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Sample records for operation plumbbob tertiary

  1. Analysis of Operation Plumbbob nuclear test: BOLTZMANN radiological and meteorological data

    International Nuclear Information System (INIS)

    Steadman, C.R. Jr.; Kennedy, N.C.; Quinn, V.E.

    1983-09-01

    This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the BOLTZMANN nuclear test of Operation PLUMBBOB. Inconsistencies in the radiological data and their resolution are discussed. The methods of converting aerial radiological data to equivalent ground-level values and of estimating fallout arrival times are presented. The meteorological situation on D-day is described. A comparison of the WSNSO fallout analyses with analyses in the late 1950's is presented. The appendices contain tabulated radiological data used in the fallout analyses, and contain discussions of the BOLTZMANN hot spot contention and of the enhanced activity at Portola, California

  2. Test of Detonation Locator System AN/GSS-4. Operation PLUMBBOB, Desert Rock VII and VIII, Project 50.3

    Science.gov (United States)

    1979-10-01

    GSS-k was assigned in May 1957 to the system of equipments as used in Operation Plumbbob. Quantitative measurements of the em pulse have been made... quantitative data from the recordings of the SWR vavefoims, It vas necessary to record other infoimation on the photographs. Figure 35, a typical...Capilla vuvefonnG. The Heef’s I’dne and other Gleeson triplet observations confirmed the In/if ground wave positiv « half cycle and indicated a sharply

  3. Distribution, Characteristics, and Biotic Availability of Fallout, Operation Plumbbob

    Science.gov (United States)

    1957-10-01

    EATA FOR~ OPEMWOIN CA!,TT’:- UNION DM-T i-r F" L"C d Dir yd 1 r 8ce fect dorco Limuiph dCgrk’e: m1phi dul~ -’ csr Mph Surf’ace 050 20 090) .6 oklu 38 1...Lyon ATTN: J. McGahan ATTN: J. Goetz Veterans Administration ATTN: W. Layson ATTN: L. Hobson 2 cy ATTN: D. Starbuck Tech Reps, Inc. 2 cy ATTN: F. Kuta

  4. 4950TH Test Group (N) Final Report. Operation PLUMBBOB

    Science.gov (United States)

    1980-12-01

    WIS «Mkl DTIC TAB Unannounced Justification D j^jggjgjgg; Distribution/ Availability Codes Avail and/or Special s DTIC ELECTE: JUN...5ft ■g»8f I , s I». I Isaia &^sxsisaHSMaBS 5| 1 « g u ; «IS 0 ? it I •0 < | s w 5 O u. -i O c u 1 i tr a. i o rt...Support Itens ...•..• • 129 irctlen 3 Use of Jro.iect Code Nunber •.•...••».•••.••... 130 fTctlcn U lin^crvj cable Tires

  5. Operation PLUMBBOB. Summary Report, Test Group 57, Nevada Test Site. Extracted Version

    Science.gov (United States)

    1982-06-04

    02 to 1 micron A common suction pump was used for all air samplers. Its intake rate of approximately 17 liters per minute, or one cubic meter per...the wind, are isokinetic in their sampling for normal wind-speed ranges. The volume sampled is directly proportional to wind speed, since impact...3.2.2 Chronic Exposures As soon as isoconcentration lines were established from alpha- meter survey readings, the chronic-exposure pens were set out

  6. A Guide for Developing Standard Operating Job Procedures for the Tertiary Chemical Treatment - Lime Precipitation Process Wastewater Treatment Facility. SOJP No. 6.

    Science.gov (United States)

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary chemical treatment - lime precipitation process of wastewater treatment plants. Step-by-step instructions are given for pre-start up, start-up, continuous operation, and shut-down procedures. In addition, some theoretical material is presented along with some relevant…

  7. Assessment of safety levels in operation rooms at two major tertiary care public hospitals of Karachi. Safe surgery saves life

    International Nuclear Information System (INIS)

    Minhas, M.S.; Muzzammil, M.; Effendi, J.

    2017-01-01

    The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. Method: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month. A structured questionnaire was constructed and an informed verbal consent was taken. The questionnaire was then distributed; data collected and analysed on SPSS 20.0. Results: A total of 543 respondents participated in the study out of which there were 375 (69%) men and 168 (31%) women. The ages ranged between 23-58 years, mean 40.5+-24.74. There were 110 (20.25%) surgeons, 58 (10.68%) anaesthetist, 132 (24.30%) trainees, 125 (23.02%) technicians, and were 118 (21.73%) nurses. The question regarding briefing operation room personnel is important for patient safety was agreed by 532 (98%) respondents. Amongst the respondents, 239 (44%) did not feel safe to be operated in their own setup. Team communication improvement through the check list implementation was agreed by 483 (89%) respondents. 514 (94.7%) opted for the checklist to be used while they are being operated. That operation room personnel frequently disregard established protocols was agreed by 374 (69%) respondents. 193 (35.54%) of the respondents stated that it is difficult for them to speak up in the or if they perceive a problem with patient care. Conclusion: Operation room personnel were not aware of several important areas related to briefing, communication, safety attitude, following standard protocols and use of WHO Surgical Safety check list. A pre-post intervention study should be conducted after formal introduction of the Checklist. Successful implementation will require taking all stake holders on board

  8. Cost Analysis of Operation Theatre Services at an Apex Tertiary Care Trauma Centre of India.

    Science.gov (United States)

    Siddharth, Vijaydeep; Kumar, Subodh; Vij, Aarti; Gupta, Shakti Kumar

    2015-12-01

    Operating room services are one of the major cost and revenue-generating centres of a hospital. The cost associated with the provisioning of operating department services depends on the resources consumed and the unit costs of those resources. The objective of this study was to calculate the cost of operation theatre services at Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi. The study was carried out at the operation theatre department of Jai Prakash Narayan Apex Trauma Centre (JPNATC), AIIMS from April 2010 to March 2011 after obtaining approval from concerned authorities. This study was observational and descriptive in nature. Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of operation theatre (OT) services. Cost was calculated under two heads; as capital and operating cost. Annualised cost of capital assets was calculated according to the methodology prescribed by the World Health Organization and operating costs were taken on actual basis; thereafter, per day cost of OT services was obtained. The average number of surgeries performed in the trauma centre per day is 13. The annual cost of providing operating room services at JPNATC, New Delhi was calculated to be 197,298,704 Indian rupees (INR) (US$ 3,653,679), while the per hour cost was calculated to be INR 22,626.92 (US$ 419). Majority of the expenditures were for human resource (33.63 %) followed by OT capital cost (31.90 %), consumables (29.97 %), engineering maintenance cost (2.55 %), support services operating cost (1.22 %) and support services capital cost (0.73 %). Of the total cost towards the provisioning of OT services, 32.63 % was capital cost while 67.37 % is operating cost. The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 54).

  9. Organizational Commitment and Job Satisfaction of Security Operatives in Selected Tertiary Institutions In Kwara State

    Directory of Open Access Journals (Sweden)

    Alade Y. Saliu

    2015-11-01

    Full Text Available The prevalence of civil disorder and cultism in higher institutions of learning in Nigeria and the apparent inability of security operatives to stem the tide has continued to be a source of concern to both the Government and Individuals in recent times. This study examines the effect of organisational commitment on job satisfaction among security operatives working in Nigeria universities. In this study a sample of three hundred (300 security operatives were selected from both public and private universities in Kwara State. Data were collected through self-administered questionnaire and analysed through Descriptive, Comparative, Regression analysis and Spearman Rank Correlation. The findings revealed that these security operatives, a positive relationship exists between organisational commitment and job satisfaction with affective commitment having little or no significant relationship and continuance commitment having significant positive relationship. The study also found that the level of affective commitment was significantly lower than the other components. The study thus concludes that there is a significant positive relationship between organisation commitment and job satisfaction amongst the security operatives. Based on the findings, it was recommended that the selected Universities should focus on improving affective and normative commitment among security operatives in order to be able to deal with the problem of high job turnover and poor performance.

  10. Results of Operative Fixation of Fractures of the Ankle at a Tertiary ...

    African Journals Online (AJOL)

    Background: Operative fixation of ankle fractures is becoming popular in developing countries. The concern however is the outcome of care. The objective was to evaluate the results of open reduction and internal fixation (ORIF) of fractures of the ankle in our hospital. Methods: All cases ORIF of fractures of the ankle at the ...

  11. Proposal for the award of an industrial support contract for the maintenance of and work on tertiary buildings at CERN, and operation of their installations

    CERN Document Server

    2005-01-01

    This document concerns the award of a contract for maintenance of and work on tertiary (i.e. non-accelerator) buildings and operation of their installations. The Finance Committee is invited to agree to the negotiation of a contract with the consortium CEGELEC CENTRE EST (FR) â?" CEGELEC (CH) â?" G.T.M. (FR), the lowest bidder complying with the specification, for the provision of the maintenance of and work on tertiary buildings at CERN, and operation of their installations, for three years for a total amount not exceeding 9 346 650 euros (14 379 454 Swiss francs), not subject to revision until 1st January 2009, with options for additional services for an amount not exceeding 457 600 euros (704 000 Swiss francs), not subject to revision until 1st January 2009, bringing the total to an amount not exceeding 9 804 250 euros (15 083 454 Swiss francs), not subject to revision until 1st January 2009. The contract will include options for two one-year extensions beyond the initial three-year period.

  12. Perioperative cardiac arrest: an evolutionary analysis of the intra-operative cardiac arrest incidence in tertiary centers in Brazil

    Directory of Open Access Journals (Sweden)

    Matheus Fachini Vane

    2016-03-01

    Full Text Available Background: Great changes in medicine have taken place over the last 25 years worldwide. These changes in technologies, patient risks, patient profile, and laws regulating the medicine have impacted the incidence of cardiac arrest. It has been postulated that the incidence of intraoperative cardiac arrest has decreased over the years, especially in developed countries. The authors hypothesized that, as in the rest of the world, the incidence of intraoperative cardiac arrest is decreasing in Brazil, a developing country. Objectives: The aim of this study was to search the literature to evaluate the publications that relate the incidence of intraoperative cardiac arrest in Brazil and analyze the trend in the incidence of intraoperative cardiac arrest. Contents: There were 4 articles that met our inclusion criteria, resulting in 204,072 patients undergoing regional or general anesthesia in two tertiary and academic hospitals, totalizing 627 cases of intraoperative cardiac arrest. The mean intraoperative cardiac arrest incidence for the 25 years period was 30.72:10,000 anesthesias. There was a decrease from 39:10,000 anesthesias to 13:10,000 anesthesias in the analyzed period, with the related lethality from 48.3% to 30.8%. Also, the main causes of anesthesia-related cause of mortality changed from machine malfunction and drug overdose to hypovolemia and respiratory causes. Conclusions: There was a clear reduction in the incidence of intraoperative cardiac arrest in the last 25 years in Brazil. This reduction is seen worldwide and might be a result of multiple factors, including new laws regulating the medicine in Brazil, incorporation of technologies, better human development level of the country, and better patient care. Resumo: Justificativa: Nos últimos 25 anos ocorreram grandes mudanças na medicina em todo o mundo. Essas mudanças de tecnologias, riscos do paciente, perfil do paciente e leis que regulam medicamentos tiveram impacto na incid

  13. Operating in a Yellow Nation; the frequency of hepatitis B and hepatitis C positive at a tertiary care teaching hospital

    International Nuclear Information System (INIS)

    Waheed, A.; Zafar-ul-Ahsan; Zaeem, F.A.; Shariff, M.M.; Qayyum, A.

    2010-01-01

    Objects contaminated with blood and other body fluids of patients suffering from hepatitis B and C are an occupational health hazard to the health care personnel and a source of nosocomial spread. This descriptive cross sectional study estimated the frequency of hepatitis B surface antigen (HBsAg) and anti hepatitis C antibody (Anti HCV) positive patients among those undergoing a urological procedure in a tertiary care teaching hospital. A sample size of 550 patients was estimated using Stat Calc for Epi Info. A cluster off 558 patients were included. Ninety five (17%) were positive for serum HBsAg and/or anti HCV by Elisa. Gender/sex, admission year, urological diagnosis did not predict statistically significant relationship with the positive status. Past surgical history was marginally significant. In conclusion, all patients undergoing a urological procedure should be checked for anti HCV and HBsAg. A solid policy outlining the preventive practices is needed to stop this high burden of hepatitis turning into public health disaster. (author)

  14. Destructive operations--a vanishing art in modern obstetrics: 25 year experience at a tertiary care center in India.

    Science.gov (United States)

    Sikka, Pooja; Chopra, Seema; Kalpdev, Arun; Jain, Vanita; Dhaliwal, Lakhbir

    2011-05-01

    Destructive operations have a limited role in modern day obstetrics. In the developed countries, obstetrics has become so advanced that these instruments have actually been put away. However, in developing countries like India, these procedures have a limited role where obstructed labor still continues to plague thousands of women every year and accounts for 8% of maternal deaths. This study was planned to define the changing role of destructive operations in obstetrics over the years as more number of abdominal deliveries are conducted in modern day obstetrics than these procedures. A retrospective analysis of destructive operations performed at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, over a span of 25 years, between 1983 and 2007, was carried out. Of a total of 85,952 deliveries in PGIMER in these 25 years, there were 25,474 cesarean deliveries (29.63%), and 8,826 (10.26%) operative vaginal deliveries. The total number of destructive operations performed was 230 (0.26%). There were 202 craniotomies (87.8%), 13 decapitations (5.7%), 8 eviscerations (3.6%) and 7 cleidotomies (2.9%). There should be an individualized approach to each case of obstructed labor. The health care provider has to decide on the options available to him to deliver the mother by the safest route without causing morbidity and mortality. If the fetus is dead, a destructive procedure can be considered in place of abdominal-route delivery which carries considerable risk to the debilitated mother in neglected labor.

  15. Surgical scheduling categorization system (SSCS): A novel classification system to improve coordination and scheduling of operative cases in a tertiary pediatric medical system.

    Science.gov (United States)

    Gantwerker, Eric A; Bannos, Cassandra; Cunningham, Michael J; Rahbar, Reza

    2017-01-01

    To describe a surgical categorization system to create a universal nomenclature, delineating patient complexity as a first step toward developing a true risk stratification system. Retrospective database review of all otolaryngology surgical procedures performed in a tertiary pediatric hospital system over one academic year (July 2012-June 2013). All otolaryngology surgical procedures were reviewed, encompassing 8478 procedures on 5711 patients. The attending otolaryngologist assigned surgical scheduling category (SSCS) at the time of case booking based on an institution specific guidelines. The guidelines are as follow: Category I was assigned to American Society of Anesthesiologists physical status classification (ASA) I/II patients, designating them appropriate for institution's suburban ambulatory surgery centers; Category II was ASA I/II patients with social or transportation issues; Category III was ASA I/II patients who required case coordination with other medical or surgical departments; Category IV was reserved for patients of any ASA class whom the surgeon designated to be of a higher complexity. 8478 total procedures analyzed with 7198 having complete records. 48% were Category I, 13.6% were Category II, 1.9% were Category III and 36.5% were Category IV. The ASA were 34.7% ASA I, 50% ASA II, 13.39% ASA III, and 1.9% ASA IV. Although the largest proportion of patients were ASA II (50%), 39.6% of all ASA II were Category IV. Category IV was split into 54.2% ASA II and 34% ASA III and shows that peri-operative surgical concerns were not encompassed by the ASA system. This surgical categorization system streamlines surgical scheduling in a tertiary pediatric hospital system, particularly with respect to the designation of cases as ambulatory surgery center or main operating room appropriate. The case mix complexity is also readily apparent, enhancing recognition of the coordination and attention required for the perioperative management of high complexity

  16. Successful strategies for the reduction of operating room turnover times in a tertiary care academic medical center.

    Science.gov (United States)

    Kodali, Bhavani S; Kim, Dennie; Bleday, Ronald; Flanagan, Hugh; Urman, Richard D

    2014-04-01

    Turnover time (TOT) is one of the classic measures of operating room (OR) efficiency. There have been numerous efforts to reduce TOTs, sometimes through the employment of a process improvement framework. However, most examples of process improvement in the TOT focus primarily on operational changes to workflows and statistical significance. These examples of process improvement do not detail the complex organizational challenges associated with implementing, expanding, and sustaining change. TOT data for general and gastrointestinal surgery were collected retrospectively over a 26-mo period at a large multispecialty academic institution. We calculated mean and median TOTs. TOTs were excluded if the sequence of cases was changed or cases were canceled. Data were retrieved from the perioperative nursing data entry system. Using performance improvement strategies, we determined how various events and organizational factors created an environment that was receptive to change. This ultimately led to a sustained decrease in the OR TOT both in the general and gastrointestinal surgery ORs that were the focus of the study (44.8 min versus 48.6 min; P managers, and change agents commonly face. Awareness of the numerous variables that may support or impede a particular change effort can inform effective change implementation strategies that are "organizationally compatible." Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung [Tuen Mun Hospital, Department of Radiology, Tuen Mun (China); Yeung, Yuk Nam [Tune Mun Hospital, Department of Orthopaedics and Traumatology, Tuen Mun (China)

    2015-06-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  18. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    International Nuclear Information System (INIS)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung; Yeung, Yuk Nam

    2015-01-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  19. Parathyroid carcinoma in tertiary hyperparathyroidism.

    Science.gov (United States)

    Kim, Byung Seup; Ryu, Han Suk; Kang, Kyung Ho; Park, Sung Jun

    2016-10-01

    Parathyroid carcinoma is a rare disease of unknown etiology. This study presents a case of parathyroid carcinoma in a patient with tertiary hyperparathyroidism. Despite a successful kidney transplantation, the intact parathyroid hormone (iPTH) level of the patient was elevated consistently and could not be controlled by medical therapy. Due to the development of tertiary hyperparathyroidism with bone pain and osteoporosis, subtotal parathyroidectomy was performed 4 months after the kidney transplantation. Histological evaluation revealed that one of four parathyroid lesions was a parathyroid carcinoma, while the others were diffuse hyperplasia. Postoperative laboratory studies indicated a decreased level of iPTH. A positron emission tomography-computed tomography performed 6 months after the operation revealed no evidence of local recurrence or distant metastasis. Copyright © 2013. Published by Elsevier Taiwan.

  20. Secondary and tertiary hyperparathyroidism.

    Science.gov (United States)

    Jamal, Sophie A; Miller, Paul D

    2013-01-01

    We reviewed the etiology and management of secondary and tertiary hyperparathyroidism. Secondary hyperparathyroidism is characterized by an increase in parathyroid hormone (PTH) that is appropriate and in response to a stimulus, most commonly low serum calcium. In secondary hyperparathyroidism, the serum calcium is normal and the PTH level is elevated. Tertiary hyperparathyroidism is characterized by excessive secretion of PTH after longstanding secondary hyperparathyroidism, in which hypercalcemia has ensued. Tertiary hyperparathyroidism typically occurs in men and women with chronic kidney disease usually after kidney transplant. The etiology and treatment of secondary hyperparathyroidism is relatively straightforward whereas data on the management of tertiary hyperparathyroidism is limited to a few small trials with short follow-up. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  1. Intra-Abdominal Hydatid Cyst: Sociodemographics, Clinical Profiles, and Outcomes of Patients Operated on at a Tertiary Hospital in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Engida Abebe

    2017-01-01

    Full Text Available Background. Hydatid cyst is caused by the tapeworm Echinococcus granulosus. The abdomen, specifically the liver, is the most common site affected. Objective. Determine the presentation patterns, types of surgical management, and outcomes of patients operated for intra-abdominal hydatid cyst (IAHC. Methodology. A retrospective descriptive study of patients admitted and operated for IAHC from September 1, 2011, to August 31, 2015. Results. Forty-two patients whose age ranged from 10 to 65 (mean of 37 years were operated on. Females comprised 27 (64.3% of the patients. The commonest presenting complaint was abdominal pain (41, 97.6%. Abdominal mass was documented in 23 (54.7% cases. Abdominal ultrasound (AUS and CT were the main imaging studies done on 38 (90.5% and 24 (57.1% patients, respectively. Cysts measuring more than 10 cm in diameter were the most common finding in both studies. Liver was the primary site involved, 30 (71.4% cases, the right lobe being the main side, 73%. Thirty-eight (90.5% patients underwent deroofing, evacuation, marsupialization, and omentoplasty (DEMO. There was no perioperative death, but 4 (9.5% of the patients had post-op complications. Conclusion. Abdominal pain was the most common presenting complaint. AUS and CT remain the preferred imaging. DEMO was the most common surgery.

  2. 2. Tertiary Foraminifera

    NARCIS (Netherlands)

    Umbgrove, J.H.F.

    1931-01-01

    In his review of the palaeozoology of Java, K. Martin could in 1919, record 49 foraminifera from tertiary strata of Java, on the strength of a critical study of the existant literature, and especially on the strength of his own studies and knowledge of the above mentioned fossils (Bibl. 49). In

  3. Use of lean and six sigma methodology to improve operating room efficiency in a high-volume tertiary-care academic medical center.

    Science.gov (United States)

    Cima, Robert R; Brown, Michael J; Hebl, James R; Moore, Robin; Rogers, James C; Kollengode, Anantha; Amstutz, Gwendolyn J; Weisbrod, Cheryl A; Narr, Bradly J; Deschamps, Claude

    2011-07-01

    Operating rooms (ORs) are resource-intense and costly hospital units. Maximizing OR efficiency is essential to maintaining an economically viable institution. OR efficiency projects often focus on a limited number of ORs or cases. Efforts across an entire OR suite have not been reported. Lean and Six Sigma methodologies were developed in the manufacturing industry to increase efficiency by eliminating non-value-added steps. We applied Lean and Six Sigma methodologies across an entire surgical suite to improve efficiency. A multidisciplinary surgical process improvement team constructed a value stream map of the entire surgical process from the decision for surgery to discharge. Each process step was analyzed in 3 domains, ie, personnel, information processed, and time. Multidisciplinary teams addressed 5 work streams to increase value at each step: minimizing volume variation; streamlining the preoperative process; reducing nonoperative time; eliminating redundant information; and promoting employee engagement. Process improvements were implemented sequentially in surgical specialties. Key performance metrics were collected before and after implementation. Across 3 surgical specialties, process redesign resulted in substantial improvements in on-time starts and reduction in number of cases past 5 pm. Substantial gains were achieved in nonoperative time, staff overtime, and ORs saved. These changes resulted in substantial increases in margin/OR/day. Use of Lean and Six Sigma methodologies increased OR efficiency and financial performance across an entire operating suite. Process mapping, leadership support, staff engagement, and sharing performance metrics are keys to enhancing OR efficiency. The performance gains were substantial, sustainable, positive financially, and transferrable to other specialties. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Radioguided parathyroidectomy for tertiary hyperparathyroidism.

    Science.gov (United States)

    Somnay, Yash R; Weinlander, Eric; Alfhefdi, Amal; Schneider, David; Sippel, Rebecca S; Chen, Herbert

    2015-05-15

    Tertiary hyperparathyroidism (3HPT) is defined as the persistent hyperproduction of parathyroid hormone and resulting hypercalcemia after renal transplantation. Here, we examine the utility of radioguided parathyroidectomy (RGP) in patients with 3HPT. We reviewed a prospective surgery database containing 80 3HPT patients who underwent RGP from January 2001-July 2014 at our institution. We evaluated patient demographics, operative management, radioguided neoprobe utilization, and operative outcomes. Data are reported as mean ± standard error of the mean. The mean age of the patients was 52 ± 1 y, and 46% were male. A total of 69 patients had hyperplasia and received subtotal parathyroidectomy, whereas 5 patients had double adenomas and 6 patients had single adenomas. The average calcium level among 3HPT patients was 10.8 ± 0.1 mg/dL preoperatively and 8.7 ± 0.1 mg/dL postoperatively. In vivo radioguided counts normalized to background counts averaged 145 ± 4%, whereas ex vivo counts normalized to background counts averaged 69 ± 5%. All but one ex vivo count was >20%. Ectopically located glands were successfully localized in 38 patients using the gamma probe. Ex vivo percentage did not correlate with parathyroid gland weight, preoperative parathyroid hormone, or preoperative calcium. Our radioguided approach achieved normocalcemia in 96% of 3HPT patients undergoing RGP; two patients developed recurrent disease. In this series, all enlarged parathyroid glands were localized and resected using the gamma probe. Thus, RGP reliably localizes adenomatous, hyperplastic, and ectopically located glands in patients with 3HPT, resulting in high cure rate after resection. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Tertiary climatic fluctuations and methods of analysis of tertiary floras

    Science.gov (United States)

    Wolfe, J.A.

    1971-01-01

    On theoretical grounds, an analysis of the physiognomy of a Tertiary leaf assemblage is more direct and reliable than a circuitous floristic analysis in assigning thermal regimes to fossil assemblages. Using primarily foliar physiognomy and secondarily floristic composition, it can be shown that: (1) some middle latitude Tertiary assemblages probably lived under meteoroligically tropical climates; (2) a major and rapid climatic deterioration occurred in the Oligocene; and (3) a major climatic fluctuation probably occurred in the Late Eocene. These analyses thus substantiate the conclusions of several other paleobotanists regarding climatic fluctuations. Recent criticisms of these analyses are shown to be invalid and to be based largely on misinterpretations. ?? 1971.

  6. Rethinking the Tertiary Mathematics Curriculum

    Science.gov (United States)

    Petocz, Peter; Reid, Anna

    2005-01-01

    Mathematics curriculum at the tertiary level is located within a range of social and cultural theories, and is often constructed by academics seeking to promulgate a particular view of mathematics. We argue that such a curriculum should incorporate a real acknowledgement of the different ways in which students understand the nature of mathematics…

  7. Tertiary syphilis in the lumbar spine: a case report.

    Science.gov (United States)

    Bai, Yang; Niu, Feng; Liu, Lidi; Sha, Hui; Wang, Yimei; Zhao, Song

    2017-07-24

    The incidence of tertiary syphilis involvement in the spinal column with destructive bone lesions is very rare. It is difficult to establish the correct diagnosis from radiographs and histological examination alone. Limited data are available on surgical treatment to tertiary syphilitic spinal lesions. In this article, we report a case of tertiary syphilis in the lumbar spine with osteolytic lesions causing cauda equina compression. A 44-year-old man who suffered with low back pain for 6 months and progressive radiating pain at lower extremity for 1 week. Radiologic findings showed osteolytic lesion and new bone formation in the parts of the bodies of L4 and L5. Serum treponema pallidum hemagglutination (TPHA) test was positive. A surgery of posterior debridement, interbody and posterolateral allograft bone fusion with instrumentation from L3 to S1 was performed. The low back pain and numbness abated after operation. But the follow-up radiographs showed absorption of the bone grafts and failure of instrumentation. A Charcot's arthropathy was formed between L4 and L5. It is challenging to diagnose the tertiary syphilis in the spine. Surgery is a reasonable auxiliary method to antibiotic therapy for patients who suffered with neuropathy. Charcot's arthropathy should be considered as an operative complication.

  8. Regionalised tertiary psychiatric residential facilities.

    Science.gov (United States)

    Lesage, Alain; Groden, David; Goldner, Elliot M; Gelinas, Daniel; Arnold, Leslie M

    2008-01-01

    Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely--with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call. This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing. In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments with hostel wards since the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia, Community Care Units (CCUs) have been applying this concept. In the Canadian province of British Columbia (BC), Tertiary Psychiatric Residential Facilities (TPRFs) have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital. This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary

  9. Recruitment Of International Students Into Cameroon Tertiary ...

    African Journals Online (AJOL)

    Recruitment Of International Students Into Cameroon Tertiary Institutions In The Absence Of International Offices. ... The present system of recruiting international students is haphazardly been handled by ... AJOL African Journals Online.

  10. Learning Enhancement in Tertiary Institutions Using Mobile ...

    African Journals Online (AJOL)

    2012-12-01

    Dec 1, 2012 ... model that is still by far the dominant mode of education and learning in tertiary institutions. In addition to identifying ... education has there been a technology that ..... Determinant of Mobile Learning Acceptance: An Empirical.

  11. Tertiary recovery and tritide injection equipment

    International Nuclear Information System (INIS)

    Li Lin

    1989-01-01

    The exploitation of an oil field is a continously developing process, undergoing seveal stages, such as the low production, the high production, the stable production and the decline. The tertiary recovery is an important means of the enhanced oil recovery. Since the object of the tertiary recovery is to treat the oil in micropores which is difficult to be produced, it is more necessary to know further the reservoir. Tritide can be used as a tracer and is an ideal marker of knowing the reservoir and the state of the fluid movement. The paper presents the tritide injection equipment

  12. Solvent effects on the magnetic shielding of tertiary butyl alcohol

    African Journals Online (AJOL)

    )4 and tetramethyl ammonium cation N(CH3)4(+) have also been presented. KEY WORDS: Solvent effects, Magnetic shielding, Tertiary butyl alcohol, Tertiary butyl amine, Continuum solvation calculations, Chemical shift estimation methods

  13. Modelling the harmonized tertiary Institutions Salary Structure ...

    African Journals Online (AJOL)

    This paper analyses the Harmonized Tertiary Institution Salary Structure (HATISS IV) used in Nigeria. The irregularities in the structure are highlighted. A model that assumes a polynomial trend for the zero step salary, and exponential trend for the incremental rates, is suggested for the regularization of the structure.

  14. American Tertiary mollusks of the genus Clementia

    Science.gov (United States)

    Woodring, W.P.

    1927-01-01

    Aside from its value as an aid in determining the age of Tertiary beds, the chief interest of the genus Clementia lies in the anomalous features of its present and former distribution. An attempt is made in this paper to trace its geologic history, to point out its paleobiologic significance, and to describe all the known American Tertiary species. The fossils from Colombia used in preparing this report were collected during explorations made under the direction of Dr. 0. B. Hopkins, chief geologist of the Imperial Oil Co. (Ltd.), who kindly donated them to the United States National Museum. Dr. T. Wayland Vaughan, of the Scripps Institution of Oceanography, furnished information relating to specimens collected by him in Mexico. Dr. Bruce L. Clark, of the University of California; Dr. G. Dallas Hanna, of the California Academy of Sciences; Dr. H. A. Pilsbry, of the Philadelphia Academy of Natural Sciences; and Dr. W. D. Matthew, of the American Museum of Natural History, generously loaned type specimens and other material. Doctor Clark and Doctor Hanna also gave information concerning the Tertiary species from California. Mr. Ralph B. Stewart, of the University of California, read the manuscript, and I have taken advantage of his suggestions. I am also indebted to Mr. L. R. Cox, of the British Museum, for information relating to the fossil species from Persia, Zanzibar, and Burma, and to Dr. Axel A. Olsson, of the International Petroleum Co., for data concerning undescribed Tertiary species from Peru.

  15. Misconception of emergency contraception among tertiary school ...

    African Journals Online (AJOL)

    Objective: To assess the degree of awareness and use of emergency contraception among tertiary school students in Akwa Ibom State, Nigeria. Design: A self-administered questionnaire survey. Setting: The Akwa Ibom State Polytechnic, Ikot Osurua, located on the outskirts of Ikot Ekpene local government area between ...

  16. Understanding Australian Aboriginal Tertiary Student Needs

    Science.gov (United States)

    Oliver, Rhonda; Rochecouste, Judith; Bennell, Debra; Anderson, Roz; Cooper, Inala; Forrest, Simon; Exell, Mike

    2013-01-01

    Drawing from a study of the experiences of Australian Aboriginal and Torres Strait Islander university students, this paper presents an overview of the specific needs of these students as they enter and progress through their tertiary education. Extracts from a set of case studies developed from both staff and student interviews and an online…

  17. Indigenous Students in the Tertiary Education Sector

    Science.gov (United States)

    Bandias, Susan; Fuller, Don; Larkin, Steven

    2014-01-01

    Important recent objectives of indigenous education policy in Australia have been aimed at redressing indigenous economic and social disadvantage through increasing student retention, progression and completion rates in both compulsory and post-compulsory education. The two sectors of the tertiary education system, vocational education and…

  18. SECTORAL ANALYSIS: GROWTH ACCOUNTING OF TERTIARY INDUSTRIES

    Directory of Open Access Journals (Sweden)

    Yahya Z. ALSHEHHI

    2017-08-01

    Full Text Available The tertiary sector is one of the modern styles of economic systems in view of the share it occupies in the field of production as well as employment occupied share. Hence, just like other lands, the UAE, witnessed an economic structural change similar to developed and developing nations, where the tertiary industries contributed 55.4% in 2015 to total country’s income. The empirical study aimed to analyze the contribution portion of growth in the tertiary industries through using the growth accounting framework in time-series from 1990 to 2015. The empirical study found that most of the industries contributed significantly to the growth of the tertiary sector. The contribution shares of growth due to labor and capital varied among industries. The main observed results show that there was a vice versa relationship between TFP performance and the size of labor, where the TFP positively corresponded with the decline in the size of labor specifically from 2010-2015.

  19. Economics of Tertiary Education - Challenges and dynamics of the public tertiary education in Albania

    Directory of Open Access Journals (Sweden)

    Gledian Llatja

    2016-07-01

    Full Text Available The tertiary education is a critic mechanism for the socio-economic progress, for individuals who aspire a brighter future and it is also considered an important catalyzer of the economic mobility (Department of Treasury and Department of Education, 2012, 2. Based on the positive role and impact that the tertiary education has on the sustainable development, President Obama once stated that it is of damage to treat education as a luxurious public service. In line with the general considerations about the tertiary education in the U.S. the parallel comparison with Albania comes as a direct interpretation of utopia in the education policy-making. As policies are usually drafted based on data and findings, in the case of Albania there is a lack of data on expenses on tertiary education as share of GDP. This stands also for the main limitation of the paper.

  20. Diversification Management at Tertiary Education Level: A Review

    Science.gov (United States)

    Takwate, Kwaji Tizhe

    2016-01-01

    This paper examines the concept of management of diversification at tertiary education level in view of the growth of national secondary education system which vested high scramble for tertiary education was made in relation to question of access and expansion. This paper examines management of diversification at tertiary education level as a…

  1. Tertiary Education in the Czech Republic: The Pathway to Change

    Science.gov (United States)

    Pesik, Richard; Gounko, Tatiana

    2011-01-01

    This article analyzes recent policy proposals to reform Czech tertiary education. A brief overview of the evolution of Czech tertiary education presents the background against which emerging policy trends in education are examined. We relate the changes in tertiary education to the policy framework and recommendations of the OECD, underpinned by…

  2. COMPARATIVE STUDY OF TERTIARY WASTEWATER TREATMENT BY COMPUTER SIMULATION

    Directory of Open Access Journals (Sweden)

    Stefania Iordache

    2010-01-01

    Full Text Available The aim of this work is to asses conditions for implementation of a Biological Nutrient Removal (BNR process in theWastewater Treatment Plant (WWTP of Moreni city (Romania. In order to meet the more increased environmentalregulations, the wastewater treatment plant that was studied, must update the actual treatment process and have tomodernize it. A comparative study was undertaken of the quality of effluents that could be obtained by implementationof biological nutrient removal process like A2/O (Anaerobic/Anoxic/Oxic and VIP (Virginia Plant Initiative aswastewater tertiary treatments. In order to asses the efficiency of the proposed treatment schemata based on the datamonitored at the studied WWTP, it were realized computer models of biological nutrient removal configurations basedon A2/O and VIP process. Computer simulation was realized using a well-known simulator, BioWin by EnviroSimAssociates Ltd. The simulation process allowed to obtain some data that can be used in design of a tertiary treatmentstage at Moreni WWTP, in order to increase the efficiency in operation.

  3. Analysis of colonoscopic perforations at a local clinic and a tertiary hospital.

    Science.gov (United States)

    Sagawa, Toshihiko; Kakizaki, Satoru; Iizuka, Haruhisa; Onozato, Yasuhiro; Sohara, Naondo; Okamura, Shinichi; Mori, Masatomo

    2012-09-21

    To define the clinical characteristics, and to assess the management of colonoscopic complications at a local clinic. A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010. Data obtained from a tertiary hospital in the same region were also analyzed. The underlying conditions, clinical presentations, perforation locations, treatment types (operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared. A total of 10  826 colonoscopies, and 2625 therapeutic procedures were performed at a local clinic and 32  148 colonoscopies, and 7787 therapeutic procedures were performed at the tertiary hospital. The clinic had no perforations during diagnostic colonoscopy and 8 (0.3%) perforations were determined to be related to therapeutic procedures. The perforation rates in each therapeutic procedure were 0.06% (1/1609) in polypectomy, 0.2% (2/885) in endoscopic mucosal resection (EMR), and 3.8% (5/131) in endoscopic submucosal dissection (ESD). Perforation rates for ESD were significantly higher than those for polypectomy or EMR (P hospital. Six perforations occurred with therapeutic endoscopy (perforation rate, 0.08%; 1 per 1298 procedures). Perforation rates for specific procedure types were 0.02% (1 per 5500) for polypectomy, 0.17% (1 per 561) for EMR, 2.3% (1 per 43) for ESD in the tertiary hospital. There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital. The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital. No procedure-related mortalities occurred. Performing closure with endoscopic clipping reduced the C-reactive protein (CRP) titers. The mean maximum CRP titer was 2.9 ± 1.6 mg/dL with clipping and 9.7 ± 6.2 mg/dL without clipping

  4. Tertiary Treatment Process of Preserved Wastewater

    Directory of Open Access Journals (Sweden)

    Wang Qingyu

    2016-01-01

    Full Text Available The effects of the composite coagulants on coagulation sedimentation for the preserved wastewater was investigated by changing the composite coagulant dosages, and the coagulant was composed of polymeric ferric sulfate (PFS, polyaluminium chloride (PAC, and polyaluminum ferric silicate (PAFSC, while the effect of the tertiary treatment process on the preserved wastewater was tested, which was exceeded the standard seriously. The results showed that 400 mg/L was the optimum composite coagulant dosage. The removal rates of salt and sugar were as high as 99.1% and 99.5% respectively, and the removal rates of CODCr and SS were 99.3% and 96.0%, respectively after the preserved wastewater was treated by the tertiary treatment technology, which both reached the primary standard of “The Integrated Wastewater Discharge Standard” (GB8978-1996.

  5. Optimising Tertiary Student Accommodation within University Neighbourhoods

    OpenAIRE

    Ike, Nnenna; Baldwin, Claudia; Lathouras, Athena

    2017-01-01

    Tertiary students’ activities within neighbourhoods adjacent to universities engender positive and negative impacts that have consequences for neighbourhood sustainability. This might lead to studentification, a process that triggers physical, economic and socio-cultural transformation of university towns. Where non-student residents perceive negative impacts, it can lead to conflict and resentment towards the student population, mistrust between student and local resident groups and a decrea...

  6. Tertiary lymphoid organs in Takayasu Arteritis

    OpenAIRE

    Marc eClement; Marc eClement; Adrien eGaly; Patrick eBruneval; Marion eMorvan; Fabien eHyafil; Fabien eHyafil; Khadija eBenali; Nicoletta ePasi; Lydia eDeschamps; Quentin ePellenc; Quentin ePellenc; Thomas ePapo; Antonino eNicoletti; Antonino eNicoletti

    2016-01-01

    Objective: The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients.Methods: Hematoxylin and eosin–stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune cells from t...

  7. Tertiary Lymphoid Organs in Takayasu Arteritis

    OpenAIRE

    Clement, Marc; Galy, Adrien; Bruneval, Patrick; Morvan, Marion; Hyafil, Fabien; Benali, Khadija; Pasi, Nicoletta; Deschamps, Lydia; Pellenc, Quentin; Papo, Thomas; Nicoletti, Antonino; Sacre, Karim

    2016-01-01

    Objective The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients. Methods Hematoxylin and eosin-stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune ce...

  8. Updated Simulation Studies of Damage Limit of LHC Tertiary Collimators

    CERN Document Server

    AUTHOR|(CDS)2085459; Bertarelli, Alessandro; Bruce, Roderik; Carra, Federico; Cerutti, Francesco; Gradassi, Paolo; Lechner, Anton; Redaelli, Stefano; Skordis, Eleftherios

    2015-01-01

    The tertiary collimators (TCTs) in the LHC, installed in front of the experiments, in standard operation intercept fractions of 10−3 halo particles. However, they risk to be hit by high-intensity primary beams in case of asynchronous beam dump. TCT damage thresholds were initially inferred from results of destructive tests on a TCT jaw, supported by numerical simulations, assuming simplified impact scenarios with one single bunch hitting the jaw with a given impact parameter. In this paper, more realistic failure conditions, including a train of bunches and taking into account the full collimation hierarchy, are used to derive updated damage limits. The results are used to update the margins in the collimation hierarchy and could thus potentially have an influence on the LHC performance.

  9. A theoretical analysis of procurement auctions for tertiary control in Germany

    International Nuclear Information System (INIS)

    Mueller, Gernot; Rammerstorfer, Margarethe

    2008-01-01

    As far as energy policy is concerned, the design of the regulatory framework for energy transmission and distribution is a key issue. Consequently, also the embodiment of balancing power markets drives mainly the effectiveness of political implications for the energy sector. Initially, tertiary control in Germany was solely offered by transmission system operators of the respective power control areas and their associated power plant. The recast of the Energy Industry Act of 2005 led in last consequence to a common procurement auction for the supply of tertiary control, which starts on December 1, 2006. Admittedly, the reform has fallen short of expectations so far, first concerning the intensification of market entry of tertiary control providers as well as the desired decline of the price level. Hence, this article examines the effects of the changeover on observable demand charges. In order to identify attributes of the common procurement auction for tertiary control hampering market entry of providers, giving stimuli to collusion and strategic behavior, reducing intensity of competition and encouraging an upswing of prices, we analyze the design under an auction theoretical approach and deduce empirically whether structural components of the auction design have to be touched up again

  10. Distribution of Independent Boutique Hotels on Secondary and Tertiary Markets in Germany

    OpenAIRE

    Dambach, Marie-Theres

    2016-01-01

    Boutique hotels are a recent trend in the hospitality industry. As they are receiving more and more attention independent operators on secondary and tertiary markets need to find ways to reach and sell to their customer in order to stay competitive. Therefore, the question is raised whether the way independent German boutique hoteliers distribute their products matches the way their guests prefer or would prefer to buy them. Moreover, it was evaluated if soft brands are an efficient tool to s...

  11. Concise Redox Deracemization of Secondary and Tertiary Amines with a Tetrahydroisoquinoline Core via a Nonenzymatic Process.

    Science.gov (United States)

    Ji, Yue; Shi, Lei; Chen, Mu-Wang; Feng, Guang-Shou; Zhou, Yong-Gui

    2015-08-26

    A concise deracemization of racemic secondary and tertiary amines with a tetrahydroisoquinoline core has been successfully realized by orchestrating a redox process consisted of N-bromosuccinimide oxidation and iridum-catalyzed asymmetric hydrogenation. This compatible redox combination enables one-pot, single-operation deracemization to generate chiral 1-substituted 1,2,3,4-tetrahydroisoquinolines with up to 98% ee in 93% yield, offering a simple and scalable synthetic technique for chiral amines directly from racemic starting materials.

  12. Stereoinversion of tertiary alcohols to tertiary-alkyl isonitriles and amines.

    Science.gov (United States)

    Pronin, Sergey V; Reiher, Christopher A; Shenvi, Ryan A

    2013-09-12

    The SN2 reaction (bimolecular nucleophilic substitution) is a well-known chemical transformation that can be used to join two smaller molecules together into a larger molecule or to exchange one functional group for another. The SN2 reaction proceeds in a very predictable manner: substitution occurs with inversion of stereochemistry, resulting from the 'backside attack' of the electrophilic carbon by the nucleophile. A significant limitation of the SN2 reaction is its intolerance for tertiary carbon atoms: whereas primary and secondary alcohols are viable precursor substrates, tertiary alcohols and their derivatives usually either fail to react or produce stereochemical mixtures of products. Here we report the stereochemical inversion of chiral tertiary alcohols with a nitrogenous nucleophile facilitated by a Lewis-acid-catalysed solvolysis. The method is chemoselective against secondary and primary alcohols, thereby complementing the selectivity of the SN2 reaction. Furthermore, this method for carbon-nitrogen bond formation mimics a putative biosynthetic step in the synthesis of marine terpenoids and enables their preparation from the corresponding terrestrial terpenes. We expect that the general attributes of the methodology will allow chiral tertiary alcohols to be considered viable substrates for stereoinversion reactions.

  13. managing tertiary institutions for the promotion of lifelong learning

    African Journals Online (AJOL)

    Global Journal

    KEYWORDS: Managing, tertiary institutions, promotion, lifelong learning. INTRODUCTION ... science, medicine and technology towards the ... different environments, whether formal, informal ... schools considering that each day gives birth to.

  14. Tertiary windings in power transformers: advantages and disadvantages of their utilization; Enrolamentos terciarios em transformadores de potencia: vantagens e desvantagens de sua utilizacao

    Energy Technology Data Exchange (ETDEWEB)

    Vaccari, Francisco; Alferes, Paulo J.; Etrusco, Wellington M.; Miranda, Rubens Nelson; Komukai, Oscar S.; Laudanna, Paulo R.; Santos, Marcos A. dos; Brito, Joao C.Costa; Melao, Claudio G.; Junqueira Filho, Ary; Mori, Tosio [Companhia Energetica de Sao Paulo (CESP), SP (Brazil)

    1995-12-31

    Problems related to tertiary of some CESP, an electric power company of Sao Paulo state - Southeast Brazil, large scale transformers lead to reevaluation of the need of such windings in future acquisition of such equipment, as well as analyse the consequences of the opening of the tertiary windings in the operating transformers units. Therefore several studies were performed, which are presented in this work 5 figs., 6 tabs., 7 refs.

