, clinical and magnetic resonance imaging findings of osteonecrosis in the distal femur and proximal tibia. Materials and methods: evaluation of 19 patients (12 women and 7 men), with no previous history of causative factors, with magnetic resonance imaging findings suggestive of osteonecrosis in the tibial plateau or femoral condyle. Results: osteochondral abnormalities were observed in 63.1% of the cases; in 73.6% of them, such abnormality was associated with ipsilateral meniscal lesion. Also, a significant association with bone marrow edema (grade III in 16 cases) was observed. Conclusion: magnetic resonance imaging has demonstrated to be a noninvasive method with good sensitivity in the diagnosis of knee osteonecrosis as well as of associated lesions which are most frequently found in women (63% of cases). (author)

Case-control study on infant mortality in Southern Brazil

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Mendes Karina Giane

2006-01-01

Full Text Available OBJECTIVE: To identify risk factors associated with infant mortality and, more specifically, with neonatal mortality. METHODS: A case-control study was carried out in the municipality of Caxias do Sul, Southern Brazil. Characteristics of prenatal care and causes of mortality were assessed for all live births in the 2001-2002 period with a completed live-birth certificate and whose mothers lived in the municipality. Cases were defined as all deaths within the first year of life. As controls, there were selected the two children born immediately after each case in the same hospital, who were of the same sex, and did not die within their first year of life. Multivariate analysis was performed using conditional logistic regression. RESULTS: There was a reduction in infant mortality, the greatest reduction was observed in the post-neonatal period. The variables gestational age (<36 weeks, birth weight (<2,500 g, and 5-minute Apgar (<6 remained in the final model of the multivariate analysis, after adjustment. CONCLUSIONS: Perinatal conditions comprise almost the totality of neonatal deaths, and the majority of deaths occur at delivery. The challenge for reducing infant mortality rate in the city is to reduce the mortality by perinatal conditions in the neonatal period.

Case study - Czechoslovakia

International Nuclear Information System (INIS)

Kovar, P.

1986-01-01

In the lecture Case Study - Czechoslovakia with the sub-title 'Unified System of Personnel Preparation for Nuclear Programme in Czechoslovakia' the actual status and the current experience of NPP personnel training and preparation in Czechoslovakia are introduced. The above mentioned training system is presented and demonstrated by the story of a proxy person who is going to become shift engineer in a nuclear power plant in Czechoslovakia. (orig./HP)

Minority Voices: A Case Study of Children and Parents in a Manchester Primary School

Science.gov (United States)

Winterbottom, Christian; Leedy, Allyson K.

2014-01-01

Presently, there are a growing number of ethnic minority students in the primary schools in northwest England. Through sociocultural theory, this paper examines student and parent perspectives of their experiences in the schools. Using a qualitative methodology, including observation, in-depth interviews, and field notes this case study focused on…

Waterparks are high risk for cryptosporidiosis: A case-control study in Victoria, 2015.

Science.gov (United States)

de Gooyer, Tanyth E; Gregory, Joy; Easton, Marion; Stephens, Nicola; Fearnley, Emily; Kirk, Martyn

2017-06-30

An increase in notifications of cryptosporidiosis was observed in Victoria between March and April 2015. Cases mostly resided in one metropolitan region and hypothesis-generating interviews identified common exposures to aquatic facilities. We conducted a case-control study to determine exposure source(s) and facilitate control measures. Laboratory-confirmed cases of cryptosporidiosis from the region of interest notified between 1 March and 23 April 2015 were included. Controls residing in the same region were recruited from participants in a population health survey and frequency matched (2 per case) by age group. Details of exposure to potential risk factors were collected using a standardised telephone questionnaire for the 14-days prior to illness for cases, and an analogous exposure period for controls. Univariable and multivariable logistic regression were used to determine risk factors associated with illness using STATA SE 13.1. Thirty cases and 66 controls were included in the study. Half the cases were less than 12 years of age and 62% were female. Illness was most strongly associated with recreational water exposure at any waterpark (adjusted odds ratio (aOR)=73.5; 95% confidence interval (CI):6.74-802), and specifically at Victorian waterparks (aOR=45.6; 95% CI:5.20-399). Cases were linked with attendance at either a waterpark in the region or an adjacent region. As a result of this investigation, hyperchlorination was completed at identified facilities and swim hygiene information distributed. This study reinforces the potential for recreational water facilities, particularly waterparks, to act as a transmission source of Cryptosporidium infections. Continued communication to patrons is required to ensure healthy swimming practice in Victorian aquatic facilities.