  15. Management for the children with otitis media with effusion in the tertiary hospital.

    Science.gov (United States)

    Choung, Yun-Hoon; Shin, You Ree; Choi, Seong Jun; Park, Keehyun; Park, Hun Yi; Lee, Jong Bin; Han, Dong Hee; Kahng, Hison

    2008-12-01

    Recently, new evidence-based recommendations have been introduced for diagnosing and managing otitis media with effusion (OME) in children. However, there are some difficulties to follow the general guidelines in the tertiary hospitals. The purpose is to evaluate the efficiency of antibiotics or antihistamines for treatment of children with OME in the tertiary hospital with a randomized prospective clinical study. Eighty-four children with OME who had been diagnosed in the tertiary hospital were randomized to receive 5 different medications for 2 weeks. We prescribed antibiotics (amoxicillin-clavulanate syrup) in Group I (n=16), antibiotics/steroids (prednisolone) in Group II (n=18), antibiotics/antihistamines (ebastine) in Group III (n=15), antibiotics/steroids/antihistamines in Group IV (n=17), and mucolytics (ivy leaf extract) in Group V (n=17) for control. We followed-up children every 2 weeks and evaluated the state of OME at 3 months. Thirty six (42.9%) of 84 children were resolved within average 6.9 weeks after the treatments. Thirty-six (42.9%) were treated with ventilation tube insertion and 12 patients (14.3%) were observed. There was no difference in the resolution rates of OME among the five different protocols (P>0.05). There was no difference in the resolution rates among groups who used steroids, antihistamines, steroids and antihistamines, or other medications to manage 42 children with allergies (P>0.05). In the tertiary hospital, the cure rate of children with OME was not as high as well-known, and antibiotics or anti-allergic medications were not more effective than control. We may, therefore, need any other guidelines which are different from the previous evidence-based recommendations, including early operation in the tertiary hospitals.

  16. Experience of Oesophageal atresia management in a tertiary Bangladeshi hospital.

    Science.gov (United States)

    Islam, Md Kabirul

    2018-01-16

    Background and aim: This study has been conducted to determine the clinical presentations and surgical outcome of patients with OA admitted in a tertiary level hospital in Bangladesh. A prospective analysis was conducted for 32 patients with confirmed OA between July 2007 and June 2015. Of them surgical correction was done in 25 cases. The other 7, in whom surgery could not be done, were excluded from the study. Of the 25 cases, that had been operated, 15 were full term and 52% were more than 48 hours old. Type-C OA with TOF was the commonest type (96%). 24 cases were operated through Right Thoracotomy. Of them 52% were done by Single Lung (left) ventilation. 'Division of the fistula' with 'end to end anastomosis' was done in all of them. Only 1 patient had a Gastric pull up surgery. Of the 25 cases, 16 survived (64%). In follow up all the patients were found thriving and showed no problem in swallowing. Our study which shows 64% survival is a great achievement for us but not satisfactory in international standard. However, the experience and encouragement that we are gathering, will guide us to achieve better result in near future.

  17. Determinants of propensity of tertiary agricultural students in Ghana ...

    African Journals Online (AJOL)

    The study aimed to identify factors that affect the decision of tertiary agricultural students in Ghana to enter agribusiness as a self-employment venture after graduation. The results showed that tertiary agricultural students in Ghana were predominantly males with little or no farming background. They had a rather moderate ...

  18. Crime and Crime Management in Nigeria Tertiary Institutions

    Science.gov (United States)

    Adebanjo, Margaret Adewunmi

    2014-01-01

    This paper examines crime and its management in Nigerian tertiary institutions. Tertiary institutions today have become arenas for crime activities such as rape, cultism, murder, theft, internet fraud, drug abuse, and examination malpractices. This paper delves into what crime is, and its causes; and the positions of the law on crime management.…

  19. Massification and Quality Assurance in Tertiary Education: The ...

    African Journals Online (AJOL)

    The study sets out to examine massification and its impact on quality assurance in tertiary education and the extent to which lecturer–student ratio, adequacy of infrastructure and pedagogical resources affect quality in tertiary institutions. Two research questions and one hypothesis were posed to guide the investigation.

  20. Pushing the frontiers of atomic models for protein tertiary structure ...

    Indian Academy of Sciences (India)

    as an NP complete or NP hard problem.4,5 This notwith- standing, the dire need for tertiary structures of proteins in drug discovery and other areas6–8 has propelled the development of a multitude of computational recipes. In this article, we focus on ab initio/de novo strategies,. Bhageerath in particular, for protein tertiary ...

  1. Academic mentoring and the future of tertiary education in Nigeria ...

    African Journals Online (AJOL)

    Tertiary education is a major outlet for the provision of high manpower for national development. This paper therefore highlighted the challenges of tertiary education in Nigeria, early perspectives of mentoring undergraduates, the rationale for academic mentoring, the role of a mentor, and the role of library as catalyst in the ...

  2. Ensuring Effective Mentoring in Tertiary Institutions in Anambra State ...

    African Journals Online (AJOL)

    This paper concerns itself only with ascertaining the strategies that could ensure effective mentoring in tertiary institutions. The survey method was employed. The study population comprised 78 teacher educators in tertiary institutions in Anambra State. One research question guided the study while one null hypothesis was ...

  3. 10 CFR 212.78 - Tertiary incentive crude oil.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Tertiary incentive crude oil. 212.78 Section 212.78 Energy DEPARTMENT OF ENERGY OIL MANDATORY PETROLEUM PRICE REGULATIONS Producers of Crude Oil § 212.78 Tertiary incentive crude oil. Annual prepaid expenses report. By January 31 of each year after 1980, the project...

  4. 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 ...

  5. Seepage characteristics of the second tertiary combined model

    Directory of Open Access Journals (Sweden)

    Huan ZHAO

    2015-08-01

    Full Text Available The second tertiary combined model experiment zone has been developed in Block B, Field L. The percolation feature of the second tertiary combined develop model shows great importance to rational and efficient development of the reservoir. In order to clearly illuminate its percolation feature, the typical reservoir numerical model is built by Eclipse, which is a reservoir numerical simulation software. The percolation features of original and added perforation interval under the second tertiary combined model are studied, and the variation features of general water-cut, recovery percentage, wellbore pressure, reservoir pressure and water saturation on condition of higher injection rate under the second tertiary combined model are analyzed. The research indicates that the second tertiary combined enhances the recovery of remaining oil on top of thick reservoir by developing and enhancing original perforation interval under water drive, then improves development results by polymer flooding, and gains higher recovery rate by synthetic action of water driver and polymer flooding.

  6. Tertiary lymphoid structures in cancer and beyond.

    Science.gov (United States)

    Dieu-Nosjean, Marie-Caroline; Goc, Jérémy; Giraldo, Nicolas A; Sautès-Fridman, Catherine; Fridman, Wolf Herman

    2014-11-01

    Tertiary lymphoid structures (TLS) are ectopic lymphoid formations found in inflamed, infected, or tumoral tissues. They exhibit all the characteristics of structures in the lymph nodes (LN) associated with the generation of an adaptive immune response, including a T cell zone with mature dendritic cells (DC), a germinal center with follicular dendritic cells (FDC) and proliferating B cells, and high endothelial venules (HEV). In this review, we discuss evidence for the roles of TLS in chronic infection, autoimmunity, and cancer, and address the question of whether TLS present beneficial or deleterious effects in these contexts. We examine the relationship between TLS in tumors and patient prognosis, and discuss the potential role of TLS in building and/or maintaining local immune responses and how this understanding may guide therapeutic interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Navigating the global space of tertiary education:

    DEFF Research Database (Denmark)

    Wilken, Lisanne

    , and to the development of transnational elites. This is especially true for mobile students who attend “elite universities” in the USA, UK and France. As pointed out by sociologist Michael Börjesson (2005), an investment in an education at one of the American Ivy League universities or France’s Grand Ecoles, is not only......Over the past ten years the number of students who go abroad to pursue tertiary education has more than doubled, from 1, 9 million in 2000 to 4.1 million in 2010 (OECD 2012). This growing number of students studying abroad contributes to the overall flow of individuals and ideas across borders...... an investment in a significant educational capital with global applicability, but also an investment in an institutionalized transnational social capital that stretches across most of the world. It is less clear to what extent this also applies to students who go abroad to attend international programs...

  8. JACoW A new distributed control system for the consolidation of the CERN tertiary infrastructures

    CERN Document Server

    Scibile, Luigi; Villeton Pachot, Patrick

    2018-01-01

    The operation of the CERN tertiary infrastructures is carried out via a series of control systems distributed over the CERN sites (Meyrin and Prevessin). The scope comprises: $\\sim$ 260 buildings, 2 large heating plants ($\\sim$ 50 MW overall capacity) with 27 km heating network and 200 radiators circuits, $\\sim$ 500 air handling units, $\\sim$ 52 chillers, $\\sim$ 300 split systems, $\\sim$ 3000 electric boards and $\\sim$ 100k light points. In the last five years and with the launch of major tertiary infrastructure consolidations, CERN is carrying out a migration and an extension of the old control systems dated back to the 70's, 80's and 90's to a new simplified, yet innovative, distributed control system aimed at minimizing the programming and implementation effort, standardizing equipment and methods and reducing lifecycle costs. This new methodology allows for a rapid development and simplified integration of the new controlled building/infrastructure processes. The basic principle is based on open standards...

  9. Laparoscopy in Urology Practice at a Tertiary Care Centre

    International Nuclear Information System (INIS)

    Quddus, M. B.; Mahmud, S. M.

    2014-01-01

    Objective: To describe the results of laparoscopic procedures at a Urology - Nephrology tertiary care centre. Study Design: Case series / observational study. Place and Duration of Study: The Kidney Centre Postgraduate Training Institute, Karachi, from August 2007 to March 2012. Methodology: Medical records of all planned laparoscopic surgery conducted during the study period were reviewed. Those cases which to open surgery were excluded. All were performed by a single surgeon, initially as supervised and later independently. Data was maintained for demographic data, procedure details, length of hospital stay, and complications including conversion to open surgeries. Data was analyzed through SPSS 17.0. Results: There were 36 planned laparoscopic surgeries in the specified period. Out of 36 cases, 8 were converted to open surgery. Those who underwent laparoscopic surgery include two diagnostic procedures and renal cyst deroofing each, four ureterolithotomy, nineteen simple nephrectomy and one radical nephrectomy. So in total 28 cases were performed on 15 females and 13 males with mean age of 33.01 A +- 10.9 years. The mean operative time was 216 A +- 100 minutes and mean length of hospital stay was as 2.7 A +- 1.04 days. There were 10 complications in 28 cases, majority being Clavien Grade II including 7% (2/28) blood transfusion. Conclusion: There are technical challenges in learning laparoscopy for practicing urologists. Following some learning model in a systematic manner will help surmounting the technical challenges in learning laparoscopy. (author)

  10. Mixed La-Li heterobimetallic complexes for tertiary nitroaldol resolution.

    Science.gov (United States)

    Tosaki, Shin-ya; Hara, Keiichi; Gnanadesikan, Vijay; Morimoto, Hiroyuki; Harada, Shinji; Sugita, Mari; Yamagiwa, Noriyuki; Matsunaga, Shigeki; Shibasaki, Masakatsu

    2006-09-13

    A kinetic resolution of tertiary nitroaldols derived from simple ketones is described. Mixed BINOL/biphenol La-Li heterobimetallic complexes gave the best selectivity in retro-nitroaldol reactions of racemic tertiary nitroaldols. By using a mixture of La-Li3-(1a)3 complex (LLB 2a) and La-Li3-(1b)3 (LLB* 2b) complex in a ratio of 2/1, chiral tertiary nitroaldols were obtained in 80-97% ee and 30-47% recovery yield.

  11. Characterization of molybdenum interfacial crud in a uranium mill that employs tertiary-amine solvent extraction

    International Nuclear Information System (INIS)

    Moyer, B.; McDowell, W.J.

    1983-01-01

    In the present work, samples of a molybdenum-caused green gummy interfacial crud from an operating western US uranium mill have been physically and chemically examined. Formaton of cruds of this description has been a long-standing problem in the use of tertiary amine solvent extraction for the recovery of uranium from low-grade ores (Amex Process). The crud is essentially an organic-continuous dispersion containing about 10 wt % aqueous droplets and about 37 wt % greenish-yellow crystalline solids suspended in kerosene-amine process solvent. The greenish-yellow crystals were found to be a previously unknown double salt of tertiary amine molybdophosphate with three tertiary amine chlorides having the empirical formula (R 3 NH) 3 [PMo 12 O 40 ].3(R 3 NH)Cl. To confirm the identification of the compound, a pure trioctylamine (TOA) analog was synthesized. In laboratory extraction experiments, it was demonstrated that organic-soluble amine molydophosphate forms slowly upon contact of TOA solvent with dilute sulfuric acid solutions containing low concentrations of molybdate and phosphate. If the organic solutions of amine molybdophosphate were then contacted with aqueous NaCl solutions, a greenish-yellow precipitate of (TOAH) 3 [PMo 12 O 40 ].3(TOAH)Cl formed at the interface. The proposed mechanism for the formation of the crud under process conditions involves build up of molybdenum in the solvent, followed by reaction with extracted phosphate to give dissolved amine molybdophosphate. The amine molybdophosphate then co-crystallizes with amine chloride, formed during the stripping cycle, to give the insoluble double salt, which precipitates as a layer of small particles at the interface. The proposed solution to the problem is the use of branched-chain, instead of straight-chain, tertiary amine extractants under the expectation that branching would increase the solubility of the double salt. 2 figures, 5 tables

  12. Social Activities and Manifest Anxiety among Freshmen in Tertiary ...

    African Journals Online (AJOL)

    ) in tertiary institutions in Lagos state of Nigeria were analysed to determine the relationship between social activities and manifest anxiety. Social activities in the study were measured in terms of freshmen adjustment to religious activities and ...

  13. Factors affecting utilization of University health services in a tertiary ...

    African Journals Online (AJOL)

    2013-01-16

    Jan 16, 2013 ... Objective: To determine students' perception of health care services provided in a tertiary institution and ... evaluation of health services utilization among students in the .... African culture and health. ... Asian Am Pac Isl J.

  14. Assessment of job satisfaction among health workers in a tertiary ...

    African Journals Online (AJOL)

    Assessment of job satisfaction among health workers in a tertiary hospital in Zaria ... factors affecting job satisfaction and retention of health professionals working in ... help the hospital management to increase their employee's job satisfaction.

  15. Employees' Assessment Of Customer Focus In A Tertiary Hospital In ...

    African Journals Online (AJOL)

    Employees' Assessment Of Customer Focus In A Tertiary Hospital In ... tool 'Are we making progress?' were used by respondents to rate customer focus. ... that they were allowed to take decisions to solve problems for customers (p < 0.001).

  16. Helpless patients' perception of bed-bath in tertiary health ...

    African Journals Online (AJOL)

    Helpless patients' perception of bed-bath in tertiary health institutions in Enugu, Southeast Nigeria. ... Journal Home > Vol 10, No 2 (2005) > ... patients to bed bathing by nurses is a very important aspect of quality assurance in nursing care.

  17. Enhancing learning in tertiary institutions through multimedia based ...

    African Journals Online (AJOL)

    Enhancing learning in tertiary institutions through multimedia based ... convenient and cost-effective courseware reengineering methodology of our age. ... Also discussed are the reasons for converting classroom courses to e-learning format.

  18. Effect of health education on knowledge and attitude of tertiary ...

    African Journals Online (AJOL)

    Background: In order to make good decisions about their sexual and ... of health education on the knowledge and attitude of tertiary school students towards sexually ... Methods: The study employed a quasi-experimental study design in which ...

  19. Integrated Identity and Access Management System for Tertiary ...

    African Journals Online (AJOL)

    Nigerian Journal of Technology ... identity management and access control and the unavailability of actionable information on pattern of ... This Tertiary Identity and Access Management System (T-IAMS) is a fingerprint biometric database that ...

  20. Sexism and Sexual Harassment in Tertiary Institutions | Akpotor ...

    African Journals Online (AJOL)

    Gender and Behaviour ... Sexual harassment is a recurring decimal in tertiary institutions. The paper therefore investigates the effects of sexual harassment on the academic performance of female students, using Delta State University, Abraka, ...

  1. Challenges with Tertiary-Level Mechatronic Fluid Power

    DEFF Research Database (Denmark)

    Dransfield, Peter; Conrad, Finn

    1996-01-01

    As authors we take the view that mechatronics, as it relates to fluid power, has three levels which we designate as primary, secondary and tertiary. A brief review of the current status of fluid power, hydraulic and pneumatic, and of electronic control of it is presented and discussed. The focus...... is then on tertiary-level mechatronic fluid power and the challenges to it being applied successfully....

  2. Interactive Intranet Portal for effective Management in Tertiary Institution

    OpenAIRE

    Idogho O. Philipa; Akpado Kenneth; James Agajo

    2011-01-01

    Interactive Intranet Portal for effective management in Tertiary Institution is an enhanced and interactive method of managing and processing key issues in Tertiary Institution, Problems of result processing, tuition fee payment, library resources management are analyzed in this work. An interface was generated to handle this problem; the software is an interactive one. Several modules are involved in the paper, like: LIBRARY CONSOLE, ADMIN, STAFF, COURSE REGISTRATION, CHECKING OF RESULTS and...

  3. Tertiary colleges: a study of perspectives on organizational innovation

    OpenAIRE

    Preedy, Margaret

    1998-01-01

    The purpose of this research study was to explore organisational innovation in education with reference to one particular type of organisation - the tertiary college. The research sought to examine the extent to which the intended objectives for new educational organisations are realised in practice, and how far the goals and ethos which organisational leaders seek to promote are shared by organisational members. The study focused on eleven tertiary colleges, comparing the 'official' view of ...

  4. Assessment Quality in Tertiary Education: An Integrative Literature Review

    OpenAIRE

    Gerritsen-van Leeuwenkamp, Karin; Joosten-ten Brinke, Desirée; Kester, Liesbeth

    2018-01-01

    In tertiary education, inferior assessment quality is a problem that has serious consequences for students, teachers, government, and society. A lack of a clear and overarching conceptualization of assessment quality can cause difficulties in guaranteeing assessment quality in practice. Thus, the aim of this study is to conceptualize assessment quality in tertiary education by providing an overview of the assessment quality criteria, their influences, the evaluation of the assessment quality ...

  5. CLINICAL SPECTRUM OF HYPONATRAEMIA IN TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Suresh Chincholi

    2017-02-01

    Full Text Available BACKGROUND Hyponatraemia is defined as a serum sodium level less than 135 mEq/L. High mortality among the patients of hyponatraemia is secondary to the underlying medical condition. Frequency is high in elderly patients. MATERIALS AND METHODS The study was conducted at a tertiary care centre (Basaveshwar Teaching and General Hospital, Gulbarga, from the period September 2014 to August 2016. These patients were evaluated for the underlying cause of hyponatraemia, which included detailed history and physical examination followed by appropriate laboratory investigations. Patients were followed up till the hyponatraemia was treated or patients were discharged from the hospital. RESULTS 100 patients of hyponatraemia were included in the study. 46% of the patients were asymptomatic. 33% patients had lethargy, 28% patients had postural dizziness and 19% had abnormal behaviour. Overall incidence of hyponatraemia was 4.58% in the hospitalised population, whereas its incidence in ICU patients was 22.4%. Twelve patients of symptomatic severe hyponatraemia were treated with hypertonic saline infusion, 25% patients were given loop diuretics with oral supplementation of sodium chloride for free water excretion in SIADH cases and in patients with hypervolaemia, hyponatraemia, fluid restriction was advised to 44 patients, oral supplementation of sodium chloride was given in 36 patients and 64 patients received normal saline. 9 patients included in the study died, 5 of which had advanced cirrhosis of liver as underlying cause. One patient developed Osmotic Demyelination Syndrome (ODS. CONCLUSION The possible cause of hyponatraemia should always be sought as outcome in severe hyponatraemia is governed by aetiology, and not by the serum sodium level. Treatment of severe symptomatic hyponatraemia with hypertonic saline is safe if recommendation for the rate of correction of hyponatraemia is strictly followed.

  6. Tertiary lymphoid organs in Takayasu Arteritis

    Directory of Open Access Journals (Sweden)

    Marc eClement

    2016-04-01

    Full Text Available Objective: The role of B cells in the pathogenesis of Takayasu arteritis (TA is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs in the aortic wall of TA patients.Methods: Hematoxylin and eosin–stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20, follicular dendritic cells (FDCs, CD21, and high endothelial venules (HEVs, PNAd was investigated by immunohistochemistry. Immune cells from the adventitial layer of one patient were characterized by flow cytometry. Demographic, medical history, laboratory, imaging, treatment and follow up data were extracted from medical records.Results: Aorta specimens from Bentall procedures were available from 7 patients (five female, aged 22 to 57 years with TA. Surgical treatment was performed at TA diagnosis (n=4 or at a median of 108 months [84-156] after TA diagnosis. Disease was active at surgery in four patients according to NIH score. B cell aggregates-TLOs containing HEVs were observed in the adventitia of all but one patient.. Of note, ectopic follicles containing CD21+ FDCs were found in all patients (4/4 with increased aortic FDG uptake before surgery but were absent in all but one patients (2/3 with no FDG uptake. In addition, flow cytometry analysis confirmed the accumulation of memory/germinal center–like B cells in the adventitial layer and showed the presence of antigen-experienced T follicular helper cells.Conclusion: Ectopic lymphoid neogenesis displaying functional features can be found in the aortic wall of a subset of patients with active TA. The function of these local B cell clusters on the pathogenesis of TA remains to be elucidated.

  7. Tertiary Lymphoid Organs in Takayasu Arteritis.

    Science.gov (United States)

    Clement, Marc; Galy, Adrien; Bruneval, Patrick; Morvan, Marion; Hyafil, Fabien; Benali, Khadija; Pasi, Nicoletta; Deschamps, Lydia; Pellenc, Quentin; Papo, Thomas; Nicoletti, Antonino; Sacre, Karim

    2016-01-01

    The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients. Hematoxylin and eosin-stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune cells from the adventitial layer of one patient were characterized by flow cytometry. Demographic, medical history, laboratory, imaging, treatment, and follow-up data were extracted from medical records. Aorta specimens from Bentall procedures were available from seven patients (5 females, aged 22-57 years) with TA. Surgical treatment was performed at TA diagnosis (n = 4) or at a median of 108 months (84-156) after TA diagnosis. Disease was active at surgery in four patients according to NIH score. B cell aggregates-TLOs containing HEVs were observed in the adventitia of all but one patient. Of note, ectopic follicles containing CD21(+) FDCs were found in all patients (4/4) with increased aortic (18)F-fluoro-deoxyglucose (FDG) uptake before surgery but were absent in all but one patients (2/3) with no FDG uptake. In addition, flow cytometry analysis confirmed the accumulation of memory/germinal center-like B cells in the adventitial layer and showed the presence of antigen-experienced T follicular helper cells. Ectopic lymphoid neogenesis displaying functional features can be found in the aortic wall of a subset of patients with active TA. The function of these local B cell clusters on the pathogenesis of TA remains to be elucidated.

  8. Frequency of fungal infection in the nasal polyposis patients undergoing polypectomy in a tertiary care unit

    International Nuclear Information System (INIS)

    Jawad, A.; Nisar, Y.B.

    2015-01-01

    Objective: To determine the frequency of fungal infection in nasal polyposis patients undergoing polypectomy in a tertiary care ENT unit. Methodology: This cross sectional study was conducted in the department of ENT, Pakistan Institute of Medical Sciences, Islamabad. A total of 60 patients with nasal polyposis were enrolled. Patients who did not give consent, with sinonasal malignancy, diabetes, and pregnant or lactating women were excluded from study. All the patients were operated and specimens of polypectomies were sent to the Department of Pathology for fungal culture, direct microscopy and histopathology. Data was entered and analysed using SPSS version 20. (author)

  9. Auditing surgical service provision at a South African tertiary institution: Implications for the development of district services.

    Science.gov (United States)

    Laing, G L; Skinner, D L; Bruce, J L; Aldous, C; Govindasamy, V; Thomson, S R; Clarke, D L

    2017-11-01

    The optimal management of resources within South African state hospitals has been hampered by a paucity of data due to a lack of robust auditing information systems. This study reviews the use of a Hybrid Electronic Medical Record (HEMR) system to capture and aggregate data pertaining to the inpatient service demands on a South African tertiary surgical service. This dataset was used to analyse the appropriateness of tertiary surgical resource utilisation. The HEMR system was implemented at Greys Hospital, in the city of Pietermaritzburg, Kwa-Zulu Natal, South Africa on 1 January 2013. Inpatient data pertaining to surgical admissions and operative interventions were captured prospectively. Following an 18-month study period, the data were extracted, aggregated and analysed. The district referral hospitals were mapped, and district surgical procedures performed within the tertiary center were identified and quantified. Results: 7314 patients were admitted and managed by the tertiary surgical service during the study period. The median patient age was 33 years (IQR 6.5-42.4 years). 59.7% were male and 40.3% were female. General, trauma and paediatric surgical admissions constituted 54.8%, 28.6% and 16.6% respectively. Emergency admissions constituted 62.4% and elective admissions 37.6%. Referral sources were captured for 6653 (91%) of the cohort. 4338 (65.2%) patients were referred from district hospitals. The district hospital (Northdale) closest to Greys Hospital was responsible for 1675 (25.2%) of surgical referrals. 4174 operative procedures were performed during the study period, 54.7% performed as an emergency, 34.1% electively and 11.2% semi-electively. The median waiting time for emergency operative intervention was 535 minutes (IQR 130-663). A total of 1272 (30.5%) operative procedures performed were assessed as district-level operations. The time intervals of 07:00-07:59 and 17:00-17:59 were identified as the time periods during which the least number of

  10. An approach of optimal sensitivity applied in the tertiary loop of the automatic generation control

    Energy Technology Data Exchange (ETDEWEB)

    Belati, Edmarcio A. [CIMATEC - SENAI, Salvador, BA (Brazil); Alves, Dilson A. [Electrical Engineering Department, FEIS, UNESP - Sao Paulo State University (Brazil); da Costa, Geraldo R.M. [Electrical Engineering Department, EESC, USP - Sao Paulo University (Brazil)

    2008-09-15

    This paper proposes an approach of optimal sensitivity applied in the tertiary loop of the automatic generation control. The approach is based on the theorem of non-linear perturbation. From an optimal operation point obtained by an optimal power flow a new optimal operation point is directly determined after a perturbation, i.e., without the necessity of an iterative process. This new optimal operation point satisfies the constraints of the problem for small perturbation in the loads. The participation factors and the voltage set point of the automatic voltage regulators (AVR) of the generators are determined by the technique of optimal sensitivity, considering the effects of the active power losses minimization and the network constraints. The participation factors and voltage set point of the generators are supplied directly to a computational program of dynamic simulation of the automatic generation control, named by power sensitivity mode. Test results are presented to show the good performance of this approach. (author)

  11. Survival following orbital exenteration at a tertiary brazilian hospital

    Directory of Open Access Journals (Sweden)

    Juliana Mika Kato

    Full Text Available Objective: to analyze the epidemiology, clinical features and survival rate of patients undergoing orbital exenteration (OE in a tertiary referral hospital. Methods : we conducted a retrospective study of all patients undergoing OE at the Hospital das Clínicas, FMUSP between January 2007 and December 2012. We collected data records related to gender, age, origin, length of stay, duration of the disease, other treatments related to the disease, number of procedures outside of the face related to the disease, follow-up and histological diagnosis. Results : we treated 37 patients in the study period. The average survival in one year was 70%, in two years, 66.1%, and 58.3% in three years. There was no significant difference in the one-year survival related to histological diagnosis (p=0.15, days of hospitalization (p=0.17, gender (p=0.43, origin (p=0.78, disease duration (p=0.27 or the number of operations for the tumor (p=0.31. Mortality was higher in elderly patients (p=0.02. The average years of life lost was 33.9 in patients under 60 years, 14.7 in patients in the 61-80 years range and 11.3 in patients over 80 years. Conclusion : the present series of cases is significant in terms of prevalence of orbital exenteration; on the other hand, it shows one of the lowest survival rates in the literature. This suggests an urgent need for improved health care conditions to prevent deforming, radical resections.

  12. Biometric Secured Result Processing Software For Nigerian Tertiary Institutions

    Directory of Open Access Journals (Sweden)

    Oladipo Oluwasegun

    2015-08-01

    Full Text Available Abstract One of the challenges facing result processing in Nigerian tertiary institutions is the problem of insecurity. Untraceable changes are made to students result and this result to various disasters such as innocent people losing their jobs since their innocence cannot be proven. Biometric based systems operate on behavioral and physiological biometric data to identify a person and grant required access to a user. Physiological characteristics such as fingerprint remains unchanged throughout an individuals life time and thus it can serve as a viable means of identifying and authenticating users who are to access a system. In this study fingerprint biometric based result processing software is developed to ensure that users are well authenticated and are made to see only what they are pre-configured to see and work with. The fingerprint authentication system was developed using visual basic.net. Staff fingerprints were enrolled into the system to form a biometric template which the system validates against at every login attempt on the result processing software. The digital personal one touch ID sdk and other libraries were used in developing the authentication system. The result processing software also ensures that all write transactions to the database are confirmed and identified by forcing another biometric authentication at the point of making a write request to the web server and associated database. This ensures that the exact person initiating the transaction was the same user who logged in to the application. The users identified at login and various confirmation milestones set for write transactions are logged into a table for future reference and audit trail. Conclusively the developed system has helped to eradicate the problem of user impersonation by ensuring only authorized users are made to access the software and in-turn participate in result processing activities.

  13. Urgent tracheostomy: four-year experience in a tertiary hospital.

    Science.gov (United States)

    Costa, Liliana; Matos, Ricardo; Júlio, Sara; Vales, Fernando; Santos, Margarida

    2016-01-01

    Urgent airway management is one of the most important responsibilities of otolaryngologists, often requiring a multidisciplinary approach. Urgent surgical airway intervention is indicated when an acute airway obstruction occurs or there are intubation difficulties. In these situations, surgical tracheostomy becomes extremely important. We retrospectively studied the patients who underwent surgical tracheostomy from 2011 to 2014 by an otolaryngologist team at the operating theater of the emergency department of a tertiary hospital. Indications, complications and clinical evolution of the patients were reviewed. The study included 56 patients (44 men and 12 women) with a median age of 55 years. The procedure was performed under local anesthesia in 21.4% of the patients. Two (3.6%) patients were subjected to conversion from cricothyrostomy to tracheostomy. Head and neck neoplasm was indicated in 44.6% of the patients, deep neck infection in 19.6%, and bilateral vocal fold paralysis in 10.7%. Stridor was the most frequent signal (51.8%). Of the 56 patients, 15 were transferred to another hospital. Among the other 41 patients, 21 were decannulated (average time: 4 months), and none of them were cancer patients. Complications occurred in 5 (12.2%) patients: hemorrhage in 3, surgical wound infection in 1, and cervico-thoracic subcutaneous emphysema in 1. No death was related to the procedure. Urgent tracheostomy is a life-saving procedure for patients with acute airway obstruction or with difficult intubation. It is a safe and effective procedure, with a low complication rate, and should be performed before the patient's clinical status turns into a surgical emergency situation.

  14. Safety Climate of Ab-Initio Flying Training Organizations: The Case of an Australian Tertiary (Collegiate) Aviation Program

    OpenAIRE

    Gao, Yi; Rajendran, Natalia

    2017-01-01

    A healthy safety culture is essential to the safe operation of any aviation organization, including flight schools. This study aimed to assess the safety climate of an Australian tertiary (collegiate) aviation program using a self-constructed instrument. Factor analysis of the instrument identified four safety themes, which are Safety Reporting Culture, Safety Reporting Procedure, Organizational Culture and Practice, and General Safety Knowledge. The responses of student pilots suggested that...

  15. The equity imperative in tertiary education: Promoting fairness and efficiency

    Science.gov (United States)

    Salmi, Jamil; Bassett, Roberta Malee

    2014-06-01

    While the share of the tertiary education age cohort (19-25) which is being given the opportunity to study has increased worldwide over the past two decades, this does not in fact translate into reduced inequality. For many young people, especially in the developing world, major obstacles such as disparities in terms of gender, minority population membership or disabilities as well as academic and financial barriers are still standing in their way. The authors of this article propose a conceptual framework to analyse equity issues in tertiary education and document the scope, significance and consequences of disparities in tertiary education opportunities. They throw some light on the main determinants of these inequalities and offer suggestions about effective equity promotion policies directed towards widening participation and improving the chances of success of underprivileged youths in order to create societies which uphold humanistic values.

  16. Tertiary wastewater treatment in membrane photobioreactor using microalgae: Comparison of forward osmosis & microfiltration.

    Science.gov (United States)

    Praveen, Prashant; Heng, Jonathan Yun Ping; Loh, Kai-Chee

    2016-12-01

    Discharge of wastewater with high nitrogen and phosphorus content is a major cause of eutrophication. In this study, a microfiltration-based membrane photobioreactor (MPBR) and forward osmosis-based osmotic membrane photobioreactor (OMPBR) have been operated with Chlorella vulgaris for continuous tertiary wastewater treatment. Both the bioreactors exhibited good biomass accumulation (over 2g/L), although the OMPBR achieved better nutrients removal due to high rejection properties of the membranes. At 2days HRT, the OMPBR achieved nitrogen and phosphorus removal efficiencies of 86-99% and 100%, respectively, whereas the corresponding values in the MPBR were 48-97% and 46%, respectively. Based on the energy input, the total operating costs for OMPBR were 32-45% higher than that of the MPBR, and filtration cost for OMPBR was 3.5-4.5 folds higher than that of the MPBR. These results indicate that the integration of membrane filtration with photobioreactors is promising in microalgae-based tertiary wastewater treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Investigating the expectations of business management students as future leaders regarding the influence of leadership on organisational strategy: A survey at a South African tertiary institution

    OpenAIRE

    Dawid A.J. Bornman

    2017-01-01

    Orientation: Unpredictable technology changes challenge how organisations operate in the global competitive business environment. Organisational strategy needs to be flexible, a capability that is impossible to achieve without effective leadership. Research purpose: To investigate the expectations of first year undergraduate business management students at a South African tertiary institution towards leadership and to what extent leadership influences organisational strategy. Motivation...

  18. Spatio-temporal observations of the tertiary ozone maximum

    Directory of Open Access Journals (Sweden)

    V. F. Sofieva

    2009-07-01

    Full Text Available We present spatio-temporal distributions of the tertiary ozone maximum (TOM, based on GOMOS (Global Ozone Monitoring by Occultation of Stars ozone measurements in 2002–2006. The tertiary ozone maximum is typically observed in the high-latitude winter mesosphere at an altitude of ~72 km. Although the explanation for this phenomenon has been found recently – low concentrations of odd-hydrogen cause the subsequent decrease in odd-oxygen losses – models have had significant deviations from existing observations until recently. Good coverage of polar night regions by GOMOS data has allowed for the first time to obtain spatial and temporal observational distributions of night-time ozone mixing ratio in the mesosphere.

    The distributions obtained from GOMOS data have specific features, which are variable from year to year. In particular, due to a long lifetime of ozone in polar night conditions, the downward transport of polar air by the meridional circulation is clearly observed in the tertiary ozone maximum time series. Although the maximum tertiary ozone mixing ratio is achieved close to the polar night terminator (as predicted by the theory, TOM can be observed also at very high latitudes, not only in the beginning and at the end, but also in the middle of winter. We have compared the observational spatio-temporal distributions of the tertiary ozone maximum with that obtained using WACCM (Whole Atmosphere Community Climate Model and found that the specific features are reproduced satisfactorily by the model.

    Since ozone in the mesosphere is very sensitive to HOx concentrations, energetic particle precipitation can significantly modify the shape of the ozone profiles. In particular, GOMOS observations have shown that the tertiary ozone maximum was temporarily destroyed during the January 2005 and December 2006 solar proton events as a result of the HOx enhancement from the increased ionization.

  19. Discovery of tertiary sulfonamides as potent liver X receptor antagonists.

    Science.gov (United States)

    Zuercher, William J; Buckholz, Richard G; Campobasso, Nino; Collins, Jon L; Galardi, Cristin M; Gampe, Robert T; Hyatt, Stephen M; Merrihew, Susan L; Moore, John T; Oplinger, Jeffrey A; Reid, Paul R; Spearing, Paul K; Stanley, Thomas B; Stewart, Eugene L; Willson, Timothy M

    2010-04-22

    Tertiary sulfonamides were identified in a HTS as dual liver X receptor (LXR, NR1H2, and NR1H3) ligands, and the binding affinity of the series was increased through iterative analogue synthesis. A ligand-bound cocrystal structure was determined which elucidated key interactions for high binding affinity. Further characterization of the tertiary sulfonamide series led to the identification of high affinity LXR antagonists. GSK2033 (17) is the first potent cell-active LXR antagonist described to date. 17 may be a useful chemical probe to explore the cell biology of this orphan nuclear receptor.

  20. Usability of cerebrospinal fluid biomarkers in a tertiary memory clinic

    DEFF Research Database (Denmark)

    Brandt, C.; Bahl, J.C.; Heegaard, N.H.

    2008-01-01

    AIM: Assays for cerebrospinal fluid (CSF) levels of total tau, phospho-tau protein and beta-amyloid 1-42 have been available for some years. The aim of the study was to assess the usability of these biomarkers in a mixed population of tertiary dementia referral patients in a university-based memory......, the sensitivity of a single abnormal value was between 33 and 66%. The specificity was high except when discriminating AD from amnestic mild cognitive impairment. Two or more abnormal markers further increased the specificity and decreased the sensitivity. CONCLUSION: In a tertiary setting, abnormal CSF biomarker...

  1. Sexual harassment in tertiary institutions: A comparative perspective

    Directory of Open Access Journals (Sweden)

    Joseph Janice

    2015-01-01

    Full Text Available Sexual harassment is not a new phenomenon in tertiary institutions. It has been receiving considerable attention in research and the media and public awareness has increased dramatically. However, the term sexual harassment is not used uniformly across the globe because countries have defined it differently. Consequently, prevalence of sexual harassment in education varies across cultures. This paper examines sexual harassment from a comparative perspective. It specifically focuses on the definition of sexual harassment, incidence of sexual harassment of students in tertiary institutions, effects of sexual harassment on victims; and victims’ responses to sexual harassment. It also offers suggestions for curtailing sexual harassment in these institutions.

  2. Forensic analysis of tertiary-butyl alcohol (TBA) detections in a hydrocarbon-rich groundwater basin.

    Science.gov (United States)

    Quast, Konrad W; Levine, Audrey D; Kester, Janet E; Fordham, Carolyn L

    2016-04-01

    Tertiary-butyl alcohol (TBA), a high-production volume (HPV) chemical, was sporadically detected in groundwater and coalbed methane (CBM) wells in southeastern Colorado's hydrocarbon-rich Raton Basin. TBA concentrations in shallow water wells averaged 75.1 μg/L, while detections in deeper CBM wells averaged 14.4 μg/L. The detection of TBA prompted a forensic investigation to try to identify potential sources. Historic and recent data were reviewed to determine if there was a discernable pattern of TBA occurrence. Supplemental samples from domestic water wells, monitor wells, CBM wells, surface waters, and hydraulic fracturing (HF) fluids were analyzed for TBA in conjunction with methyl tertiary-butyl ether (MTBE) and ethyl tertiary-butyl ether (ETBE), proxies for evidence of contamination from reformulated gasoline or associated oxygenates. Exploratory microbiological sampling was conducted to determine if methanotrophic organisms co-occurred with TBA in individual wells. Meaningful comparisons of historic TBA data were limited due to widely varying reporting limits. Mapping of TBA occurrence did not reveal any spatial patterns or physical associations with CBM operations or contamination plumes. Additionally, TBA was not detected in HF fluids or surface water samples. Given the widespread use of TBA in industrial and consumer products, including water well completion materials, it is likely that multiple diffuse sources exist. Exploratory data on stable isotopes, dissolved gases, and microbial profiling provide preliminary evidence that methanotrophic activity may be producing TBA from naturally occurring isobutane. Reported TBA concentrations were significantly below a conservative risk-based drinking water screening level of 8000 μg/L derived from animal toxicity data.

  3. A Case Series of the Probability Density and Cumulative Distribution of Laryngeal Disease in a Tertiary Care Voice Center.

    Science.gov (United States)

    de la Fuente, Jaime; Garrett, C Gaelyn; Ossoff, Robert; Vinson, Kim; Francis, David O; Gelbard, Alexander

    2017-11-01

    To examine the distribution of clinic and operative pathology in a tertiary care laryngology practice. Probability density and cumulative distribution analyses (Pareto analysis) was used to rank order laryngeal conditions seen in an outpatient tertiary care laryngology practice and those requiring surgical intervention during a 3-year period. Among 3783 new clinic consultations and 1380 operative procedures, voice disorders were the most common primary diagnostic category seen in clinic (n = 3223), followed by airway (n = 374) and swallowing (n = 186) disorders. Within the voice strata, the most common primary ICD-9 code used was dysphonia (41%), followed by unilateral vocal fold paralysis (UVFP) (9%) and cough (7%). Among new voice patients, 45% were found to have a structural abnormality. The most common surgical indications were laryngotracheal stenosis (37%), followed by recurrent respiratory papillomatosis (18%) and UVFP (17%). Nearly 55% of patients presenting to a tertiary referral laryngology practice did not have an identifiable structural abnormality in the larynx on direct or indirect examination. The distribution of ICD-9 codes requiring surgical intervention was disparate from that seen in clinic. Application of the Pareto principle may improve resource allocation in laryngology, but these initial results require confirmation across multiple institutions.

  4. Montane pollen from the Tertiary of NW. Borneo

    NARCIS (Netherlands)

    Muller, J.

    1966-01-01

    In NW. Borneo thick series of Tertiary sediments occur which are rich in fossil pollen and spores. The majority of these plant microfossils were derived from the various types of tropical lowland vegetation such as mangrove (Muller, 1964), mixed peat swamp forest and mixed Dipterocarp forest. Some

  5. Adults Studying Pure Mathematics in Adult Tertiary Preparation.

    Science.gov (United States)

    Bennison, Anne

    2002-01-01

    Investigated the experiences of a group of adults enrolled in the Pure Mathematics module of the Certificate IV in Adult Tertiary Preparation in 2000 at one of the Institutes of TAFE in Brisbane, Australia. Classroom learning experiences, exposure to technology, and the impact of returning to study on other facets of students' lives were…

  6. Indications for and outcomes of tertiary referrals in refractive surgery

    NARCIS (Netherlands)

    Patryn, Eliza K.; Vrijman, Violette; Nieuwendaal, Carla P.; van der Meulen, Ivanka J. E.; Mourits, Maarten P.; Lapid-Gortzak, Ruth

    2014-01-01

    To review the spectrum of disease, symptomatology, and management offered to patients referred for a second opinion after refractive surgery. A prospective cohort study was done on all patients referred from October 1, 2006, to September 30, 2011, to a tertiary eye clinic after refractive surgery of

  7. Knowledge and perception of plastic surgery among tertiary ...

    African Journals Online (AJOL)

    2015-10-16

    Oct 16, 2015 ... tertiary education students in Enugu, South‑East. Nigeria. CM Isiguzo ..... This finding should be a motivation for plastic surgeons who have private ... population of this country some of whom travel abroad to source for these ...

  8. Sexual Harassment in Tertiary Science: Implications for Gender Equity

    African Journals Online (AJOL)

    The paper focuses on the incidence of sexual harassment in tertiary science education and its attendant effects on students and academics. Data from a survey of six higher institutions comprising two universities, two colleges of education and two polytechnics was used. Results indicate high rate of sexual harassment of ...

  9. Research Productivity of ]unior Academic Staff at a Tertiary Medical ...

    African Journals Online (AJOL)

    Research Productivity of ]unior Academic Staff at a Tertiary Medical College in South West, Nigeria. OA Lesi, OO Orenuga, A Roberts, OO Abudu. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL.

  10. Utilization of Antihypertensive Drugs: A Comparison of Tertiary and ...

    African Journals Online (AJOL)

    To compare the quality of antihypertensive prescriptions at 2 different health care levels in a hypertensive Nigerian population.We carried out a retrospective comparative analysis of the quality and pattern of antihypertensive and low-dose aspirin prescription in a tertiary and two secondary health care institutions providing ...

  11. Improving listening skills of tertiary level students for effective ...

    African Journals Online (AJOL)

    Listening is essential to the leaming process. Students in tertiary institutions of learning need to acquire effective listening and note-taking skiils in order to benefit from lectures. This paper focused on factors militating against effective listening during lectures such as poor rate of presentation, poor communication skills, ...

  12. Knowledge, attitude, and infection control practices of two tertiary ...

    African Journals Online (AJOL)

    2014-04-02

    Apr 2, 2014 ... This study assessed the effects of the implementation of the policy in a tertiary hospital in Port Harcourt, ... malpractice suit in developing countries, not only for the ... Infection control policy has however been shown to reduce the burden of ..... SSIs‑activities that mirror the plan‑do‑check‑act that is applied in ...

  13. Counselling for Sustainable Peace in Tertiary Institutions in Nigeria

    Science.gov (United States)

    Nduka-Ozo, Stella Ngozi

    2016-01-01

    This study reviewed the nature of peace in Tertiary Institutions in Nigeria using Ebonyi State University as a case study. The purpose of the study was to review the various factors responsible for lack of peace. The sample was drawn from the three hundred level students of the Faculty of Education. Thirty students were selected from each of the…

  14. Food Insecurity: Is It an Issue among Tertiary Students?

    Science.gov (United States)

    Gallegos, Danielle; Ramsey, Rebecca; Ong, Kai Wen

    2014-01-01

    Insufficient access to food is known to compromise tertiary studies. Students often belong to groups known to have poor food security such as those renting or relying on government payments. The present study administered a cross-sectional survey incorporating the USDA food security survey module (FSSM) to 810 students at a metropolitan university…

  15. Sexual behaviours of undergraduates of tertiary institutions in Kwara ...

    African Journals Online (AJOL)

    The study also examined whether or not variables of gender and school type had significant influence on the sexual behaviours of undergraduates of tertiary ... the school counsellors and teachers should provide guidance to students on developmental challenges and help youths to abstain from risky sexual behaviours.

  16. Tertiary Institutions, Entrepreneurship Education and Youth Empowerment in Nigeria

    Science.gov (United States)

    Olasunkanmi, Abari Ayodeji; Olufunke, Oyetola Idowu; Adetayo, Okunuga Adedapo

    2013-01-01

    Entrepreneurship Education has recently become a global phenomenon in the development of world youths for self employment and self-reliance. The Nigerian nation cannot afford to be left out and left behind in this new trend in education both at the secondary and tertiary levels. However, while the Universal Basic Education (UBE) curriculum has…

  17. Epilepsy in Ireland: towards the primary-tertiary care continuum.

    Science.gov (United States)

    Varley, Jarlath; Delanty, Norman; Normand, Charles; Coyne, Imelda; McQuaid, Louise; Collins, Claire; Boland, Michael; Grimson, Jane; Fitzsimons, Mary

    2010-01-01

    Epilepsy is a chronic neurological disease affecting people of every age, gender, race and socio-economic background. The diagnosis and optimal management relies on contribution from a number of healthcare disciplines in a variety of healthcare settings. To explore the interface between primary care and specialist epilepsy services in Ireland. Using appreciative inquiry, focus groups were held with healthcare professionals (n=33) from both primary and tertiary epilepsy specialist services in Ireland. There are significant challenges to delivering a consistent high standard of epilepsy care in Ireland. The barriers that were identified are: the stigma of epilepsy, unequal access to care services, insufficient human resources, unclear communication between primary-tertiary services and lack of knowledge. Improving the management of people with epilepsy requires reconfiguration of the primary-tertiary interface and establishing clearly defined roles and formalised clinical pathways. Such initiatives require resources in the form of further education and training and increased usage of information communication technology (ICT). Epilepsy services across the primary-tertiary interface can be significantly enhanced through the implementation of a shared model of care underpinned by an electronic patient record (EPR) system and information communication technology (ICT). Better chronic disease management has the potential to halt the progression of epilepsy with ensuing benefits for patients and the healthcare system. Copyright 2009 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. Relevance of Donation to Special Federal Tertiary Institution ...

    African Journals Online (AJOL)

    While structured and open-ended interview and relevant documents, including gift and donation files, acquisition records and library accession registers were used to collect data for the study. The population of the study consisted of the Special Federal Tertiary Institution Libraries under study while the subjects of the study ...

  19. Epidemiology of paediatric poisoning reporting to a tertiary hospital ...

    African Journals Online (AJOL)

    Methods. We conducted a retrospective study from January 2007 to January 2012 at the Komfo Anokye Teaching Hospital, a tertiary hospital in Ghana. Results. Poisoning is a significant health problem in the study area. A total of 253 children reported to the hospital with poisoning over the 61month period, with an average ...

  20. Noble metals in cretaceous/tertiary sediments from El Kef

    International Nuclear Information System (INIS)

    Kuslys, M.; Kraehenbuehl, U.

    1983-01-01

    Sediments from El Kef, Tunisia, were analysed by RNAA for Au, Ir and Os. All three elements show a 10-20 fold enrichment at the Cretaceous/Tertiary boundary. This enrichment must be the result of the addition of material with a high concentration of noble metals. It is plausible that this exotic material has an extra-terrestrial origin. (orig.)

  1. Noble metals in Cretaceous/Tertiary sediments from El Kef

    International Nuclear Information System (INIS)

    Kuslys, M.; Kraehenbuehl, U.

    1983-01-01

    Sediments from El Kef, Tunisia, were analysed by RNAA for Au, Ir and Os. All three elements show a 10-20 fold enrichment at the Cretaceous/Tertiary boundary. This enrichment must be the result of the addition of material with a high concentration of noble metals. It is plausible that this exotic material has an extraterrestrial origin. (orig.)

  2. Initial Educational Experiences of Tertiary Students. LSAY Briefing Number 14

    Science.gov (United States)

    Hillman, Kylie

    2008-01-01

    This "Briefing" presents information about the initial tertiary education experiences, such as satisfaction with aspects of student life and changes to initial enrolments, of two groups of young people, based on two recent Longitudinal Surveys of Australian Youth (LSAY) research reports. One study focused on the first year experiences of…

  3. Hand hygiene amongst dental professionals in a tertiary dental clinic ...

    African Journals Online (AJOL)

    Objective: To evaluate hand washing attitude and practices among Dentists and Dental Students treating patients in a Nigerian Tertiary Dental Clinic. Materials and Methods: A cross-sectional survey of Dentists and Dental Students treating patients in University of Benin Teaching Hospital was conducted between February ...

  4. Self care activities among patients with diabetes attending a tertiary ...

    African Journals Online (AJOL)

    Self care activities among patients with diabetes attending a tertiary care hospital in Mangalore Karnataka, India. ... Conclusions: Self‑care practices were found to be unsatisfactory in almost all aspects except for blood sugar monitoring and treatment adherence. As these practices are essential for prevention of ...

  5. Accountability of Tertiary Education at the National Level: A Chimera?

    Science.gov (United States)

    Lindsay, Alan; O'Byrne, Garry

    1979-01-01

    The concept of accountability and its application to Australian higher education are discussed. It is suggested that due to political, financial, and educational characteristics of tertiary education at the national system level there are fundamental and insoluble problems associated with achieving accountability. (SF)

  6. An audit of colorectal cancer histopathology reports in a Tertiary ...

    African Journals Online (AJOL)

    Objective: To audit the completeness of histopathologic reports of Colorectal Cancer for prognostic information in a tertiary care hospital in the light of the minimum reporting standards for colorectal cancer resections recently proposed for use in Nigeria. Material and Methods: Twenty–five histopathology reports of colorectal ...

  7. Maternal mortality audit in a tertiary health institution in Nigeria ...

    African Journals Online (AJOL)

    Introduction: Nigeria has the second highest number of maternal deaths in the world.The study aimed at determining the causes of and non-obstetric contributors to maternal mortality at a tertiary referral hospital. Materials and Methods: It was a prospective audit of all consecutive maternal deaths in the hospital over a ...

  8. Drug Production in Tertiary Health Institutions – Needs, Constraints ...

    African Journals Online (AJOL)

    The use of questionnaires was employed in the study covering all pharmacists in the pharmaceutical services department, pharmacy technicians and quality control technologist in the drug production unit of the hospital. It was unanimously agreed by the respondents that local drug production was necessary in tertiary ...

  9. Omalizumab use during pregnancy for CIU: a tertiary care experience.

    Science.gov (United States)

    Cuervo-Pardo, L; Barcena-Blanch, M; Radojicic, C

    2016-07-01

    The treatment of antihistamine and steroid resistant Chronic Idiopathic Urticaria (CIU) during pregnancy poses a challenge due to teratogenicity of immunosuppressants. Omalizumab is a recently FDA approved therapy for CIU and is classified as pregnancy category B. We present an initial series of subjects treated at a tertiary care center for antihistamine and steroid resistant CIU with omalizumab who became pregnant during therapy.

  10. A sequence of events across the Cretaceous-Tertiary boundary

    NARCIS (Netherlands)

    Smit, J.; Romein, A.J.T.

    1985-01-01

    The lithological and biological sequence of events across the Cretaceous-Tertiary (K/T), as developed in thick and complete landbased sections and termed the standard K/T event sequence, is also found in many DSDP cores from all over the globe. Microtektite-like spherules have been found in

  11. Ectopic pregnancy experience in a tertiary health facility in South ...

    African Journals Online (AJOL)

    Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria. Objective: To determine the incidence, clinical presentation, risk factors and management outcomes of ectopic pregnancies in a tertiary health facility. Methods: A retrospective ...

  12. Strength and Deformation Properties of Tertiary Clay at Moesgaard Museum

    DEFF Research Database (Denmark)

    Kaufmann, Kristine Lee; Nielsen, Benjaminn Nordahl; Augustesen, Anders Hust

    The tertiary clay at Moesgaard Museum near Aarhus in the eastern part of Jutland in Denmark is a highly plastic, glacially disturbed nappe of Viborg Clay. The clay is characterised as a swelling soil, which could lead to damaging of the building due to additional heave of the soil. To take...

  13. Effectiveness of Using Games in Tertiary-Level Mathematics Classrooms

    Science.gov (United States)

    Afari, Ernest; Aldridge, Jill M.; Fraser, Barry J.

    2012-01-01

    The primary focus of this study was to investigate the effectiveness of games when used in tertiary-level mathematics classes in the United Arab Emirates. Our study incorporated a mixed-method approach that involved surveys (to assess students' perceptions of the learning environment and attitudes towards mathematics), interviews, observations of…

  14. Obesity and associated factors in young adults attending tertiary ...

    African Journals Online (AJOL)

    Obesity and associated factors in young adults attending tertiary institutions ... and associated factors in a group of university undergraduates in south-east Nigeria. ... being a female (X2 = 47.91), first year student (X2 = 41.82), and having high ...

  15. Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary ...

    African Journals Online (AJOL)

    Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics ...

  16. Tertiary Educational Institutions for Teaching, Research and Development

    Science.gov (United States)

    Amoo, Sikiru A.

    2014-01-01

    This paper examines the quality of teaching and research in developing human resources to facilitate the development of tertiary education in the nation. It discusses the challenges and the roles of research in higher education. The author argues that the combination of content and pedagogical knowledge could help to develop human resources for…

  17. Motivation in vocational education: a reform issue in tertiary ...

    African Journals Online (AJOL)

    Working in a non-motivating environment is a nagging issue in various tertiary institutions in Cross River State .This dampens staff morale a great deal. However, the provision of motivation in work places will be a great boost to staff morale especially in Vocational Education. This paper discusses the meaning of motivation, ...

  18. Patient satisfaction in neurological second opinions and tertiary referrals

    NARCIS (Netherlands)

    Wijers, D.; Wieske, L.; Vergouwen, M. D. I.; Richard, E.; Stam, J.; Smets, E. M. A.

    2010-01-01

    Although the number of neurological second opinions (SOs) and tertiary referrals (TRs) is increasing, only little is known about expectations and patient satisfaction in this group of patients. Therefore, the purpose of this study was to explore expectations of patients who get a neurological SO or

  19. Fuego Volcano eruption (Guatemala, 1974): evidence of a tertiary fragmentation?

    International Nuclear Information System (INIS)

    Brenes-Andre, Jose

    2014-01-01

    Values for mode and dispersion calculated from SFT were analyzed using the SFT (Sequential Fragmentation/Transport) model to Fuego Volcano eruption (Guatemala, 1974). Analysis results have showed that the ideas initially proposed for Irazu, can be applied to Fuego Volcano. Experimental evidence was found corroborating the existence of tertiary fragmentations. (author) [es

  20. Sexual harassment in tertiary institutions: A comparative perspective

    OpenAIRE

    Joseph Janice

    2015-01-01

    Sexual harassment is not a new phenomenon in tertiary institutions. It has been receiving considerable attention in research and the media and public awareness has increased dramatically. However, the term sexual harassment is not used uniformly across the globe because countries have defined it differently. Consequently, prevalence of sexual harassment in education varies across cultures. This paper examines sexual harassment from a comparative perspective...

  1. The Equity Imperative in Tertiary Education: Promoting Fairness and Efficiency

    Science.gov (United States)

    Salmi, Jamil; Bassett, Roberta Malee

    2014-01-01

    While the share of the tertiary education age cohort (19-25) which is being given the opportunity to study has increased worldwide over the past two decades, this does not in fact translate into reduced inequality. For many young people, especially in the developing world, major obstacles such as disparities in terms of gender, minority population…

  2. Constructing Knowledge Societies: New Challenges for Tertiary Education.

    Science.gov (United States)

    Salmi, Jamil

    2003-01-01

    The principal set of challenges facing tertiary education today is that set which links it to the construction of knowledge societies. Governments, the private sector, and the World Bank have specific tasks to perform in meeting these challenges. Countries--depending upon whether or not they are transition economies, low-income countries, or small…

  3. Induction of secondary and tertiary lymphoid structures in the skin.

    NARCIS (Netherlands)

    Cupedo, T.; Jansen, W.; Kraal, G.; Mebius, R.E.

    2004-01-01

    During embryogenesis a developmental program leading to the formation of lymph nodes and Peyer's patches is initiated. We now show that lymph node-like structures as well as tertiary lymphoid structures can ectopically be induced by intradermal injection of newborn lymph node-derived cells.

  4. Patterns of Eye Diseases in Children Visiting a Tertiary Teaching ...

    African Journals Online (AJOL)

    Background: About 19 million children worldwide live with visual impairments resulting from different ocular morbidities. This study aimed to identify the different causes of eye diseases in children visiting a tertiary eye centre at Jimma University Hospital. Methods: We conducted a retrospective review of charts of patients of ...

  5. PASS Student Leader and Mentor Roles: A Tertiary Leadership Pathway

    Science.gov (United States)

    Skalicky, Jane; Caney, Annaliese

    2010-01-01

    In relation to developing leadership skills during tertiary studies, this paper considers the leadership pathway afforded by a Peer Assisted Study Sessions (PASS) program which includes the traditional PASS Leader role and a more senior PASS Mentor role. Data was collected using a structured survey with open-ended questions designed to capture the…

  6. Anti Diabetic Drug Utilization by Elderly Patients in a Tertiary ...

    African Journals Online (AJOL)

    This study is intended to determine the pattern and rational use of drugs in the elderly diabetic patients in a tertiary health care facility in Western Nigeria. ... Metformin was the most commonly prescribed antidiabetic medication for the patients followed by glimepiride (52.8%) (highest within age 50-59 years) and then ...

  7. Automated Stock Control System for Bookshops in Tertiary Institutions

    African Journals Online (AJOL)

    The recent need for automated stock control system for bookshops in tertiary institutions was generated by unequal availability of books and stiff scarcity of books in some areas while in ... This approach provides for faster response times for users because the database is local to each business unit within the organization.

  8. Assessment Quality in Tertiary Education: An Integrative Literature Review

    NARCIS (Netherlands)

    Gerritsen-van Leeuwenkamp, Karin; Joosten-ten Brinke, Desirée; Kester, Liesbeth

    2018-01-01

    In tertiary education, inferior assessment quality is a problem that has serious consequences for students, teachers, government, and society. A lack of a clear and overarching conceptualization of assessment quality can cause difficulties in guaranteeing assessment quality in practice. Thus, the

  9. The Impact of Cooperative Learning on Tertiary EFL Learners' Motivation

    Science.gov (United States)

    Ning, Huiping; Hornby, Garry

    2014-01-01

    This study was aimed at investigating the impact of cooperative learning on the motivation of tertiary English learners. Participants were from two randomly assigned classes at a university in the north of China. A pre-test-post-test control group design was employed to compare the impact of the cooperative learning approach with that of…

  10. An Innovation Systems Perspectives on Tertiary-Level Agricultural ...

    African Journals Online (AJOL)

    This paper examines how tertiary-level agricultural education in sub-Saharan Africa can contribute to agricultural development beyond its current role as a source of technical training. The paper draws on data and information gathered from semistructured key informant interviews conducted in late 2006 in and around Addis ...

  11. An Audit of Otorhinolaryngological Practice in a Tertiary Institution in ...

    African Journals Online (AJOL)

    Background: The Niger Delta University Teaching Hospital (NDUTH) is a young tertiary hospital with recently established department in various specialties. In spite of this it caters for the health needs of a lot of the patients in Bayelsa state and its environs. The aim of this study therefore is to audit the otorhinolaryngological ...

  12. Depression in pregnancy and the puerperium in a tertiary health ...

    African Journals Online (AJOL)

    BACKGROUND: Depression is common in pregnancy in high-income-countries but rarely spoken about in Nigerian Tertiary Obstetric Centres. OBJECTIVES: This study was conducted to ascertain the prevalence and risk factors for major depression in pregnancy and puerperium at the University of Port Harcourt Teaching ...

  13. Pursuing Discipline and Ethical Issues in Tertiary Institutions in Nigeria

    African Journals Online (AJOL)

    Nekky Umera

    Adeyinka Adeniji - Department of Educational Management & Business. Education ... dealing with the study of what is good and bad, right and wrong and with .... decay, neglect, decadence and crisis that characterize our tertiary institutions .... what happens in most cases is that they get directly involved in the day to day.

  14. opinions of nigerian students in tertiary institutions on family size

    African Journals Online (AJOL)

    Admin

    The study examined the opinions of Nigerian students in tertiary institutions on their ideal family size. It was conducted among students in four ... opinions of male and female students on family size. KEY WORD: Family Size, Nigerian ... two children per woman, with many couples who desire to remain childless and some ...

  15. A Conceptual Approach for Blended Leadership for Tertiary Education Institutions

    Science.gov (United States)

    Jones, Sandra; Harvey, Marina; Lefoe, Geraldine

    2014-01-01

    Over the last 20 years, the tertiary education sector has adopted new administrative management approaches, with the aim of improving accountable and strategic focus. Over the same period, the question of how to build leadership capacity to improve learning and teaching and research outcomes has led to discussion on what constitutes academic…

  16. Tertiary classes–after Chern-Simons theory

    Indian Academy of Sciences (India)

    J.N. Iyer Institute of Mathematical Sciences Chennai, India

    2013-11-08

    Nov 8, 2013 ... Euler characteristic class. In early twentieth century, the notion of local product structure, i.e. fiber spaces and their generalizations appeared, in the study of topological spaces (with additional structures). J.N. Iyer. IMSc, Chennai. Tertiary classes–after Chern-Simons theory ...

  17. An Examination of Tertiary Students' Desire to Found an Enterprise

    Science.gov (United States)

    Birdthistle, Naomi

    2008-01-01

    Purpose: The purpose of this paper is twofold. First, the paper aims to identify and explain the behaviour and intentions of students in their decision to start entrepreneurial activities and establish an enterprise. Second, the paper aims to identify whether students in tertiary level institutions in Ireland display the personality traits of an…

  18. Secondary and Tertiary Hyperparathyroidism, State of the Art Surgical Management

    Science.gov (United States)

    Pitt, Susan C.; Sippel, Rebecca S.

    2010-01-01

    Synopsis This article reviews the current surgical management of patients with secondary and tertiary hyperparathyroidism. The focus is on innovative surgical strategies that have improved the care of these patients over the past 10 to 15 years. Modalities such as intraoperative parathyroid hormone monitoring and radioguided probe utilization are discussed. PMID:19836494

  19. Religious extremism as a challenge to tertiary education in Nigeria ...

    African Journals Online (AJOL)

    Extremists use religion as a shield either for political or economic agenda and manipulate their gullible followers in order to impose their ideology on them. The reality of religious extremism in Nigeria is a challenge to tertiary education to search for a lasting solution that will enable Nigerians overcome the problem and focus ...

  20. Limits and opportunities of marketeering tertiary education in post-colonial Zimbabwe

    OpenAIRE

    Patrick Sibanda

    2016-01-01

    This paper intended to assess the impact of marketeering tertiary education in Zimbabwe. The paper revealed that marketeering of tertiary education in Zimbabwe has drastically impacted on access to higher education and training. Poor and vulnerable students have found it difficult to access tertiary education due to escalating commercialized fees. Literature indicates that, even in developed countries like UK, marketeering tertiary education has led to decreased enrolments, diminishing prospe...

  1. Favorability for uranium in tertiary sedimentary rocks, southwestern Montana

    International Nuclear Information System (INIS)

    Wopat, M.A.; Curry, W.E.; Robins, J.W.; Marjaniemi, D.K.

    1977-10-01

    Tertiary sedimentary rocks in the basins of southwestern Montana were studied to determine their favorability for potential uranium resources. Uranium in the Tertiary sedimentary rocks was probably derived from the Boulder batholith and from silicic volcanic material. The batholith contains numerous uranium occurrences and is the most favorable plutonic source for uranium in the study area. Subjective favorability categories of good, moderate, and poor, based on the number and type of favorable criteria present, were used to classify the rock sequences studied. Rocks judged to have good favorability for uranium deposits are (1) Eocene and Oligocene strata and undifferentiated Tertiary rocks in the western Three Forks basin and (2) Oligocene rocks in the Helena basin. Rocks having moderate favorability consist of (1) Eocene and Oligocene strata in the Jefferson River, Beaverhead River, and lower Ruby River basins, (2) Oligocene rocks in the Townsend and Clarkston basins, (3) Miocene and Pliocene rocks in the Upper Ruby River basin, and (4) all Tertiary sedimentary formations in the eastern Three Forks basin, and in the Grasshopper Creek, Horse Prairie, Medicine Lodge Creek, Big Sheep Creek, Deer Lodge, Big Hole River, and Bull Creek basins. The following have poor favorability: (1) the Beaverhead Conglomerate in the Red Rock and Centennial basins, (2) Eocene and Oligocene rocks in the Upper Ruby River basin, (3) Miocene and Pliocene rocks in the Townsend, Clarkston, Smith River, and Divide Creek basins, (4) Miocene through Pleistocene rocks in the Jefferson River, Beaverhead River, and Lower Ruby River basins, and (5) all Tertiary sedimentary rocks in the Boulder River, Sage Creek, Muddy Creek, Madison River, Flint Creek, Gold Creek, and Bitterroot basins

  2. Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

    Science.gov (United States)

    AbdulAzeez, Abbas Tunde

    2016-01-01

    This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

  3. Status of hospital infection control measures at seven major tertiary care hospitals of northern Punjab

    International Nuclear Information System (INIS)

    Ikram, A.; Shah, S.I.H.; Naseem, S.; Absar, S.A.; Safi-Ullah; Ambreen, T.

    2010-01-01

    To determine the availability and implementation of various hospital infection control measures at tertiary care hospitals. Study Design: Survey. Place and Duration of Study: National Institute of Science and Technology, Islamabad, from June through August 2008. Methodology: Seven tertiary care very busy hospitals were selected; one from Islamabad, 5 from Rawalpindi, and one from Lahore. A detailed proforma was designed addressing all the issues pertaining to hospital infection control measures. Air sampling was done and growth yielded was identified by standard methods. Results: Analyses revealed that all of the hospitals had an Infection Control Committee. Microbiological diagnostic facilities were adequate at all the hospitals and overall microorganism yield was very high. Antibiotic policy was claimed by most, not available on ground. Majority of the operation theatres were without proper air flow system and autoclaves were not being regularly monitored. There was no proper disposal for sharps and needles. Incineration was not the usual mode for infectious waste. Conclusion: The results of the present study imply availability of proper hospital infection control policies with need of strict implementation of such measures. (author)

  4. Public Healthcare Services - Component of Tertiary Economy

    Directory of Open Access Journals (Sweden)

    Mircea Bunaciu

    2016-05-01

    Full Text Available The field of public health care is a major social objective in all countries of the world. The public health care assistance reflects an effort organised to protect and promote the health of population, being achievable through political-legislative measures, programs and strategies addressed to the forums in the field of public health, as well as by establishing an organisational framework that would favour the provision of medical services requested by the population. The implementation of the objectives of health policy and strategy is done by the Ministry of Public Health as central authority in the field of public health, and local actions of public health are developed and implemented by the county authorities of public health. Public health authorities in the ascribed territory operate under the subordination of the public health authorities. Also, the county public health authorities coordinate locally the implementation of the activities arising from obligations assumed under the Treaty of Accession of Romania to the European Union and the plans for implementing the Community instruments relating to health.

  5. Use of Treated Municipal Wastewater as Power Plant Cooling System Makeup Water: Tertiary Treatment versus Expanded Chemical Regimen for Recirculating Water Quality Management

    Energy Technology Data Exchange (ETDEWEB)

    David Dzombak; Radisav Vidic; Amy Landis

    2012-06-30

    nitrification helped to reduce the corrosivity and biocide demand. Also, the lower pH and alkalinity resulting from nitrification reduced the scaling to an acceptable level, without the addition of anti-scalant chemicals. Additional GAC adsorption treatment, MWW_NFG, yielded no net benefit. Removal of organic matter resulted in pitting corrosion in copper and cupronickel alloys. Negligible improvement was observed in scaling control and biofouling control. For all of the tertiary treatments, biofouling control was achievable, and most effectively with pre-formed monochloramine (2-3 ppm) in comparison with NaOCl and ClO2. Life cycle cost (LCC) analyses were performed for the tertiary treatment systems studied experimentally and for several other treatment options. A public domain conceptual costing tool (LC3 model) was developed for this purpose. MWW_SF (lime softening and sand filtration) and MWW_NF were the most cost-effective treatment options among the tertiary treatment alternatives considered because of the higher effluent quality with moderate infrastructure costs and the relatively low doses of conditioning chemicals required. Life cycle inventory (LCI) analysis along with integration of external costs of emissions with direct costs was performed to evaluate relative emissions to the environment and external costs associated with construction and operation of tertiary treatment alternatives. Integrated LCI and LCC analysis indicated that three-tiered treatment alternatives such as MWW_NSF and MWW_NFG, with regular chemical addition for treatment and conditioning and/or regeneration, tend to increase the impact costs and in turn the overall costs of tertiary treatment. River water supply and MWW_F alternatives with a single step of tertiary treatment were associated with lower impact costs, but the contribution of impact costs to overall annual costs was higher than all other treatment alternatives. MWW_NF and MWW_SF alternatives exhibited moderate external impact costs

  6. Yb(OTf){sub 3}-catalyzed one-pot three component synthesis for tertiary amines

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bum Seok; Kim, Ji Hye; Nam, Tae Kyu; Jang, Doo Ok [Dept. of Chemistry, Yonsei University, Wonju (Korea, Republic of)

    2015-07-15

    Tertiary amine functionality is found in many natural bioactive products such as alkaloids, amino acids, nucleic acids, pharmaceuticals, and agrochemicals. Tertiary amines have also been used as building blocks for nitrogen-containing organic compounds and synthetic polymers. A one-pot method for direct reductive amination of aldehydes has been developed to synthesize tertiary amines using HMDS as a nitrogen source in the presence of Yb(OTf ){sub 3}. With a stoichiometric amount of HMDS, the reaction afforded the desired tertiary amines without competitive reduction of the parent carbonyl compounds. This reaction offers a convenient and efficient protocol for synthesizing aromatic and aliphatic tertiary amines under mild reaction conditions.

  7. Speciation and fate of copper in sewage treatment works with and without tertiary treatment: the effect of return flows.

    Science.gov (United States)

    Innaa, D; Lester, J N; Scrimshawb, M D; Cartmell, E

    2014-01-01

    The removal of metals from wastewaters is becoming an important issue, with new environmental quality standards putting increased regulatory pressure on operators of sewage treatment works. The use of additional processes (tertiary treatment) following two-stage biological treatment is frequently seen as a way of improving effluent quality for nutrients and suspended solids, and this study investigates the impact of how back washes from these tertiary processes may impact the removal of copper during primary sedimentation. Seven sites were studied, three conventional two-stage biological treatment, and four with tertiary processes. It was apparent that fluxes of copper in traditional return flows made a significant contribution to the load to the primary treatment tanks, and that tanks. These return flows had an impact on copper removal in the primary tanks, probably due to their aerobic nature. Returning such aerobic back wash flows to the main process stream after primary treatment may therefore be worth consideration. The opportunity to treat consolidated liquor and sludge.flows in side-stream processes to remove toxic elements, as they are relatively concentrated, low volume flow streams, should also be evaluated.

  8. Ten years of energy consumption in the tertiary sector

    International Nuclear Information System (INIS)

    Rabai, Yacine

    2012-11-01

    This document presents and comments data regarding electricity consumption by the tertiary sector over the last ten years in France. It notably outlines its strong increase compared to the other sectors (housing, industry, transport, agriculture). It comments the evolution of the energy mix of the tertiary sector (electricity with 47%, gas with 25% and oil with 19% are prevailing). It briefly comments the evolution of energy efficiency within this sector. It indicates and comments the shares of energy consumption, of high voltage electricity and gas consumption by the different sub-sectors (retail, automobile and motorcycle repair, public administration, health and social activity, real estate, specialised, scientific and technical activities, education, and so on)

  9. Medical treatment of primary, secondary, and tertiary hyperparathyroidism.

    Science.gov (United States)

    Vestergaard, Peter; Thomsen, Susanna vid Strym

    2011-04-01

    Hyperparathyroidism is a condition with elevated parathyroid hormone (PTH). The increase may be due to a) primary hyperparathyroidism which is caused by adenoma of one or more parathyroid glands or hyperplasia of all four glands, b) secondary hyperparathyroidism, which may be caused by deficiency in vitamin D or uremia, and 3) tertiary hyperparathyroidism, which most often is the result of a long-standing, severe secondary hyperparathyroidism, which has turned autonomous once the cause of the secondary hyperparathyroidism has been removed. Many new treatment options have been introduced in recent years. Cinacalcet is calcium sensing receptor agonist, which by stimulating the receptor decreases PTH and calcium levels. It may be used in primary hyperparathyroidism, secondary hyperparathyroidism caused by uremia, which may not be controlled with calcium and activated vitamin D. It may also be used in tertiary hyperparathyroidism. Newer analogues of vitamin D such as paricalcitol have also been introduced, which may have an advantage over traditional compounds such as alphacalcidol and calcitriol.

  10. Products of the reaction between methylene iodide and tertiary arsines

    International Nuclear Information System (INIS)

    Gigauri, R.D.; Arabuli, L.G.; Machaidze, Z.I.; Rusiya, M.Sh.

    2005-01-01

    Iodides of iodomethylenetrialkyl(aryl) arsonium were synthesized with high yields as a result of interaction between methylene iodide and tertiary arsines. Exchange reactions of the iodides prepared with lead(II) nitrate in water-alcohol solutions gave rise to formation of iodomethylenetrialkyl(aryl) arsonium nitrates. All the products prepared were characterized by data of elementary analysis, IR spectroscopy, conductometry and melting points measurements [ru

  11. English Textbooks in Parallel-Language Tertiary Education

    OpenAIRE

    Pecorari, D.; Shaw, P.; Irvine, Aileen; Malmstrom, H.

    2011-01-01

    Tertiary education in many countries is increasingly bilingual, with English used in parallel with the national language, particularly as a reading language. This article describes the results of a survey of student attitudes toward, and reading practices regarding, English language textbooks. Over 1,000 students at three Swedish universities responded to a questionnaire asking about their experiences with English textbooks. Textbooks written in English were generally unpopular, and the perce...

  12. Oral food challenge outcomes in a pediatric tertiary care center

    OpenAIRE

    Abrams, Elissa M.; Becker, Allan B.

    2017-01-01

    Background Oral food challenges are the clinical standard for diagnosis of food allergy. Little data exist on predictors of oral challenge failure and reaction severity. Methods A retrospective chart review was done on all pediatric patients who had oral food challenges in a tertiary care pediatric allergy clinic from 2008 to 2010. Results 313 oral challenges were performed, of which the majority were to peanut (105), egg (71), milk (41) and tree nuts (29). There were 104 (33%) oral challenge...

  13. Engineering of Droplet Manipulation in Tertiary Junction Microfluidic Channels

    Science.gov (United States)

    2017-06-30

    mechanics point-of-view, the larger motivation to carry out this research work derives from its application in biomedical engineering for sorting CTCs...AFRL-AFOSR-JP-TR-2017-0055 Engineering of Droplet Manipulation in Tertiary Junction Microfluidic Channels Shalini Gupta INDIAN INSTITUTE OF...2017 2. REPORT TYPE Final 3. DATES COVERED (From - To) 14 May 2015 to 13 Nov 2016 4. TITLE AND SUBTITLE Engineering of Droplet Manipulation in

  14. Global trends in nuclear education at the tertiary level

    International Nuclear Information System (INIS)

    Kemeny, L.G.

    2001-01-01

    The public perception of nuclear science and engineering and the nuclear industry is today, primarily shaped by radical greens, nuclear-opponents, the media and socio-political opportunists. Only countries with a well diversified tertiary education system embracing all aspects of nuclear science and engineering can counter efficiently the pseudo-science and socio-political manipulation which has severely restricted nuclear energy development over the past three decades. National laboratories alone find this task extremely difficult, if not impossible

  15. Glycerol tertiary butyl ethers via etherification of glycerol with isobutene

    Energy Technology Data Exchange (ETDEWEB)

    Behr, A. [Dortmund Univ. (Germany). Chair of Chemical Process Development/Technical Chemistry A

    2007-07-01

    Glycerol and isobutene can react to a mixture of glycerol tertiary butyl ethers (GTBE) which can be used as additives for gasoline, diesel or biodiesel. This reaction was investigated in lab scale yielding a proposal for a process flow diagram containing reaction, extraction, flash and rectification units. This process has the advantages that only the suitable higher ethers are formed and that both glycerol and isobutene are fully converted. The homogeneous acid catalyst is low-priced and can be completely recycled. (orig.)

  16. Tertiary Intratumor Lymphoid Tissue in Colo-Rectal Cancer

    OpenAIRE

    Bergomas, Francesca; Grizzi, Fabio; Doni, Andrea; Pesce, Samantha; Laghi, Luigi; Allavena, Paola; Mantovani, Alberto; Marchesi, Federica

    2011-01-01

    Ectopic (or tertiary) lymphoid tissue develops at sites of inflammation or infection in non lymphoid organs and is associated with chronic inflammation. In colon mucosa, small lymphoid aggregates are already present in homeostatic conditions, as part of the gut-associated lymphoid tissue and play an essential role in the immune response to perturbations of the mucosal microenvironment. Despite the recognized role of inflammation in tumor progression, the presence and biological function of ly...

  17. Increased oil recovery: secondary and tertiary. Application and future prospect

    Energy Technology Data Exchange (ETDEWEB)

    Whiting, R L

    1978-01-01

    Oil is initially produced using the nature reservoir pressure present, in a process called primary oil recovery. Secondary recovery uses artificial means to increase the natural reservoir pressure; tertiary, or enhanced oil recovery, uses a number of methods to enhance the flow characteristics of the oil. The scope for such techniques to increase the yield from oil fields in the US is estimated; the practicality of their application is shown to be particularly dependent upon pricing, taxation, and other existing policies. 16 references.

  18. Catalyst Deactivation Reactions : The Role of Tertiary Amines Revisited

    NARCIS (Netherlands)

    Novarino, Elena; Rios, Itzel Guerrero; van der Veer, Siebe; Meetsma, Auke; Hessen, Bart; Bouwkamp, Marco W.

    2011-01-01

    Decamethylzirconocene cation [Cp*2ZrMe](+) (2) decomposes in bromobenzene-d(5) solution to generate sigma-aryl species [Cp*Zr-2(2-C6H4Br-kappa Br,C)][B(C6F5)(4)] (3). This a-bond metathesis reaction is catalyzed by tertiary amines via a two-step mechanism, in which the amine acts as a proton relay.

  19. Assessment Indicators of Tertiary Student of Internship Programs Adjust Industry 4.0

    Directory of Open Access Journals (Sweden)

    Chun-Mei Chou

    2017-04-01

    Full Text Available The purpose of this study was to study the assessment indicators for the entrepreneurial learned by tertiary student of internship programs adjust Industry 4.0. This study used in-depth interviews and focus groups were used to develop the ability indicators and gain consistency between the ability items. The research results showed that there were three types of entrepreneurial cognition learned by students of internship programs adjust Industry 4.: start-up experience, industry-specific experience, and managerial experience. The ability content included 11 items of entrepreneurial cognition ability: entrepreneurial traits, basic commercial ability, communication ability, digital ability, professional innovative ability, financial management ability, human resource management ability, marketing management ability, operational (work ability, and risk management ability, and there were a total of 91 ability indicators. There were 48 items of entrepreneurial cognition that had high importance and usage frequency.

  20. Noise and room acoustic conditions in a tertiary referral hospital in Seoul, Korea

    DEFF Research Database (Denmark)

    Jeong, Cheol-Ho; Cho, Wan-Ho; Chang, Ji-ho

    2018-01-01

    Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital in Korea, are investigated. Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over...... level for the first night was 66 dBA, which came down to 56 dBA for the next day. The reason for the higher noise level for the first night in the ICU was frequent alarm sound and treatment noise related to a critical patient. The noise level in the measured ERs is about 10 dB lower than those measured...... about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured: examination rooms, operating rooms, nurse stations, patient rooms, and audiometric rooms. The equivalent A-weighted noise level, LAeq, ranges from 54 to 56 dBA in two ERs. In an ICU, the noise...

  1. Treatment of self-poisoning at a tertiary level hospital in Bangladesh

    DEFF Research Database (Denmark)

    Verma, Vasundhara; Paul, Sujat; Ghose, Aniruddha

    2017-01-01

    OBJECTIVES: Approximately 10,000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning. METHODS: Data on direct costs to families, sources of funds for treatment...... and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data. RESULTS: Agrochemicals were the most common...... as organophosphorus poisoning in 17(.) 0% of agrochemical cases resulted in increased cost to patients. Only 51(.) 9% of patients had indicators of wealth; 78(.) 1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21(.) 30 per patient) were markedly lower than costs to patients...

  2. Selective rhodium-catalyzed reduction of tertiary amides in amino acid esters and peptides.

    Science.gov (United States)

    Das, Shoubhik; Li, Yuehui; Bornschein, Christoph; Pisiewicz, Sabine; Kiersch, Konstanze; Michalik, Dirk; Gallou, Fabrice; Junge, Kathrin; Beller, Matthias

    2015-10-12

    Efficient reduction of the tertiary amide bond in amino acid derivatives and peptides is described. Functional group selectivity has been achieved by applying a commercially available rhodium precursor and bis(diphenylphosphino)propane (dppp) ligand together with phenyl silane as a reductant. This methodology allows for specific reductive derivatization of biologically interesting peptides and offers straightforward access to a variety of novel peptide derivatives for chemical biology studies and potential pharmaceutical applications. The catalytic system tolerates a variety of functional groups including secondary amides, ester, nitrile, thiomethyl, and hydroxy groups. This convenient hydrosilylation reaction proceeds at ambient conditions and is operationally safe because no air-sensitive reagents or highly reactive metal hydrides are needed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Tertiary work-up of apparent treatment-resistant hypertension.

    Science.gov (United States)

    Heimark, Sondre; Eskås, Per Anders; Mariampillai, Julian Eek; Larstorp, Anne Cecilie K; Høieggen, Aud; Fadl Elmula, Fadl Elmula M

    2016-10-01

    Treatment-resistant hypertension (TRH) has regained attention with development of new methods for treatment. However, the prevalence of TRH varies considerably from primary to secondary and tertiary care. We aimed to assess the prevalence of true TRH in a population of patients with apparent TRH in a university hospital setting of tertiary work-up and also investigate reasons for poor BP control and evaluate how work-up can be performed in general practice and secondary care. In this cohort study, we characterize a study population from Oslo Renal Denervation (RDN) Study. Patients (n = 83) were referred for RDN from secondary care. All patients underwent thorough medical investigation and 24-h ambulatory blood pressure measurements (24ABPM) after directly observed therapy (DOT). We then assessed reasons for lack of BP control. Fifty-three of 83 patients did not have true TRH. Main reasons for non-TRH were poor drug adherence (32%), secondary hypertension (30%) and white coat hypertension (15%). Forty-seven percent achieved blood pressure control after DOT with subsequent 24ABPM. There were otherwise no statistically significant differences in patient characteristics between the true TRH and the non-TRH group. Despite being a highly selected cohort referred for tertiary work-up of apparent TRH, BP control was achieved or secondary causes were identified in almost two thirds of the patients. Thorough investigation according to guidelines and DOT with subsequent 24ABPM is needed in work-up of apparent TRH.

  4. Tertiary Education and the Crisis of Public Finance

    Directory of Open Access Journals (Sweden)

    Milos Maryska

    2012-04-01

    Full Text Available Turbulent economic environment after overwhelming the last crisis period is typical for present days as well as permanent increasing dependability of all our activities on information and communication technology (ICT. Although the global economic crisis was the reason for disinvestment into ICT in 2009 there is expected that ICT will generate almost 5.8 million new jobs in Europe till year 2013 and they have to be saturated also by adequately qualified ICT specialists.This contribution presents the research in the progress focused on the tertiary education system in the Czech Republic. We are predicting trends in education and especially in ICT education in Europe and in the Czech Republic as well for next ten years. We can expect that future ten years period will be critical not only for the Czech tertiary education system, but also for the Czech Republic because number of ICT students will be decreasing and number of ICT specialist demanded by labor market will be increasing. From macroeconomic point of view we can expect that also state subventions into state governed tertiary education system will decrease in the whole Europe.Some recommendations, proposals and forecasts for further development of education system are presented at the end of this contribution.

  5. General Allylic C–H Alkylation with Tertiary Nucleophiles

    Science.gov (United States)

    2015-01-01

    A general method for intermolecular allylic C–H alkylation of terminal olefins with tertiary nucleophiles has been accomplished employing palladium(II)/bis(sulfoxide) catalysis. Allylic C–H alkylation furnishes products in good yields (avg. 64%) with excellent regio- and stereoselectivity (>20:1 linear:branched, >20:1 E:Z). For the first time, the olefin scope encompasses unactivated aliphatic olefins as well as activated aromatic/heteroaromatic olefins and 1,4-dienes. The ease of appending allyl moieties onto complex scaffolds is leveraged to enable this mild and selective allylic C–H alkylation to rapidly diversify phenolic natural products. The tertiary nucleophile scope is broad and includes latent functionality for further elaboration (e.g., aliphatic alcohols, α,β-unsaturated esters). The opportunities to effect synthetic streamlining with such general C–H reactivity are illustrated in an allylic C–H alkylation/Diels–Alder reaction cascade: a reactive diene is generated via intermolecular allylic C–H alkylation and approximated to a dienophile contained within the tertiary nucleophile to furnish a common tricyclic core found in the class I galbulimima alkaloids. PMID:24641574

  6. General allylic C-H alkylation with tertiary nucleophiles.

    Science.gov (United States)

    Howell, Jennifer M; Liu, Wei; Young, Andrew J; White, M Christina

    2014-04-16

    A general method for intermolecular allylic C-H alkylation of terminal olefins with tertiary nucleophiles has been accomplished employing palladium(II)/bis(sulfoxide) catalysis. Allylic C-H alkylation furnishes products in good yields (avg. 64%) with excellent regio- and stereoselectivity (>20:1 linear:branched, >20:1 E:Z). For the first time, the olefin scope encompasses unactivated aliphatic olefins as well as activated aromatic/heteroaromatic olefins and 1,4-dienes. The ease of appending allyl moieties onto complex scaffolds is leveraged to enable this mild and selective allylic C-H alkylation to rapidly diversify phenolic natural products. The tertiary nucleophile scope is broad and includes latent functionality for further elaboration (e.g., aliphatic alcohols, α,β-unsaturated esters). The opportunities to effect synthetic streamlining with such general C-H reactivity are illustrated in an allylic C-H alkylation/Diels-Alder reaction cascade: a reactive diene is generated via intermolecular allylic C-H alkylation and approximated to a dienophile contained within the tertiary nucleophile to furnish a common tricyclic core found in the class I galbulimima alkaloids.

  7. Cryptosporidium and Giardia removal by secondary and tertiary wastewater treatment.

    Science.gov (United States)

    Taran-Benshoshan, Marina; Ofer, Naomi; Dalit, Vaizel-Ohayon; Aharoni, Avi; Revhun, Menahem; Nitzan, Yeshayahu; Nasser, Abidelfatah M

    2015-01-01

    Wastewater disposal may be a source of environmental contamination by Cryptosporidium and Giardia. This study was conducted to evaluate the prevalence of Cryptosporidium oocysts and Giardia cysts in raw and treated wastewater effluents. A prevalence of 100% was demonstrated for Giardia cysts in raw wastewater, at a concentration range of 10 to 12,225 cysts L(-1), whereas the concentration of Cryptosporidium oocysts in raw wastewater was 4 to 125 oocysts L(-1). The removal of Giardia cysts by secondary and tertiary treatment processes was greater than those observed for Cryptosporidium oocysts and turbidity. Cryptosporidium and Giardia were present in 68.5% and 76% of the tertiary effluent samples, respectively, at an average concentration of 0.93 cysts L(-1) and 9.94 oocysts L(-1). A higher detection limit of Cryptosporidium oocysts in wastewater was observed for nested PCR as compared to immune fluorescent assay (IFA). C. hominis was found to be the dominant genotype in wastewater effluents followed by C. parvum and C. andersoni or C. muris. Giardia was more prevalent than Cryptosporidium in the studied community and treatment processes were more efficient for the removal of Giardia than Cryptosporidium. Zoonotic genotypes of Cryptosporidium were also present in the human community. To assess the public health significance of Cryptosporidium oocysts present in tertiary effluent, viability (infectivity) needs to be assessed.

  8. Mudflow utilization for construction materials of tertiary irrigation canal lining

    Science.gov (United States)

    Azis, Subandiyah; Kustamar

    2017-11-01

    Mudflow in Siring Village, Sidoarjo Regency, Indonesia, has been in eruption since May 29, 2006. It still shows irregular large bursts which loaded in a sludge reservoir with capacity of 59 million m3. From 2007 until 2015, there were more than 20 studies which concluded that the mudflow could be used as a mixture of building materials. However, the studies were not detailed and needed further research. This research aims to investigate the use of mudflow as tertiary irrigation canal lining material. This research comes with several laboratory tests to obtain a mixture that is solid and water-resistant. The methods that were used are descriptive methods as follows: 1). Sampling of mudflow, to be analyzed in Material Testing Laboratory. 2). Sampling of soil at research site, to be analyzed in Soil Mechanics Laboratory 3). Mixing of materials which are consist of mudflow and other materials and doing strength test in the laboratory. 4). Installation of tertiary irrigation canal lining using materials that have been tested. 5). Observation of lining's strength inactive soil pressure-bearing and its impermeability. It is expected that the results of this research will be applied extensively throughout the tertiary irrigation canals, so mudflow can be utilized as raw materials that are environmentally friendly, which are able to help preserving the environment, also to reduce the removal of sand / rock in the river, which has been used for lining materials, that benefits in preventing damage to the river ecosystem.