Software Design Reviews Using the Software Architecture Analysis Method: A Case Study

Science.gov (United States)

2000-02-01

Management, pp. 323-356, JAI Press Inc. Stake, R. E. (1994). Case Studies. In Handbook of Qualitative Research. (N. K. Denzin and Y. S. Lincoln . Eds.), pp. 236...Henderson and Gabb 1997). References Adler, P. A. and P. Adler (1994). Observational Techniques. In Handbook of Qualitative Research. (N. K. Denzin and Y...S. Lincoln . Eds.), pp. 377-392, SAGE Publications, Thousand Oaks, California. ADO (1998). Electronic Systems Acquisition Division Compendium

The Costs of Commonality: Examination of the JLTV as a Case Study

Science.gov (United States)

2016-07-15

Joint Light Tactical Vehicle (JLTV) program as a case study to validate the concept. We conclude from our analysis that the Joint Value Model has...Light Tactical Vehicle (JLTV) program over the course of development. We observed that decisions to divest of several JLTV requirements were...the priority and visibility of a program, often ensuring its survival in the wake of budget fluctuations. Regardless of program performance, vested

Inorganic bromine in organic molecular crystals: Database survey and four case studies

Science.gov (United States)

Nemec, Vinko; Lisac, Katarina; Stilinović, Vladimir; Cinčić, Dominik

2017-01-01

We present a Cambridge Structural Database and experimental study of multicomponent molecular crystals containing bromine. The CSD study covers supramolecular behaviour of bromide and tribromide anions as well as halogen bonded dibromine molecules in crystal structures of organic salts and cocrystals, and a study of the geometries and complexities in polybromide anion systems. In addition, we present four case studies of organic structures with bromide, tribromide and polybromide anions as well as the neutral dibromine molecule. These include the first observed crystal with diprotonated phenazine, a double salt of phenazinium bromide and tribromide, a cocrystal of 4-methoxypyridine with the neutral dibromine molecule as a halogen bond donor, as well as bis(4-methoxypyridine)bromonium polybromide. Structural features of the four case studies are in the most part consistent with the statistically prevalent behaviour indicated by the CSD study for given bromine species, although they do exhibit some unorthodox structural features and in that indicate possible supramolecular causes for aberrations from the statistically most abundant (and presumably most favourable) geometries.

[Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies].

Science.gov (United States)

Lianhui, Yang; Meifei, Lian; Zhongyue, Hu; Yunzhi, Feng

2017-08-01

Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence. Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, Pchronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, Pperiodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipoprotein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.

Erysipelas of the leg (cellulitis in sub-Saharan Africa: A multicentric study of 562 cases

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Bayaki Saka

2017-01-01

Full Text Available Introduction: Erysipelas of the leg is a common and serious infection. We carried out this study aiming at describing the epidemiological and clinical characteristics, and assessing the risks factors associated with the local complications of erysipelas of the leg in sub-Saharan Africa. Methods: This was a prospective multicentric study carried out in the dermatology units of Hospitals located in seven sub-Saharan African countries during a period of 12 months. Patients aged 15 and above with a first episode of erysipelas of the leg were recruited. Results: In this study, 562 patients were recruited, having a mean age of 43.7±16.9 years and a sex-ratio (M/F of 0.67. Patients infected on one leg were 562 while those infected with two were 27. Bullous forms of the disease were observed in 95 patients, while purpuric forms were observed in 167 patients. The existence of a point of entry (485 cases, obesity (230, lymph edema (130 and the use of bleaching agents (97 were the mains risk factors. Complications during the course of the infection such as necrotizing fasciitis (34 cases and abscesses (63 cases were observed. They were due to the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm. Conclusion: This study reveals that existence of a point of entry, obesity and lymph edema, and the use of bleaching agents were the mains risk factors influencing the local complications of erysipelas of the leg. Necrotizing fasciitis and abscesses were influenced by the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm.

Using Case Studies to Teach Courtesy Strategies.

Science.gov (United States)

Moore, Patrick

1990-01-01

Explains some courtesy techniques that technical professionals can use to deal with interpersonal problems that arise in writing situations. Presents three case studies with sample responses to show how case studies can teach these courtesy strategies to technical writing students. (MM)

The long-term use of cyproterone acetate in pedophilia: a case study.