  9. Pancreaticoduodenectomy in a tertiary referral center in Saudi Arabia: A retrospective case series

    International Nuclear Information System (INIS)

    Aziz, A.M.; Gad, H.; Leung, K; Abbas, A.; Al-Saif, O.H.; Meshikhes, A.N.

    2012-01-01

    Context: Perioperative outcome of pancreaticoduodenectomy is related to work load volume and to whether the procedure is carried out in a tertiary specialized hepato-pancreatico-biliary (HPB) unit. Objective: To evaluate the perioperative outcome associated with pancreaticoduodenectomy in a newly established HPB unit. Patients: Analysis of 32 patients who underwent pancreaticoduodenectomy (PD) for benign and malignant indications. Design: Retrospective collection of data on preoperative, intraoperative and postoperative care of all patients undergoing PD. Results: Thirty-two patients (16 male and 16 female) with a mean age of 59.5 ± 12.7 years were analyzed. The overall morbidity rate was high at 53%. The most common complication was wound infection (n = 11; 34.4%). Pancreatic and biliary leaks were seen in 5 (15.6%) and 2 (6.2%) cases, respectively, while delayed gastric emptying was recorded in 7 (21.9%). The female sex was not associated with increased morbidity. Presence of co-morbid illness, pylorus-preserving PD, intra-operative blood loss > 1 L, and perioperative blood transfusion were not associated with significantly increased morbidity. The overall hospital mortality was 3.1% and the cumulative overall (OS) and disease free survival (DFS) at 1 year were 80% and 82.3%, respectively. The cumulative overall survival for pancreatic cancer vs ampullary tumor at 1 year were 52% vs 80%, respectively. Conclusion: PD is associated with a low risk of operative death when performed by specialized HPB surgeons even in a tertiary referral hospital. However, the postoperative morbidity rate remains high, mostly due to wound infection. Further improvement by reducing postoperative infection may help curtail the high postoperative morbidity

  10. Frozen Chirality of Tertiary Aromatic Amides: Access to Enantioenriched Tertiary α-Amino Acid or Amino Alcohol without Chiral Reagent.

    Science.gov (United States)

    Mai, Thi Thoa; Viswambharan, Baby; Gori, Didier; Guillot, Régis; Naubron, Jean-Valère; Kouklovsky, Cyrille; Alezra, Valérie

    2017-04-27

    One of the fundamental and intriguing aspects of life is the homochirality of the essential molecules. In this field, the absolute asymmetric synthesis of α-amino acids is a major challenge. Herein, we report access, by chemical means, to tertiary α-amino acid derivatives in up to 96 % ee without using any chiral reagent. In our strategy, the dynamic axial chirality of tertiary aromatic amides is frozen in a crystal and is responsible for the stereoselectivity of the subsequent steps. Furthermore, we could control the configuration of the final product by manually sorting and selecting the initial crystals. Based on vibrational circular dichroism studies, we could rationalize the observed stereoselectivity. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Post-operative analgesia for major abdominal surgery and its effectiveness in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Aliya Ahmed

    2013-01-01

    Conclusion: Epidural, PCIA and opioid infusions are used for pain relief after major abdominal surgeries at our hospital. Although there is limited drug availability, regular assessments and appropriate dose adjustments by acute pain management service (APMS and use of multimodal analgesia led to a high level of patient satisfaction. We recommend that feedback to the primary anesthesiologists by APMS is of utmost importance to enable improvement in practice.

  12. Modeling of beam-induced damage of the LHC tertiary collimators

    Directory of Open Access Journals (Sweden)

    E. Quaranta

    2017-09-01

    Full Text Available Modern hadron machines with high beam intensity may suffer from material damage in the case of large beam losses and even beam-intercepting devices, such as collimators, can be harmed. A systematic method to evaluate thresholds of damage owing to the impact of high energy particles is therefore crucial for safe operation and for predicting possible limitations in the overall machine performance. For this, a three-step simulation approach is presented, based on tracking simulations followed by calculations of energy deposited in the impacted material and hydrodynamic simulations to predict the thermomechanical effect of the impact. This approach is applied to metallic collimators at the CERN Large Hadron Collider (LHC, which in standard operation intercept halo protons, but risk to be damaged in the case of extraction kicker malfunction. In particular, tertiary collimators protect the aperture bottlenecks, their settings constrain the reach in β^{*} and hence the achievable luminosity at the LHC experiments. Our calculated damage levels provide a very important input on how close to the beam these collimators can be operated without risk of damage. The results of this approach have been used already to push further the performance of the present machine. The risk of damage is even higher in the upgraded high-luminosity LHC with higher beam intensity, for which we quantify existing margins before equipment damage for the proposed baseline settings.

  13. Modeling of beam-induced damage of the LHC tertiary collimators

    Science.gov (United States)

    Quaranta, E.; Bertarelli, A.; Bruce, R.; Carra, F.; Cerutti, F.; Lechner, A.; Redaelli, S.; Skordis, E.; Gradassi, P.

    2017-09-01

    Modern hadron machines with high beam intensity may suffer from material damage in the case of large beam losses and even beam-intercepting devices, such as collimators, can be harmed. A systematic method to evaluate thresholds of damage owing to the impact of high energy particles is therefore crucial for safe operation and for predicting possible limitations in the overall machine performance. For this, a three-step simulation approach is presented, based on tracking simulations followed by calculations of energy deposited in the impacted material and hydrodynamic simulations to predict the thermomechanical effect of the impact. This approach is applied to metallic collimators at the CERN Large Hadron Collider (LHC), which in standard operation intercept halo protons, but risk to be damaged in the case of extraction kicker malfunction. In particular, tertiary collimators protect the aperture bottlenecks, their settings constrain the reach in β* and hence the achievable luminosity at the LHC experiments. Our calculated damage levels provide a very important input on how close to the beam these collimators can be operated without risk of damage. The results of this approach have been used already to push further the performance of the present machine. The risk of damage is even higher in the upgraded high-luminosity LHC with higher beam intensity, for which we quantify existing margins before equipment damage for the proposed baseline settings.

  14. [Occupational exposure investigation and protective measures in a tertiary infectious disease hospital].

    Science.gov (United States)

    Ding, H M; Zhou, X P; Huang, J Z

    2018-02-20

    Objective: To investigate the cause of occupational exposure among 136 nurses in a tertiary infectious disease hospital, and puts forward the prevention strategy. Methods: A total of 136 nurses exposed to occupational exposure between 2014 and 2016 were included in the study. Analysis was conducted from the years of work of nurses, exposure routes, and the pathogens. Results: The nurses suffer from the highest risk of occupational exposures (73.91%) .Nurses working for less than 5 years and interns are most likely to suffer occupational exposure (45.59% and 35.29% respectively) . Occupational exposure was mainly caused by needle injuries, in which infusion was the main route of occupational exposure (36.76%) . The improper treatment of needle pulling after infusion is the main link of needle puncture (36.76%) . Occupational exposure pathogens were mainly HBV (63.24%) . Conclusion: Nursing staff is the high-risk group of occupational exposure. Irregular operation, lack of awareness of protection, improper disposal after the needle withdrawal and poor safety assessment of the operating environment are the main causes of occupational exposure. It is suggested to strengthen the training of occupational safety and protection, enhance clinical nurses occupational safety protection consciousness, standardize medical operation, so as to prevent the occurrence of occupational exposure.

  15. Robotic assisted laparoscopic adrenalectomy: Initial experience from a tertiary care centre in India

    Directory of Open Access Journals (Sweden)

    Mrinal Pahwa

    2015-01-01

    Full Text Available Introduction: Laparoscopic adrenalectomy (LA is now considered the standard for treatment of surgically correctable adrenal disorders. Robotic adrenalectomy has been performed worldwide and has established itself as safe, feasible and effective approach. We hereby present the first study in robotic transperitoneal LA from Indian subcontinent. Materials and Methods: We conducted a retrospective evaluation of 25 patients who had undergone robotic assisted LA at a tertiary health centre by a single surgeon. Demographic, clinical, histopathological and perioperative outcome data were collected and analysed. Results: Mean age of the patients was 45 years (range: 27-65 years. Eleven male and 14 female patients were operated. Mean operative time was 139 min ± 30 min (range: 110-232 min and mean blood loss was 85 ml ± 12 ml (range: 34-313 ml. Mean hospital stay was 2.5 ± 1.05 days (range: 2-6 days. Mean visual analogue scale score was 3.2 (range: 1-6 mean analgesic requirement was 50 mg diclofenac daily (range: 0-150 mg. Histopathological evaluation revealed 11 adenomas, eight phaeochromocytomas, two adrenocortical carcinomas, and four myelolipomas. According to Clavien-Dindo classification, three patients developed Grade I post-operative complications namely hypotension and pleural effusion. Conclusion: Robotic adrenalectomy is safe, technically feasible and comfortable to the surgeon. It is easier to perform with a short learning curve.

  16. Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Brian; Chhabra, Avneesh [UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Zuniga, John R. [UT Southwestern Medical Center, Department of Oral and Maxillofacial Surgery, Surgery, Neurology and Neurotherapeutics, Dallas, TX (United States); Panchal, Neeraj [University of Pennsylvania, Department of Oral Maxillofacial Surgery, Philadelphia, PA (United States); Cheng, Jonathan [UT Southwestern Medical Center, Department of Plastic Surgery, Dallas, TX (United States)

    2016-10-15

    This tertiary care experience examines the utility of magnetic resonance neurography (MRN) in the management of peripheral trigeminal neuropathies. Seventeen patients with clinically suspected peripheral trigeminal neuropathies (inferior alveolar nerve and lingual nerve) were imaged uniformly with 1.5-T examinations. MRN results were correlated with clinical and surgical findings in operated patients and the impact on clinical management was assessed. Clinical findings included pain (14/17), sensory changes (15/17), motor changes (2/17) and palpable masses (3/17). Inciting events included prior dental surgery (12/17), trauma (1/17) and idiopathic incidents (4/17). Non-affected side nerves and trigeminal nerves in the intracranial and skull base course were normal in all cases. Final diagnoses on affected sides were nerve inflammation (4/17), neuroma in continuity (2/17), LN transection (1/17), scar entrapment (3/17), infectious granuloma (1/17), low-grade injuries (3/17) and no abnormality (3/17). Associated submandibular gland and sublingual gland oedema-like changes were seen in 3/17 cases because of parasympathetic effects. Moderate-to-excellent MRN-surgical correlation was seen in operated (8/17) patients, and neuroma and nerve transection were prospectively identified in all cases. MRN is useful for the diagnostic work-up of suspected peripheral trigeminal neuropathy patients with significant impact on clinical management and moderate-to-excellent correlation with intra-operative findings. (orig.)

  17. Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre

    International Nuclear Information System (INIS)

    Cox, Brian; Chhabra, Avneesh; Zuniga, John R.; Panchal, Neeraj; Cheng, Jonathan

    2016-01-01

    This tertiary care experience examines the utility of magnetic resonance neurography (MRN) in the management of peripheral trigeminal neuropathies. Seventeen patients with clinically suspected peripheral trigeminal neuropathies (inferior alveolar nerve and lingual nerve) were imaged uniformly with 1.5-T examinations. MRN results were correlated with clinical and surgical findings in operated patients and the impact on clinical management was assessed. Clinical findings included pain (14/17), sensory changes (15/17), motor changes (2/17) and palpable masses (3/17). Inciting events included prior dental surgery (12/17), trauma (1/17) and idiopathic incidents (4/17). Non-affected side nerves and trigeminal nerves in the intracranial and skull base course were normal in all cases. Final diagnoses on affected sides were nerve inflammation (4/17), neuroma in continuity (2/17), LN transection (1/17), scar entrapment (3/17), infectious granuloma (1/17), low-grade injuries (3/17) and no abnormality (3/17). Associated submandibular gland and sublingual gland oedema-like changes were seen in 3/17 cases because of parasympathetic effects. Moderate-to-excellent MRN-surgical correlation was seen in operated (8/17) patients, and neuroma and nerve transection were prospectively identified in all cases. MRN is useful for the diagnostic work-up of suspected peripheral trigeminal neuropathy patients with significant impact on clinical management and moderate-to-excellent correlation with intra-operative findings. (orig.)

  18. Tertiary survey in polytrauma patients should be an ongoing process.

    Science.gov (United States)

    Ferree, Steven; Houwert, Roderick M; van Laarhoven, Jacqueline J E M; Smeeing, Diederik P J; Leenen, Luke P H; Hietbrink, Falco

    2016-04-01

    Due to prioritisation in the initial trauma care, non-life threatening injuries can be overlooked or temporally neglected. Polytrauma patients in particular might be at risk for delayed diagnosed injuries (DDI). Studies that solely focus on DDI in polytrauma patients are not available. Therefore the aim of this study was to analyze DDI and determine risk factors associated with DDI in polytrauma patients. In this single centre retrospective cohort study, patients were considered polytrauma when the Injury Severity Score was ≥ 16 as a result of injury in at least 2 body regions. Adult polytrauma patients admitted from 2007 until 2012 were identified. Hospital charts were reviewed to identify DDI. 1416 polytrauma patients were analyzed of which 12% had DDI. Most DDI were found during initial hospital admission after tertiary survey (63%). Extremities were the most affected regions for all types of DDI (78%) with the highest intervention rate (35%). Most prevalent DDI were fractures of the hand (54%) and foot (38%). In 2% of all patients a DDI was found after discharge, consisting mainly of injuries other than a fracture. High energy trauma mechanism (OR 1.8, 95% CI 1.2-2.7), abdominal injury (OR 1.5, 95% CI 1.1-2.1) and extremity injuries found during initial assessment (OR 2.3, 95% CI 1.6-3.3) were independent risk factors for DDI. In polytrauma patients, most DDI were found during hospital admission but after tertiary survey. This demonstrates that the tertiary survey should be an ongoing process and thus repeated daily in polytrauma patients. Most frequent DDI were extremity injuries, especially injuries of the hand and foot. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Intense acidic volcanism at the Cretaceous-Tertiary boundary

    International Nuclear Information System (INIS)

    Javoy, M.; Courtillot, V.

    1989-01-01

    A 87 Sr/ 86 Sr spike in seawater strontium with amplitude 2 x 10 -4 and duration of order 2 Ma is superimposed on longer-term variations at the Cretaceous-Tertiary boundary. The anomaly has been attributed to increased continental runoff due either to meteorite impact-related acid rain or sea-level regression. We speculate here that the spike could have resulted from intense, explosive acid volcanism preceding the development of the Deccan traps. A good model, both in tectonic position and geochemical characteristics, for these as yet elusive acidic products is provided by granites in the Seychelles Islands and particularly Mahe. (orig.)

  20. Loop Entropy Assists Tertiary Order: Loopy Stabilization of Stacking Motifs

    Directory of Open Access Journals (Sweden)

    Daniel P. Aalberts

    2011-11-01

    Full Text Available The free energy of an RNA fold is a combination of favorable base pairing and stacking interactions competing with entropic costs of forming loops. Here we show how loop entropy, surprisingly, can promote tertiary order. A general formula for the free energy of forming multibranch and other RNA loops is derived with a polymer-physics based theory. We also derive a formula for the free energy of coaxial stacking in the context of a loop. Simulations support the analytic formulas. The effects of stacking of unpaired bases are also studied with simulations.

  1. Proximal Cretaceous-Tertiary boundary impact deposits in the Caribbean

    Science.gov (United States)

    Hildebrand, Alan R.; Boynton, Willam V.

    1990-01-01

    Trace element, isotopic, and mineralogic studies indicate that the proposed impact at the Cretaceous-Tertiary boundary occurred in an ocean basin, although a minor component of continental material is required. The size and abundance of shocked minerals and the restricted geographic occurrence of the ejecta layer and impact-wave deposits suggest an impact between the Americas. Coarse boundary sediments at sites 151 and 153 in the Colombian Basin and 5- to 450-meter-thick boundary sediments in Cuba may be deposits of a giant wave produced by a nearby oceanic impact.

  2. Uranium in tertiary stream channels, Lake Frome area, South Australia

    International Nuclear Information System (INIS)

    Brunt, D.A.

    1978-01-01

    Uranium exploration over a wide area of the Southern Frome Embayment, South Australia, has defined a number of Lower Tertiary fluvial palacochannels incised in older rocks. The buried channels contain similar stratigraphic sequences of interbedded sand, silt, and clay, probably derived from the adjacent uranium-rich Olary Province. Uranium mineralization is pervasive within two major palacochannels, and four small uranium deposits have been found in the basal sands of these channel sequences, at the margins of extensive tongues of limonitic sand. A genetic model is proposed suggesting formation by a uraniferous geochemical cell which migrated down the stream gradient and concentrated uranium on its lateral margins adjacent to the channel bank

  3. Financial impact of tertiary care in an academic medical center.

    Science.gov (United States)

    Huber, T S; Carlton, L M; O'Hern, D G; Hardt, N S; Keith Ozaki, C; Flynn, T C; Seeger, J M

    2000-06-01

    To analyze the financial impact of three complex vascular surgical procedures to both an academic hospital and a department of surgery and to examine the potential impact of decreased reimbursements. The cost of providing tertiary care has been implicated as one potential cause of the financial difficulties affecting academic medical centers. Patients undergoing revascularization for chronic mesenteric ischemia, elective thoracoabdominal aortic aneurysm repair, and treatment of infected aortic grafts at the University of Florida were compared with those undergoing elective infrarenal aortic reconstruction and carotid endarterectomy. Hospital costs and profit summaries were obtained from the Clinical Resource Management Office. Departmental costs and profit summary were estimated based on the procedural relative value units (RVUs), the average clinical cost per RVU ($33.12), surgeon charges, and the collection rate for the vascular surgery division (30.2%) obtained from the Faculty Group Practice. Surgeon work effort was analyzed using the procedural work RVUs and the estimated total care time. The analyses were performed for all payors and the subset of Medicare patients, and the potential impact of a 15% reduction in hospital and physician reimbursement was analyzed. Net hospital income was positive for all but one of the tertiary care procedures, but net losses were sustained by the hospital for the mesenteric ischemia and infected aortic graft groups among the Medicare patients. In contrast, the estimated reimbursement to the department of surgery for all payors was insufficient to offset the clinical cost of providing the RVUs for all procedures, and the estimated losses were greater for the Medicare patients alone. The surgeon work effort was dramatically higher for the tertiary care procedures, whereas the reimbursement per work effort was lower. A 15% reduction in reimbursement would result in an estimated net loss to the hospital for each of the tertiary

  4. Cervical pap smear- A prospective study in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    S Pudasaini

    2015-09-01

    Full Text Available Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015. All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%. Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5% include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years.Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

  5. Tertiary Intratumor Lymphoid Tissue in Colo-Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bergomas, Francesca [Department of Immunology and Inflammation, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy); Grizzi, Fabio [Laboratory of Molecular Gastroenterology, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy); Doni, Andrea; Pesce, Samantha [Department of Immunology and Inflammation, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy); Laghi, Luigi [Laboratory of Molecular Gastroenterology, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy); Department of Gastroenterology, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy); Allavena, Paola [Department of Immunology and Inflammation, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy); Mantovani, Alberto [Department of Immunology and Inflammation, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy); Department of Translational Medicine, University of Milan, Milan 20089 (Italy); Marchesi, Federica, E-mail: federica.marchesi@humanitasresearch.it [Department of Immunology and Inflammation, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan (Italy)

    2011-12-28

    Ectopic (or tertiary) lymphoid tissue develops at sites of inflammation or infection in non lymphoid organs and is associated with chronic inflammation. In colon mucosa, small lymphoid aggregates are already present in homeostatic conditions, as part of the gut-associated lymphoid tissue and play an essential role in the immune response to perturbations of the mucosal microenvironment. Despite the recognized role of inflammation in tumor progression, the presence and biological function of lymphoid tissue in cancer has been poorly investigated. We identified aggregates of lymphocytes resembling tertiary lymphoid tissue in human colorectal cancer specimens; intratumor accumulations of lymphocytes display a high degree of compartmentalization, with B and T cells, mature dendritic cells and a network of CD21{sup +} follicular dendritic cells (FDC). We analyzed the adaptation of colon lymphoid tissue in a murine model of colitis-associated cancer (AOM/DSS). B cell follicle formation increases in the context of the chronic inflammation associated to intestinal neoplasia, in this model. A network of lymphatic and haematic vessels surrounding B cell follicles is present and includes high endothelial venules (HEV). Future task is to determine whether lymphoid tissue contributes to the persistence of the tumor-associated inflammatory reaction, rather than represent a functional immune compartment, potentially participating to the anti tumor response.

  6. EXPLORING THE TERTIARY EFL STUDENTS' ACADEMIC WRITING COMPETENCIES

    Directory of Open Access Journals (Sweden)

    Aunurrahman Aunurrahman

    2017-05-01

    Full Text Available For tertiary English as a Foreign Language (EFL students, academic writing is not an easy task. It requires knowledge of the academic writing genres with their particular linguistic features. Moreover, academic writing demands good critical thinking. This research aims to explore the students' academic writing competencies that also focus on critical thinking. The research involved thirty-six first-year tertiary EFL students from a regular class of a private university in Pontianak, West Kalimantan, Indonesia. The source for data collection was the students’ texts. Three texts were selected and the students were categorized into low, medium, and high levels of writing achievement. The text analysis utilized functional grammar rooted in systemic functional linguistics (Emilia, 2014. The analysis shows that the students, regardless of their levels of writing achievement, have little control over the schematic structure and linguistic features of an argumentative writing. The text analysis also shows that the students’ texts have some limitations as regards their critical thinking capacity. Still, a few examples of academic language were detected in the texts. The findings suggest that the lecturer should incorporate explicit teaching and cooperative learning activities to alleviate the students' difficulties and develop their academic writing and critical thinking capacity.

  7. Hydrochemical synthesis Northern Switzerland: tertiary- and Malm-aquifers

    International Nuclear Information System (INIS)

    Schmassmann, H.; Kullin, M.; Wexsteen, P.

    1990-05-01

    This Tertiary-Malm synthesis represents the first part of an overall hydrochemical synthesis of deep groundwaters in Northern Switzerland and adjacent areas. The investigation is mainly based on data from Nagra deep boreholes, from Nagra regional programme as well as from external sources. The first part provides a hydrogeological overview including a brief description of the aquifer rocks. A compilation of all existing hydraulic potential data is given and discussed for Northern Switzerland, Bodensee area and western Swabian Alb. In the Molasse Basin, hydrochemical and isotope analyses allowed a distinction of three main water types positioned one upon another: calcium-magnesium-bicarbonate groundwaters, sodium-bicarbonate and sodium-chloride deep groundwaters. Hydrochemical and isotopegeochemical details of these three water types comprise the major part of this report. Unlike the other two water types, the calcium-magnesium-bicarbonate groundwaters also include shallow waters with considerable tritium activities, indicating a mean residence time of less than 35 years. The spacial distribution of these three water types are demonstrated and different secular flow models in the Tertiary-Malm Aquifer group are discussed. (author) figs., tabs., 194 refs

  8. Tertiary Intratumor Lymphoid Tissue in Colo-Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Federica Marchesi

    2011-12-01

    Full Text Available Ectopic (or tertiary lymphoid tissue develops at sites of inflammation or infection in non lymphoid organs and is associated with chronic inflammation. In colon mucosa, small lymphoid aggregates are already present in homeostatic conditions, as part of the gut-associated lymphoid tissue and play an essential role in the immune response to perturbations of the mucosal microenvironment. Despite the recognized role of inflammation in tumor progression, the presence and biological function of lymphoid tissue in cancer has been poorly investigated. We identified aggregates of lymphocytes resembling tertiary lymphoid tissue in human colorectal cancer specimens; intratumor accumulations of lymphocytes display a high degree of compartmentalization, with B and T cells, mature dendritic cells and a network of CD21+ follicular dendritic cells (FDC. We analyzed the adaptation of colon lymphoid tissue in a murine model of colitis-associated cancer (AOM/DSS. B cell follicle formation increases in the context of the chronic inflammation associated to intestinal neoplasia, in this model. A network of lymphatic and haematic vessels surrounding B cell follicles is present and includes high endothelial venules (HEV. Future task is to determine whether lymphoid tissue contributes to the persistence of the tumor-associated inflammatory reaction, rather than represent a functional immune compartment, potentially participating to the anti tumor response.

  9. Halitosis amongst students in tertiary institutions in Lagos state.

    Science.gov (United States)

    Arinola, J E; Olukoju, O O

    2012-12-01

    Halitosis is defined as a noticeable unpleasant odor from the mouth. It is a medico-social problem that affects a significant number of people around the world. Research reveals that nearly 50% of the adult population has halitosis. To determine level of awareness of halitosis and prevalence of the condition amongst students in tertiary institutions as a baseline survey. For this project, 100 students from three tertiary institutions in Lagos state were chosen: University of Lagos, Lagos State University, Ojo campus and Yaba College of Technology. A semi-structured questionnaire and practical testing/diagnostic tool were utilized. Data collected was collated and analyzed using Microsoft Excel 2007 and SPSS statistical software. Most of the respondents were single and Christian. Level of awareness of halitosis was high. Results showed that 15%, 2% and 22% from UNILAG, LASU and YCT respectively said they had halitosis. Using the diagnostic tool, 6%, 8% and 2% respectively were positive for halitosis. There is high level of awareness of halitosis among the respondents. The prevalence of the disorder is low, however, it is recommended that enlightenment campaigns be mounted in schools to improve level of awareness and treatment seeking.

  10. Pedagogical Study into Tertiary Learning Styles in Vietnam

    Directory of Open Access Journals (Sweden)

    Barry Ramsay

    2016-07-01

    Full Text Available Pedagogical studies for tertiary students in Vietnam are limited and no comparative benchmarking studies with other Asian tertiary students found. As a means to fill this gap and provide a better understanding the following study using Biggs (1987c Study Process Questionnaire (SPQ, a 42-item self-report survey consisting of ratings on a 5-point scale to questions relating to respondents' study motivations and their usual study patterns was conducted with 355 respondents. Findings were consistent with Hong Kong students and supports studies carried out in other countries by Kemper et al. (1989, Kemper and Gow (1991, Niles (1995, Volet and Renshaw (1996, Ramburuth (2001 and Hua, Williams and Hoi (2007. Despite learning in a “rote” manner during their formative years, students have adapted to deeper learning approaches although there is a still a slight but insignificant bias to surface learning. They desire to achieve and get good marks although strategy is limiting their progress. According to Biggs, this is commonly caused by a language problem.

  11. Extraterrestrial cause for the Cretaceous-Tertiary extinction

    International Nuclear Information System (INIS)

    Alvarez, L.W.; Alvarez, W.; Asaro, F.; Michel, H.V.

    1980-01-01

    Platinum metals are depleted in the earth's crust relative to their cosmic abundance; concentrations of these elements in deep-sea sediments may thus indicate influxes of extraterrestrial material. Deep-sea limestones exposed in Italy, Denmark, and New Zealand show iridium increases of about 30, 160, and 20 times, respectively, above the background level at precisely the time of the Cretaceous-Tertiary extinctions, 65 million years ago. Reasons are given to indicate that this iridium is of extraterrestrial origin, but did not come from a nearby supernova. A hypothesis is suggested which accounts for the extinctions and the iridium observations. Impact of a large earth-crossing asteroid would inject about 60 times the object's mass into the atmosphere as pulverized rock; a fraction of this dust would stay in the stratosphere for several years and be distributed worldwide. The resulting darkness would suppress photosynthesis, and the expected biological consequences match quite closely the extinctions observed in the paleontological record. One prediction of this hypothesis has been verified: the chemical composition of the boundary clay, which is thought to come from the stratospheric dust, is markedly different from that of clay mixed with the Cretaceous and Tertiary limestones, which are chemically similar to each other. Four different independent estimates of the diameter of the asteroid give values that lie in the range 10 +- 4 kilometers

  12. Tertiary Intratumor Lymphoid Tissue in Colo-Rectal Cancer

    International Nuclear Information System (INIS)

    Bergomas, Francesca; Grizzi, Fabio; Doni, Andrea; Pesce, Samantha; Laghi, Luigi; Allavena, Paola; Mantovani, Alberto; Marchesi, Federica

    2011-01-01

    Ectopic (or tertiary) lymphoid tissue develops at sites of inflammation or infection in non lymphoid organs and is associated with chronic inflammation. In colon mucosa, small lymphoid aggregates are already present in homeostatic conditions, as part of the gut-associated lymphoid tissue and play an essential role in the immune response to perturbations of the mucosal microenvironment. Despite the recognized role of inflammation in tumor progression, the presence and biological function of lymphoid tissue in cancer has been poorly investigated. We identified aggregates of lymphocytes resembling tertiary lymphoid tissue in human colorectal cancer specimens; intratumor accumulations of lymphocytes display a high degree of compartmentalization, with B and T cells, mature dendritic cells and a network of CD21 + follicular dendritic cells (FDC). We analyzed the adaptation of colon lymphoid tissue in a murine model of colitis-associated cancer (AOM/DSS). B cell follicle formation increases in the context of the chronic inflammation associated to intestinal neoplasia, in this model. A network of lymphatic and haematic vessels surrounding B cell follicles is present and includes high endothelial venules (HEV). Future task is to determine whether lymphoid tissue contributes to the persistence of the tumor-associated inflammatory reaction, rather than represent a functional immune compartment, potentially participating to the anti tumor response

  13. Secondary and tertiary hyperparathyroidism in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Lilit V. Egshatyan

    2017-12-01

    Full Text Available In the treatment of secondary hyperparathyroidism of end-stage chronic kidney disease, vitamin D receptor activation and allosteric modulators of the calcium-sensing receptor – inhibit glandular hyperplasia, reduce parathyroid hormone levels, impact on bone turnover and mineral density. But the use of calcimimetic and vitamin D analogs or mimetics did not reduce the need for parathyroidectomy for refractory hyperparathyroidism. The enlarged parathyroid gland and gland nodular transformation became refractory to medical therapy and patient need for parathyroidectomy. Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone after a long period of secondary hyperparathyroidism and renal transplantation. In this article, we present the case of a Caucasian male with chronic kidney disease (end-stage on chronic hemodialysis and after kidney transplantation and different forms of hyperparathyroidism (secondary and tertiary. Our case study shows that only a multi-interventional strategy is likely to be more effective treatment in cases of severe and refractory to medical therapy hyperparathyroidism.

  14. Reflections on entrepreneurship education in African tertiary institutions

    Directory of Open Access Journals (Sweden)

    K. Bawuah

    2006-12-01

    Full Text Available It is a well-established fact that several developed economies grew on the back of small businesses and entrepreneurial development. It stands to reason then that the development of Sub-Saharan Africa (SSA can also be catalysed by a rise in the number of entrepreneurs and entrepreneurial activity. In that general regard, this paper sought to investigate the state of entrepreneurship education in Sub-Saharan Africa (SSA. The method adopted in investigating this phenomenon was to critique the existing tertiary education entrepreneurship structures (where these existed at all and to proffer recommendations where anomalies were discovered. It came to light that despite the critical importance of entrepreneurs in the economic development of a nation, Sub-Saharan African (SSA countries have not fully developed strategies to tap this resource. What the countries have, are haphazard policies designed to promote the lesser or uneducated individuals in the informal sector into entrepreneurship. SSA educational leaders must find ways to structure their curricula so that all or most of their students can take courses in entrepreneurship. This is essential for SSA countries in order to move them from their present disadvantaged economic status, to greater economic and social development. A tentative syllabus for African tertiary education is proffered at the end of the article but its robustness needs to be tested.

  15. Tuberculosis treatment outcome in a tertiary care setting

    International Nuclear Information System (INIS)

    Bukhary, Zakeya A.; Alrajhi, Abdulrahman A.

    2007-01-01

    The outcome of the chemotherapy for pulmonary, extraplumonary and disseminated tuberculosis is not well documented, especially in developing countries. This study assessed tuberculosis treatment outcome, cure-to-treatment ratio and mortality among all types of tuberculosis patients in a tertiary care setting in Saudi Arabia. All cases diagnosed and treated for active Mycobacterium tuberculosis infection between 1991 and 2000 were included retrospectively. Data collected included type of tuberculosis involvement, treatment outcome, relapse and co-morbidities. Over a ten-year period, 535 case of tuberculosis were diagnosed and treated. Isolated pulmonary tuberculosis was identified in 141 cases (26.4%), extrapulmonary tuberculosis in 339 cases (63.3%). Co-morbidities were noted in 277 (52%) patients. Immunosuppression was found in 181 (34%) cases. The cure rate was 82%. The cure-to-treatment ratio was 86% in extrapulmonary tuberculosis and 65% in disseminated tuberculosis. Overall mortality was 18%. Disseminated tuberculosis had the highest mortality (34.9%), followed by pulmonary (21.8%), the extrapulmonary tuberculosis (13.6%). Forty-seven percent of all mortalities were directly related to tuberculosis. Relapse was documented in 14 out of 349 patients (4%) who had 24 months of follow-up. Despite tertiary care support, complicated tuberculosis carries a high mortality. Earlier diagnosis and complete appropriate chemotherapy are essential for improved outcome. (author)

  16. Emotional Intelligence and the Conflict Resolution Repertoire of Couples in Tertiary Institutions in Imo State

    Science.gov (United States)

    Nnodum, B. I.; Ugwuegbulam, C. N.; Agbaenyi, I. G.

    2016-01-01

    This study is a descriptive survey that investigated the relationship between emotional intelligence and conflict resolution repertoire of couples in tertiary institutions. A sample of 250 married people were drawn from the population of couples in tertiary institutions in Imo State. Two researcher made and validated instruments were used in…

  17. A Collaborative Governance Approach to Improving Tertiary Education in Papua New Guinea

    Science.gov (United States)

    Eldridge, Kaye; Larry, Lisa; Baird, Jeanette; Kavanamur, David

    2018-01-01

    Tertiary education in Papua New Guinea (PNG) is in a critical state, as the sector struggles to address increased demand for student places with severely curtailed capacity. Recent thinking about improving public services in PNG has emphasized "whole of sector" or collaborative governance. Such an approach in tertiary education has the…

  18. Student Expectations of Tertiary Institutions: A Case Study of the Fiji National University (FNU)

    Science.gov (United States)

    Khan, Shana Nigar

    2012-01-01

    Education is a human right and Fiji's tertiary education board recently declared that all tertiary institutions in Fiji must abide by the framework in order to meet student-customers' needs. The Fiji National University's (FNU's) destiny to be Fiji's leading higher education provider could be a reality if students and staff's expectations are…

  19. Entrepreneurship Education in Delta State Tertiary Institution as a Means of Achieving National Growth and Development

    Science.gov (United States)

    Osakwe, Regina N.

    2015-01-01

    This study examined entrepreneurship education in Delta Sate tertiary institutions as a means of national growth and development. Two research questions were asked to guide the study. The population comprised all the 1,898 academic staff in eight tertiary institutions in the state. A sample of 800 lecturers was drawn through the multi stage and…

  20. Tertiary Journalism Education: Its Value in Cadet Selection at Metropolitan Media.

    Science.gov (United States)

    Alysen, Barbara

    2001-01-01

    Notes tertiary study in journalism has been a feature of the education of Australian journalists for decades, yet many industry representatives remain skeptical of its value. Finds applicants for entry-level jobs with a tertiary journalism qualification can expect to secure, on average, at least half the available positions in any cadet or trainee…

  1. Evaluation of a tertiary teledermatology service between peripheral and academic dermatologists in the Netherlands

    NARCIS (Netherlands)

    van der Heijden, Job P.; de Keizer, Nicolette F.; Witkamp, Leonard; Spuls, Phyllis I.

    2014-01-01

    Tertiary teledermatology (TTD)-secondary-care to tertiary-care teleconsultation-is applied rarely compared with the frequently applied secondary teledermatology (primary to secondary care). The objective of this study was to determine the effect of TTD on referrals from peripheral dermatologists to

  2. Submarine fans and associated deposits in the Lower Tertiary of Guipuzcoa (Northern Spain)

    NARCIS (Netherlands)

    Vliet, van A.

    1982-01-01

    The Lower Tertiary outcrop along the coast of Guipuzcoa, northern Spain, consists exclusively of deep-marine sediments, deposited in a narrow elongated (ESE-WNW) basin. The early Tertiary sedimentary history of this basin can be described in terms of three main phases:

    - a phase of

  3. A Comparison of Teacher and Lecturer Perspectives on the Transition from Secondary to Tertiary Mathematics Education

    Science.gov (United States)

    Hong, Ye Yoon; Kerr, Suzanne; Klymchuk, Sergiy; McHardy, Johanna; Murphy, Priscilla; Spencer, Sue; Thomas, Michael O. J.; Watson, Peter

    2009-01-01

    The transition from school to tertiary study of mathematics comes under increasing scrutiny in research. This article reports on some findings from a project analysing the transition from secondary to tertiary education in mathematics. One key variable in this transition is the teacher or lecturer. This article deals with a small part of the data…

  4. Hospital-acquired infections in a Nigerian tertiary health facility: An ...

    African Journals Online (AJOL)

    Hospital-acquired infections in a Nigerian tertiary health facility: An audit of surveillance reports. ... This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. Materials and Methods: A retrospective survey of records from the infection control ...

  5. Transition and Tertiary Education: A Case Study of Mzuzu University, Malawi

    Science.gov (United States)

    Zozie, Paxton Andrew; Kayira, Peter Benwell

    2012-01-01

    This article reviews the role of guidance and counselling in Malawi in reducing dropout and easing the transition of students to tertiary education, as well as in helping them during their time in tertiary education. It begins by identifying key success factors in guidance and counselling services for learners in both developed and developing…

  6. bilingualism in the english of tertiary students: a sine-qua-non

    African Journals Online (AJOL)

    REV YOUNG EZENWA OBIOHA

    questions were used to investigate the effects of Bilingualism on the English of tertiary students. A total of three hundred students from two tertiary institutions were used. ... thoughts, inner feelings, personal psychological ... Chinese migration to the U.S.A (Akindele & ... child is taught Mathematical multiplication and division ...

  7. Why Do Tertiary Education Graduates Regret Their Study Program? A Comparison between Spain and the Netherlands

    Science.gov (United States)

    Kucel, Aleksander; Vilalta-Bufi, Montserrat

    2013-01-01

    In this paper we investigate the determinants of regret of study program for tertiary education graduates in Spain and the Netherlands. These two countries differ in their educational system in terms of the tracking structure in their secondary education and the strength of their education-labor market linkages in tertiary education. Therefore, by…

  8. On Progress of Mass Tertiary Education: Case of Lebanon, Kenya and Oman

    Science.gov (United States)

    Liu, Zhimin; Mutinda, Gladys

    2016-01-01

    Mass higher education is a huge force to be reckoned with and its existence, already in the expansion of tertiary institutions is undeniable. This study will focus on three countries: Lebanon, Kenya and Oman. The purpose of this study is to evaluate mass tertiary education progress in these countries. It will synthesize data results of gross…

  9. "Community of Practice" as a Framework for Supporting Tertiary Teachers' Informal Workplace Learning

    Science.gov (United States)

    Viskovic, Alison R.

    2005-01-01

    This article discusses aspects of the informal learning of tertiary teachers in a polytechnic, a wananga (Maori tertiary institution) and a university in New Zealand. Case studies showed that they gained their teaching knowledge and skills mainly on the job, through informal, experiential learning, and much less through formal courses,…

  10. Challenges Faced by Key Stakeholders Using Educational Online Technologies in Blended Tertiary Environments

    Science.gov (United States)

    Tuapawa, Kimberley

    2016-01-01

    Traditional learning spaces have evolved into dynamic blended tertiary environments (BTEs), providing a modern means through which tertiary education institutes (TEIs) can augment delivery to meet stakeholder needs. Despite the significant demand for web-enabled learning, there are obstacles concerning the use of EOTs, which challenge the…

  11. A retrospective review of snake bite victims admitted in a tertiary ...

    African Journals Online (AJOL)

    Objective: Snake bite remains major public health problem worldwide. We present our experience with cases of snake bites managed in our tertiary care teaching center of South India. Materials and Methods: The details of all patients with snake bite admitted to a tertiary teaching care hospital from 2010 to 2012 were ...

  12. Innovating in the Real World: Exploring Institutional Effects on Tertiary Teacher Innovations in New Zealand

    Science.gov (United States)

    Lawrence, Belinda

    2018-01-01

    Innovation is a key goal of many tertiary education and distance learning providers. This research explores how teachers and educational designers across three New Zealand tertiary institutions worked to innovatively achieve teaching goals. A longitudinal design using the Cultural Historical Activity Theory (CHAT) framework explored the influence…

  13. Characteristics and risk factors of preterm births in a tertiary center in ...

    African Journals Online (AJOL)

    Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria. ... Introduction: preterm birth is a dire complication of pregnancy that poses ... to a tertiary center for prenatal care in order to significantly reduce adverse birth ...

  14. Framework of Assessment for the Evaluation of Thinking Skills of Tertiary Level Students

    Science.gov (United States)

    Heng, Chan Swee; Ziguang, Yan

    2015-01-01

    In the 21st century, students are required to master thinking skills in order to deal with many situations that arise in the tertiary environment which later would translate into the workplace. Nowadays, thinking skills play a vital role in tertiary education. To provide an approach for teachers, this paper identifies a 4-step model that can be…

  15. Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

    Directory of Open Access Journals (Sweden)

    İbrahim Kalelioğllu

    2013-09-01

    Full Text Available Objective: We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly. Methods: In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed. Results: In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3% cases had experienced at least one cesarean delivery before. Majority of the operations (82.4% were performed in elective conditions. In 16 (18.8% cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2% cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7% cases during and 50 (58.8% patients after operation. Dilutional trombocytopenia developed in 17 (20% patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%, placenta increata in 1 (1.2% and placenta percreata in 25 (29.4% patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435 in 2005-2006 up to 0.8% (37/4344 in 2011-2012. Conclusion: The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

  16. Entrepreneurship Education at Tertiary Education Level: Implication to Historical Studies

    Directory of Open Access Journals (Sweden)

    Salahu Mohammed Lawal

    2012-07-01

    Full Text Available Nigeria is richly endowed with both human and material resources that when well utilized can make her one of the richest and developed nation in the world.  But poor utilization of the resources, corruption and dwindling fortune in her education system made her among the first twenty five poorest nations in the world.  Similarly, report shows that 26% of the employable population remained unemployed.  This called for the need for entrepreneurship education most especially at tertiary level where high level manpower is supposed to be trained.  It is on this premise that the paper attempts to examine entrepreneurship education and its implication to history students and graduates.

  17. Tertiary proton diagnostics in future inertial confinement fusion experiments

    International Nuclear Information System (INIS)

    Cremer, S.; Verdon, C.P.; Petrasso, R.D.

    1998-01-01

    Recently, it was proposed to use energetic (up to 31 MeV) tertiary protons produced during the final stage of inertial confinement fusion implosions to measure the fuel areal density of compressed deuterium endash tritium (DT). The method is based on seeding the fuel with 3 He. The reaction of 3 He ions with the energetic knock-on deuterons, produced via the elastic scattering of 14.1 MeV neutrons, is a source of very energetic protons capable of escaping from very large areal density targets. This work presents results of detailed time-dependent Monte Carlo simulations of the nuclear processes involved in producing and transporting these protons through imploding targets proposed for direct-drive experiments on OMEGA [D. K. Bradley et al., Phys. Plasmas 5, 1870 (1998)] and the National Ignition Facility [S. W. Haan et al., Phys. Plasmas 2, 2480 (1995)]. copyright 1998 American Institute of Physics

  18. Assessment of pediatric residents burnout in a tertiary academic centre

    Directory of Open Access Journals (Sweden)

    Roaa S. Jamjoom

    2018-03-01

    Full Text Available Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4 in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital. The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally.

  19. Tertiary phosphine complexes of rhenium: a spectroscopic study

    International Nuclear Information System (INIS)

    Fergusson, J.E.; Heveldt, P.F.

    1976-01-01

    Complexes of the type ReOX 3 L 2 , ReNX 2 L 3 , ReX 3 (NO)L 2 and ReX 2 (NO)L 3 have been studied using, UV visible, IR and H 1 , C 13 NMR spectroscopy. (X is a halogen, Cl, Br, I and L is a tertiary phosphine Et 3 P and Et 2 PhP). Evidence obtained on the blue cis isomer ReOCl 3 L 2 suggests that the halogens are arranged on a face of the octahedral complex. Assignments of ν(Re-X) and ν(Re-P) vibrations have been made. Three complexes of technetium, [TcCl 4 (Ph 3 P) 2 ], [TcCl 3 (Et 2 PhP) 3 ] and [TcCl 3 (NO)(Et 2 PhP) 2 ] have been isolated. (author)

  20. Cooperative activity and its potential for learning in tertiary education

    Directory of Open Access Journals (Sweden)

    Cirila Peklaj

    2007-01-01

    Full Text Available A learning situation can be structured in different ways, as an individual, competitive, or cooperative activity. Each of these structures can be used for different purposes and can lead to different learning outcomes. This paper focuses on cooperative activity and its potential for learning in tertiary education. After defining cooperative activity (or, in a broader sense, learning in interaction and introducing the CAMS theoretical framework to analyse cooperative activity, the main discussion focuses on the theoretical reasons for the usefulness of group learning and on the research of effects of cooperative learning on cognitive (metacognitive, affective-motivational and social processes in university students. The key elements that should be established for successful cooperation are also discussed. At the end, a new direction in using cooperative activity in learning—computer supported collaborative learning (CSCL, which emerged with rapid technology development in the last two decades—is presented and discussed.

  1. Constructivism in Teaching English for Special Purposes at Tertiary School

    Directory of Open Access Journals (Sweden)

    Anna Y. Polenova

    2017-09-01

    Full Text Available The article looks at some principles of constructivism philosophy and the ways they are realized in ESP teaching at tertiary school. The purpose of this article is to describe constructivist teaching approach in enhancing students’ use of appropriate ESP learning strategies. Constructivism is a theory that emphasizes the active role of students in building understanding and making sense of the information. The constructivist teaching is learner-centered where students are actively involved in knowledge construction rather than passive listeners. Students construct knowledge by transforming, organizing, reorganizing previous knowledge through social interaction in construction of knowledge and understanding. The paper is an attempt to examine the principles of constructivist teaching and learning by providing analysis of features of constructivist theory and the organization of a constructivist classroom.

  2. Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

    Directory of Open Access Journals (Sweden)

    Elad Asher

    Full Text Available OBJECTIVE: To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists. STUDY DESIGN: A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel. RESULTS: Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97% felt that their daily work practice is influenced by concern about being sued for medical negligence and not only by genuine medical considerations. As a result, 102 (87% physicians are more likely to offer the cesarean section option, even in the absence of a clear medical indication, 70 (60% follow court rulings concerning medical practices, and 85 (73% physicians mentioned that discussions about medical negligence court rulings are included in their departments' meetings. CONCLUSIONS: Defensive medicine is a well-embedded phenomenon affecting the medical decision process of obstetricians and gynecologists.

  3. Frequency of candidemias in a tertiary care intensive care unit

    International Nuclear Information System (INIS)

    Yaqub, K.M.; Usman, J.; Zaidi, S.B.H.; Khalil, A.; Noor, N.; Gill, M.M.

    2013-01-01

    Objective: To determine the frequency of fungal infections in intensive care unit (ICU) of Military Hospital, Rawalpindi, a tertiary care health facility. Study Design: Cross sectional study. Place and Duration of Study: Intensive Care Department of Military Hospital Rawalpindi from 01 Jan 2012 to 30 Jun 2012. Methodology: A total of 89 patients were screened with stay of more than 5 days in intensive care unit. Thirty cases were enrolled in the study for investigation of fungal infections that had fever even after 05 days of being on broad spectrum antibiotics. Culture was done on blood, urine and catheter tip samples as per clinical condition of a patient. Results: Candida infection was found in 23.4% of study cases. The mean age of study patients was 41.2 +- 20.0 years while 63.4% were female patients as compared to 36.7% males. Conclusion: Fungal infections especially candidemias are quite frequent in the intensive care units. (author)

  4. Spatial Operations

    Directory of Open Access Journals (Sweden)

    Anda VELICANU

    2010-09-01

    Full Text Available This paper contains a brief description of the most important operations that can be performed on spatial data such as spatial queries, create, update, insert, delete operations, conversions, operations on the map or analysis on grid cells. Each operation has a graphical example and some of them have code examples in Oracle and PostgreSQL.

  5. Operational amplifiers

    CERN Document Server

    Dostal, Jiri

    1993-01-01

    This book provides the reader with the practical knowledge necessary to select and use operational amplifier devices. It presents an extensive treatment of applications and a practically oriented, unified theory of operational circuits.Provides the reader with practical knowledge necessary to select and use operational amplifier devices. Presents an extensive treatment of applications and a practically oriented, unified theory of operational circuits

  6. Tertiary alphabet for the observable protein structural universe.

    Science.gov (United States)

    Mackenzie, Craig O; Zhou, Jianfu; Grigoryan, Gevorg

    2016-11-22

    Here, we systematically decompose the known protein structural universe into its basic elements, which we dub tertiary structural motifs (TERMs). A TERM is a compact backbone fragment that captures the secondary, tertiary, and quaternary environments around a given residue, comprising one or more disjoint segments (three on average). We seek the set of universal TERMs that capture all structure in the Protein Data Bank (PDB), finding remarkable degeneracy. Only ∼600 TERMs are sufficient to describe 50% of the PDB at sub-Angstrom resolution. However, more rare geometries also exist, and the overall structural coverage grows logarithmically with the number of TERMs. We go on to show that universal TERMs provide an effective mapping between sequence and structure. We demonstrate that TERM-based statistics alone are sufficient to recapitulate close-to-native sequences given either NMR or X-ray backbones. Furthermore, sequence variability predicted from TERM data agrees closely with evolutionary variation. Finally, locations of TERMs in protein chains can be predicted from sequence alone based on sequence signatures emergent from TERM instances in the PDB. For multisegment motifs, this method identifies spatially adjacent fragments that are not contiguous in sequence-a major bottleneck in structure prediction. Although all TERMs recur in diverse proteins, some appear specialized for certain functions, such as interface formation, metal coordination, or even water binding. Structural biology has benefited greatly from previously observed degeneracies in structure. The decomposition of the known structural universe into a finite set of compact TERMs offers exciting opportunities toward better understanding, design, and prediction of protein structure.

  7. Impact of tertiary Gleason pattern 5 on prostate cancer aggressiveness: Lessons from a contemporary single institution radical prostatectomy series

    Directory of Open Access Journals (Sweden)

    Zachary B. Koloff

    2015-01-01

    Conclusion: Our results emphasize the importance of TP5 and suggest that criteria for tertiary pattern reporting in prostate cancer should be standardized. Further studies are needed to evaluate the role of tertiary patterns in prognostic models.

  8. Design and operating condition. Consequences for EDF NPP's chemistry

    International Nuclear Information System (INIS)

    Bretelle, Jean-Luc; Stutzmann, Agnes; Nordmann, Francis

    2009-01-01

    Since the beginning of the French nuclear programme in 1977, four major types of design have been commissioned, the fifth one being under construction (EPR). The paper points out advantages and drawbacks of chemistry choices for the primary, secondary and tertiary systems in French NPP, for each design particularity and it describes the corresponding operating conditions. Chemistry option proposals are drawn for the future of the French fleet, taking into account the material behaviour and the operation improvement. (orig.)

  9. Disease patterns and clinical outcomes of patients admitted in intensive care units of tertiary referral hospitals of Tanzania.

    Science.gov (United States)

    Sawe, Hendry R; Mfinanga, Juma A; Lidenge, Salum J; Mpondo, Boniventura C T; Msangi, Silas; Lugazia, Edwin; Mwafongo, Victor; Runyon, Michael S; Reynolds, Teri A

    2014-09-23

    In sub-Saharan Africa the availability of intensive care unit (ICU) services is limited by a variety of factors, including lack of financial resources, lack of available technology and well-trained staff. Tanzania has four main referral hospitals, located in zones so as to serve as tertiary level referral centers. All the referral hospitals have some ICU services, operating at varying levels of equipment and qualified staff. We analyzed and describe the disease patterns and clinical outcomes of patients admitted in ICUs of the tertiary referral hospitals of Tanzania. This was a retrospective analysis of ICU patient records, for three years (2009 to 2011) from all tertiary referral hospitals of Tanzania, namely Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Mbeya Referral Hospital (MRH) and Bugando Medical Centre (BMC). MNH is the largest of the four referral hospitals with 1300 beds, and MRH is the smallest with 480 beds. The ratio of hospital beds to ICU beds is 217:1 at MNH, 54:1 at BMC, 39:1 at KCMC, and 80:1 at MRH. KCMC had no infusion pumps. None of the ICUs had a point-of-care (POC) arterial blood gas (ABG) analyzer. None of the ICUs had an Intensive Care specialist or a nutritionist. A masters-trained critical care nurse was available only at MNH. From 2009-2011, the total number of patients admitted to the four ICUs was 5627, male to female ratio 1.4:1, median age of 34 years. Overall, Trauma (22.2%) was the main disease category followed by infectious disease (19.7%). Intracranial injury (12.5%) was the leading diagnosis in all age groups, while pneumonia (11.7%) was the leading diagnosis in pediatric patients (<18 years). Patients with tetanus (2.4%) had the longest median length ICU stay: 8 (5,13) days. The overall in-ICU mortality rate was 41.4%. The ICUs in tertiary referral hospitals of Tanzania are severely limited in infrastructure, personnel, and resources, making it difficult or impossible to provide optimum care

  10. Improving patient safety in cardiothoracic surgery: an audit of surgical handover in a tertiary center.

    Science.gov (United States)

    Bauer, Natasha Johan

    2016-01-01

    Novel research has revealed that the relative risk of death increased by 10% and 15% for admissions on a Saturday and Sunday, respectively. With an imminent threat of 7-day services in the National Health Service, including weekend operating lists, handover plays a pivotal role in ensuring patient safety is paramount. This audit evaluated the quality, efficiency, and safety of surgical handover of pre- and postoperative cardiothoracic patients in a tertiary center against guidance on Safe Handover published by the Royal College of Surgeons of England and the British Medical Association. A 16-item questionnaire prospectively audited the nature, time and duration of handover, patient details, operative history and current clinical status, interruptions during handover, and difficulties cross-covering specialties over a month. Just over half (52%) of the time, no handover took place. The majority of handovers (64%) occurred over the phone; two-thirds of these were uninterrupted. All handovers were less than 10 minutes in duration. About half of the time, the senior house officer had previously met the registrar involved in the handover, but the overwhelming majority felt it would facilitate the handover process if they had prior contact. Patient details handed over 100% of the time included name, ward, and current clinical diagnosis. A third of the time, the patient's age, responsible consultant, and recent operations or procedures were not handed over, potentially compromising future management due to delays and lack of relevant information. Perhaps the most revealing result was that the overall safety of handover was perceived to be five out of ten, with ten being very safe with no aspects felt to impact negatively on optimal patient care. These findings were presented to the department, and a handover proforma was implemented. Recommendations included the need for a new face-to-face handover. A reaudit will evaluate the effects of these changes.

  11. Gastric volvulus in children: Experience of 6 years at a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Pradeep S

    2010-01-01

    Full Text Available Background: The aim of the study was to review the cases of all children who had gastric volvulus from 2002 to 2007 at a tertiary care centre in India and to compare the outcome of management with the reported series on gastric volvulus in a paediatric age group. Materials and Methods: This was a retrospective study of eight children with an age range between 10 days and 2 years who were managed for gastric volvulus between 2002 and 2007. The records of these patients were reviewed for clinical features, investigations, management and outcome. Results: All patients were less than 3 years of age with female preponderance (n = 5. Three patients had acute presentation and three had acute-on-chronic symptoms, while two had chronic gastric volvulus. The commonest symptom was abdominal distension. Two patients were diagnosed by barium studies and six had clinical suspicion because of their symptoms and were confirmed intra-operatively. Seven had secondary gastric volvulus of organo axial type with associated pathologies as congenital diaphragmatic hernia (n = 5, Para oesophageal hiatus hernia (n = 2, and one had primary gastric volvulus in a postoperative period in an operated case for a tracheo-oesophageal fistula (n = 1. Seven patients were symptom free at follow-up; one patient succumbed due to septicaemia in the immediate post-operative period which was not related to the pathology of gastric volvulus. Conclusion: Gastric volvulus is a rare condition in children and requires prompt diagnosis and urgent intervention in acute presentation where it mimics acute abdomen and strong clinical suspicion.

  12. Tertiary treatment of landfill leachate by an integrated Electro-Oxidation/Electro-Coagulation/Electro-Reduction process: Performance and mechanism.

    Science.gov (United States)

    Ding, Jing; Wei, Liangliang; Huang, Huibin; Zhao, Qingliang; Hou, Weizhu; Kabutey, Felix Tetteh; Yuan, Yixing; Dionysiou, Dionysios D

    2018-06-05

    This study presents an integrated Electro-Oxidation/Electro-Coagulation/Electro-Reduction (EO/EC/ER) process for tertiary landfill leachate treatment. The influence of variables including leachate characteristics and operation conditions on the performance of EO/EC/ER process was evaluated. The removal mechanisms were explored by comparing results of anode, cathode, and bipolar electrode substitution experiments. The performance of the process in a scaled-up reactor was investigated to assure the feasibility of the process. Results showed that simultaneous removal of carbonaceous and nitrogenous pollutants was achieved under optimal conditions. Ammonia removal was due to the free chlorine generation of EO while organic matter degradation was achieved by both EO and EC processes. Nitrate removal was attributed to both ER and EC processes, with the higher removal achieved by ER process. In a scaled-up reactor, the EO/EC/ER process was able to remove 50-60% organic matter and 100% ammonia at charge of 1.5 Ah/L with energy consumption of 15 kW h/m 3 . Considering energy cost, the process is more efficient to meet the requirement of organic removal efficiency less than 70%. These results show the feasibility and potential of the EO/EC/ER process as an alternative tertiary treatment to achieve the simultaneous removal of organic matter, ammonia, nitrate, and color of leachate. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Tertiary Technical Education and Youth Integration in Brazil, Colombia and Mexico

    Directory of Open Access Journals (Sweden)

    Claudia Jacinto

    2014-11-01

    Full Text Available Vocational training versus a traditional university education. This chapter seeks to answer the question of whether ‘tertiary technical education’ has contributed to increasing economic and social opportunity for young people in Latin America, using three case studies from Brazil, Colombia and Mexico. It examines the extent to which tertiary technical education has contributed towards democratising access to education through institutional diversification, expanded enrolment and, at least theoretically, improved access to quality employment. The analysis shows that tertiary technical education has contributed to widening of opportunities by offering an alternative form of education to new generations of young people. Tertiary technical education is more accessible, shorter in duration, has a vocational orientation, and tends to be cheaper than a university education. However, the case studies also reveal that while a tertiary technical education diploma is an asset for young people seeking employment, it nonetheless does not have the same perceived value as a traditional university education. Available data appear to indicate that graduates of tertiary technical education earn less on average than university graduates and face several challenges in the labour market. Furthermore, the studies reveal that despite the presence of highly regarded tertiary technical education institutions in all three countries, these carry less prestige and status than universities.

  14. Effects of Primary, Secondary and Tertiary Education on Conflict Intensity in Africa

    Directory of Open Access Journals (Sweden)

    Julius A. Agbor

    2015-10-01

    Full Text Available This study investigates the impact of different schooling dimensions (primary, secondary and tertiary on the intensity of intra-state conflicts in 25 African states during the period 1989–2008. It uses fixed-effects and Generalized Methods of Moments (GMM estimators in an annualized panel data framework. Parameter estimates suggest the following (1 primary schooling broadly mitigates conflicts in Africa. However, in environments with high natural resource rents, it could ignite conflicts; (2 there is evidence, although not overwhelming, that secondary schooling potentially drives conflicts in Africa. There is also evidence that urbanization potentially drives conflicts in Africa. However, although secondary schooling and urbanization potentially drives conflicts, in environments where secondary schooling (urbanization is high, urbanization (secondary schooling mitigates conflicts; (3 there is no evidence of a strong direct positive impact of tertiary education on conflicts and conditioning on tertiary schooling, income inequality potentially drives conflicts in African states. However, in contexts where income inequality (tertiary schooling is high, tertiary schooling (inequality mitigates conflict. Two important policy implications follow from this study. First, in contexts where income inequality is high (for instance, in South Africa, governments should strive to foster tertiary education in order to reduce conflict. Second, where urbanization rates are high, they should foster both secondary and tertiary education. This study contributes to existing knowledge by clearly demonstrating the utility of distinguishing between different educational dimensions and the contexts wherein they matter for conflict mitigation in Africa.

  15. Formation mechanism of NDMA from ranitidine, trimethylamine, and other tertiary amines during chloramination: a computational study.

    Science.gov (United States)

    Liu, Yong Dong; Selbes, Meric; Zeng, Chengchu; Zhong, Rugang; Karanfil, Tanju

    2014-01-01

    Chloramination of drinking waters has been associated with N-nitrosodimethylamine (NDMA) formation as a disinfection byproduct. NDMA is classified as a probable carcinogen and thus its formation during chloramination has recently become the focus of considerable research interest. In this study, the formation mechanisms of NDMA from ranitidine and trimethylamine (TMA), as models of tertiary amines, during chloramination were investigated by using density functional theory (DFT). A new four-step formation pathway of NDMA was proposed involving nucleophilic substitution by chloramine, oxidation, and dehydration followed by nitrosation. The results suggested that nitrosation reaction is the rate-limiting step and determines the NDMA yield for tertiary amines. When 45 other tertiary amines were examined, the proposed mechanism was found to be more applicable to aromatic tertiary amines, and there may be still some additional factors or pathways that need to be considered for aliphatic tertiary amines. The heterolytic ONN(Me)2-R(+) bond dissociation energy to release NDMA and carbocation R(+) was found to be a criterion for evaluating the reactivity of aromatic tertiary amines. A structure-activity study indicates that tertiary amines with benzyl, aromatic heterocyclic ring, and diene-substituted methenyl adjacent to the DMA moiety are potentially significant NDMA precursors. The findings of this study are helpful for understanding NDMA formation mechanism and predicting NDMA yield of a precursor.

  16. CLINICAL PROFILE OF ANAEMIA IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ather Akhtar

    2016-04-01

    Full Text Available BACKGROUND Anaemia causes a reduction in the oxygen carrying capacity of the blood resulting in tissue hypoxia. Cardiac output at rest is not usually increased in most chronic anaemia until haemoglobin levels fall below 7 g/dL, but abnormal rise in output with exercise may occur with levels as high as 10 g/dL. The increase in cardiac output has been observed to correlate well with the degree of anaemia. Other compensatory mechanisms to chronic anaemia available to the body include decreased circulation time and increased tissue oxygen uptake. The latter is facilitated by a shift to the right of the oxygen haemoglobin dissociation curve. Cardiomegaly may also be as a result of the increased workload on the heart from the increased viscosity of blood in anaemia patients. Anaemia in the elderly is an extremely common problem that is associated with increased mortality and poorer health-related quality of life, regardless of the underlying cause of the low haemoglobin. A study of anaemia in elderly patients found a wide variation in prevalence, ranging from 2.9% to 61% in men and 3.3% to 41% in women. Higher rates were found in hospitalised patients than in community dwellers. It is easy to overlook anaemia in the elderly, since such symptoms as fatigue, weakness, or shortness of breath may be attributed to the ageing process itself. Our objective is to show the prevalence of anaemia even in a tertiary health care centre. METHODS One hundred patients were identified who were admitted in the Department of Medicine, Deccan College of Medical Sciences. Among the 100 patients, 38 were male and 62 were female. The study was conducted from Jan 2014 To Jan 2015. Patients having haemoglobin less than 10 g% in the medical wards were enrolled in the study. RESULTS Among the 100 patients, 38 were male and 62 were female. The average haemoglobin was 6.4 g%, the lowest being 2.8 g%. Peripheral blood smear showed hypochromic picture in 58, macrocytic picture in

  17. Evaluation of methodology for quantifying radiopharmaceuticals in tertiary-treated sewage

    International Nuclear Information System (INIS)

    Krieger, H.; Frishkorn, G.; Martin, E.; Jacobs, B.

    1980-01-01

    The production and utilization of radioactive pharmaceuticals and radionuclides for medical diagnosis and therapy warrant consideration of their fate and their radiation hazard to the population after discharge. Some of these nuclides represent curies of activity from a single facility that are being released to the sewers over a years's time. Although their relatively short half-life and the large sewer dilution may reduce the activity in the waste by several orders of magnitude at the point of treatment, the unpredictable range of decontamination by normal sewage treatment practices means that some will remain in the final effluent. Even after tertiary treatment operations, necessary when sewage effluents are to be used as coolants for nuclear reactors, and the confirmation of the nuclides in these effluents becomes of major concern as possible radiation hazards. Methodology to identify and measure the activity of five radionuclides - 131 I, 85 Sr, 57 Co, 51 Cr, and 75 Se - was developed and tested. Chemical yields agreed with radiochemical yields, and the chemical yields were at least 70%. Since the normal activity levels of each of these nuclides will be low, the required precision and accuracy can best be satisfied by radiochemical analysis of large volumes. Analyses on the influents, sludges, and treated effluents will indicate the overall efficiency of the entire sewage treatment process, provide evidence of the fate of each nuclide discharged into the sewage stream, and indicate whether a potential radiation hazard exists

  18. Metal-Free Conversion of Carboxamides to Ureas Using Tertiary Amines and Iodosylmesitylene

    Energy Technology Data Exchange (ETDEWEB)

    Han, Hoon; Chang, Suk Bok [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2010-03-15

    A new synthetic route has been developed for the preparation of ureas from the reaction of carboxamides with tertiary amines with the use of iodosylmesitylene as a stoichiometric oxidant. Although the reaction proceeds under the mild conditions to afford urea products in moderate yields, further optimization studies are required to improve the reaction efficiency and regioselectivity in the dealkylative pathway. Ureas are recognized as an important synthetic building unit, finding a wide range of applications in the preparation of agrochemicals, petrochemicals, and pharmaceuticals. In addition, hydrogen bond-mediated communication between ureas and certain types of compounds is an important structural motif in asymmetric catalysis, molecular recognition, and crystal engineering. Although numerous procedures have been developed for the urea synthesis, the most commonly employed strategy involves the reaction of amine precursors with phosgene, or its surrogates, isocyanates, or carbamates. Whereas these traditional methods are operative under conventional reaction conditions, they often lead to incomplete conversion. Additional drawback of these protocols is that unsymmetric ureas are difficult to prepare in many cases.

  19. Reuse of refinery's tertiary-treated wastewater in cooling towers: microbiological monitoring.

    Science.gov (United States)

    Dos Santos, Vera Lúcia; Veiga, Andréa Azevedo; Mendonça, Rafael Silva; Alves, Andrea Lima; Pagnin, Sérgio; Santiago, Vânia M J

    2015-02-01

    The study was planned to quantify the distribution of bacteria between bulk water and biofilm formed on different materials in an industrial scale cooling tower system of an oil refinery operating with clarified and chlorinated freshwater (CCW) or chlorinated tertiary effluent (TRW) as makeup water. The sessile and planktonic heterotrophic bacteria and Pseudomonas aeruginosa densities were significantly higher in the cooling tower supplied with clarified and chlorinated freshwater (CTCW) (p towers, the biofilm density was higher on the surface of glass slides and stainless steel coupons than on the surface of carbon steel coupons. The average corrosion rates of carbon steel coupons (0.4-0.8 millimeters per year (mpy)) and densities of sessile (12-1.47 × 10(3) colony-forming unit (CFU) cm(-1)) and planktonic (0-2.36 × 10(3) CFU mL(-1)) microbiota remained below of the maximum values of reference used by water treatment companies as indicative of efficient microbial control. These data indicate that the strategies of the water treatment station (WTS) (free chlorine) and industrial wastewater treatment station (IWTS) followed by reverse electrodialysis system (RES) (free chlorine plus chloramine) were effective for the microbiological control of the two makeup water sources.

  20. Lessons learned from the development of health applications in a tertiary hospital.

    Science.gov (United States)

    Park, Joong-Yeol; Lee, Guna; Shin, Soo-Yong; Kim, Jeong Hun; Han, Hye-Won; Kwon, Tae-Wan; Kim, Woo Sung; Lee, Jae Ho

    2014-03-01

    Adoption of smart devices for hospital use has been increasing with the development of health applications (apps) for patient point-of-care and hospital management. To promote the use of health apps, we describe the lessons learned from developing 12 health apps in the largest tertiary hospital in Korea. We reviewed and analyzed 12 routinely used apps in three categories-Smart Clinic, Smart Patient, and Smart Hospital-based on target users and functions. The log data for each app were collected from the date of release up until December 2012. Medical personnel accessed a mobile electronic medical record app classified as Smart Clinic an average of 452 times per day. Smart Hospital apps are actively used to communicate with each other. Patients logged on to a mobile personal health record app categorized as Smart Patient an average of 222 times per day. As the mobile trend, the choice of supporting operating system (OS) is more difficult. By developing these apps, a monitoring system is needed for evaluation. We described the lessons learned regarding OS support, device choice, and developmental strategy. The OS can be chosen according to market share or hospital strategic plan. Smartphones were favored compared with tablets. Alliance with an information technology company can be the best way to develop apps. Health apps designed for smart devices can be used to improve healthcare. However, to develop health apps, hospitals must define their future goals and carefully consider all the aspects.

  1. Transverse musculocutaneous gracilis flap for treatment of capsular contracture in tertiary breast reconstruction.

    Science.gov (United States)

    Pülzl, Petra; Huemer, Georg M; Schoeller, Thomas

    2015-02-01

    Capsular contracture is a common complication associated with implant-based breast reconstruction and augmentation leading to pain, displacement, and rupture. After capsulectomy and implant exchange, the problem often reappears. We performed 52 deepithelialized free transverse musculocutaneous gracilis (TMG) flaps in 33 patients for tertiary breast reconstruction or augmentation of small- and medium-sized breasts. The indications for implant removal were unnatural feel and emotion of their breasts with foreign body feel, asymmetry, pain, and sensation of cold. Anyway, most of the patients did not have a severe capsular contracture deformity. The TMG flap is formed into a cone shape by bringing the tips of the ellipse together. Depending on the contralateral breast, the muscle can also be shaped in an S-form to get more projection if needed. The operating time for unilateral TMG flap breast reconstruction or augmentation was on average 3 hours and for bilateral procedure 5 hours. One patient had a secondary revision of the donor site due to disruption of the normal gluteal fold. Eighty percent of the unilateral TMG flap reconstructions had a lipofilling procedure afterward to correct small irregularities or asymmetry. The advantages of the TMG flap such as short harvesting time, inconspicuous donor site, and the possibility of having a natural breast shape make it our first choice to treat capsular contracture after breast reconstruction and augmentation.

  2. Electro-oxidation of reverse osmosis concentrates generated in tertiary water treatment.

    Science.gov (United States)

    Pérez, G; Fernández-Alba, A R; Urtiaga, A M; Ortiz, I

    2010-05-01

    This work investigates the application of the electro-oxidation technology provided with boron doped diamond (BDD), an electrode material which has shown outstanding properties in oxidation of organic and inorganic compounds, for the treatment of reverse osmosis (RO) concentrates generated in tertiary wastewater treatment plants (WWTP). Chemical oxygen demand (COD), ammonium and several anions were measured during the electro-oxidation process, and the influence of the applied current density (20-200A/m(2)) was analysed on process kinetics. Analytical assessment showed that several emerging pollutants (pharmaceuticals, personal care products, stimulants, etc.) were presented both in the effluent of the secondary WWTP as well as in the RO concentrate. For this reason, a group of 10 emerging pollutants, those found with higher concentrations, was selected in order to test whether electro-oxidation can be also applied for their mitigation. In the removal of emerging pollutants the electrical current density in the range 20-100A/m(2) did not show influence likely due to the mass transfer resistance developed in the process when the oxidized solutes are present in such low concentrations. Their removal rates were fitted to first order expressions, and the apparent kinetic constants for the anodic oxidation of each compound were calculated. Finally, the formation of trihalomethanes (THMs) has been checked; concluding that after selecting the appropriate operational conditions the attained concentration is lower than the standards for drinking water established in European and EPA regulations. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  3. An integrated system for buildings’ energy-efficient automation: Application in the tertiary sector

    International Nuclear Information System (INIS)

    Marinakis, Vangelis; Doukas, Haris; Karakosta, Charikleia; Psarras, John

    2013-01-01

    Highlights: ► We developed an interactive software for building automation systems. ► Monitoring of energy consumption in real time. ► Optimization of energy consumption implementing appropriate control scenarios. ► Pilot appraisal on remote control of active systems in the tertiary sector building. ► Significant decrease in energy and operating cost of A/C system. -- Abstract: Although integrated building automation systems have become increasingly popular, an integrated system which includes remote control technology to enable real-time monitoring of the energy consumption by energy end-users, as well as optimization functions is required. To respond to this common interest, the main aim of the paper is to present an integrated system for buildings’ energy-efficient automation. The proposed system is based on a prototype software tool for the simulation and optimization of energy consumption in the building sector, enhancing the interactivity of building automation systems. The system can incorporate energy-efficient automation functions for heating, cooling and/or lighting based on recent guidance and decisions of the National Law, energy efficiency requirements of EN 15232 and ISO 50001 Energy Management Standard among others. The presented system was applied to a supermarket building in Greece and focused on the remote control of active systems.

  4. First report of tertiary syphilis presenting as lipoatrophic panniculitis in an immunocompetent patient.

    Science.gov (United States)

    Drago, Francesco; Ciccarese, Giulia; Tomasini, Carlo F; Calamaro, Paola; Boggio, Maurizio; Rebora, Alfredo; Parodi, Aurora

    2017-03-01

    We describe herein a woman who developed subcutaneous gummas in her trochanteric regions, bilaterally, although she had been treated for syphilis two decades earlier. Evidence of Treponema pallidum latent late infection was the presence of IgG antibodies against T. pallidum and the positive non-treponemal and treponemal tests. Moreover, immunohistochemical staining for T. pallidum detected some spirochetes close to the atrophic adipocytes allowing the diagnosis of lypo-atrophic panniculitis tertiary syphilis. This is the first case of tertiary syphilis presenting as panniculitis in an immunocompetent patient, demonstrating that subcutaneous fat may be another organ infected in tertiary syphilis.

  5. Fungal Profile of Vulvovaginal Candidiasis in a Tertiary Care Hospital.

    Science.gov (United States)

    Kalaiarasan, Krishnapriya; Singh, Rakesh; Chaturvedula, Latha

    2017-03-01

    Vulvovaginal Candidiasis (VVC) is a common medical health problem of adult women. It is most commonly caused by Candida albicans . But there is a change in fungal profile. Sabouraud's Dextrose Agar (SDA) is the most common culture medium used where mixed fungal infection may be missed. It can be detected easily by using chromogenic culture medium. To know the fungal profile of vulvovaginal candidiasis using Candida CHROMagar and antifungal susceptibility pattern in patients attending tertiary care hospital. Culture confirmed cases of VVC presented at Department of Obstetrics and Gynaecology of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, from July 2015 to December 2015 were included in the cross-sectional study. Two high vaginal swabs were collected and inoculated on SDA and Candida CHROMagar (Hi-Media, Mumbai, India). After overnight incubation the colonies were counted and colour of the colonies were recorded from Candida CHROMagar. Candida spp. were identified by sugar fermentation and assimilation tests and other conventional tests. Antifungal susceptibility tests were performed by the disc diffusion method using fluconazole (25 μg) and voriconazole (1μg) as per the Clinical and Laboratory Standards Institute (CLSI - M44-A2) guidelines. A total of 50 culture confirmed (23.7%) cases were detected from 211 clinically suspected VVC cases. Candida glabrata (45.1%) was the most common isolate, followed by Candida tropicalis (23.5%) , Candida albicans (17.6%) , Candida krusei (9.8%) and Candida parapsilosis (3.9%) . One mixed infection of C. glabrata and C. albicans was identified on Candida CHROMagar. Mixed fungal infection was observed in 2% of positive culture and 0.5% of VVC cases. The antifungal susceptibility testing revealed that 15.7% and 9.8% isolates of Candida spp. were resistant and Susceptible Dose Dependent (S-DD) respectively to fluconazole. The increase resistant against fluconazole was because of

  6. Ethyl tertiary-butyl ether: a toxicological review.

    Science.gov (United States)

    McGregor, Douglas

    2007-05-01

    A number of oxygenated compounds (oxygenates) are available for use in gasoline to reduce vehicle exhaust emissions, reduce the aromatic compound content, and avoid the use of organo-lead compounds, while maintaining high octane numbers. Ethyl tertiary-butyl ether (ETBE) is one such compound. The current use of ETBE in gasoline or petrol is modest but increasing, with consequently similar trends in the potential for human exposure. Inhalation is the most likely mode of exposure, with about 30% of inhaled ETBE being retained by the lungs and distributed around the body. Following cessation of exposure, the blood concentration of ETBE falls rapidly, largely as a result of its metabolism to tertiary-butyl alcohol (TBA) and acetaldehyde. TBA may be further metabolized, first to 2-methyl-1,2-propanediol and then to 2-hydroxyisobutyrate, the two dominant metabolites found in urine of volunteers and rats. The rapid oxidation of acetaldehyde suggests that its blood concentration is unlikely to rise above normal as a result of human exposure to sources of ETBE. Single-dose toxicity tests show that ETBE has low toxicity and is essentially nonirritant to eyes and skin; it did not cause sensitization in a maximization test in guinea pigs. Neurological effects have been observed only at very high exposure concentrations. There is evidence for an effect of ETBE on the kidney of rats. Increases in kidney weight were seen in both sexes, but protein droplet accumulation (with alpha(2u)-globulin involvement) and sustained increases in cell proliferation occurred only in males. In liver, centrilobular necrosis was induced in mice, but not rats, after exposure by inhalation, although this lesion was reported in some rats exposed to very high oral doses of ETBE. The proportion of liver cells engaged in S-phase DNA synthesis was increased in mice of both sexes exposed by inhalation. ETBE has no specific effects on reproduction, development, or genetic material. Carcinogenicity studies

  7. The consumption of electric power on the tertiary sector - an instrument for economical and social analysis and market studies

    International Nuclear Information System (INIS)

    Villela, L.E.

    1991-04-01

    The main subjective of this thesis is to analyse the effects of the growth of the tertiary sector on the electric power demand. In order to accomplish this goal an economical and social, analysis of the tertiary sector is made to identify its dynamic, its relations with the other sectors of the economy and to describe the methodologies for measuring the overall tertiary production. Afterwards it is made an analysis of the electric power consumption evolution in the tertiary sector, in order to identify the consumption per region of the country, per consumers and tertiary subsectors. It is also analysed the product power intensify and, finally its described the present tariff system. (author)

  8. Operating systems

    CERN Document Server

    Tsichritzis, Dionysios C; Rheinboldt, Werner

    1974-01-01

    Operating Systems deals with the fundamental concepts and principles that govern the behavior of operating systems. Many issues regarding the structure of operating systems, including the problems of managing processes, processors, and memory, are examined. Various aspects of operating systems are also discussed, from input-output and files to security, protection, reliability, design methods, performance evaluation, and implementation methods.Comprised of 10 chapters, this volume begins with an overview of what constitutes an operating system, followed by a discussion on the definition and pr

  9. Operational calculus

    CERN Document Server

    Boehme, Thomas K

    1987-01-01

    Operational Calculus, Volume II is a methodical presentation of operational calculus. An outline of the general theory of linear differential equations with constant coefficients is presented. Integral operational calculus and advanced topics in operational calculus, including locally integrable functions and convergence in the space of operators, are also discussed. Formulas and tables are included.Comprised of four sections, this volume begins with a discussion on the general theory of linear differential equations with constant coefficients, focusing on such topics as homogeneous and non-ho

  10. MONITORING OF THE CEPHALOSPORINS CONSUMPTION IN THE TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Radmila Veličković-Radovanović

    2015-06-01

    Full Text Available Irrational antibiotic consumption, especially in the case when there is no appropriate indication for its usage, may be one of the most crucial global issues for public health care, leading to bacterial resistance and the increase of indirect medical expenses. According to the report of the European program for the monitoring of the antibiotic consumption, Serbia is on the fifth place among the countries which are not members of EU. The goal of this work is the evaluation of antibiotic consumption in the Clinical Centre Niš, from 2007 to 2013, with the focus on the monitoring of the cephalosporins utilization, as they are one of the most prescribed groups of antibiotics in the tertiary health care. The utilization of antibiotics in the Clinical Center Niš in the observed period was obtained from the computerized database of the Department of Pharmacotherapy and expressed as defined daily dose (DDD per 100 bed/days (DBD. Our results showed that there was an increase in antibiotic use of the whole group of cephalosporins and penicillin as well as a reduction of quinolones consumption within the observed period. Our analysis showed that ceftriaxone was the most frequently prescribed cephalosporin, followed by cefuroxime. Although antibiotic therapy and prophylaxis in our hospital are in keeping with the recommended guidelines, the obtained results may suggest that cephalosporin consumption, and especially ceftriaxone consumption is higher than in other European countries.

  11. Oral food challenge outcomes in a pediatric tertiary care center.

    Science.gov (United States)

    Abrams, Elissa M; Becker, Allan B

    2017-01-01

    Oral food challenges are the clinical standard for diagnosis of food allergy. Little data exist on predictors of oral challenge failure and reaction severity. A retrospective chart review was done on all pediatric patients who had oral food challenges in a tertiary care pediatric allergy clinic from 2008 to 2010. 313 oral challenges were performed, of which the majority were to peanut (105), egg (71), milk (41) and tree nuts (29). There were 104 (33%) oral challenge failures. Children were more likely to fail an oral challenge if they were older (P = .04), had asthma (P = .001) or had atopic dermatitis (P = .03). Risk of challenge failure was significantly different between food allergens, with more failures noted for peanut than for tree nuts, milk or egg (P = .001). Among challenge failures, 19% met criteria for anaphylaxis. Significantly more tree nut and peanut challenges met criteria for anaphylaxis than milk or egg (P Skin test size and specific IgE level were significantly higher in those who failed oral challenges (P < .001). The highest rate of challenge failure and severity of failure was to cashew, with 63% of cashew challenges reacting, of which 80% met clinical criteria for anaphylaxis. The risk of challenge failure differed with type of food studied, with peanut and tree nut having a higher risk of challenge failure and anaphylaxis. Cashew in particular carried a high risk and caution must be exercised when performing these types of oral challenges in children.

  12. Factors Hindering the Integration of CALL in a Tertiary Institution

    Directory of Open Access Journals (Sweden)

    Izaham Shah Ismail

    2008-12-01

    Full Text Available The field of Computer Assisted Language Learning (CALL is a field that is constantly evolving as it is very much dependent on the advancement of computer technologies. With new technologies being invented almost every day, experts in the field are looking for ways to apply these new technologies in the language classroom. Despite that, teachers are said to be slow at adopting technology in their classrooms and language teachers, whether at schools or tertiary institutions, are no exception. This study attempts to investigate the factors that hinder ESL instructors at an institution of higher learning from integrating CALL in their lessons. Interviews were conducted with five ESL instructors and results revealed that factors which hinder them from integrating CALL in their teaching are universal factors such as knowledge in technology and pedagogy, computer facilities and resources, absence of exemplary integration of CALL, personal beliefs on language teaching, views on the role of a computers as teacher, and evaluation of learning outcomes.

  13. Job satisfaction among anesthesiologists at a tertiary hospital in Nigeria.

    Science.gov (United States)

    Rukewe, Ambrose; Fatiregun, Akinola; Oladunjoye, Adeolu O; Oladunjoye, Olubunmi O

    2012-01-01

    We assessed job satisfaction among anesthesiologists at a tertiary hospital in Nigeria and identified elements of job stress and dissatisfaction. A cross-sectional study design was employed; a structured self-administered questionnaire was distributed, which focused on sociodemographic data, rating of job satisfaction, identification of stressors, and work relationships. Out of 55 questionnaires distributed, 46 (83.6%) completed questionnaires were returned. Overall, 27 (58.7%) of the anesthesiologists were satisfied with their job. While 8.7% were very satisfied (grade 5), 6.5% were very dissatisfied (grade 1) with their job. The stressors identified by the respondents were time pressures, long working hours with complaints of insufficient sleep, and employment status. Among the respondents, the medical officers were the most discontented (9 out of 12, 75%), followed by senior registrars (5 out of 9, 56%). A high percentage of participants (54.1%) declared that the one change if implemented that would enhance their job satisfaction was having a definite closing time. Our results showed that despite the demanding nature of anesthesiology as a specialty, many anesthesiologists were contented with their job.

  14. Pattern of drug eruptions in a tertiary care hospital

    International Nuclear Information System (INIS)

    Tahir, Z.; Nadeem, N.; Aman, S.; Kazmi, A.H.

    2013-01-01

    Background: An adverse drug reaction is unintentional which occurs at doses used for prophylaxis, diagnosis or treatment. Objectives: To determine the frequency of various cutaneous drug eruptions that occur in patients in a tertiary care hospital setting. Patients and Methods: All patients with cutaneous drug eruptions seen at the Dermatology Department of Mayo Hospital, Lahore, over 6 months were enrolled and the pattern of drug eruptions like urticaria, angioedema, fixed drug eruption, maculopapular rash, erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis etc. were recorded, along with drugs that caused it. Results:A total of 160 patients (86 males, 74 females) were included in the study. Mean age of patients was 30.7+-15.4 years. Major eruptions were fixed drug eruption (21.3%) followed by urticaria without angioedema (10%), maculopapular rash (9.3%), lichenoid drug eruption (8.7%), acneiform drug eruption (7.5%), Stevens-Johnson syndrome (6.9%), vesiculobullous eruption (5.6%), erythema multiforme and eczematous eruption (5% each). Common drugs causing eruptions were sulfonamides (16.3%), followed by NSAIDs (14.4%), herbal and homeopathic medications (12.5%), penicillins (9.3%), tetracyclines (8.7%), antituberculous drugs, cephalosporins and antiepileptics (6.3% each). Conclusion: Fixed drug eruption and urticaria without angioedema were commonest eruptions while, sulfonamides and NSAIDs were the major causative drugs. Policy message: Reporting of adverse drug reactions is not done in Pakistan and needs to be done in each hospital. (author)

  15. The residential tertiary sector - Technical Guidebook nr. 2

    International Nuclear Information System (INIS)

    Bardinal, Marc; Bejanin Emmanuel; Berly Frederic; Blaser Jocelyne; Mesmain Jean-Eric; Yalamas Pierrick; Ouradou Frederic; Riey Benedicte; Chene-Pezot, Anne

    2011-06-01

    After having recalled objectives defined within the Building Plan of the Grenelle de l'Environnement, this guide aims at providing local communities with a relatively precise view of the energy consumption of buildings (residential and office buildings) on their territory in order to define actions to be undertaken, with keys to integrate these actions into a regional energy planning, and with tools for the follow-up of equipment, techniques, and tax or regulatory arrangements aimed at a better energy efficiency in order to be able to assess the impact of undertaken actions and to steer their implementation. Thus, the different parts of this guide describe how to perform an energy assessment in the residential-tertiary sector (indication of reference data, assessment of additional data), how to plan a regional energy renovation (definition of objectives, identification of associated needs, assessment of externalities), and how to perform a follow-up of energy efficiency (existing monitoring organisations and bodies, networking of actors and sharing of good practices, information sites)

  16. Open-Access Single Balloon Enteroscopy: A Tertiary Care Experience.

    Science.gov (United States)

    Holman, Nathan; Wallace, Kristin; Moore, J Matthew; Brock, Andrew S

    2015-12-01

    To compare single balloon enteroscopy (SBE) between patients seen in consultation by a member of our gastroenterology team with those performed as open-access cases. Retrospective study of all patients who underwent SBE at a single tertiary care center from April 2008 to January 2012. Open- and closed-access procedures were compared in terms of diagnostic and therapeutic yield, adverse events, and procedural success. A total of 125 SBEs were performed on 125 patients. The mean age was 63.1 (53% men) years. In all, 43 procedures were performed open access and 82 after face-to-face consultation. Indications included anemia/gastrointestinal bleeding (110), abdominal pain (8), and other (7). Diagnostic yield for open- and closed-access procedures was 53% and 60%, respectively (P = 0.501) and therapeutic yield was 37% and 52%, respectively (P = 0.11). Overall technical success was 91% with no difference between the groups (P = 0.27). There were no major adverse events in either group. SBE can be performed as an open-access procedure without compromise to safety or diagnostic yield.

  17. Students’ Perceptions on a Good Tertiary Foreign Language Teacher

    Directory of Open Access Journals (Sweden)

    Siti Tarwiyah

    2013-11-01

    Full Text Available This paper investigates students’ perception of tertiary teachers’ attitude, method of teaching and classroom management in the teaching and learning of (professional, pedagogic, social and personality competence English and Arabic Language at IAIN Walisongo Semarang. This study is designed quantitavely and qualitatively using closed and open-ended questionnaire for collecting data. The subject of this research is the second semester students of the two faculties at IAIN Walisongo who, in that semester, take Arabic or English language course. The subject is chosen because based on 2012 course distribution, English and Arabic are distributed in the first and the second semester. The findings revealed that it is clearly seen that KPI (Islamic Communication & Broadcasting department students have better perception to their English language teachers. Meanwhile, students who have better perception to their Arabic Language Teachers are those from Islamic Counseling Departments (BPI of Dakwah faculty. Data of Tarbiyah Faculty shows Arabic language teachers are dominating. Arabic language teachers win 0.5 over English language teachers in almost all characteristics. This implies that expected performance of students in English Language is based on the teachers’ attitude, method of teaching the subject and classroom management. Based on the above-findings, recommendations were made.

  18. ANALYSIS OF ORGANOPHOSPHORUS POISONING, AT TERTIARY CARE HOSPITAL: A REPORT

    Directory of Open Access Journals (Sweden)

    Shakuntala

    2015-01-01

    Full Text Available BACKGROUND: Organophosphorus (OP compounds are the most common suicidal poison in developing countries and mortality continues to be high. The present study was aimed to know the pattern and outcome of the OP poisoning. METHODOLOGY: A record based retrospective study from January 2013 - December 2013 was Conducted in a tertiary care hospital and data regarding age, gender, domicile, type of poison, manner of poisoning, seasonal trends, marital status, motive behind poisoning , socio - economic status and outcome was collected in a pre - structured Performa. All data were documented, analyzed and interpreted as per the laid down protocol. RESULTS : out of total 1575 cases of OP compound poisoning, 71.73% (1130 were male, 28.27% (445 were female, 34.6% were in the age group 21 - 30 years, 70.95% were of low socio - economic status, Occupation wise agricultural workers were on top of the list (70.07%, The commonest (93.78% motive behind poisoning was suicidal in both males and females, Financial problem was one of the commonest (51.22% reasons of poisoning. The mortality rate in our study was 13.47%. CONCLUSION : Y oung and adult males of Low socio - economic class, rural, both literate and illiterate agriculturists commonly abuse this substance to commit suicide

  19. Gasification of various types of tertiary coals: A sustainability approach

    International Nuclear Information System (INIS)

    Öztürk, Murat; Özek, Nuri; Yüksel, Yunus Emre

    2012-01-01

    Highlights: ► Production energy by burning of coals including high rate of ash and sulfur is harmful to environment. ► Energy production via coal gasification instead of burning is proposed for sustainable approach. ► We calculate exergy and environmental destruction factor of gasification of some tertiary coals. ► Sustainability index, improvement potential of gasification are evaluated for exergy-based approach. - Abstract: The utilization of coal to produce a syngas via gasification processes is becoming a sustainability option because of the availability and the economic relevance of this fossil source in the present world energy scenario. Reserves of coal are abundant and more geographically spread over the world than crude oil and natural gas. This paper focuses on sustainability of the process of coal gasification; where the synthesis gas may subsequently be used for the production of electricity, fuels and chemicals. The coal gasifier unit is one of the least efficient step in the whole coal gasification process and sustainability analysis of the coal gasifier alone can substantially contribute to the efficiency improvement of this process. In order to evaluate sustainability of the coal gasification process energy efficiency, exergy based efficiency, exergy destruction factor, environmental destruction factor, sustainability index and improvement potential are proposed in this paper.