Science.gov (United States)

Cooper, A J; Cernovsky, Z; Magnus, R V

1992-01-01

This investigation reports the long-term use of the antiandrogen cyproterone acetate (CPA) in a pedophile, who was studied continuously over 38 months. Measures of sexual arousal, serum testosterone, and gonadotropin levels were significantly reduced by the drug as compared with placebo and no treatment; prolactin levels were significantly elevated. Some workers have observed that long-term administration of CPA (more than one year, which was then discontinued) produced enduring (in some cases apparently permanent) anti-libidinal effects; however, in the case described, within three weeks of stopping the drug, all measures had returned to pretrial levels. The importance of continuous long-term monitoring in sex offenders receiving an antiandrogen is discussed.

Saharan and Arabian Dust Aerosols: A Comparative Case Study of Lidar Ratio

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Córdoba-Jabonero Carmen

2016-01-01

Full Text Available This work presents a first comparative study of the Lidar Ratio (LR values obtained for dust particles in two singular dust-influenced regions: the Canary Islands (Spain, close to the African coast in the North Atlantic Ocean, frequently affected by Saharan dust intrusions, and the Kuwait area (Arabian Peninsula as usually influenced by Arabian dust storms. Synergetic lidar and sun-photometry measurements are carried out in two stations located in these particular regions for that purpose. Several dusty cases were observed during 2014 in both stations and, just for illustration, two specific dusty case studies have been selected and analyzed to be shown in this work. In general, mean LR values of 54 sr and 40 sr were obtained in these studies cases for Saharan and Arabian dust particles, respectively. Indeed, these results are in agreement with other studies performed for dust particles arriving from similar desert areas. In particular, the disparity found in Saharan and Arabian dust LR values can be based on the singular composition of the suspended dust aerosols over each station. These results can be useful for CALIPSO extinction retrievals, where a single LR value (40 sr is assumed for pure dust particles independently on the dust source region.

Maternal periodontal disease and preterm birth: A case-control study

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Pushpalatha Govindaraju

2015-01-01

Full Text Available Background and Objective: Preterm birth (PTB is an important issue in public health and is a major cause for infant mortality and morbidity. There is a growing consensus that systemic diseases elsewhere in the body may influence PTB. Recent studies have hypothesized that maternal periodontitis could be a high-risk factor for PTB. The aim of the present study was to investigate the relationship between maternal periodontitis on PTB. Materials and Methods: Forty systemically healthy primiparous mothers aged 18–35 years were recruited for the study. Based on inclusion and exclusion criteria, they were categorized into PTB group as cases and full term birth group (FTB as controls. PTB cases (n = 20 defined as spontaneous delivery before/<37 completed weeks of gestation. Controls (FTB were normal births at or after 37 weeks of gestation. Data on periodontal status, pregnancy outcome variables, and information on other factors that may influence adverse pregnancy outcomes were collected within 2 days of labor. Data were subjected to Student's t-test and Pearson's correlation coefficient statistical analysis. Results: Statistically significant difference with respect to the gestational period at the time of delivery and birth weight of the infants in (PTB group (<0.001 compared to (FTB group was observed. Overall, there was statistically significant poor periodontal status in the (PTB group compared to (FTB group. The statistical results also showed a positive correlation between gestational age and clinical parameters. Conclusion: An observable relationship was noticed between periodontitis and gestational age, and a positive correlation was found with respect to PTB and periodontitis. Further studies should be designed to establish periodontal disease as an independent risk factor for PTB/preterm low birth weight.

Human factors and ergonomics assessment of food pantry work: A case study.

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Higgins, Nicholas A; Talone, Andrew B; Fraulini, Nicholas W; Smither, Janan A

2017-01-01

Research assessing work processes in food pantries has been limited to the client's experience and aspects of food donations [3-5]. Research on food pantries has yet to focus on understanding and evaluating worker-environment interaction. The present case study examined the interaction between workers and their work environment while performing common tasks in a food pantry. Data were collected through naturalistic observations and structured interviews. A task analysis was performed on the data. Several potential issues in the pantry were identified including with the workspace layout, environmental conditions, and signage. Human factors and ergonomics principles were then utilized to provide insights and recommendations (e.g., use of numbered rather than color-coded signage). Recommendations were provided to the case study food pantry for enhancing safety and productivity. Further research is needed to assess the generalizability of our findings to other food pantries.