  20. Wildfires and animal extinctions at the Cretaceous/Tertiary boundary

    Science.gov (United States)

    Adair, Robert K.

    2010-06-01

    Persuasive models of the ejection of material at high velocities from the Chicxulub asteroid impact marking the Cretaceous/Tertiary boundary have led to the conclusion that upon return, that material, heated in passage through the upper atmosphere, generated a high level of infrared energy density over the Earth's surface. That radiant energy has been considered to be a direct source of universal wildfires, which were presumed to be a major cause of plant and animal species extinctions. The extinction of many animal species, especially the dinosaurs, has also been attributed to the immediate lethal effects of the radiation. I find that the absorption of the radiation by the atmosphere, by cloud formations, and by ejecta drifting in the lower atmosphere reduced the radiation at the surface to a level that cannot be expected to have generated universal fires. Although the reduced radiation will have likely caused severe injuries to many animals, such insults alone seem unlikely to have generated the overall species extinctions that have been deduced.

  1. The debate over the Cretaceous-Tertiary boundary

    Science.gov (United States)

    Alvarez, W.; Asaro, F.; Alvarez, L. W.; Michel, H. V.

    1988-01-01

    Large-body impact on the Earth is a rare but indisputable geologic process. The impact rate is approximately known from objects discovered in Earth-crossing orbits and from the statistics of craters on the Earth's surface. Tektite and microtektite strewn fields constitute unmistakable ejecta deposits that can be due only to large-body impacts. The Cretaceous-Tertiary (K-T) boundary coincides with an unusually severe biological trauma, and this stratigraphic horizon is marked on a worldwide basis by anomalous concentrations of noble metals in chondritic proportions, mineral spherules with relict quench-crystallization textures, and mineral and rock grains showing shock deformation. These features are precisely compatible with an impact origin. Although only impact explains all the types of K-T boundary evidence, the story may not be as simple as once thought. The original hypothesis envisioned one large impact, triggering one great extinction. Newer evidence hints at various complications. Different challenges are faced by the occupants of each apex of a three-cornered argument over the K-T event. Proponents of a non-impact explanation must show that the evidence fits their preferred model better than it fits the impact scenario. Proponents of the single impact-single extinction view must explain away the complications. Proponents of a more complex impact crisis must develop a reasonable scenario which honors the new evidence.

  2. Pylephlebitis: incidence and prognosis in a tertiary hospital.

    Science.gov (United States)

    Belhassen-García, Moncef; Gomez-Munuera, Mercedes; Pardo-Lledias, Javier; Velasco-Tirado, Virginia; Perez-Persona, Ernesto; Galindo-Perez, Inmaculada; Alvela-Suárez, Lucia; Romero-Alegría, Angela; Muñoz-Bellvis, Luis; Cordero-Sánchez, Miguel

    2014-01-01

    Septic thrombophlebitis of the portal vein or its branches, most often secondary to intra-abdominal infection is known as pylephlebitis. The frequency and the prognosis of this complication are unknown. The aim of this study was to determine the global and relative incidence of the most frequent intra-abdominal infections and the real prognosis of this disease. An observational retrospective study was conducted in a tertiary care hospital (University Hospital of Salamanca, Spain) from January 1999 to December 2008. A total of 7796 patients with intra-abdominal infection were evaluated, of whom 13 (0.6%) had been diagnosed with pylephlebitis. Diverticulitis was the most frequent underlying process, followed by biliary infection. Early mortality was 23%. Survivors had no recurrences, but one of them developed portal cavernomatosis. Pylephlebitis is a rare complication of intra-abdominal infection, with a high early mortality, but with a good prognosis for survivors. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Seawater strontium isotopes at the Cretaceous-Tertiary boundary

    Science.gov (United States)

    Macdougall, J. D.; Martin, E.

    1988-01-01

    Anomalously high values of Seawater Sr-87/Sr-86 near the Cretaceous-Tertiary (K-T) boundary have been reported. However, few of the data from the literature are from a single continuous section, and perhaps the most complete study of the boundary region, from a shallow marine limestone sequence in Alabama, showed elevated Sr-87/Sr-86 but no pronounced spike. Thus, in order to investigate the cause of the change in strontium isotopic composition, it is important to determine the exact nature and magnitude of the increase by studying in detail continuous sections through the boundary. If there is indeed a Sr isotope spike at the K-T boundary, it requires the addition of a large amount of radiogenic Sr to the oceans over a short time period, a phenomenon that may be linked to other large-scale environmental disturbances which occurred at that time. In order to address this question, a high-resolution strontium isotope study of foraminifera from three Deep Sea Drilling Project (DSDP) cores which recovered the K-T boundary section: Site 356 in the South Atlantic, Site 384 in the North Atlantic and Site 577 from the Shatsky Rise in the Pacific was initiated. The isotope measurements are being made on either single or small numbers of forams carefully picked and identified and in most cases examined by SEM before analysis. Because this work is not yet complete, conclusions drawn here must be viewed as tentative. They are briefly discussed.

  4. Terpenoid composition and class of Tertiary resins from India

    Energy Technology Data Exchange (ETDEWEB)

    Dutta, Suryendu; Mallick, Monalisa; Mathews, Runcie Paul [Department of Earth Sciences, Indian Institute of Technology Bombay, Powai, Mumbai-400076 (India); Bertram, Norbert [LTA-Labor fuer Toxikologie und Analytik, Friedrichshoeher Str. 28, D-53639 Koenigswinter (Germany); Greenwood, Paul F. [John De Laeter Mass Spectrometry and WA Biogeochemitry Centres (M090), The University of Western Australia, 35 Stirling Hwy, Crawley, WA, 6009 (Australia); WA - Organic and Isotope Geochemistry Centre, Curtin University of Technology, Kent St., Bentley 6102 (Australia)

    2009-10-01

    The terpenoid composition and class of Tertiary resins preserved within lignites of Cambay, Kutch and Cauvery Basins of India have been characterized using Pyrolysis-Gas Chromatography-Mass Spectrometry (Py-GC-MS) and Fourier Transform Infrared (FTIR) Spectroscopy. Major pyrolysis products include cadalene-based C{sub 15}-bicyclic sesquiterpenoids with some C{sub 30} and C{sub 31} bicadinanes and bicadinenes typical of Class II or dammar resin. The occurrence of these terpenoids in Early Eocene sediments may extend the first appearance of Dipterocarpaceae angiosperms, the predominant source of this resin class, back to the Early Eocene epoch in India. The same terpenoid biomarkers have been detected in many SE Asian oils reflecting a close source relationship with these resins. Strong CH{sub 3} (1377 cm{sup -} {sup 1}) and other CH{sub x} (3000-2800 and 1460-1450 cm{sup -} {sup 1}) aliphatic absorptions of much larger intensity than the aromatic C = C (1560-1650 cm{sup -} {sup 1}) absorption were detected in the Indian resins by FTIR Spectroscopy, confirming the quantitative significance of the terpenoid pyrolysates. (author)

  5. Xeroderma pigmentosum at a tertiary care center in Saudi Arabia.

    Science.gov (United States)

    Alwatban, Lenah; Binamer, Yousef

    2017-01-01

    Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder caused by defective DNA repair that results in extreme sensitivity to ultraviolet (UV) rays. Depending on the type of XP, the disease may affect the skin, eyes and nervous system. Describe the dermatologic manifestations in patients suffering from XP. Retrospective, descriptive review of medical records. Dermatology clinic at tertiary care center in Riyadh. This study included Saudi patients with clinically confirmed XP. Demographic and clinical data including pathology and associated conditions and outcomes. Of 21 patients with XP, the most common manifestation was lentigines, affecting 18 patients (86%). The most common skin cancer was basal cell carcinoma followed by squamous cell carcinoma (SCC) affecting 15 (71.4%) and 9 (42.8%), respectively. Other skin findings included neurofibroma, trichilemmoma and seborrheic keratosis. Ocular involvement included photophobia, which was the most common finding followed by dryness and ocular malignancies. Two patients showed neurological involvement, which correlated with the type of mutation. Considering that XP is a rare genetic disease, this description of our patient population will aid in early recognition and diagnosis. Retrospective and small number of patients. Genetic analyses were done for only 5 of the 21 patients.

  6. Tertiary Lymphoid Organs in Central Nervous System Autoimmunity

    Directory of Open Access Journals (Sweden)

    Meike Mitsdoerffer

    2016-10-01

    Full Text Available Multiple sclerosis (MS is an autoimmune disease characterized by chronic inflammation in the central nervous system (CNS, which results in permanent neuronal damage and substantial disability in patients. Autoreactive T cells are important drivers of the disease, however, the efficacy of B cell depleting therapies uncovered an essential role for B cells in disease pathogenesis. They can contribute to inflammatory processes via presentation of autoantigen, secretion of pro-inflammatory cytokines and production of pathogenic antibodies. Recently, B cell aggregates reminiscent of tertiary lymphoid organs (TLOs were discovered in the meninges of MS patients, leading to the hypothesis that differentiation and maturation of autopathogenic B and T cells may partly occur inside the CNS. Since these structures were associated with a more severe disease course, it is extremely important to gain insight into the mechanism of induction, their precise function and clinical significance. Mechanistic studies in patiens are limited. However, a few studies in the MS animal model experimental autoimmune encephalomyelitis (EAE recapitulate TLO formation in the CNS and provide new insight into CNS TLO features, formation and function. This review summarizes what we know so far about CNS TLOs in MS and what we have learned about them from EAE models. It also highlights the areas that are in need of further experimental work, as we are just beginning to understand and evaluate the phenomenon of CNS TLOs.

  7. Job satisfaction among anesthesiologists at a tertiary hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Ambrose Rukewe

    2012-01-01

    Full Text Available Background : We assessed job satisfaction among anesthesiologists at a tertiary hospital in Nigeria and identified elements of job stress and dissatisfaction. Methods : A cross-sectional study design was employed; a structured self-administered questionnaire was distributed, which focused on sociodemographic data, rating of job satisfaction, identification of stressors, and work relationships. Results : Out of 55 questionnaires distributed, 46 (83.6% completed questionnaires were returned. Overall, 27 (58.7% of the anesthesiologists were satisfied with their job. While 8.7% were very satisfied (grade 5, 6.5% were very dissatisfied (grade 1 with their job. The stressors identified by the respondents were time pressures, long working hours with complaints of insufficient sleep, and employment status. Among the respondents, the medical officers were the most discontented (9 out of 12, 75%, followed by senior registrars (5 out of 9, 56%. A high percentage of participants (54.1% declared that the one change if implemented that would enhance their job satisfaction was having a definite closing time. Conclusion : Our results showed that despite the demanding nature of anesthesiology as a specialty, many anesthesiologists were contented with their job.

  8. Fast Track Extubation In Adult Patients On Pump Open Heart Surgery At A Tertiary Care Hospital.

    Science.gov (United States)

    Akhtar, Mohammad Irfan; Sharif, Hasanat; Hamid, Mohammad; Samad, Khalid; Khan, Fazal Hameed

    2016-01-01

    Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i.e., from Oct 2014 to June-2015. All on pump elective adult cardiac surgery patients including isolated CABG, isolated Valve replacements, combined procedures and aortic root replacements were enrolled in the study. Standardized anesthetic technique was adopted. Surgical and bypass techniques were tailored according to the procedure. Success of Fast track extubation was defined as extubation within 6 hours of arrival in CICU. A total of 290 patients were recruited. The average age of the patients was 56.3±10.5 years. There were 77.6% male and 22.4% female patients. Overall success rate was 51.9% and failure rate was 48.1%. The peri-operative renal insufficiency, cross clamp time and CICU stay (hours) were significantly lower in success group. Re-intubation rate was 0.74%. The perioperative parameters were significantly better in success group and the safety was also demonstrated in the patients who were fast tracked successfully. To implement the practice in its full capacity and benefit, a fast track protocol needs to be devised to standardize the current practices and to disseminate the strategy among junior anaesthesiologists, perfusionists and nursing staff.

  9. Evaluation of Parathyroidectomy for Secondary and Tertiary Hyperparathyroidism by the Parathyroid Surgeons' Society of Japan.

    Science.gov (United States)

    Tominaga, Yoshihiro; Kakuta, Takatoshi; Yasunaga, Chikao; Nakamura, Michio; Kadokura, Yoshiyuki; Tahara, Hideki

    2016-02-01

    Secondary hyperparathyroidism (SHPT) remains a serious complication in patients with chronic kidney disease, and some patients require parathyroidectomy. The Parathyroid Surgeons' Society of Japan (PSSJ) evaluated parathyroidectomy for SHPT and tertiary hyperparathyroidism (THPT) in Japan. The annual numbers of parathyroidectomies between 2004 and 2013 were evaluated using questionnaires. Since 2010, the PSSJ has registered the patients. In total, 826 patients from 42 institutions were registered. The annual number of parathyroidectomies for SHPT and THPT in Japan increased from 2004 to 2007 and then decreased markedly after 2007, with 296 operations performed in 2013. The number of women and men was almost equal (397/427). Median (interquartile range) age of these patients was 59.0 (24-87) years, the duration of hemodialysis before parathyroidectomy was 10.83 (0.0-38.7) years, and diabetic nephropathy was 87/826 (10.5%). Of these patients 59.6% were treated with cinacalcet at undergoing parathyroidectomy. In 75.3% of patients, a total parathyroidectomy with forearm autograft was performed. In 77.7% of patients, four or more parathyroid glands were removed during the initial operation. The incidences of husky voice and wound hemorrhage were 2.9% and 1.1%, respectively. The number of parathyroidectomies for SHPT in Japan decreased markedly after the introduction of cinacalcet. Based on the evaluation of registered patients, parathyroidectomies have been successfully performed at the institutions participating in the PSSJ. © 2016 The Authors. Therapeutic Apheresis and Dialysis published by John Wiley & Sons Australia, Ltd on behalf of International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  10. Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

    Science.gov (United States)

    Duke, Roseline E.; Adio, Adedayo; Oparah, Sidney K.; Odey, Friday; Eyo, Okon A.

    2016-01-01

    Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit. PMID:27347247

  11. Management of anterior triangle swellings in a tertiary vascular centre with emphasis on the roles of duplex ultrasound, computed tomography angiogram and magnetic resonance angiogram: a case series.

    LENUS (Irish Health Repository)

    Colleran, Gabrielle C

    2009-01-01

    BACKGROUND: Anterior triangle masses pose an important clinical dilemma. It is very difficult to distinguish the potential pathologies pre operatively by clinical and radiological assessment. CASE REPORT: The first case highlights the management of a bilateral chemodectoma, the second case is a presentation of castleman\\'s disease and the third is that of metastatic tonsillar adenocarcinoma. All three cases had a similar presentation and radiological appearance pre-operatively. CONCLUSION: Anterior triangle masses span the clinical spectrum of pathologies from chemodectoma to castleman\\'s disease to carcinoma. Expert vascular and radiological management is required for optimum patient care and should take place in a tertiary referral centre. Duplex US, CTA and MRA are important pre operative assessment tools to ensure that adequate information regarding the relationship of the lesion to the carotid artery is available to the operating surgeon who should have vascular expertise as deliberate practice volume has been repeatedly shown to result in improved patient outcome.

  12. High energy beam impact tests on a LHC tertiary collimator at the CERN high-radiation to materials facility

    Directory of Open Access Journals (Sweden)

    Marija Cauchi

    2014-02-01

    Full Text Available The correct functioning of a collimation system is crucial to safely operate highly energetic particle accelerators, such as the Large Hadron Collider (LHC. The requirements to handle high intensity beams can be demanding. In this respect, investigating the consequences of LHC particle beams hitting tertiary collimators (TCTs in the experimental regions is a fundamental issue for machine protection. An experimental test was designed to investigate the robustness and effects of beam accidents on a fully assembled collimator, based on accident scenarios in the LHC. This experiment, carried out at the CERN High-Radiation to Materials (HiRadMat facility, involved 440 GeV proton beam impacts of different intensities on the jaws of a horizontal TCT. This paper presents the experimental setup and the preliminary results obtained, together with some first outcomes from visual inspection and a comparison of such results with numerical simulations.

  13. High energy beam impact tests on a LHC tertiary collimator at the CERN high-radiation to materials facility

    Science.gov (United States)

    Cauchi, Marija; Aberle, O.; Assmann, R. W.; Bertarelli, A.; Carra, F.; Cornelis, K.; Dallocchio, A.; Deboy, D.; Lari, L.; Redaelli, S.; Rossi, A.; Salvachua, B.; Mollicone, P.; Sammut, N.

    2014-02-01

    The correct functioning of a collimation system is crucial to safely operate highly energetic particle accelerators, such as the Large Hadron Collider (LHC). The requirements to handle high intensity beams can be demanding. In this respect, investigating the consequences of LHC particle beams hitting tertiary collimators (TCTs) in the experimental regions is a fundamental issue for machine protection. An experimental test was designed to investigate the robustness and effects of beam accidents on a fully assembled collimator, based on accident scenarios in the LHC. This experiment, carried out at the CERN High-Radiation to Materials (HiRadMat) facility, involved 440 GeV proton beam impacts of different intensities on the jaws of a horizontal TCT. This paper presents the experimental setup and the preliminary results obtained, together with some first outcomes from visual inspection and a comparison of such results with numerical simulations.

  14. Corot 310266512: A Light Curve With Primary, Secondary And Tertiary Eclipses

    Directory of Open Access Journals (Sweden)

    Fernández Fernández Javier

    2015-01-01

    Full Text Available We present the photometric study of an interesting target in the CoRoT exoplanet database: CoRoT 310266512. Its light curve shows primary, secondary and tertiary eclipses that suggests the presence of at least three celestial bodies. The primary and secondary eclipses have the same orbital period, 7.42 days, and the tertiary eclipse has an orbital period of 3.27 days. Two of the tertiary eclipses fall within a primary eclipse and a secondary eclipse. The properties of the light curve indicate the presence of two physically separated systems. The primary and secondary eclipses corresponds to a binary system (System I. The tertiary eclipses correspond to a star-planet system or a star-dwarf system (System II. Some parameters of these two systems are obtained from JKTEBOP [1] program.

  15. The development of the tertiary sector in the economy and the reduction in CO2 emissions

    International Nuclear Information System (INIS)

    Morvan, R.; Hubert, M.; Gregoire, P.; Lowezanin, Ch.

    2004-09-01

    The development of the tertiary sector appears to support sustainable development since it now accounts for almost two thirds of the national economy and is responsible for low CO 2 emission levels. Between 1980 and 1997, CO 2 emissions from the tertiary sector increased by 20 % compared with a 48 % rise in the sector value added. In terms of production, CO 2 levels in the tertiary sector are low, compared with 55 % for the secondary sector (industry). However, when trade between economic activities is taken into account, there is cause to qualify the assessment. This makes it possible to ascertain emissions from the point of view of satisfying final demand for products, and to identify direct and indirect emissions in each branch of activity. Thus, when emissions from certain industrial and agricultural activities are redistributed specifically to branches of activity in the tertiary sector, CO 2 emissions in this sector account for almost one-third of total emissions. (A.L.B.)

  16. A Survey of Patients with Oro-Facial tumours in two Tertiary ...

    African Journals Online (AJOL)

    A Survey of Patients with Oro-Facial tumours in two Tertiary Hospitals in Lagos, ... Hence the present study was conducted to assess the care the knowledge, ... might not be unrelated to poor awareness of the tumours in our environment.

  17. [Decomposition model of energy-related carbon emissions in tertiary industry for China].

    Science.gov (United States)

    Lu, Yuan-Qing; Shi, Jun

    2012-07-01

    Tertiary industry has been developed in recent years. And it is very important to find the factors influenced the energy-related carbon emissions in tertiary industry. A decomposition model of energy-related carbon emissions for China is set up by adopting logarithmic mean weight Divisia method based on the identity of carbon emissions. The model is adopted to analyze the influence of energy structure, energy efficiency, tertiary industry structure and economic output to energy-related carbon emissions in China from 2000 to 2009. Results show that the contribution rate of economic output and energy structure to energy-related carbon emissions increases year by year. Either is the contribution rate of energy efficiency or the tertiary industry restraining to energy-related carbon emissions. However, the restrain effect is weakening.

  18. Distinguishing between tertiary and secondary facilities: a case study of cardiac diagnostic-related groups (DRGs).

    Science.gov (United States)

    Rouse, Paul; Arulambalam, Ajit; Correa, Ralph; Ullman, Cornelia

    2010-05-14

    To develop a classification of tertiary cardiac DRGs in order to investigate differences in tertiary/secondary product mix across New Zealand district health boards (DHBs). 67 DRGs from 85,442 cardiac cases were analysed using cost weights and patient comorbidity complexity levels, which were used as a proxy for complexity. The research found high variability of severity within some DRGs. 5 DHBs are the main providers of 27 DRGs which are high cost and identified as tertiary by several ADHB clinicians; the same 5 DHBs have on average higher severity by DRG than the other DHBs. NZ tertiary hospitals have a product mix of DRGs with higher complexity than secondary hospitals. Funding based on case weights needs to recognise the additional resource requirements for this higher complexity.

  19. Tertiary instability of zonal flows within the Wigner-Moyal formulation of drift turbulence

    Science.gov (United States)

    Zhu, Hongxuan; Ruiz, D. E.; Dodin, I. Y.

    2017-10-01

    The stability of zonal flows (ZFs) is analyzed within the generalized-Hasegawa-Mima model. The necessary and sufficient condition for a ZF instability, which is also known as the tertiary instability, is identified. The qualitative physics behind the tertiary instability is explained using the recently developed Wigner-Moyal formulation and the corresponding wave kinetic equation (WKE) in the geometrical-optics (GO) limit. By analyzing the drifton phase space trajectories, we find that the corrections proposed in Ref. to the WKE are critical for capturing the spatial scales characteristic for the tertiary instability. That said, we also find that this instability itself cannot be adequately described within a GO formulation in principle. Using the Wigner-Moyal equations, which capture diffraction, we analytically derive the tertiary-instability growth rate and compare it with numerical simulations. The research was sponsored by the U.S. Department of Energy.

  20. Oro-Dental and Maxillofacial Trauma in Epilepsy at a Tertiary ...

    African Journals Online (AJOL)

    Oro-Dental and Maxillofacial Trauma in Epilepsy at a Tertiary Hospital in Lagos. ... Information sought included patient's sociodemographics, type of seizure, ... bones were not so common, all such cases received surgical treatment in hospital.

  1. Self-Concept as a Correlate of Career Choice of Students in Tertiary ...

    African Journals Online (AJOL)

    concept and career choice of students in Post-Secondary Institutions in Sokoto State. The sample consisted of 300 students (140 males and 160 females) deliberately selected from the population of three tertiary institutions in Sokoto State.

  2. Oxidation of tertiary homoallylic alcohols by thallium trinitrate: fragmentation versus ring contraction

    International Nuclear Information System (INIS)

    Silva Junior, Luiz F.; Quintiliano, Samir A.P.; Ferraz, Helena M.C.; Santos, Leonardo S.; Eberlin, Marcos N.

    2006-01-01

    The oxidation of tertiary homoallylic alcohols with thallium trinitrate (TTN) was investigated. The alcohols bearing an allylic methyl group lose a molecule of acetone via a fragmentation reaction that leads to isomeric secondary allylic alcohols as major products, together with their corresponding acetylated derivatives. On the other hand, treating analogous tertiary alcohols without the allylic methyl group with TTN gives indans, through a ring contraction reaction. (author)

  3. The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

    Energy Technology Data Exchange (ETDEWEB)

    Crespo, Livia T.C., E-mail: livia.vilela@ifrj.edu.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Quimica. Departamento de Quimica Organica; Instituto Federal de Educacao, Ciencia e Tecnologia do Rio de Janeiro (IF-RJ), Duque de Caxias, RJ (Brazil); Mattos, Marcio C.S. de; Esteves, Pierre M. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Quimica. Departamento de Quimica Organica

    2013-09-01

    Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA). The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture. (author)

  4. A Comparative study of early postpartum IUCD insertion to interval IUCD insertion at Tertiary Care Centre

    OpenAIRE

    Roopal, Dr.; Bisht, Vandana

    2018-01-01

    Background: A Comparative study of early postpartum IUCD insertion to interval IUCD insertion at Tertiary Care Centre.Methods: This prospective study was conducted among 100 women at tertiary care centre, Haldwani, Nainital. Patients were divided in to two groups. Group A (n=50)-post placental insertion within 10 minutes of delivery of placenta. Group B (n=50)-Interval insertion after 6 weeks of delivery. Both groups were compared in terms of pain abdomen, bleeding, missing thread, expulsion,...

  5. West Hackberry Tertiary Project. Annual report, September 3, 1997--September 2, 1998

    Energy Technology Data Exchange (ETDEWEB)

    Gillham, T.H.

    1997-09-10

    The following report is the Project Management Plan for the fifth year of the West Hackberry Tertiary Project. The West Hackberry Tertiary Project is one of four mid-term projects selected by the United States Department of Energy (DOE) as part of the DOE`s Class 1 Program for the development of advance recovery technologies in fluvial dominated deltaic reservoirs. The West Hackberry Tertiary Project is a field test of the idea that air injection can be combined with the Double Displacement Process to produce a low cost tertiary recovery process which is economic at current oil prices. The Double Displacement Process is the gas displacement of a water invaded oil column for the purpose of recovering tertiary oil by gravity drainage. The Double Displacement Process is based upon the concept that in fields such as West Hackberry waterdrive recoveries are typically 50%-60% of the original oil in place while gravity drainage recoveries average 80%-90% of the original oil in place. Therefore, by injecting a gas into a watered out reservoir, a gas cap will form an additional oil can be recovered due to gravity drainage. Although the Double Displacement Process has been shown to be successful in recovering tertiary oil in other fields, this project will be the first to utilize air injection in the Double Displacement Process. The use of air injection in this process combines the benefits of air`s low cost and universal accessibility with the potential for accelerated oil recovery due to the combustion process. If successful, this project will demonstrate that the use of air injection in the Double Displacement Process will result in an economically viable tertiary process in reservoirs where tertiary oil recovery is presently uneconomical.

  6. Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities.

    Science.gov (United States)

    Chiò, A; Bottacchi, E; Buffa, C; Mutani, R; Mora, G

    2006-08-01

    To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.

  7. The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

    International Nuclear Information System (INIS)

    Crespo, Livia T.C.; Mattos, Marcio C.S. de; Esteves, Pierre M.

    2013-01-01

    Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA). The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture. (author)

  8. The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

    Directory of Open Access Journals (Sweden)

    Lívia T. C. Crespo

    2013-01-01

    Full Text Available Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA. The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture.

  9. Tentorial and dural calcification with tertiary hyperparathyroidism: a rare entity in chronic renal failure

    International Nuclear Information System (INIS)

    Dorenbeck, U.; Bretschneider, T.; Feuerbach, S.; Leingaertner, T.; Kraemer, B.K.

    2002-01-01

    A case of rare calcification of the tentorium cerebelli, the thoracal dura mater of the spine, and the sclera in an adult male patient with tertiary hyperparathyroidism is presented. The often reported feature in the skull is that of a combination of osteopenia and osteosclerosis giving a granular bone texture. Extensive dura calcification with this condition has very rarely been reported. It is the aim of this paper to document the latter in a patient with chronic renal failure and tertiary hyperparathyroidism. (orig.)

  10. Spacecraft operations

    CERN Document Server

    Sellmaier, Florian; Schmidhuber, Michael

    2015-01-01

    The book describes the basic concepts of spaceflight operations, for both, human and unmanned missions. The basic subsystems of a space vehicle are explained in dedicated chapters, the relationship of spacecraft design and the very unique space environment are laid out. Flight dynamics are taught as well as ground segment requirements. Mission operations are divided into preparation including management aspects, execution and planning. Deep space missions and space robotic operations are included as special cases. The book is based on a course held at the German Space Operation Center (GSOC).

  11. Operator substitution

    NARCIS (Netherlands)

    Hautus, M.L.J.

    1994-01-01

    Substitution of an operator into an operator-valued map is defined and studied. A Bezout-type remainder theorem is used to derive a number of results. The tensor map is used to formulate solvability conditions for linear matrix equations. Some applications to system theory are given, in particular

  12. Operation amplifier

    NARCIS (Netherlands)

    Tetsuya, Saito; Nauta, Bram

    2008-01-01

    To provide an operation amplifier which improves power source voltage removal ratios while assuring phase compensation characteristics, and therefore can be realized with a small-scale circuit and low power consumption. SOLUTION: The operation amplifier comprises: a differential amplifier circuit 1;

  13. Operation Amplifier

    NARCIS (Netherlands)

    Tetsuya, Saito; Nauta, Bram

    2011-01-01

    PROBLEM TO BE SOLVED: To provide an operation amplifier which improves power source voltage removal ratios while assuring phase compensation characteristics, and therefore can be realized with a small-scale circuit and low power consumption. SOLUTION: The operation amplifier comprises: a

  14. Operation Amplifier

    NARCIS (Netherlands)

    Tetsuya, S.; Nauta, Bram

    2007-01-01

    PROBLEM TO BE SOLVED: To provide an operation amplifier which improves power source voltage removal ratios while assuring phase compensation characteristics, and therefore can be realized with a small-scale circuit and low power consumption. ; SOLUTION: The operation amplifier comprises: a

  15. Accelerator operations

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Operations of the SuperHILAC, the Bevatron/Bevalac, and the 184-inch Synchrocyclotron during the period from October 1977 to September 1978 are discussed. These include ion source development, accelerator facilities, the Heavy Ion Spectrometer System, and Bevelac biomedical operations

  16. Hanaro operation

    International Nuclear Information System (INIS)

    Lee, Ji Bok; Jeon, Byung Jin; Kwack, Byung Ho

    1997-01-01

    HANARO was configurated its first operating core in 1995. Long term operation test was conducted up to 3-1 cycle during 1996, in order to investigate the reactor characteristics due to fuel depletion and additional fuel loading. Now HANARO has accumulated 168.4 days of total operation time and 2,687.5 MWD of total thermal output. Reactor analysis, producing operation datum and its validation with test, periodic inspection and maintenance of the facility are continuously conducted for safe operation of the HANARO. Conducted the verification tests for installed utilization facilities, and successfully performed the radiation emergency drill. The shutdown report of TRIGA Mark II and III was submitted to MOST, and decommissioning will be started from 1997. (author). 70 tabs., 50 figs., 27 refs

  17. Binocular diplopia in a tertiary hospital: Aetiology, diagnosis and treatment.

    Science.gov (United States)

    Merino, P; Fuentes, D; Gómez de Liaño, P; Ordóñez, M A

    2017-12-01

    To study the causes, diagnosis and treatment in a case series of binocular diplopia. A retrospective chart review was performed on patients seen in the Diplopia Unit of a tertiary centre during a one-year period. Diplopia was classified as: acute≤1 month since onset; subacute (1-6 months); and chronic (>6 months). Resolution of diplopia was classified as: spontaneous if it disappeared without treatment, partial if the course was intermittent, and non-spontaneous if treatment was required. It was considered a good outcome when diplopia disappeared completely (with or without treatment), or when diplopia was intermittent without significantly affecting the quality of life. A total of 60 cases were included. The mean age was 58.65 years (60% female). An acute or subacute presentation was observed in 60% of the patients. The mean onset of diplopia was 82.97 weeks. The most frequent aetiology was ischaemic (45%). The most frequent diagnosis was sixth nerve palsy (38.3%), followed by decompensated strabismus (30%). Neuroimaging showed structural lesions in 17.7% of the patients. There was a spontaneous resolution in 28.3% of the cases, and there was a good outcome with disappearance of the diplopia in 53.3% at the end of the study. The most frequent causes of binocular diplopia were cranial nerve palsies, especially the sixth cranial nerve, followed by decompensated strabismus. Structural lesions in imaging tests were more than expected. Only one third of patients had a spontaneous resolution, and half of them did not have a good outcome despite of treatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Experience of vascular trauma in a tertiary care hospital

    International Nuclear Information System (INIS)

    Imtiaz, N.

    2010-01-01

    To highlight the presentation and management of various vascular injuries and their outcome. Thirty nine cases of vascular trauma were referred to vascular surgeon CMH Rawalpindi, in the above mentioned period. These cases were evaluated for mechanism of injury, age, gender and time of presentation. Out of these, only thirty cases were found suitable for surgical intervention. These thirty cases were evaluated for site of vascular injury, associated injuries, type of surgery performed and the outcome. Blunt trauma was the predominant cause of vascular injuries in our study 16/39 (41%). Fourteen cases (35.8%) had gun shot wounds. Only thirty patients (76.9 %) underwent various surgical procedures. Primary end to end anastomosis was possible in only 5/30 cases (16.6%) while reversed venous graft was used in 13/30 cases (43.3%). Wound infection occurred in 2/30(6.6%) cases out of which 1 case (3.3%) ultimately had an amputation. The time period between injury and surgical intervention ranged between 1 to 20 hours for most of the vascular injuries while delayed presentation in the form of traumatic arteriovenous fistula or pseudoaneurysm was between 48 hours to 3 months. There are reasonable numbers of vascular trauma cases being referred to a tertiary care hospital. Most of these cases reach us quite late due to unnecessary investigations, delayed referral and transportation. Early intervention and revascularization definitely reduces amputation and complication rate. All gunshot wounds not only require thorough surrounding soft tissue debridement but also liberal excision of traumatised vessel itself, resulting in interposition graft repair. (author)

  19. Attitudes Toward Cognitive Enhancer Use Among New Zealand Tertiary Students.

    Science.gov (United States)

    Ram, Sanyogita Sanya; Hussainy, Safeera; Henning, Marcus; Stewart, Kay; Jensen, Maree; Russell, Bruce

    2017-09-19

    Cognitive enhancement is the use of prescription stimulant medicines by healthy individuals for nonmedical use in academic settings. Commonly used cognitive enhancers (CEs) include methylphenidate, amphetamines, and modafinil. To understand the motivation to use CEs, it is important to look beyond prevalence and explore the extent to which attitudes, beliefs, and intentions predict the decision to use CEs. The study aimed to investigate what factors explain the decision to use CEs among tertiary students in New Zealand, using the Theory of Planned Behaviour (TPB). Students from the Schools of Pharmacy, Nursing, Medicine, Law, and Accounting at a university in New Zealand were invited to complete a paper-based questionnaire. The questionnaire elicited students' attitudes, subjective norms, and perceived control toward illicit use of CEs using TPB. An exploratory factor analysis was conducted. Response rate was 88.6% (442/499). Students who perceived CE use to be socially and ethically acceptable were more likely to use CEs (odds ratio, OR: 1.56, 95% confidence interval, 95% CI: 1.153-2.105, p = 0.004). Students who were concerned about the health impact of CE use were less likely to use CEs (OR: 0.54, 95% CI: 0.492-0.826, p = 0.001). Students who believed that CE use was approved were more likely to use them (OR: 1.648, CI: 1.193-2.278, p = 0.002). This research supports the notion that the decision to use CEs is not just an autonomous choice that occurs in isolation. Attitudes on the ethical and social acceptability of CE use were more likely to drive the decision to use CEs. The study provides the impetus for an integrative discussion by health care professionals and academics on the impact of attitudes, social norms, and advocates on the decision to use CEs.

  20. Mothers’ experiences of labour in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    M S Maputle

    2008-11-01

    Full Text Available The purpose of the study was to explore and describe experiences of mothers during childbirth in a tertiary hospital in the Limpopo Province. This was achieved through a qualitative research study which was exploratory, descriptive, contextual and inductive in nature. A sample of 24 mothers participated in this study. Data obtained from unstructured in-depth interviews were analysed according to the protocol by Tesch (1990, cited in Cresswell, 1994:155. Five themes were identified, namely mutual participation and responsibility sharing, dependency and decision-making; information sharing and empowering autonomy and informed choices; open communication and listening; accommodative/non-accommodative midwifery actions; and maximising human and material infrastructure. The themes indicated experiences that foster or promote dependency on midwifery care. Guidelines on how to transform this dependency into a mother-centered care approach during childbirth are provided. Opsomming Die doel van die studie was om moeders se belewenis van kindergeboorte in ’n tersiêre hospitaal in die Limpopo Provinsie te verken en te beskryf. Dit is gedoen deur middel van kwalitatiewe navorsing wat verkennend, beskrywend, en kontekstueel was. ‘n Steekproef van 24 moeders het aan die studie deelgeneem. Inligting is verkry deur middel van ongestruktureerde in-diepte onderhoude. Hierdie inligting is geanaliseer aan die hand van Tesch (1990: aangehaal in Creswell, 1994:155 se protokol. Die volgende kategorieë is geïdentifiseer, wedersydse deelname en gedeelde verantwoordelik- hede, afhanklikheid en besluitneming, deel van inligting, bemagtiging tot outonomie en ingeligte keuse, oop kommunikasie en luister, akkommoderende/nie-akkommoderende vroedvrou-aksies en bevordering van menslike en materiële infrastrukture. Die resultate van die onderhoude het belewenisse blootgelê wat dui op die bevordering van afhanklikheid in vroedvrouversorging. Riglyne om hierdie

  1. STUDY OF GASTROINTESTINAL CANCERS IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Rema Nair Sarkar

    2017-11-01

    Full Text Available BACKGROUND Cancer is one of the leading cause of death both in developed and developing countries. In India, it accounts for 0.3 million deaths per year. Cancers of lung, GIT and oral cancers dominated among men while breast, cervix, ovary and oral cavity were commonest cancer seen in women. Among the gastrointestinal cancers, cancers of the oesophagus, stomach, colon, rectum and liver cancers were commonest. The aim of the study is to evaluate the incidence of the various GIT cancers in a tertiary hospital of Coastal Andhra when compared to other studies. MATERIALS AND METHODS In this retrospective study, a total of 509 health records of patients affected by cancers were studied and relevant details noted. RESULTS A total of 509 cancer cases were reported in this period of 18 months (January 2016 - June 2017 of which 85 cases (16.3% were of Gastrointestinal (GIT cancers. The age group between 40 and 60 recorded the maximum incidence of 47 cancers (55.1%. The incidence of gastrointestinal cancers were significantly higher in the men (56 cases (65.8% than the women (29 cases (34.11%. The commonest site of GIT cancers was the colorectal region (30 cases (35.7%. The most common type of cancer seen was adenocarcinoma seen in 73 cases (85.8%. CONCLUSION Public education and awareness for the warning symptoms should be increased to prevent reduction of the life span and health caused by the gastrointestinal cancers with intense awareness drive using various means including social media undertaken to educate the public regarding the warning symptoms and screening of such group for GIT cancers.

  2. Remote Sensing Tertiary Education Meets High Intensity Interval Training

    Science.gov (United States)

    Joyce, K. E.; White, B.

    2015-04-01

    Enduring a traditional lecture is the tertiary education equivalent of a long, slow, jog. There are certainly some educational benefits if the student is able to maintain concentration, but they are just as likely to get caught napping and fall off the back end of the treadmill. Alternatively, a pre-choreographed interactive workshop style class requires students to continually engage with the materials. Appropriately timed breaks or intervals allow students to recover briefly before being increasingly challenged throughout the class. Using an introductory remote sensing class at Charles Darwin University, this case study presents a transition from the traditional stand and deliver style lecture to an active student-led learning experience. The class is taught at undergraduate and postgraduate levels, with both on-campus as well as online distance learning students. Based on the concept that active engagement in learning materials promotes 'stickiness' of subject matter, the remote sensing class was re-designed to encourage an active style of learning. Critically, class content was reviewed to identify the key learning outcomes for the students. This resulted in a necessary sacrifice of topic range for depth of understanding. Graduates of the class reported high levels of enthusiasm for the materials, and the style in which the class was taught. This paper details a number of techniques that were used to engage students in active and problem based learning throughout the semester. It suggests a number of freely available tools that academics in remote sensing and related fields can readily incorporate into their teaching portfolios. Moreover, it shows how simple it can be to provide a far more enjoyable and effective learning experience for students than the one dimensional lecture.

  3. Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania

    Directory of Open Access Journals (Sweden)

    Mashurano Marcellina

    2004-10-01

    Full Text Available Abstract Background Antimicrobial resistance is particularly harmful to infectious disease management in low-income countries since expensive second-line drugs are not readily available. The objective of this study was to implement and evaluate a computerized system for surveillance of antimicrobial resistance at a tertiary hospital in Tanzania. Methods A computerized surveillance system for antimicrobial susceptibility (WHONET was implemented at the national referral hospital in Tanzania in 1998. The antimicrobial susceptibilities of all clinical bacterial isolates received during an 18 months' period were recorded and analyzed. Results The surveillance system was successfully implemented at the hospital. This activity increased the focus on antimicrobial resistance issues and on laboratory quality assurance issues. The study identified specific nosocomial problems in the hospital and led to the initiation of other prospective studies on prevalence and antimicrobial susceptibility of bacterial infections. Furthermore, the study provided useful data on antimicrobial patterns in bacterial isolates from the hospital. Gram-negative bacteria displayed high rates of resistance to common inexpensive antibiotics such as ampicillin, tetracycline and trimethoprim-sulfamethoxazole, leaving fluoroquinolones as the only reliable oral drugs against common Gram-negative bacilli. Gentamicin and third generation cephalosporins remain useful for parenteral therapy. Conclusion The surveillance system is a low-cost tool to generate valuable information on antimicrobial resistance, which can be used to prepare locally applicable recommendations on antimicrobial use. The system pinpoints relevant nosocomial problems and can be used to efficiently plan further research. The surveillance system also functions as a quality assurance tool, bringing attention to methodological issues in identification and susceptibility testing.

  4. Carcinogenicity of methyl-tertiary butyl ether in gasoline.

    Science.gov (United States)

    Mehlman, Myron A

    2002-12-01

    Methyl tertiary butyl ether (MTBE) was added to gasoline on a nationwide scale in 1992 without prior testing of adverse, toxic, or carcinogenic effects. Since that time, numerous reports have appeared describing adverse health effects of individuals exposed to MTBE, both from inhalation of fumes in the workplace and while pumping gasoline. Leakage of MTBE, a highly water-soluble compound, from underground storage tanks has led to contamination of the water supply in many areas of the United States. Legislation has been passed by many states to prohibit the addition of MTBE to gasoline. The addition of MTBE to gasoline has not accomplished its stated goal of decreasing air pollution, and it has posed serious health risks to a large portion of the population, particularly the elderly and those with respiratory problems, asthma, and skin sensitivity. Reports of animal studies of carcinogenicity of MTBE began to appear in the 1990s, prior to the widespread introduction of MTBE into gasoline. These reports were largely ignored. In ensuing years, further studies have shown that MTBE causes various types of malignant tumors in mice and rats. The National Toxicology Program (NTP) Board of Scientific Counselors' Report on Carcinogens Subcommittee met in December 1998 to consider listing MTBE as "reasonably anticipated to be a human carcinogen." In spite of recommendations from Dr. Bailer, the primary reviewer, and other scientists on the committee, the motion to list MTBE in the report was defeated by a six to five vote, with one abstention. On the basis of animal studies, it is widely accepted that if a chemical is carcinogenic in appropriate laboratory animal test systems, it must be treated as though it were carcinogenic in humans. In the face of compelling evidence, NTP Committee members who voted not to list MTBE as "reasonably anticipated to be a human carcinogen" did a disservice to the general public; this action may cause needless exposure of many to health risks

  5. Mainstreaming of Climate Change into the Ghanaian Tertiary Educational System

    Science.gov (United States)

    Nyarko, B. K.

    2013-12-01

    The impact of Climate Change has a far-reaching implication for economies and people living in the fragile Regions of Africa analysts project that by 2020, between 75 million and 250 million people will be exposed various forms of Climate Change Stresses. Education as a key strategy identified under Agenda 21 has been incorporated into the efforts of various educational institutions as a means of mitigating climate change and enhancing sustainability. Climate Change education offers many opportunities and benefits for educators, researchers, learners, and for wider society, but there are also many challenges, which can hinder the successful mainstreaming of climate change education. The study aims at understanding barriers for Climate Change Education in selected tertiary institutions in Ghana. The study was conducted among Geoscience Departments of the 7 main public universities of Ghana. The transcript analysis identified issues that hinders the mainstreaming of Climate Change, these includes existing levels of knowledge and understanding of the concept of climate change, appreciating the threshold concepts, ineffective teaching of Climate Change and some Departments are slow in embracing Climate Change as a discipline. Hence to develop strategies to mainstream climate change education it is important to recognise that increasing the efficiency and delivery of Climate Change education requires greater attention and coordination of activities and updating the educators knowledge and skill's. Various Ministries should be challenged to develop and integrate climate change into education policies. In the design of curriculum, there is a need to integrate Climate Change Education into curricula without compromising already overstretched programmes of study. There is a need to encourage and enhance innovative teaching approaches such as Problem-based learning (PBL) is an approach that challenges students to learn through engagement in a real problem. Institutions and

  6. Spectrum of vaginal discharge in a tertiary care setting.

    Science.gov (United States)

    Sivaranjini, R; Jaisankar, Tj; Thappa, Devinder Mohan; Kumari, Rashmi; Chandrasekhar, Laxmisha; Malathi, M; Parija, Sc; Habeebullah, S

    2013-07-01

    Vaginal discharge is one of the common reasons for gynecological consultation. Many of the causes of vaginitis have a disturbed vaginal microbial ecosystem associated with them. Effective treatment of vaginal discharge requires that the etiologic diagnosis be established and identifying the same offers a precious input to syndromic management and provides an additional strategy for human immunodeficiency virus prevention. The present study was thus carried out to determine the various causes of vaginal discharge in a tertiary care setting. A total of 400 women presenting with vaginal discharge of age between 20 and 50 years, irrespective of marital status were included in this study and women who had used antibiotics or vaginal medication in the previous 14 days and pregnant women were excluded. Of the 400 women with vaginal discharge studied, a diagnosis was established in 303 women. Infectious causes of vaginal discharge were observed in 207 (51.75%) women. Among them, bacterial vaginosis was the most common cause seen in 105 (26.25%) women. The other infections observed were candidiasis alone (61, 15.25%), trichomoniasis alone (12, 3%), mixed infections (22, 5.5%) and mucopurulent cervicitis (7 of the 130 cases looked for, 8.46%). Among the non-infectious causes, 72 (18%) women had physiological vaginal discharge and 13 (3.3%) women had cervical in situ cancers/carcinoma cervix. The pattern of infectious causes of vaginal discharge observed in our study was comparable with the other studies in India. Our study emphasizes the need for including Papanicolaou smear in the algorithm for evaluation of vaginal discharge, as it helps establish the etiology of vaginal discharge reliably and provides a valuable opportunity to screen for cervical malignancies.

  7. MANAGEMENT OF POSTERIOR DISLOCATED INTRAOCULAR LENSES IN A TERTIARY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Shashidhar

    2016-10-01

    Full Text Available BACKGROUND The aim of this study was to assess and compare the visual outcome of different approaches in the management of dislocated PCIOL. MATERIALS AND METHODS 20 eyes of 20 patients who underwent 3PPPV/anterior vitrectomy to refixate or IOL exchange for dislocation or subluxation of PCIOL from 2012 to 2015. SFIOLs were implanted in 12 patients, IOL refixation was done in four patients and four were left aphakic. This is a retrospective study of 20 eyes of 20 patients with dislocated/subluxated PCIOLs in a tertiary hospital from 2012 to 2015. STATISTICAL ANALYSIS Paired t-test statistical method. RESULTS We retrospectively analysed hospital records of patients who had undergone three PPPV/anterior vitrectomy for posteriorly dislocated/subluxated IOLs 20 eyes of 20 patients were analysed. SFIOLs were implanted in 12 patients, IOL refixation was done in four patients and four were left aphakic. Postoperative BCVA of 6/12 or better was achieved in 66.67% in primary SFIOL, secondary SFIOL and IOL refixation groups. BCVA of <6/60 was seen in all patients left aphakic. Early and late complications were most in aphakic patients. IOL refixation procedure had minimum early and late complications. Subluxated PCIOLs do better than dislocated lens where a successful SFIOL was placed. CONCLUSION IOL refixation procedure has the least complication rate. Early complications of SFIOL management resolve with time. Thus, 3PPPV/anterior vitrectomy with SFIOL and IOL refixation procedures offer a novel approach towards visual rehabilitation of patients with subluxated or dislocated PCIOLs.

  8. Cool episodes in Early Tertiary Arctic climate: Evidence from Svalbard

    Science.gov (United States)

    Spielhagen, R. F.; Tripati, A.

    2009-04-01

    The Arctic is a climatically sensitive and important region. However, very little is known about the climatic and oceanographic evolution of the area, particularly prior to the Neogene. Until recently, the Arctic was assumed to be characterized by relatively warm conditions during the early Cenozoic. The Early Tertiary sedimentary sequence on Svalbard contains several layers with coal seams and broad-leaved plants which were commonly accepted as indicators of a generally temperate-warm climate. Here we report on the intermittent occurrence of certain temperature indicators in the succession, which may represent the first northern high-latitude record of near-freezing temperatures for the early Cenozoic. Besides the findings of probably ice-rafted erratic clasts in the Paleocene and Eocene sandstones and shales, we note especially the occurrence of glendonites which are pseudomorphs of calcite after ikaite (calcium carbonate hexahydrate). We measured the chemical composition of Svalbard glendonites which is almost identical to that of similar pseudomorphs from the Lower Cretaceaous of Northern Canada. Mass spectrometric analyses of the glendonite calcite gave very low carbon isotope values. These values suggest a provenance of the calcium carbonate from marine organic carbon and connect our glendonites to the precursor mineral ikaite which has similar low values. Since a variety of studies has demonstrated that ikaite is stable only at temperatures close to freezing point, we have to infer low temperatures also for the deepositional environment of which the sediments were deposited that now hold glendonites. These results imply the occurrence of cooling phases episodically during the warm background climate of the Paleocene and Eocene, suggesting that temperature variability was much greater than previously recognized.

  9. Malaysian Instructors’ Assessment Beliefs in Tertiary ESL Classrooms

    Directory of Open Access Journals (Sweden)

    Niveen R. M. Elshawa

    2017-04-01

    Full Text Available Language assessment can be a valuable tool for providing information regarding language teaching. Given the importance of assessment that has undergone much change, there are important issues that warrant investigation, particularly those related to language instructors. Understanding the assessment beliefs of ESL instructors, especially at the tertiary level, is important since it can help improve the quality of assessment practices as well. Therefore, this study investigated English language instructors’ assessment beliefs in the Malaysian context. This study adopted a cross-sectional research design. The survey method was utilized to collect data from six Malaysian universities using a purposive sampling strategy. English language instructors (n=83 were selected via purposive sampling for the study. Findings of the study revealed that English language instructors believed that the purpose of assessment was to improve teaching and learning. Regarding the assessment beliefs that are related to the assessment purposes, analyses of data showed that the items that received the highest percentage of agreement were diagnosing strength and weaknesses in students, providing information about students’ progress and providing feedback to students as they learn, respectively. Although they reported using both formal and informal assessment of their students’ work, English language instructors relied heavily on paper and pencil assessment while giving more weightage on formative assessment. The majority of English language instructors reported employing marking schemes for the courses they taught, carrying out sample marking and providing feedback. Finally, English language instructors reported using different types of assessments for every language skill taught in their language unit/center. The findings highlight the fact that English instructors should be more empowered in their role as the assessors of students. Their knowledge about what, how

  10. Patient Understanding of Hypoglycemia in Tertiary Referral Centers

    Directory of Open Access Journals (Sweden)

    Nan Hee Cho

    2018-02-01

    Full Text Available BackgroundHypoglycemia is an important complication in the treatment of patients with diabetes. We surveyed the insight by patients with diabetes into hypoglycemia, their hypoglycemia avoidance behavior, and their level of worry regarding hypoglycemia.MethodsA survey of patients with diabetes, who had visited seven tertiary referral centers in Daegu or Gyeongsangbuk-do, Korea, between June 2014 and June 2015, was conducted. The survey contained questions about personal history, symptoms, educational experience, self-management, and attitudes about hypoglycemia.ResultsOf 758 participants, 471 (62.1% had experienced hypoglycemia, and 250 (32.9% had experienced hypoglycemia at least once in the month immediately preceding the study. Two hundred and forty-two (31.8% of the participants had received hypoglycemia education at least once, but only 148 (19.4% knew the exact definition of hypoglycemia. Hypoglycemic symptoms identified by the participants were dizziness (55.0%, sweating (53.8%, and tremor (40.8%. They mostly chose candy (62.1%, chocolate (37.7%, or juice (36.8% as food for recovering hypoglycemia. Participants who had experienced hypoglycemia had longer duration of diabetes and a higher proportion of insulin usage. The mean scores for hypoglycemia avoidance behavior and worry about hypoglycemia were 21.2±10.71 and 23.38±13.19, respectively. These scores tended to be higher for participants with higher than 8% of glycosylated hemoglobin, insulin use, and experience of emergency room visits.ConclusionMany patients had experienced hypoglycemia and worried about it. We recommend identifying patients that are anxious about hypoglycemia and educating them about what to do when they develop hypoglycemic symptoms, especially those who have a high risk of hypoglycemia.

  11. Patient Understanding of Hypoglycemia in Tertiary Referral Centers.

    Science.gov (United States)

    Cho, Nan Hee; Kim, Nam Kyung; Han, Eugene; Hong, Jun Hwa; Jeon, Eon Ju; Moon, Jun Sung; Seo, Mi Hae; Lee, Ji Eun; Seo, Hyun Ae; Kim, Mi Kyung; Kim, Hye Soon

    2018-02-01

    Hypoglycemia is an important complication in the treatment of patients with diabetes. We surveyed the insight by patients with diabetes into hypoglycemia, their hypoglycemia avoidance behavior, and their level of worry regarding hypoglycemia. A survey of patients with diabetes, who had visited seven tertiary referral centers in Daegu or Gyeongsangbuk-do, Korea, between June 2014 and June 2015, was conducted. The survey contained questions about personal history, symptoms, educational experience, self-management, and attitudes about hypoglycemia. Of 758 participants, 471 (62.1%) had experienced hypoglycemia, and 250 (32.9%) had experienced hypoglycemia at least once in the month immediately preceding the study. Two hundred and forty-two (31.8%) of the participants had received hypoglycemia education at least once, but only 148 (19.4%) knew the exact definition of hypoglycemia. Hypoglycemic symptoms identified by the participants were dizziness (55.0%), sweating (53.8%), and tremor (40.8%). They mostly chose candy (62.1%), chocolate (37.7%), or juice (36.8%) as food for recovering hypoglycemia. Participants who had experienced hypoglycemia had longer duration of diabetes and a higher proportion of insulin usage. The mean scores for hypoglycemia avoidance behavior and worry about hypoglycemia were 21.2±10.71 and 23.38±13.19, respectively. These scores tended to be higher for participants with higher than 8% of glycosylated hemoglobin, insulin use, and experience of emergency room visits. Many patients had experienced hypoglycemia and worried about it. We recommend identifying patients that are anxious about hypoglycemia and educating them about what to do when they develop hypoglycemic symptoms, especially those who have a high risk of hypoglycemia. Copyright © 2018 Korean Diabetes Association

  12. Male hypogonadism at a tertiary care hospital in Karachi, Pakistan.

    Science.gov (United States)

    Ram, Nanik; Asghar, Ali; Hashmi, Fauzan; Islam, Najmul

    2012-01-01

    Male hypogonadism is defined as 'inadequate gonadal function, manifested by deficiency in gametogenesis and/or secretion of gonadal hormones'. Signs and symptoms of hypogonadism depend primarily on the age of onset. It can be classified according to the site primarily involved: the gonads, the hypothalamus, or the pituitary gland. The objective this study was to determine the presentation and aetiology of male hypogonadism seen in a tertiary care hospital. This cross-sectional study was conducted at Endocrine Clinics, Aga Khan University Hospital Karachi. Data of male patients with hypogonadism who attended clinics during January 2009 to August 2011 were reviewed. All male patients with clinical and biochemical evidence of hypogonadism were included in the study. Patients with Diabetes Mellitus, Metabolic Syndrome, Andropause, AIDS, Chronic Renal Failure, and Cirrhosis were excluded. Mean +/- SD were computed for quantitative variables. Frequency and percentages were computed for qualitative variables. Aetiology of male hypogonadism was categorised as primary and secondary hypogonadism. A total of 85 patients with male hypogonadism attended the endocrine clinic. Mean age of patients was 25 +/- 10 years. Clinical presentations were small genitalia (65%), absent secondary sexual characteristics (53%), not attained puberty (47%), infertility (53%), erectile dysfunction (41%) and loss of libido (29%). Seventy-three (86%) patients had hypogonadotrophic hypogonadism (secondary hypogonadism) and 12 (14%) patients had hypergonadotrophic hypogonadism (primary hypogonadism). Among the patients with hypogonadotrophic hypogonadism 38 had idiopathic hypogonadotrophic hypogonadsim, 7 had pituitary adenoma, 6 had empty sella syndrome, 3 had Kallman's syndrome, and 1 patient had haemosiderosis due to thalassaemia major; 18 patients did not undergo brain imaging. Small genitalia, absent secondary sexual characteristics and infertility were the main presenting features of hypogonad

  13. Near total parathyroidectomy is effective therapy for tertiary hyperparathyroidism.

    Science.gov (United States)

    Dewberry, Lindel Krige; Weber, Collin; Sharma, Jyotirmay

    2014-07-01

    Tertiary hyperparathyroidism (3°HPT) is defined as persistent hyperparathyroidism with hypercalcemia after renal transplantation. Near total parathyroidectomy (NTPTX) is the current standard for surgical intervention. The purpose of this study was to identify outcomes of NTPTX. A retrospective review was conducted of surgeries performed between 1994 and 2013. NTPTX resulted in resolution of 96.9 per cent of patients' hypercalcemia at a median follow-up of three years (interquartile range [IQR], 1 to 8). However, 3.1 per cent of patients remained hypercalcemic with a mean calcium of 10.5 ± 0.2 mg/dL. A total of 78.4 per cent of patients had parathyroid hormone (PTH) levels below 250 pg/mL at a median follow-up of two years (IQR, 2 to 8). The remaining 21.6 per cent had a median PTH of 535 (IQR, 345 to 857). PTH levels dropped from a median of 745 (IQR, 285.75 to 1594.25) pg/mL to 97 (IQR, 60 to 285) pg/mL one month post-NTPTX (P < 0.01). The most frequent complication was transient hypocalcemia in 27.1 per cent of patients, but no patients became permanently hypocalcemic. In the 1-month postoperative period, only one patient had a cardiac complication, and there was 0 per cent all-cause mortality. Glomerular filtration rate fell from 57.9 ± 28.3 mL/min pre-NTPTX to 53.2 ± 27.5 mL/min at 1-year post-NTPTX (P < 0.01). NTPTX effectively treats hypercalcemia in 3°HPT. However, PTH remains elevated (greater than 250) in 21.6 per cent of patients.

  14. Reactor operation

    CERN Document Server

    Shaw, J

    2013-01-01

    Reactor Operation covers the theoretical aspects and design information of nuclear reactors. This book is composed of nine chapters that also consider their control, calibration, and experimentation.The opening chapters present the general problems of reactor operation and the principles of reactor control and operation. The succeeding chapters deal with the instrumentation, start-up, pre-commissioning, and physical experiments of nuclear reactors. The remaining chapters are devoted to the control rod calibrations and temperature coefficient measurements in the reactor. These chapters also exp

  15. Operator programs and operator processes

    NARCIS (Netherlands)

    Bergstra, J.A.; Walters, P.

    2003-01-01

    We define a notion of program which is not a computer program but an operator program: a detailed description of actions performed and decisions taken by a human operator (computer user) performing a task to achieve a goal in a simple setting consisting of that user, one or more computers and a

  16. Operator theory

    CERN Document Server

    2015-01-01

    A one-sentence definition of operator theory could be: The study of (linear) continuous operations between topological vector spaces, these being in general (but not exclusively) Fréchet, Banach, or Hilbert spaces (or their duals). Operator theory is thus a very wide field, with numerous facets, both applied and theoretical. There are deep connections with complex analysis, functional analysis, mathematical physics, and electrical engineering, to name a few. Fascinating new applications and directions regularly appear, such as operator spaces, free probability, and applications to Clifford analysis. In our choice of the sections, we tried to reflect this diversity. This is a dynamic ongoing project, and more sections are planned, to complete the picture. We hope you enjoy the reading, and profit from this endeavor.

  17. Operation Starvation

    National Research Council Canada - National Science Library

    Mason, Gerald

    2002-01-01

    More than 1,250,000 tons of shipping was sunk or damaged in the last five months of World War II when Twenty-first Bomber Command executed an aerial mining campaign against Japan known as Operation STARVATION...

  18. Peace Operations

    National Research Council Canada - National Science Library

    Proks, Josef

    2000-01-01

    Peace operations are more and more important in the contemporary world. The end of the Cold War increased not only possibilities of solving disputes by the international community but also by the number and diversity of threats and issues...

  19. Operator training

    International Nuclear Information System (INIS)

    Wirstad, J.

    1983-12-01

    The traditional operator job is changing, which among other things has generated a need for better job training. Surprisingly increased process automation has lead to increased operator qualifications, i.e. basic job training but also up-date and rehearsal training within certain fixed intervals. There are several, similar models for instructional system development available in the literature. One model which is of special interest integrates Operator Training development and Man-Machine Interfaces development. The extent to which Systematic Operator Training has been implemented varies with branches and companies. The nuclear power branch is given as an example in the report. This branch probably represents something better than the average among the process industries.(author)

  20. Internships enhancing entrepreneurial intent and self-efficacy: Investigating tertiary-level entrepreneurship education programmes

    Directory of Open Access Journals (Sweden)

    Melodi Botha

    2016-09-01

    Full Text Available Background: Entrepreneurship education interventions are deemed effective when they enhance interns’ entrepreneurial intent (EI and entrepreneurial self-efficacy (ESE. Notwithstanding the emergence of internship as an experiential learning approach in entrepreneurship education, evidence about their potential to foster EI and ESE lacks systemisation. Aim: The aim of this study was to determine whether internships enhance EI and ESE. Furthermore, to what extent South African tertiary institutions include internships in their entrepreneurship and management curricula and the obstacles to such inclusion. Setting: South Africa has made a concerted effort to insert an entrepreneurship component across tertiary curricula. The evolution of this entrepreneurship component to experiential learning approaches is, however, unclear. Methods: A qualitative research approach was followed. Firstly, it reviewed empirical evidence for the positive relationship between internships and EI and ESE. Secondly, it conducted a survey of entrepreneurship and business management programmes at all 23 South African tertiary institutions and content analysed the retrieved information to determine whether such programmes include internships. Finally, 10 experts were interviewed to unveil the constraints inhibiting the inclusion of internships in tertiary curricula. Results: The results revealed empirical support for the positive influence of internships on both EI and ESE. Significant lack of inclusion of internships in tertiary curricula in South Africa emerged, owing mainly to administrative issues, curriculum re-design challenges, and lack of mentoring capacity. Conclusion: Tertiary-level entrepreneurship education programmes should include an internship component. The paper suggested that tertiary institutions pilot-test the inclusion of internships with a small number of students and a selected cohort of small business owners.

  1. Operative Links

    DEFF Research Database (Denmark)

    Wistoft, Karen; Højlund, Holger

    2012-01-01

    educational goals, learning content, or value clarification. Health pedagogy is often a matter of retrospective rationalization rather than the starting point of planning. Health and risk behaviour approaches override health educational approaches. Conclusions: Operational links between health education......, health professionalism, and management strategies pose the foremost challenge. Operational links indicates cooperative levels that facilitate a creative and innovative effort across traditional professional boundaries. It is proposed that such links are supported by network structures, shared semantics...

  2. Intelligent Control and Operation of Distribution System

    DEFF Research Database (Denmark)

    Bhattarai, Bishnu Prasad

    methodology to ensure efficient control and operation of the future distribution networks. The major scientific challenge is thus to develop control models and strategies to coordinate responses from widely distributed controllable loads and local generations. Detailed models of key Smart Grid (SG) elements...... in this direction but also benefit distribution system operators in the planning and development of the distribution network. The major contributions of this work are described in the following four stages: In the first stage, an intelligent Demand Response (DR) control architecture is developed for coordinating...... the key SG actors, namely consumers, network operators, aggregators, and electricity market entities. A key intent of the architecture is to facilitate market participation of residential consumers and prosumers. A Hierarchical Control Architecture (HCA) having primary, secondary, and tertiary control...

  3. Improving patient safety in cardiothoracic surgery: an audit of surgical handover in a tertiary center

    Directory of Open Access Journals (Sweden)

    Bauer NJ

    2016-05-01

    Full Text Available Natasha Johan Bauer Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, UK Background: Novel research has revealed that the relative risk of death increased by 10% and 15% for admissions on a Saturday and Sunday, respectively. With an imminent threat of 7-day services in the National Health Service, including weekend operating lists, handover plays a pivotal role in ensuring patient safety is paramount. This audit evaluated the quality, efficiency, and safety of surgical handover of pre- and postoperative cardiothoracic patients in a tertiary center against guidance on Safe Handover published by the Royal College of Surgeons of ­England and the British Medical Association. Methods: A 16-item questionnaire prospectively audited the nature, time and duration of handover, patient details, operative history and current clinical status, interruptions during handover, and difficulties cross-covering specialties over a month. Results: Just over half (52% of the time, no handover took place. The majority of handovers (64% occurred over the phone; two-thirds of these were uninterrupted. All handovers were less than 10 minutes in duration. About half of the time, the senior house officer had previously met the registrar involved in the handover, but the overwhelming majority felt it would facilitate the handover process if they had prior contact. Patient details handed over 100% of the time included name, ward, and current clinical diagnosis. A third of the time, the patient’s age, responsible consultant, and recent operations or procedures were not handed over, potentially compromising future management due to delays and lack of relevant information. Perhaps the most revealing result was that the overall safety of handover was perceived to be five out of ten, with ten being very safe with no aspects felt to impact negatively on optimal patient care. Conclusion: These findings were presented to the department, and a handover proforma

  4. Surgical Indications and Clinical Results of Patients with Exchanged Intraocular Lenses in a Tertiary Eye Hospital.

    Science.gov (United States)

    Kavuncu, Sevim; Omay, Aslıhan Esra; Tırhış, Mehmet Hakan; Yılmazbaş, Pelin

    2016-08-01

    To evaluate the demographics, surgical indications and clinical results of patients with repositioned or explanted intraocular lens (IOL) in a tertiary referral eye hospital. Forty-eight eyes of 48 patients that underwent surgery to exchange or reposition the IOL at Ulucanlar Eye Training and Research Hospital between 2009 and 2013 were included in the study. Medical records of patients were evaluated for surgical indications, time elapsed since initial operation, preoperative and postoperative best corrected distance visual acuity and the presence of ocular disease. The mean age of the 31 male and 17 female patients was 64.91±14.26 years. Median time between the initial and final operations was 36.0 months. Pseudoexfoliation syndrome (PEX) was present in 25% of the patients. There was history of previous vitreoretinal surgery in 18.8% of patients, ocular trauma in 6.3%, high myopia and refractive surgery in 4% of patients. In the first operation the IOL was implanted in the sulcus in 50%, in the bag in 27.1%, and in the anterior chamber in 20.8%; following the final surgery the IOL was in the sulcus in 27.1%, in the anterior chamber in 22.9%, and fixated to the sclera in 10.4% of the patients, while the remaining 29.1% remained aphakic. Indication for the secondary surgery was IOL dislocation in 58%, corneal decompensation in 20.8% and IOL degeneration in 6.3%. In the final surgery, IOL was exchanged in 54.2% of the cases, removed in 31.3% of cases, and repositioned in 14.6%. Visual acuity improved by 1-3 lines in 52.3% and remained stable in 13.6% of the patients postoperatively. IOL exchange may be necessary at any time following cataract surgery due to surgical complications, IOL dislocation, biometric measurement errors and corneal decompensation. Factors such as vitreoretinal surgery and the existence of PEX increase the risk of IOL exchange surgery.

  5. Surgical Indications and Clinical Results of Patients with Exchanged Intraocular Lenses in a Tertiary Eye Hospital

    Directory of Open Access Journals (Sweden)

    Sevim Kavuncu

    2016-08-01

    Full Text Available Objectives: To evaluate the demographics, surgical indications and clinical results of patients with repositioned or explanted intraocular lens (IOL in a tertiary referral eye hospital. Materials and Methods: Forty-eight eyes of 48 patients that underwent surgery to exchange or reposition the IOL at Ulucanlar Eye Training and Research Hospital between 2009 and 2013 were included in the study. Medical records of patients were evaluated for surgical indications, time elapsed since initial operation, preoperative and postoperative best corrected distance visual acuity and the presence of ocular disease. Results: The mean age of the 31 male and 17 female patients was 64.91±14.26 years. Median time between the initial and final operations was 36.0 months. Pseudoexfoliation syndrome (PEX was present in 25% of the patients. There was history of previous vitreoretinal surgery in 18.8% of patients, ocular trauma in 6.3%, high myopia and refractive surgery in 4% of patients. In the first operation the IOL was implanted in the sulcus in 50%, in the bag in 27.1%, and in the anterior chamber in 20.8%; following the final surgery the IOL was in the sulcus in 27.1%, in the anterior chamber in 22.9%, and fixated to the sclera in 10.4% of the patients, while the remaining 29.1% remained aphakic. Indication for the secondary surgery was IOL dislocation in 58%, corneal decompensation in 20.8% and IOL degeneration in 6.3%. In the final surgery, IOL was exchanged in 54.2% of the cases, removed in 31.3% of cases, and repositioned in 14.6%. Visual acuity improved by 1-3 lines in 52.3% and remained stable in 13.6% of the patients postoperatively. Conclusion: IOL exchange may be necessary at any time following cataract surgery due to surgical complications, IOL dislocation, biometric measurement errors and corneal decompensation. Factors such as vitreoretinal surgery and the existence of PEX increase the risk of IOL exchange surgery.

  6. Study of technical and economic feasibility of a cogeneration system in the tertiary sector; Estudo de viabilidade tecnica-economica de um sistema de cogeracao no setor terciario

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Rodolffo Aquino de; Rocha, Carlos Roberto; Bortoni, Edson da Costa [Universidade Federal de Itajuba (EXCEN/UNIFEI), MG (Brazil). Centro de Excelencia em Eficiencia Energetica

    2008-07-01

    This study aims to examine the technical feasibility and financial cost for a cogeneration system in a company in the tertiary sector. For this, was studied the electromechanical and thermal characteristics of a shopping center, as well as the technologies associated with the proposed cogeneration system. From the modeling of electric and thermal loads it was determined the system of operation for the system and the possible surplus energy generated. For the analysis of economic viability compare operating costs without cogeneration and with the alternative of cogeneration chosen. Among the calculations are the costs of investment and operation of the system. Was encountered the attractiveness of a cogeneration system, which uses natural gas as fuel for alternative engines and, in turn, reject heat to the absorption chillers. The idealized cogeneration system was also evaluated positively with a view to qualification required for participation in policies to encourage the rational use of energy resources. (author)

  7. High-speed ultrafast laser machining with tertiary beam positioning (Conference Presentation)

    Science.gov (United States)

    Yang, Chuan; Zhang, Haibin

    2017-03-01

    For an industrial laser application, high process throughput and low average cost of ownership are critical to commercial success. Benefiting from high peak power, nonlinear absorption and small-achievable spot size, ultrafast lasers offer advantages of minimal heat affected zone, great taper and sidewall quality, and small via capability that exceeds the limits of their predecessors in via drilling for electronic packaging. In the past decade, ultrafast lasers have both grown in power and reduced in cost. For example, recently, disk and fiber technology have both shown stable operation in the 50W to 200W range, mostly at high repetition rate (beyond 500 kHz) that helps avoid detrimental nonlinear effects. However, to effectively and efficiently scale the throughput with the fast-growing power capability of the ultrafast lasers while keeping the beneficial laser-material interactions is very challenging, mainly because of the bottleneck imposed by the inertia-related acceleration limit and servo gain bandwidth when only stages and galvanometers are being used. On the other side, inertia-free scanning solutions like acoustic optics and electronic optical deflectors have small scan field, and therefore not suitable for large-panel processing. Our recent system developments combine stages, galvanometers, and AODs into a coordinated tertiary architecture for high bandwidth and meanwhile large field beam positioning. Synchronized three-level movements allow extremely fast local speed and continuous motion over the whole stage travel range. We present the via drilling results from such ultrafast system with up to 3MHz pulse to pulse random access, enabling high quality low cost ultrafast machining with emerging high average power laser sources.

  8. Emergent Awake tracheostomy--The five-year experience at an urban tertiary care center.

    Science.gov (United States)

    Fang, Christina H; Friedman, Remy; White, Priscilla E; Mady, Leila J; Kalyoussef, Evelyne

    2015-11-01

    There are few studies that discuss the issues surrounding emergent awake tracheostomy. We aim to review the indications, anesthesia used, complications, and outcomes of patients undergoing urgent awake tracheostomy. Chart review. Medical charts of patients who underwent an emergent awake tracheostomy at our institution-affiliated tertiary care center over a 5-year period from 2009 to 2014 were reviewed. Data were collected from inpatient, outpatient, and operative records. Sixty-eight patients underwent emergent awake tracheostomy. Over half presented with hoarseness (n=37, 54.4%) and/or stridor (n=37, 54.4%). Acute upper airway obstruction secondary to malignancy was the most common indication and accounted for 58 cases (85.3%). Thirty-nine (70.1%) of the 55 patients with squamous cell carcinoma presented with advanced disease (stage III or IV). Other indications included glottic or subglottic stenosis (4.4%), failure to intubate (2.9%), and other (7.4%). Local anesthesia was used alone in 35.3% of cases and in combination with conscious sedation in 64.7% of cases. Mild bleeding occurred postoperatively in five patients (7.4%). There were no other postoperative complications. Nineteen patients were lost to follow-up. The mean follow-up of 49 patients was 7.2 weeks, ranging from 2 to 261 weeks. Long-term complications occurred in three patients and included tracheitis 7.4% and suprastomal granuloma 2.9%. Eleven patients (22%) were decannulated at a mean of 11.8 months following tracheostomy. Emergent awake tracheostomy should be considered in patients with impeding airway obstruction and is a safe and effective method to secure an airway in these patients. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Profile of angle closure in a tertiary care center in north India

    Directory of Open Access Journals (Sweden)

    Ichhpujani Parul

    2010-01-01

    Full Text Available Purpose: To study the demographic and clinical profile of the types of primary angle closure patients presenting at a tertiary care center in North India. Materials and Methods: Clinic records of patients diagnosed as primary angle closure were reviewed. International Society of Geographical and Epidemiological Ophthalmology (ISGEO classification scheme was used to categorize patients. Demographic and clinical data including prior management was collected and analyzed. Main Outcome measures were age, sex, symptomatology, best corrected visual acuity (BCVA, intraocular pressure (IOP, gonioscopy, optic disc assessment and visual field defects. Logistic regression model and receiver operating curve (ROC were calculated for predictors of type of glaucoma. Results: Eight hundred and fourteen patients (1603 eyes; males: 380, females: 434 were diagnosed to have various subtypes of angle closure. Mean (±SD age at presentation was significantly higher for males (57.57 ± 11.62 years as compared to females (53.64 ± 10.67 years ( P < 0001. Primary angle closure glaucoma (PACG was most frequently diagnosed subtype (49.38% followed by Primary angle closure (PAC (39.68% and Primary angle closure suspect (PACS (10.93% respectively. The three subtypes differed significantly among their mean IOP (on ANOVA, F = 14.04; P < 0001 using Greenhouse-Geisser correction. Univariate analysis was done to find significant predictors for the outcome of PACG. Logistic regression model and ROC containing the significant predictors yielded a very high AUC of 0.93 with strong discriminatory ability for PACG. Conclusion: In our hospital-based study, the significant predictors for the outcome of PACG included male gender, diminution of vision, the presence of pain and worsening grades of BCVA. Nearly half of PACG presented with advanced disease. In spite of one-third of the patients being diagnosed as angle closure prior to referral, only 8.34% had iridotomy (laser or surgical

  10. Uterine rupture: A seven year review at a tertiary care hospital in New Delhi, India

    Directory of Open Access Journals (Sweden)

    Maruti Sinha

    2016-01-01

    Full Text Available Objective: To identify the obstetric risk factors, incidence, and causes of uterine rupture, management modalities, and the associated maternal and perinatal morbidity and mortality in one of the largest tertiary level women care hospital in Delhi. Materials and Methods: A 7-year retrospective analysis of 47 cases of uterine rupture was done. The charts of these patients were analyzed and the data regarding demographic characteristics, clinical presentation, risk factors, management, operative findings, maternal and fetal outcomes, and postoperative complications was studied. Results: The incidence of rupture was one in 1,633 deliveries (0.061%. The vast majority of patients had prior low transverse cesarean section (84.8%. The clinical presentation of the patients with rupture of the unscarred uterus was more dramatic with extensive tears compared to rupture with scarred uterus. The estimated blood loss ranged from 1,200 to 1,500 cc. Hemoperitoneum was identified in 95.7% of the patient and 83% of the patient underwent repair of rent with or without simultaneous tubal ligation. Subtotal hysterectomy was performed in five cases. There were no maternal deaths in our series. However, there were 32 cases of intrauterine fetal demise and five cases of stillbirths. Conclusions: Uterine rupture is a major contributor to maternal morbidity and neonatal mortality. Four major easily identifiable risk factors including history of prior cesarean section, grand multiparity, obstructed labor, and fetal malpresentations constitute 90% of cases of uterine rupture. Identification of these high risk women, prompt diagnosis, immediate transfer, and optimal management needs to be overemphasized to avoid adverse fetomaternal complications.

  11. Distribution and predictors of emergency department charges: the case of a tertiary hospital in Lebanon.

    Science.gov (United States)

    Saleh, Shadi; Mourad, Yara; Dimassi, Hani; Hitti, Eveline

    2016-03-18

    As health care costs continue to increase worldwide, health care systems, and more specifically hospitals are facing continuous pressure to operate more efficiently. One service within the hospital sector whose cost structure has been modestly investigated is the Emergency Department (ED). The study aims to report on the distribution of ED resource use, as expressed in charges, and to determine predictors of/contributors to total ED charges at a major tertiary hospital in Lebanon. The study used data extracted from the ED discharge database for visits between July 31, 2012 and July 31, 2014. Patient visit bills were reported under six major categories: solutions, pharmacy, laboratory, physicians, facility, and radiology. Characteristics of ED visits were summarized according to patient gender, age, acuity score, and disposition. Univariate and multivariate analyses were conducted with total charges as the dependent variable. Findings revealed that the professional fee (40.9 %) followed by facility fee (26.1 %) accounted for the majority of the ED charges. While greater than 80 % of visit charges went to physician and facility fee for low acuity cases, these contributed to only 52 and 54 % of the high acuity presentations where ancillary services and solutions' contribution to the total charges increased. The total charges for males were $14 higher than females; age was a predictor of higher charges with total charges of patients greater than 60 years of age being around $113 higher than ages 0-18 after controlling for all other variables. Understanding the components and determinants of ED charges is essential to developing cost-containment interventions. Institutional modeling of charging patterns can be used to offer price estimates to ED patients who request this information and ultimately help create market competition to drive down costs.

  12. Incisional hernia in pediatric surgery - experience at a single UK tertiary centre.

    Science.gov (United States)

    Mullassery, Dhanya; Pedersen, Ami; Robb, Andrew; Smith, Nicola

    2016-11-01

    Incisional hernia (IH) is a recognized complication of open and laparoscopic visceral surgery, with reported rates of 10-50% in adult surgical literature. There is a paucity of data relating to incisional hernias in children. The aim of our study was to analyze the incidence and treatment of IH in children. Retrospective review of all patients admitted for incisional hernia repair at a tertiary pediatric surgical centre in the UK more than a 7-year period was performed. Data collected included age at initial surgery, time to IH repair, and type of IH repair and postoperative complications. Twenty one patients (14 male) underwent IH repair during the study period. The incidence of IH among children who had primary abdominal surgery in our institution less than the age of 6months was 2.3%. Median age at repair was 7.9months (range: 18days-5years). Median time from primary surgery to diagnosis of IH was 2months (range 0day-3years), with 81% (17/21) diagnosed within 1year of the preceding abdominal procedure. The most common pathology necessitating the primary operative procedure was necrotising enterocolitis (n=9) in babies of gestational age less than 30weeks. The highest rates of IH were noted in infants following closure of stoma (7.5%) and pyloromyotomy (2.52%). Primary closure was undertaken in all cases. Two children had recurrence of IH, one of which underwent surgical repair. Incidence of IH in children is low but significant. IH was most commonly diagnosed following closure of stoma for NEC in this study. Copyright © 2016. Published by Elsevier Inc.

  13. Glaucoma Blindness at a Tertiary Eye Care Center.

    Science.gov (United States)

    Stone, Jordan S; Muir, Kelly W; Stinnett, Sandra S; Rosdahl, Jullia A

    2015-01-01

    Glaucoma is an important cause of irreversible blindness. This study describes the characteristics of a large, diverse group of glaucoma patients and evaluates associations between demographic and clinical characteristics and blindness. Data were gathered via retrospective chart review of patients (N = 1,454) who were seen between July 2007 and July 2010 by glaucoma service providers at Duke Eye Center. Visual acuity and visual field criteria were used to determine whether patients met the criteria for legal blindness. Descriptive and comparative statistical analyses were performed on the glaucoma patients who were not blind (n = 1,258) and those who were blind (n = 196). A subgroup analysis of only those patients with primary open-angle glaucoma was also performed. In this tertiary care population, 13% (n = 196) of glaucoma patients met criteria for legal blindness, nearly one-half of whom (n = 94) were blind from glaucoma, and another one-third of whom (n = 69) had glaucoma-related blindness. The most common glaucoma diagnosis at all levels of vision was primary open-angle glaucoma. A larger proportion of black patients compared with white patients demonstrated vision loss; the odds ratio (OR) for blindness was 2.25 (95% CI, 1.6-3.2) for black patients compared with white patients. The use of systemic antihypertensive medications was higher among patients who were blind compared with patients who were not blind (OR = 2.1; 95% CI, 1.4-3.1). A subgroup analysis including only patients with primary open-angle glaucoma showed similar results for both black race and use of systemic antihypertensive medications. The relationship between use of systemic antihypertensive medications and blindness was not different between black patients and white patients (interaction P = .268). Data were based on chart review, and associations may be confounded by unmeasured factors. Treated systemic hypertension may be correlated with blindness, and the cause cannot be explained solely

  14. Herpes–Zoster Infection in a Tertiary Hospital in Brazil

    Science.gov (United States)

    Antoniolli, Luciana; Azambuja, Aline; Rodrigues, Camila; Borges, Rafael; Goldani, Luciano

    2017-01-01

    Abstract Background herpes zoster (HZ) is a common infection with potential complications requiring hospital care, especially for patients with multiple comorbities. However, there is little information on HZ from hospital registries. Methods we searched for hospital-based records of B02 code (ICD-10) between March 2000 and January 2017 at Hospital de Clínicas de Porto Alegre, a tertiary, university hospital in south Brazil. To avoid misclassifications, we considered clinical evaluation for the diagnosis of cutaneous HZ and postherpetic neuralgia (PHN), ophthalmological evaluation for ophthalmic HZ and the combination of clinical, radiologic and cerebrospinal fluid analysis for HZ meningo-encephalitis (ME). We analyzed conditions associated with immune dysregulation, complications, length of hospital stay, and mortality. Chi-square test and Kaplan-Meier estimator were used for statistical analyses. P < 0.05 was considered statistically significant. Results there were 847 records for this period, of which 801 were confirmed according to our criteria and included in the analysis. Most patients were women (n = 448; 60%), with an average of 48.8 years, standard deviation of 22.2. There were more diagnoses in the inpatients group (74.4%), and fewer in the emergency room (22.4%) and outpatient (3.3%). The median length of hospital stay was 7 days (2-10, P25-P75) when HZ was the main reason for admission. Most patients presented cutaneous HZ (n = 743, 92.8%). There were fewer cases of PHN (6.1%), ophthalmic HZ (7.6%) and ME (4.1%). Seventy percent had some kind of immune dysregulation; more frequently AIDS (31%), use of immunosuppressive agents (18.7%) and malignant disease (16.2%). We followed the subjects for a median of 28.2 (2.8-77.5) months. During this period, there were 105 (13.1%) deaths. Five were related to HZ ME. The 30-day overall mortality rate was 1.5%. There was no statistical difference in cumulative survival (graph 1, P = 0.05) or incidence of

  15. Planktonic benthonic foraminiferal ratios: Modern patterns and Tertiary applicability

    Science.gov (United States)

    Gibson, T.G.

    1989-01-01

    The abundance of planktonic specimens in foraminiferal assemblages was determined in numerous bottom samples from inner neritic to deep oceanic depths along the Atlantic margin of the northeastern United States. The results augment previous studies in other areas that have shown a general increase in percentage of planktonic specimens in total foraminiferal bottom assemblages as water depth increases. The patterns found in this area of complex shelf bathymetry and hydrography illustrate the influence on the planktonic-benthonic percentages of water depth, distance from shore, different water mass properties and downslope movement of tests in high energy areas. The patterns found in the 661 samples from the Atlantic margin were compared with results from 795 stations in the Gulf of Mexico, Pacific Ocean and Red Sea. The relative abundance of planktonic specimens and water depth correlates positively in all open oceanic areas even though taxonomic composition and diversity of the faunas from different areas is variable. The variation of planktonic percentages in bottom samples within most depth intervals is large so that a precise depth determination cannot be made for any given value. However, an approximate upper depth limit for given percentages can be estimated for open ocean environments. A decrease in planktonic percentages is seen in the lower salinity and higher turbidity coastal waters of the Gulf of Maine. Planktonic percentages intermediate between the lower values in the less saline coastal waters and the higher values in the normal open oceanic conditions occur in the transitional area between the Gulf of Maine and the open marine Atlantic Ocean to the east. Similarly lowered values in another area of restricted oceanic circulation occur in the high salinity, clear, but nutrient-poor waters of the Gulf of Aqaba off the Red Sea. A comparison of the similarity of modern planktonic percentage values to those found in earlier Tertiary assemblages was made to

  16. REVIEW OF CELIAC DISEASE PRESENTATION IN A PEDIATRIC TERTIARY CENTRE.

    Science.gov (United States)

    Oliveira, Gracinda Nogueira; Mohan, Rajiv; Fagbemi, Andrew

    2018-01-01

    Celiac disease is an immune-mediated disorder with a multiform presentation and therefore a challenging diagnosis. Our purpose is to identify the epidemiological, clinical, laboratory and histologic characteristics of children with celiac disease at diagnosis and on follow-up. Children with previously established or newly diagnosed celiac disease, admitted in a tertiary centre in a two-year period (2014-2016) were recruited. Data was collected retrospectively from electronic medical records and clinical notes, and subsequently analysed with SPSS version 20.0. A total of 159 patients, out of 312, were included. Age ranged from 1 to 17 years (mean ± SD: 8.5±4.5 years, 69% girls). Disease presentation was classical in 60%, non-classical in 25%, subclinical in 10% and 5% classified as potential celiac disease. Non-classical and subclinical profiles had a higher mean age at presentation but not statistically significant (P-value 0.24). The most frequent gastrointestinal features at presentation were abdominal pain (58%), diarrhea (43%) and bloating (27%). A positive family history for celiac disease was present in 24% (n=35). We found anaemia in 23%, low ferritin in 63% and a moderate to severe deficiency of 25-hydroxyvitamin D in 62%. celiac disease -specific serologic testing and esophagogastroduodenoscopy were performed in 99%. Histology revealed modified Marsh 2 or 3 enteropathy in 94%, the remaining had normal histology but positive human leukocyte antigen typing. Clinical improvement at 12 months of gluten-free diet was complete in 51% and partial in 49%. IgA tTG normalized after 12-30 months of gluten-free diet in 45%. On growth assessment at diagnosis and after 12-28 months of gluten-free diet, 100% had height increase (mean ±SD: 7.11±4.43 cm) and 96% weight gain (mean ±SD: 5.60±4.91 kg). Our findings outline the diverse clinical presentations of pediatric celiac disease that should be considered irrespective of age. Increased clinician's awareness will

  17. PAEDIATRIC OCULAR INJURIES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    K. Vinayagamurthy

    2017-08-01

    good because of prompt treatment. Facilities for treatment of ocular emergencies have significantly improved in tertiary hospitals located in mofussil areas.

  18. Operation of the NuMI Beam Monitoring System

    International Nuclear Information System (INIS)

    Zwaska, Robert M.; Indurthy, Dharma; Keisler, Ryan; Kopp, Sacha; Mendoza, Steven; Pavlovich, Zarko; Proga, Marek; Bishai, Mary; Diwan, Milind; Viren, Brett; Harris, Debbie; Marchionni, Alberto; Morfin, Jorge; McDonald, Jeffrey; Naples, Donna; Northacker, David; Erwin, Albert; Ping, Huican; Velissaris, Cristos

    2006-01-01

    The NuMI (Neutrinos at the Main Injector) facility produces an intense neutrino beam for experiments. The NuMI Beam Monitoring system consists of four arrays of ion chambers that measure the intensity and distribution of the remnant hadron and tertiary muon beams produced in association with the neutrinos. The ion chambers operate in an environment of high particle fluxes and high radiation

  19. Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review.

    Science.gov (United States)

    Bonanni, L; Bontempo, G; Borrelli, I; Bifolchetti, S; Buongarzone, M P; Carlesi, N; Carolei, A; Ciccocioppo, F; Colangelo, U; Colonna, G; Desiderio, M; Ferretti, S; Fiorelli, L; D'Alessio, O; D'Amico, A; D'Amico, M C; De Lucia, R; Del Re, L; Di Blasio, F; Di Giacomo, R; Di Iorio, A; Di Santo, E; Di Giuseppe, M; Felice, N; Litterio, P; Gabriele, A; Mancino, E; Manzoli, L; Maruotti, V; Mearelli, S; Molino, G; Monaco, D; Nuccetelli, F; Onofrj, M; Perfetti, B; Sacchet, C; Sensi, F; Sensi, S; Sucapane, P; Taylor, J P; Thomas, A; Viola, P; Viola, S; Zito, M; Zhuzhuni, H

    2013-06-01

    Ascertainment bias (AB) indicates a bias of an evaluation centre in estimating the prevalence/incidence of a disease due to the specific expertise of the centre. The aim of our study was to evaluate classification of different types of dementia in new cases appearing in secondary and tertiary centres, in order to evidence possible occurrence of AB in the various (secondary to tertiary) dementia centres. To assess the mechanism of AB, the rates of new cases of the different forms of dementia reported by different centres were compared. The centres involved in the study were 11 hospital-based centres including a tertiary centre, located in the University Department of Clinical Neurology. The tertiary centre is endowed with state-of-the-art diagnostic facilities and its scientific production is prominently focused on dementia with Lewy bodies (DLB) thus suggesting the possible occurrence of a bias. Four main categories of dementia were identified: Alzheimer's disease (AD), DLB, fronto-temporal dementia (FTD), vascular dementia (VaD), with other forms in a category apart. The classification rate of new cases of dementia in the tertiary centre was compared with rates reported by secondary centres and rates of recoding were calculated during a follow-up of 2 years. The study classified 2,042 newly diagnosed cases of dementia in a population of 1,370,000 inhabitants of which 315,000 were older than 65. AD was categorized in 48-52 % of cases, DLB in 25-28 %, FTD in 2-4 % and VaD in 17-28 %. During the 2-year follow-up the diagnosis was re-classified in 40 patients (3 %). The rate of recoding was 5 % in the tertiary centre, 2-8 % in referrals from secondary to tertiary centre, 2-10 % in recodings performed in secondary centres and addressed to tertiary centre. Recoding or percentages of new cases of AD or DLB were not different in the comparison between secondary or between secondary and tertiary centres. FTD and VaD were instead significantly recoded. The results

  20. Life Cycle Assessment of urban wastewater reuse with ozonation as tertiary treatment

    International Nuclear Information System (INIS)

    Munoz, Ivan; Rodriguez, Antonio; Rosal, Roberto; Fernandez-Alba, Amadeo R.