Case-control study of amyotrophic lateral sclerosis

Energy Technology Data Exchange (ETDEWEB)

Deapen, D.M.; Henderson, B.E.

1986-05-01

The authors conducted a study of 518 amyotrophic lateral sclerosis patients identified between 1977 and 1979 and 518 controls to investigate putative risk factors for this disease. Occupations at risk of electrical exposure were reported more often by patients (odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.4-13.0) as were electrical shocks producing unconsciousness (OR = 2.8, 95% CI = 1.0-9.9). Although an overall excess of physical trauma associated with unconsciousness was observed in the amyotrophic lateral sclerosis patients (OR = 1.6, 95% CI = 1.0-2.4), the effect was inversely associated with duration of the unconscious episodes, suggesting an effect of recall bias. Only slight differences were found for surgical traumata to the nervous system. Parkinsonism was reported more often among first degree relatives of cases (OR = 2.7, 95% CI = 1.1-7.6). The frequencies of prior poliomyelitis or other central nervous system diseases were similar for patients and controls. Occupational exposure to selected toxic substances was similar for patients and controls except for the manufacture of plastics (OR = 3.7, 95% CI = 1.0-20.5), although few details of these exposures were provided. No differences in occupations with exposure to animal skins or hides were observed.

Exploring Content Management Issues in Air Force On-Line Communities of Practice: A Multiple Case Study Approach

National Research Council Canada - National Science Library

Jaime

2004-01-01

.... Addressing existing or potential content management issues will help do so. This multiple-case study research observed and interviewed managers and members of eight active CoPs busted by AFMC/DRW...

Patterned genital injury in cases of rape - A case-control study

DEFF Research Database (Denmark)

Astrup, Birgitte Schmidt; Ravn, Pernille; Thomsen, Jørgen Lange

2013-01-01

A pattern of genital injury that separates trauma seen in sexual assault cases from trauma seen following consensual sexual intercourse has been a matter of debate. This study aimed at clarifying the question by eliminating as many confounders as possible in a prospective, case-control setup. A t...

Tea consumption may decrease the risk of osteoporosis: an updated meta-analysis of observational studies.

Science.gov (United States)

Guo, Ming; Qu, Hua; Xu, Lin; Shi, Da-Zhuo

2017-06-01

Several epidemiological investigations have evaluated the correlation between tea consumption and risk of osteoporosis, but the results are inconsistent. Therefore, we conducted an updated meta-analysis of observational studies to assess this association. We searched for all relevant studies including cohort, cross-sectional, and case-control studies published from database inception to July 15, 2016, using MEDLINE EMBASE, and Cochrane Library. Polled odds ratios (ORs) were calculated using the random-effect model. Fourteen articles (16 studies) that examined 138523 patients were included in this meta-analysis. Seven studies concerning bone mineral density (BMD) showed an increase in BMD with tea consumption, including 4 cross-sectional studies (OR, 0.04, 95% confidence interval [CI], 0.01-0.08) and 3 cohort studies (OR, 0.01; 95% CI, 0.01-0.01). The remaining 9 studies concerning fracture, including 6 case-control studies and 3 cohort studies, showed no association between tea consumption and osteoporotic fracture (OR, 0.86; 95% CI, 0.74-1.01). This updated meta-analysis demonstrates that tea consumption could increase BMD, but the association with osteoporotic fracture requires further investigation. Together, the results highlight the need for future, high-quality-designed clinical trials on tea consumption and osteoporosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Rehabilitation of existing building structure in expansive soils: A case study in Laghouat, Algeria

OpenAIRE

Ouai Aissa

2017-01-01

This work presents results obtained from a case study conducted on M’kam neighborhood (600 housing social city) in Laghouat, Algeria. The bloc (J) in this location, suffering from damages that are attributed to the expansive clayey soil interaction with sewage disposal under foundations was the subject of rehabilitation in this study. The principal causes of observed structural damages were studied through diagnostic expertise (inspection-evaluation process) of the cracks and sewage dispo...

Attention deficit hyperactivity disorder in children with primary monosymptomatic nocturnal enuresis: A case-control study

Directory of Open Access Journals (Sweden)

Parsa Yousefichaijan