    2009-01-01

    Life Cycle Assessment has been used to compare different scenarios involving wastewater reuse, with special focus on toxicity-related impact categories. The study is based on bench-scale experiments applying ozone and ozone in combination with hydrogen peroxide to a wastewater effluent from a Spanish sewage treatment plant. Two alternative characterisation models have been used to account for toxicity of chemical substances, namely USES-LCA and EDIP97. Four alternative scenarios have been assessed: wastewater discharge plus desalination supply, wastewater reuse without tertiary treatment, wastewater reuse after applying a tertiary treatment consisting on ozonation, and wastewater reuse after applying ozonation in combination with hydrogen peroxide. The results highlight the importance of including wastewater pollutants in LCA of wastewater systems assessing toxicity, since the contribution of wastewater pollutants to the overall toxicity scores in this case study can be above 90%. Key pollutants here are not only heavy metals and other priority pollutants, but also non-regulated pollutants such as pharmaceuticals and personal care products. Wastewater reuse after applying any of the tertiary treatments considered appears as the best choice from an ecotoxicity perspective. As for human toxicity, differences between scenarios are smaller, and taking into account the experimental and modelling uncertainty, the benefits of tertiary treatment are not so clear. From a global warming potential perspective, tertiary treatments involve a potential 85% reduction of greenhouse gas emissions when compared with desalination

  1. Applied Operations Research: Operator's Assistant

    Science.gov (United States)

    Cole, Stuart K.

    2015-01-01

    NASA operates high value critical equipment (HVCE) that requires trouble shooting, periodic maintenance and continued monitoring by Operations staff. The complexity HVCE and information required to maintain and trouble shoot HVCE to assure continued mission success as paper is voluminous. Training on new HVCE is commensurate with the need for equipment maintenance. LaRC Research Directorate has undertaken a proactive research to support Operations staff by initiation of the development and prototyping an electronic computer based portable maintenance aid (Operator's Assistant). This research established a goal with multiple objectives and a working prototype was developed. The research identified affordable solutions; constraints; demonstrated use of commercial off the shelf software; use of the US Coast Guard maintenance solution; NASA Procedure Representation Language; and the identification of computer system strategies; where these demonstrations and capabilities support the Operator, and maintenance. The results revealed validation against measures of effectiveness and overall proved a substantial training and capability sustainment tool. The research indicated that the OA could be deployed operationally at the LaRC Compressor Station with an expectation of satisfactorily results and to obtain additional lessons learned prior to deployment at other LaRC Research Directorate Facilities. The research revealed projected cost and time savings.

  2. Operating experience

    International Nuclear Information System (INIS)

    McRae, L.P.; Six, D.E.

    1991-01-01

    In 1987, Westinghouse Hanford Company began operating a first-generation integrated safeguards system in the Plutonium Finishing Plant storage vaults. This Vault Safety and Inventory System is designed to integrate data into a computer-based nuclear material inventory monitoring system. The system gathers, in real time, measured physical parameters that generate nuclear material inventory status data for thousands of stored items and sends tailored report to the appropriate users. These data include canister temperature an bulge data reported to Plant Operations and Material Control and Accountability personnel, item presence and identification data reported to Material Control and Accountability personnel, and unauthorized item movement data reported to Security response forces and Material Control and Accountability personnel. The Westinghouse Hanford Company's experience and operational benefits in using this system for reduce radiation exposure, increase protection against insider threat, and real-time inventory control are discussed in this paper

  3. Operator companion

    International Nuclear Information System (INIS)

    Natalizio, A.; Anderson, J.W.D.; Sills, H.E.

    1988-01-01

    Abundant, cheap computing power has provided industry with a far greater opportunity than was available one or two decades ago to automate industrial processes and to improve the man-machine interface. Exciting innovations in knowledge representation methods arising from artificial intelligence research pave the way for advanced support systems for assisting plant operators. AECL has recognized the importance of knowledge based system technology, particularly expert systems, in the achievement of this objective and also, as a strategic technology to be fully exploited in the next generation of CANDU reactors. Operator Companion, an expert system intended to diagnose plant faults and advise the operator on appropriate restoring or corrective actions, is a major undertaking which is receiving support within the research and engineering groups of AECL

  4. Operative arthroscopy.

    Science.gov (United States)

    Guhl, J F

    1979-01-01

    In a period of 20 months, over 200 patients (age ranged from high school students to middle-aged persons) with knee injuries were treated by operative arthroscopy. The majority of the injuries were incurred while the patients had been participating in athletic events, either competitive or recreational. Operative arthroscopy offers the advantage of shortened hospital stay, rapid rehabilitation, lack of disfiguring scar, and reduced costs. Patients are followed yearly after the first postoperative year. Improved long-term results from diagnostic and operative arthroscopy, as compared to conventional surgical procedures, are expected. The proof of those expectations will be determined in the next several years as this group of patients requiring partial meniscectomies or procedures for pathologic and degenerative conditions is reevaluated.

  5. Tertiary-amine-containing thermo- and pH-sensitive hydrophilic ABA triblock copolymers: effect of different tertiary amines on thermally induced sol-gel transitions.

    Science.gov (United States)

    Henn, Daniel M; Wright, Roger A E; Woodcock, Jeremiah W; Hu, Bin; Zhao, Bin

    2014-03-11

    This Article reports on the synthesis of a series of well-defined, tertiary-amine-containing ABA triblock copolymers, composed of a poly(ethylene oxide) (PEO) central block and thermo- and pH-sensitive outer blocks, and the study of the effect of different tertiary amines on thermally induced sol-gel transition temperatures (T(sol-gel)) of their 10 wt % aqueous solutions. The doubly responsive ABA triblock copolymers were prepared from a difunctional PEO macroinitiator by atom transfer radical polymerization of methoxydi(ethylene glycol) methacrylate and ethoxydi(ethylene glycol) methacrylate at a feed molar ratio of 30:70 with ∼5 mol % of either N,N-diethylaminoethyl methacrylate (DEAEMA), N,N-diisopropylaminoethyl methacrylate, or N,N-di(n-butyl)aminoethyl methacrylate. The chain lengths of thermosensitive outer blocks and the molar contents of tertiary amines were very similar for all copolymers. Using rheological measurements, we determined the pH dependences of T(sol-gel) of 10 wt % aqueous solutions of these copolymers in a phosphate buffer. The T(sol-gel) versus pH curves of all polymers exhibited a sigmoidal shape. The T(sol-gel) increased with decreasing pH; the changes were small on both high and low pH sides. At a specific pH, the T(sol-gel) decreased with increasing the hydrophobicity of the tertiary amine, and upon decreasing pH the onset pH value for the T(sol-gel) to begin to increase noticeably was lower for the more hydrophobic tertiary amine-containing copolymer. In addition, we studied the effect of different tertiary amines on the release behavior of FITC-dextran from 10 wt % micellar gels in an acidic medium at 37 and 27 °C. The release profiles for three studied hydrogels at 37 °C were essentially the same, suggesting that the release was dominated by the diffusion of FITC-dextran. At 27 °C, the release was significantly faster for the DEAEMA-containing copolymer, indicating that both diffusion and gel dissolution contributed to the

  6. Analysis of 1014 consecutive operative cases to determine the utility of intraoperative neurophysiological data

    OpenAIRE

    Hussain, Namath Syed

    2015-01-01

    Introduction: Intraoperative neurophysiological monitoring (IOM) during neurosurgical procedures has become the standard of care at tertiary care medical centers. While prospective data regarding the clinical utility of IOM are conspicuously lacking, retrospective analyses continue to provide useful information regarding surgeon responses to reported waveform changes. Methods: Data regarding clinical presentation, operative course, IOM, and postoperative neurological examination were compiled...

  7. Accelerator operations

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    This section is concerned with the operation of both the tandem-linac system and the Dynamitron, two accelerators that are used for entirely different research. Developmental activities associated with the tandem and the Dynamitron are also treated here, but developmental activities associated with the superconducting linac are covered separately because this work is a program of technology development in its own right

  8. Operating Systems

    Indian Academy of Sciences (India)

    areas in which this type is useful are multimedia, virtual reality, and advanced scientific projects such as undersea exploration and planetary rovers. Because of the expanded uses for soft real-time functionality, it is finding its way into most current operating systems, including major versions of Unix and Windows NT OS.

  9. Peace Operations

    National Research Council Canada - National Science Library

    Lewis, William

    1995-01-01

    .... Indeed, despite the energetic leadership of Under Secretary-General Kofi R. Annan who directs the Department of Peacekeeping Operations, the organization has increasing difficulty in acquiring properly trained and equipped forces in time to intervene in conflict situations and humanitarian crises.

  10. Operational Circulars

    CERN Multimedia

    2003-01-01

    Operational Circular N° 4 - April 2003 Conditions for use by members of the CERN personnel of vehicles belonging to or rented by CERN - This circular has been drawn up. Operational Circular N° 5 - October 2000 Use of CERN computing facilities - Further details on the personal use of CERN computing facilities Operational Circular N° 5 and its Subsidiary Rules http://cern.ch/ComputingRules defines the rules for the use of CERN computing facilities. One of the basic principles governing such use is that it must come within the professional duties of the user concerned, as defined by the user's divisional hierarchy. However, personal use of the computing facilities is tolerated or allowed provided : a) It is in compliance with Operational Circular N° 5 and not detrimental to official duties, including those of other users; b) the frequency and duration is limited and there is a negligible use of CERN resources; c) it does not constitute a political, commercial and/or profit-making activity; d) it is not...

  11. Operation Context

    DEFF Research Database (Denmark)

    Stüben, Henning; Tietjen, Anne

    2006-01-01

    Abstract: This paper seeks to challenge the notion of context from an operational perspective. Can we grasp the forces that shape the complex conditions for an architectural or urban design within the notion of context? By shifting the gaze towards the agency of architecture, contextual analysis...

  12. Operational indicators

    International Nuclear Information System (INIS)

    2010-01-01

    The chapter presents the operational indicators related to budget, travel costs and tickets, the evolution of the annual program for regulatory inspection, the scientific production, requested patents and the numbers related to the production of the services offered by the Institution

  13. Study of tertiary creep instability in several elevated-temperature structural materials

    International Nuclear Information System (INIS)

    Booker, M.K.; Sikka, V.K.

    1978-01-01

    Data for a number of common elevated temperature structural materials have been analyzed to yield mathematical predictions for the time and strain to tertiary creep at various rupture lives and temperatures. Materials examined include types 304 and 316 stainless steel, 2 1/4 Cr-1 Mo steel, alloy 800H, alloy 718, Hastelloy alloy X, and ERNiCr--3 weld metal. Data were typically examined over a range of creep temperatures for rupture lives ranging from less than 100 to greater than 10,000 hours. Within a given material, trends in these quantities can be consistently described, but it is difficult to directly relate the onset of tertiary creep to failure-inducing instabilities. A series of discontinued tests for alloy 718 at 649 and 620 0 C showed that the material fails by intergranular cracking but that no significant intergranular cracking occurs until well after the onset of tertiary creep

  14. Early Tertiary magmatism and probable Mesozoic fabrics in the Black Mountains, Death Valley, California

    Science.gov (United States)

    Miller, Martin G.; Friedman, Richard M.

    1999-01-01

    We report two early Tertiary U-Pb zircon ages for pegmatite from the Black Mountains of Death Valley, California. These ages, 54.7 ± 0.6 Ma and 56 ± 3 Ma, are unique for much of southeastern California. The samples belong to a pegmatite suite that occupies part of the footwall of the Badwater turtleback, a late Tertiary extensional feature; similar but undated pegmatite intrudes the footwalls of the Copper Canyon and Mormon Point turtlebacks farther south. The pegmatite suite demonstrates that fabric development on the turtlebacks was at least a two-stage process. Fabrics cut by these pegmatites likely formed during the Mesozoic, whereas those that involve them formed during late Tertiary extension.

  15. Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas.

    Science.gov (United States)

    Huotari, Tiina; Antikainen, Harri; Keistinen, Timo; Rusanen, Jarmo

    2017-06-01

    The determination of an appropriate catchment area for a hospital providing highly specialized (i.e. tertiary) health care is typically a trade-off between ensuring adequate client volumes and maintaining reasonable accessibility for all potential clients. This may pose considerable challenges, especially in sparsely inhabited regions. In Finland, tertiary health care is concentrated in five university hospitals, which provide services in their dedicated catchment areas. This study utilizes Geographic Information Systems (GIS), together with grid-based population data and travel-time estimates, to assess the spatial accessibility of these hospitals. The current geographical configuration of the hospitals is compared to a normative assignment, with and without capacity constraints. The aim is to define optimal catchment areas for tertiary hospitals so that their spatial accessibility is as equal as possible. The results indicate that relatively modest improvements can be achieved in accessibility by using normative assignment to determine catchment areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Electronically implemented clinical indicators based on a data warehouse in a tertiary hospital: its clinical benefit and effectiveness.

    Science.gov (United States)

    Yoo, Sooyoung; Kim, Seok; Lee, Kee-Hyuck; Jeong, Chang Wook; Youn, Sang Woong; Park, Kyoung Un; Moon, So Young; Hwang, Hee

    2014-07-01

    Assessing and monitoring care and service using clinical indicators (CIs) can allow the measurement of and lead to improvements in the quality of care. However, the management and maintenance of CI data has been shown to be difficult because the data are usually collected and provided manually. In this study, for the purpose of efficient managing quality indicators, a data warehouse (DW)-based CI monitoring system was developed. The clinical effectiveness and efficiency of a DW-based CI monitoring was investigated through several case studies of the system's operation at a tertiary hospital. This study analyzed the CIs that have been developed over the past 8 years at a 1340-bed tertiary general university hospital in South Korea to improve and monitor the quality of care and patient safety. The hospital was opened as a fully digital hospital in 2003, and the CIs were computerized in 2005 by implementing a DW-based CI monitoring system. We classified the computerized CIs and evaluated the monitoring results for several representative CIs, such as the optimal prescribing of preventive antibiotics, the average length of stay, the mortality rate, and the rehospitalization rate. During the development of the system in 2005, 12 of 19 CIs were computerized, and this number gradually increased until 299 of 335 CIs were computerized by 2012. In addition, among the CIs built computationally through the CI task force team, focal CIs subject to monitoring were selected annually, and the results of this monitoring were shared with all of the staff or the related department and its staff. By providing some examples of our CI monitoring results, we showed the feasibility of improving the quality of care, and maintaining the optimum level of patient care with less labor. The results of this study provide evidence regarding the clinical effectiveness and efficiency as well as the systems operation experience of a DW-based CI monitoring system. These findings may aid medical

  17. Caesarean delivery-related blood transfusion: correlates in a tertiary hospital in Southwest Nigeria.

    Science.gov (United States)

    Akinlusi, Fatimat M; Rabiu, Kabiru A; Durojaiye, Idayat A; Adewunmi, Adeniyi A; Ottun, Tawaqualit A; Oshodi, Yusuf A

    2018-01-10

    Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011. A comparison was made between 188 women who underwent blood transfusion and 718 who did not. Data were obtained on a daily basis by investigators from patients, clinical notes and referral letters using structured pre-tested data collecting form. Socio-demographic characteristics; antenatal, perioperative and intraoperative details; blood loss; transfusion; and puerperal observations were recorded. EPI-Info statistical software version 3.5.3 was used for multivariable analysis to determine independent risk factors for blood transfusion. Of the 2134 deliveries during the study period, 906 (42.5%) had caesarean deliveries and of which 188 (20.8%) were transfused. The modal unit of blood transfused was 3 pints (41.3%). The most common indication for caesarean section was cephalo-pelvic disproportion (25.7%).The independent risk factors for blood transfusion at caesarean section were second stage Caesarean Section (aOR = 76.14, 95% CI = 1.25-4622.06, p = 0.04), placenta previa (aOR = 32.57, 95% CI = 2.22-476.26, p = 0.01), placental abruption (aOR = 25.35, 95% CI = 3.06-211.02, p blood transfusion (aOR = 0.24, 95% CI = 0.09-0.61, p = 0.0024). The overall risk of blood transfusion in cesarean delivery is high. Paturients with the second stage Caesarean section, placenta previa, abruptio placentae and

  18. Functional outcome transforaminal lumbar inter body fusion: an experience at a tertiary care centre

    International Nuclear Information System (INIS)

    Talha, M.; Qureshi, M.A.

    2016-01-01

    Objective: To assess functional outcome of transforaminal lumbar inter body fusion (TLIF) with specific reference to improvement in pain by visual analogue score (VAS) and Oswestry disability index (ODI). Study Design: Quasi-experimental study. Place and Duration of Study: The study was conducted at the Department of Spine Surgery of a tertiary care hospital in Rawalpindi from May 2004 to May 2013. Material and Methods: Thirty nine patients who underwent TLIF and completed one year of follow up in our department during the study period were included in the study. Cases were evaluated clinically and radiologically preoperatively and assessed for pain with VAS and general well being with ODI. After TLIF they were reassessed at 1, 3, 6 months and 1 year for improvement in VAS and ODI. Patient satisfaction and work status after surgery was also recorded at 1 year of follow up. Results: Out of 39 cases 19(48.7 percent) were operated for degenerated disc disease (DDD), 11(28.2 percent) for spinal stenosis and 7(17.9 percent) for spondylolisthesis and 2(5.2 percent) for trauma. A total of 28(71.79 percent) were males and 11(28.21 percent) were females. Common levels operated were 12 (30.8 percent) at L4-5, 11 (28.2 percent) at L5-S1, and 12(30.8 percent) at L4,5-S1, 2(5.1 percent) at L2-4 and 1(2.6 percent) each at L3-4 and L3-5. At 1 year of follow up median VAS score improved significantly from 7 to 2 and median ODI improved significantly from 76 to 34. Regarding patient satisfaction 26 (66.7 percent) patients were satisfied, 9 (23.1 percent) were partially satisfied and 4 (10.2 percent) were not satisfied with the surgical outcome. Conclusion: TLIF is a safe and effective procedure for reducing chronic low back pain as a result of DDD, instability and spondylolisthesis. (author)

  19. Provision of an emergency theatre in tertiary hospitals is cost ...

    African Journals Online (AJOL)

    Background. Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital. Objectives. To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions. Methods. We did a prospective descriptive study of ...

  20. Influence of income on tertiary students acquisition of cellular products

    Directory of Open Access Journals (Sweden)

    G. A.P Drotsky

    2007-12-01

    Full Text Available Purpose: The purpose of the article is to determine whether there are any differences between high and low-income group students in their selection of a cellular phone brand or network operator. Design/Methodology/Approach: Four hypotheses are set to determine if there are any significant differences between the two income groups in current decision-making. It is established that there exist no significant difference between high and low-income students in their selection of cellular phones and network operators. The levels of agreement or disagreement on various statements do, however, give an indication of the importance that students place on aspects that they view as important when acquiring a cellular phone or network operator. Findings: In the article, it is established that no significant differences exist between the two income groups. The levels of agreement or disagreement indicate the importance that subscription method, social value, service quality and branding has on student decision-making. Implications: The article provides a better understanding of the influence that income plays in student's decision-making in acquiring cellular products and services. Possible future research in student cellular usage can be guided through the information obtained in this article. Originality/Value: The article provides information to cellular network operators, service providers and cellular phone manufactures regarding the influence of income on students' acquisition of cellular products and services. Information from the article can assist in the establishment of marketing plans for the student market by these role players.

  1. Mechanical small bowel obstruction in children at a tertiary care ...

    African Journals Online (AJOL)

    The operative procedures performed included enterotomy in 37 (29.3%), milking of worms in 18 (14.2%), resection anastomosis in 31 (24.6%) and adhesiolysis in 13 (10.3%). Appendicular perforation was seen in 4 (1.9%) and worm in gall bladder in 1 (0.5%) patients. Surgical complications were wound infection in 18 ...

  2. Tertiary Education in the 21st Century: Challenges and Opportunities.

    Science.gov (United States)

    Salmi, Jamil

    2001-01-01

    Examines new challenges characterizing the environment in which higher education institutions operate and compete. Explores concrete implications of these challenges in terms of changing institutional forms and new ways of delivering higher education programs, looking at promising trends and experiences in countries and institutions which have…

  3. Tertiary paediatric emergency department use in children and young people with cerebral palsy.

    Science.gov (United States)

    Meehan, Elaine; Reid, Susan M; Williams, Katrina; Freed, Gary L; Babl, Franz E; Sewell, Jillian R; Rawicki, Barry; Reddihough, Dinah S

    2015-10-01

    The aim of this study was to describe the pattern of tertiary paediatric emergency department (ED) use in children and young people with cerebral palsy (CP). A retrospective analysis of ED data routinely collected at the two tertiary paediatric hospitals in Victoria, Australia, cross-matched with the Victorian Cerebral Palsy Register. Data pertaining to the ED presentations of 2183 registered individuals born 1993-2008 were obtained. Between 2008 and 2012, 37% (n = 814) of the CP cohort had 3631 tertiary paediatric ED presentations. Overall, 40% (n = 332) of presenters were residing in inner metropolitan Melbourne; 44% (n = 356) in outer Melbourne; and 13% (n = 108) in regional Victoria. Presenters were more likely than non-presenters to be younger, non-ambulant and have epilepsy. In total, 71% of presentations were triaged as Australasian Triage Scale 1-3 (urgent), and 44% resulted in a hospital admission. Disorders of the respiratory, neurological and gastrointestinal systems, and medical device problems were responsible for 72% of presentations. Many of the tertiary paediatric ED presentations in this group were appropriate based on the high admission rate and the large proportion triaged as urgent. However, there is evidence that some families are bypassing local services and travelling long distances to attend the tertiary paediatric ED, even for less urgent complaints that do not require hospital admission. Alternative pathways of care delivery, and strategies to promote the management of common problems experienced by children and young people with CP in non-paediatric EDs or primary care settings, may go some way towards reducing unnecessary tertiary paediatric ED use in this group. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. Chemical Properties, Decomposition, and Methane Production of Tertiary Relict Plant Litters: Implications for Atmospheric Trace Gas Production in the Early Tertiary

    Science.gov (United States)

    Yavitt, J. B.; Bartella, T. M.; Williams, C. J.

    2006-12-01

    Throughout the early Tertiary (ca. 65-38 Ma) Taxodiaceae-dominated (redwood) wetland forests occupied the high latitudes and were circumpolar in their distribution. Many of these forests had high standing biomass with moderate primary productivity. The geographic extent and amount of Tertiary coals and fossil forests throughout Arctic Canada suggests large areas of wetland forests that may have cycled substantial quantities of carbon, particularly methane until they were replaced by cold tolerant Pinus, Picea, and Larix following climatic cooling associated with the Terminal Eocene Event. To test this hypothesis we compared physiochemical properties, decomposition, and trace gas production of litter from extant Metasequoia, Pinus, Picea, and Larix. Initial results from plantation-grown trees indicate Metasequoia litter is a better source of labile organic substrate than pinaceous litter. Metasequoia litter contained the least lignin and highest amounts of water-soluble compounds of the four litter types studied. Analysis of the lignin structure using cupric oxide oxidation indicates that Metasequoia lignin is enriched in 4'-hydroxyacetophenone and 4'- Hydroxy-3'-methoxyacetophenone relative to the pinaceous litter. In a 12-month decomposition study using litterbags, average litter mass loss was greater for Metasequoia litter (62%) compared to the pinaceous species (50%). Moreover, Metasequoia litter incubated under anoxic conditions produced nearly twice as much CO2 (ca. 4.2 umol/g.day) and CH4 (2.1 umol/g.day) as the pinaceous litter (2.4 umol/g.day for CO2; 1.2 umol/g.day for CH4). Our results support the idea of greater decomposability and palatability of Metasequoia litter as compared to Larix, Picea, or Pinus. Provided that the biochemical properties of Metasequoia have remained relatively stable through geologic time, it appears that early Tertiary Metasequoia-dominated wetland forests may have had higher microbial driven trace gas production than the

  5. Palynological and iridium anomalies at Cretaceous-Tertiary boundary, south-central Saskatchewan

    Science.gov (United States)

    Nichols, D.J.; Jarzen, D.M.; Orth, C.J.; Oliver, P.Q.

    1986-01-01

    The Cretaceous-Tertiary boundary in south-central Saskatchewan is marked by coincident anomalies in abundance of iridium and fern spores at the extinction level of a suite of Cretaceous pollen taxa. Evidence of disruption of the terrestrial flora includes the fern-spore abundance anomaly and local extinction of as much as 30 percent of angiosperm species. The reorganized earliest Tertiary flora is made up largely of surviving species that assumed new roles of dominance. Persistence of climatically sensitive taxa across the boundary indicates that if paleoclimate was altered by the terminal Cretaceous event, it returned quickly to the pre-event condition.

  6. Tandem catalytic allylic amination and [2,3]-Stevens rearrangement of tertiary amines.

    Science.gov (United States)

    Soheili, Arash; Tambar, Uttam K

    2011-08-24

    We have developed a catalytic allylic amination involving tertiary aminoesters and allylcarbonates, which is the first example of the use of tertiary amines as intermolecular nucleophiles in metal-catalyzed allylic substitution chemistry. This process is employed in a tandem ammonium ylide generation/[2,3]-rearrangement reaction, which formally represents a palladium-catalyzed Stevens rearrangement. Low catalyst loadings and mild reaction conditions are compatible with an unprecedented substrate scope for the ammonium ylide functionality, and products are generated in high yields and diastereoselectivities. Mechanistic studies suggested the reversible formation of an ammonium intermediate.

  7. Study on tertiary in-situ leachable uranium mineralization conditions in South Songliao basin

    International Nuclear Information System (INIS)

    Zhang Zhenqiang; Li Guokuan; Zhao Zonghua; Zhang Jingxun

    2001-01-01

    Tertiary in-situ leachable mineralization in Songliao Basin was analyzed in theory in the past. Since 1998, regional investigation at 1:200000 scale has been done with about 120 holes drilled. Based on drill holes recording, section compiling and sample analysis, the authors investigate into the Tertiary in-situ leachable conditions including rock character, sedimentary facies, rock chemistry, organic substances, uranium content, sandstone porosity, sandstone bodies, interlayer oxidation, and hydro-dynamic value. The study would play important role in prospecting for in-situ leachable uranium in South Songliao basin

  8. A Critique of Singaporean Internal Tertiary Education Programmes offered by Private Colleges: A Brief Comparison with Ireland

    Directory of Open Access Journals (Sweden)

    Sherin Batcha

    2015-06-01

    cases where QA procedures are not implemented, there can be little confidence among stakeholders in respect of the quality of the programme and standards may be arbitrary. Quality assurance of Irish higher education is coordinated through Qualifications and Quality Ireland (QQI, a state body responsible for the review of institutions who usually operate their own quality assurance systems. In some cases, QQI takes direct responsibility for quality assurance within smaller institutions, while also taking direct responsibility in other education sectors, such as the further education sector. There is a widely held perception amongst stakeholders in higher education in Singapore that internal programmes in tertiary education offer lower quality than the external tertiary programmes which are affiliated to well-established, mainly British, universities. Many factors have influenced this view, leading to its reinforcement and wide acceptance. These factors are discussed here and a simple but telling case study is offered. The practices of private colleges running their own internal Diploma and Advanced Diploma programmes are evaluated by observing specific situations. Comparisons are made with similar practices of colleges that run external Diploma and Advanced Diploma programmes under the auspices of UK universities and practices followed in private colleges and institutes of technology in Ireland. In conclusion, the need for uniform quality procedures across the Singaporean higher education system is highlighted and some necessary steps in achieving this requirement are advanced.

  9. Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance.

    Science.gov (United States)

    Schmidt, C; Potter, N; Porceddu, S; Panizza, B

    2017-07-01

    Olfactory neuroblastoma is a rare sinonasal malignancy, with poorly defined treatment protocols. Management at a tertiary centre was retrospectively evaluated to inform future treatment and follow up. Cases treated with curative intent (2000-2014) were included. Data were collected, and overall and disease-free survival rates were calculated. Eleven cases were identified, with a median follow up of 87 months. One patient was Kadish stage A, one was stage B, eight were stage C and one was stage D. The latter patient underwent chemoradiotherapy alone. The remaining patients proceeded to: endoscopic-assisted wide local excision (n = 2), anterior craniofacial resection (n = 4) or endoscopic craniofacial resection (n = 4). No patients had primary nodal disease or elective neck treatment. One patient had neoadjuvant chemoradiation. Six patients had post-operative radiotherapy; three received adjuvant chemotherapy. Two patients had late cervical node failure, and proceeded to neck dissection and post-operative radiotherapy. Two patients had late local recurrence. Ten-year overall and disease-free survival rates were 68.2 and 46.7 per cent, respectively. Longer-term follow up is supported given the incidence of late regional and local recurrence. Prophylactic treatment of cervical nodes in locally advanced disease is an area for further investigation.

  10. Health Risk Assessment for Inhalation Exposure to Methyl Tertiary Butyl Ether at Petrol Stations in Southern China.

    Science.gov (United States)

    Hu, Dalin; Yang, Jianping; Liu, Yungang; Zhang, Wenjuan; Peng, Xiaowu; Wei, Qinzhi; Yuan, Jianhui; Zhu, Zhiliang

    2016-02-06

    Methyl tertiary butyl ether (MTBE), a well known gasoline additive, is used in China nationwide to enhance the octane number of gasoline and reduce harmful exhaust emissions, yet little is known regarding the potential health risk associated with occupational exposure to MTBE in petrol stations. In this study, 97 petrol station attendants (PSAs) in southern China were recruited for an assessment of the health risk associated with inhalation exposure to MTBE. The personal exposure levels of MTBE were analyzed by Head Space Solid Phase Microextraction GC/MS, and the demographic characteristics of the PSAs were investigated. Cancer and non-cancer risks were calculated with the methods recommended by the United States Environmental Protection Agency. The results showed that the exposure levels of MTBE in operating workers were much higher than among support staff (p < 0.01) and both were lower than 50 ppm (an occupational threshold limit value). The calculated cancer risks (CRs) at the investigated petrol stations was 0.170 to 0.240 per 10⁶ for operating workers, and 0.026 to 0.049 per 10⁶ for support staff, which are below the typical target range for risk management of 1 × 10(-6) to 1 × 10(-4); The hazard quotients (HQs) for all subjects were <1. In conclusion, our study indicates that the MTBE exposure of PSAs in southern China is in a low range which does not seem to be a significant health risk.

  11. Health Risk Assessment for Inhalation Exposure to Methyl Tertiary Butyl Ether at Petrol Stations in Southern China

    Directory of Open Access Journals (Sweden)

    Dalin Hu

    2016-02-01

    Full Text Available Methyl tertiary butyl ether (MTBE, a well known gasoline additive, is used in China nationwide to enhance the octane number of gasoline and reduce harmful exhaust emissions, yet  little is known regarding the potential health risk associated with occupational exposure to MTBE in petrol stations. In this study, 97 petrol station attendants (PSAs in southern China were recruited for an assessment of the health risk associated with inhalation exposure to MTBE. The personal exposure levels of MTBE were analyzed by Head Space Solid Phase Microextraction GC/MS, and the demographic characteristics of the PSAs were investigated. Cancer and non-cancer risks were calculated with the methods recommended by the United States Environmental Protection Agency. The results showed that the exposure levels of MTBE in operating workers were much higher than among support staff (p < 0.01 and both were lower than 50 ppm (an occupational threshold limit value. The calculated cancer risks (CRs at the investigated petrol stations was 0.170 to 0.240 per 106 for operating workers, and 0.026 to 0.049 per 106 for support staff, which are below the typical target range for risk management of 1 × 10−6 to 1 × 10−4; The hazard quotients (HQs for all subjects were <1. In conclusion, our study indicates that the MTBE exposure of PSAs in southern China is in a low range which does not seem to be a significant health risk.

  12. Site operations

    International Nuclear Information System (INIS)

    House, W.B.; Ebenhack, D.G.

    1989-01-01

    This chapter is a discussion of the management and operations practices used at the Barnwell Waste Management Facility in Barnwell, SC. The following topics are discussed: (1) Waste receiving and inspection, including manifest and certificates of compliance, radiological surveys, disposition of nonconforming items, and decontamination and disposition of secondary waste streams; (2) Waste disposal, including Title 10 CFR 61 requirements, disposal area evaluations, shipment offloading, container emplacement, and radiation protection; (3) Trench closure, including trench backfilling, trench capping, and permanent markers; (4) Site maintenance and stabilization, including trench maintenance, surface water management, and site closure activities; (5) Site monitoring programs, including operational monitoring, and environmental monitoring program; (6) Personnel training and qualifications, including basic training program, safety training program, special skills training, and physical qualifications; (7) Records management, including waste records, personnel training records, personnel dosimetry records, site monitoring records, trench qualification and construction records, and site drawings and stabilization records; (8) Site security; (9) Emergency response plans; and (10) Quality assurance

  13. Operators perspective

    International Nuclear Information System (INIS)

    Scragg, D.M.

    1991-01-01

    There are very few Energy from Municipal Waste processing plants in the U.K. Those which were built have usually been financed and operated by Local Authorities and are now in excess of 17 years old. The Environmental Protection Act and constraints on Public Sector spending have brought about fundamental changes in the approach taken to developing new schemes of this kind. The Public Sector and the Private Sector must work together. The investment in Mass Burning Incineration Schemes generating energy is high and the pressures to keep the waste disposal costs as low as possible mean that recovery of the investment needs to be spread over many years. For any Scheme to be successful and financially viable requires a long term commitment on the part of those involved. This paper sets out the key role which the Operating Contractor can play in this situation. (author)

  14. Operating Cigeo

    International Nuclear Information System (INIS)

    Launeau, F.

    2016-01-01

    The CIGEO facility dedicated to the geological disposal of high- and intermediate-level radioactive wastes will be composed of 2 parts: an underground facility at a depth of 500 m to dispose the waste packages in tunnels and a surface facility to take delivery of the wastes and prepare the packages. The underground facility will be built progressively and will cover a surface of 15 km 2 at the end of Cigeo operating-life. A large part of the surface facility (located a few km away from the waste reception place) will be dedicated to the works led deep underground to build the tunnels and will receive drilling cuttings. The article describes also the ramp and carts to lead waste packages underground. Most of the operations will be automated. The definitive closure of the tunnels will be made with swelling clay and concrete plugs. (A.C.)

  15. Operation Poorman

    International Nuclear Information System (INIS)

    Pruvost, N.; Tsitouras, J.

    1981-01-01

    The objectives of Operation Poorman were to design and build a portable seismic system and to set up and use this system in a cold-weather environment. The equipment design uses current technology to achieve a low-power, lightweight system that is configured into three modules. The system was deployed in Alaska during wintertime, and the results provide a basis for specifying a mission-ready seismic verification system

  16. Tertiary Students' ICT Self-Efficacy Beliefs and the Factors Affecting Their ICT-Use

    Science.gov (United States)

    Turel, Vehbi; Calik, Sinan; Doganer, Adem

    2015-01-01

    This study looked at tertiary (i.e. undergraduate /a four-year degree) students' information and communication technology (ICT) self-efficacy beliefs and their level in use of certain common programmes at a newly established (i.e. 2007) university in Turkey in the spring of 2012. The study examined the tertiary students' (a) demographic…

  17. Assessing Readiness for Integration of Electronic Learning into Business Education Programmes in Tertiary Institutions in Ebonyi State

    Science.gov (United States)

    Nwagwu, Lazarus; Azih, Nonye

    2015-01-01

    The study was conducted to assess readiness for integration of electronic learning into business education programmes in tertiary institutions in Ebonyi State. Two research questions and two hypotheses guided the study. The population was 37 business education lecturers and 748 Business Education Students in tertiary institutions that offer…

  18. Expanding the Range of the First Step to Success Intervention: Tertiary-Level Support for Children, Teachers, and Families

    Science.gov (United States)

    Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike

    2015-01-01

    This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary FirstStep was developed to engage families more effectively and influence and improve parenting practices for children having challenging…

  19. Extent of Information and Communication Technology (ICT) Utilization for Students' Learning in Tertiary Institutions in Ondo State, Nigeria

    Science.gov (United States)

    Victor, Akinfolarin Akinwale; Bolanle, Rufai Rukayat

    2017-01-01

    This study investigated the extent of information and communication technology (ICT) utilization for students' learning in Ondo State tertiary institutions. The research design was descriptive survey. The target population comprises of all students in tertiary institutions of learning in Ondo State. A sample of two hundred (200) undergraduate…

  20. The Incidence and Management of Conflicts in Secular and Non-Secular Tertiary Institutions in South West Nigeria

    Science.gov (United States)

    Ayodele, Joseph Babatola; Adewumi, Joseph Olukayode

    2007-01-01

    This paper compared the incidence and management of conflicts in secular and non-secular tertiary institutions in Nigeria. The sample of this study was made of sixty staff, and two hundred and forty students randomly selected each from two secular and two non-secular tertiary institutions in south western Nigeria. A validated questionnaire was…

  1. Identification of tertiary butyl alcohol (TBA)-utilizing organisms in BioGAC reactors using 13C-DNA stable isotope probing.

    Science.gov (United States)

    Aslett, Denise; Haas, Joseph; Hyman, Michael

    2011-09-01

    Biodegradation of the gasoline oxygenates methyl tertiary-butyl ether (MTBE) and ethyl tertiary-butyl ether (ETBE) can cause tertiary butyl alcohol (TBA) to accumulate in gasoline-impacted environments. One remediation option for TBA-contaminated groundwater involves oxygenated granulated activated carbon (GAC) reactors that have been self-inoculated by indigenous TBA-degrading microorganisms in ground water extracted from contaminated aquifers. Identification of these organisms is important for understanding the range of TBA-metabolizing organisms in nature and for determining whether self-inoculation of similar reactors is likely to occur at other sites. In this study (13)C-DNA-stable isotope probing (SIP) was used to identify TBA-utilizing organisms in samples of self-inoculated BioGAC reactors operated at sites in New York and California. Based on 16S rRNA nucleotide sequences, all TBA-utilizing organisms identified were members of the Burkholderiales order of the β-proteobacteria. Organisms similar to Cupriavidus and Methylibium were observed in both reactor samples while organisms similar to Polaromonas and Rhodoferax were unique to the reactor sample from New York. Organisms similar to Hydrogenophaga and Paucibacter strains were only detected in the reactor sample from California. We also analyzed our samples for the presence of several genes previously implicated in TBA oxidation by pure cultures of bacteria. Genes Mpe_B0532, B0541, B0555, and B0561 were all detected in (13)C-metagenomic DNA from both reactors and deduced amino acid sequences suggested these genes all encode highly conserved enzymes. One gene (Mpe_B0555) encodes a putative phthalate dioxygenase-like enzyme that may be particularly appropriate for determining the potential for TBA oxidation in contaminated environmental samples.

  2. Source of sulphur in the Ebro Basin (Northern Spain). Tertiary nonmarine evaporite deposits as evidenced by sulphur isotopes

    International Nuclear Information System (INIS)

    Birnbaum, S.J.; Coleman, D.

    1979-01-01

    The Ebro Basin is an intermontane basin, located in northern Spain, filled with Tertiary (largely Oligocene and Miocene) elastic and chemical deposits. Sulphur isotopes are utilized to determine the source of sulphur in the sulphate deposits (predominantly gypsum with accessory thenardite, mirabolite and epsomite). Data obtained from Tertiary gypsum rocks produce a range of delta 34 S values from +9.16% to + 14.02% with a mean of +13.61%. Data obtained from Triassic gypsum rocks (in source area) produce a range from +13.73% to +15.14%, with a mean of +14.66%. Values for Tertiary marine water range from +18% to +24%. These data indicate a nonmarine origin for sulpur within the Tertiary sulphate rocks. The contribution of Triassic sulphur to the groundwater system, plus varying degrees of dilution by isotopically lighter (atmospheric and sulphide) sulphur, best explains the isotopic ratios observed in the Tertiary Basin deposits. (Auth.)

  3. Contact allergy to chlorhexidine in a tertiary dermatology clinic in Denmark

    DEFF Research Database (Denmark)

    Opstrup, Morten S; Johansen, Jeanne D; Zachariae, Claus

    2016-01-01

    cause the contact allergy, and whether accidental re-exposure occurs in some patients. OBJECTIVES: To estimate the prevalence of chlorhexidine contact allergy in a tertiary dermatology clinic in Denmark; to investigate whether patch testing with both chlorhexidine diacetate and chlorhexidine digluconate...

  4. Ghostwriters Guaranteeing Grades? The Quality of Online Ghostwriting Services Available to Tertiary Students in Australia

    Science.gov (United States)

    Lines, Lisa

    2016-01-01

    Ghostwriting is difficult to detect, it has the potential to be high quality, and universities do not currently have adequate policies in place to police it. Determining the quality of the ghostwriting services available to tertiary students is of vital importance because underestimating the potential for students to use these services to pass…

  5. The Underestimated Relevance and Value of Vocational Education in Tertiary Education--Making the Invisible Visible

    Science.gov (United States)

    Hippach-Schneider, Ute; Schneider, Verena; Ménard, Boris; Tritscher-Archan, Sabine

    2017-01-01

    Increasing the number of tertiary graduates has been a priority on the political agenda of the EU for some years. The focus has mainly been on academic courses though, with less emphasis on the role of vocational education and training. International educational statistics indeed show a clear increase in the number of persons completing tertiary…

  6. Word-of-Mouth amongst Students at a New Zealand Tertiary Institution

    Science.gov (United States)

    Warring, Susan

    2013-01-01

    Purpose: The aim of this case study was to investigate the extent of word-of-mouth influence amongst international students at a New Zealand tertiary institution and to review the literature for a valid and reliable conceptualisation and measurement of word-of-mouth. Design/methodology/approach: Literature suggests that opinion-leading and seeking…

  7. Geologic framework of nonmarine cretaceous-tertiary boundary sites, raton basin, new mexico and colorado

    Science.gov (United States)

    Pillmore, C.L.; Tschudy, R.H.; Orth, C.J.; Gilmore, J.S.; Knight, J.D.

    1984-01-01

    Indium concentrations are anomalously high at the palynological Cretaceous-Tertiary boundary in fluvial sedimentary rocks of the lower part of the Raton Formation at several localities in the Raton Basin of New Mexico and Colorado. The iridium anomaly is associated with a thin bed of kaolinitic claystone in a discontinuous carbonaceous shale and coal sequence.

  8. Trace element patterns at a non-marine cretaceous-tertiary boundary

    Science.gov (United States)

    Gilmore, J.S.; Knight, J.D.; Orth, C.J.; Pillmore, C.L.; Tschudy, R.H.

    1984-01-01

    At the fossil-pollen-defined Cretaceous-Tertiary boundary in the Raton Basin of New Mexico and Colorado, an iridium abundance anomaly and excess scandium, titanium, and chromium are associated with a thin ash or dust fallout bed (now kaolinitic clay) that was preserved in freshwater coal swamps. ?? 1984 Nature Publishing Group.

  9. Changing Destinations: Ideal Attraction and Actual Movement of Cross-Border Tertiary Students from Mainland China

    Science.gov (United States)

    Ghazarian, Peter G.

    2014-01-01

    Globalization has driven growth in the market for cross-border students. Mainland China, with a burgeoning economy and the largest national population, has become an important source of cross-border students. This study identifies ideal attraction in mainland China to destinations for cross-border tertiary education, as expressed by ideal first…

  10. Angle Concept: A High School and Tertiary Longitudinal Perspective to Minimize Obstacles

    Science.gov (United States)

    Barabash, Marita

    2017-01-01

    The concept of angle emerges in numerous forms as the learning of mathematics and its applications advances through the high school and tertiary curriculum. Many difficulties and misconceptions in the usage of this multifaceted concept might be avoided or at least minimized should the lecturers in different areas of pure and applied mathematics be…

  11. Tertiary and Quaternary sedimentation in a part of the Duero Basin Palencia, (Spain)

    NARCIS (Netherlands)

    Mabesoone, J.M.

    1959-01-01

    Sediments in the foreland of a mountain chain are sometimes suited to reconstitute the conditions in these mountains at the time of deposition of the sediments. The present study gives the results of a sedimentological investigation of the Tertiary and Quaternary deposits in a part of the Duero

  12. A Study of Macao Tertiary Students' Language Attitudes after the Handover

    Science.gov (United States)

    Yan, Xi

    2017-01-01

    This study investigates Macao tertiary students' language attitudes under the dynamic interplay of local, national, and global forces. The Portuguese established their settlement at Macao during the mid-sixteenth century and their colonial rule over Macao during the mid-nineteenth century. Macao's sovereignty was transferred to China at midnight…

  13. The evaluation of tertiary institution service quality using HiEdQUAL ...

    African Journals Online (AJOL)

    One of the most important decisions that affect the future of young students is a decision as regards a Tertiary Institution of choice. In making such a decision, a number of factors are required which include service quality. Service quality consists of different attributes and many of them are intangible and difficult to measure, ...

  14. Energy Management Systems and tertiary regulation in hierarchical control architectures for islanded micro-grids

    DEFF Research Database (Denmark)

    Sanseverino, Eleonora Riva; Di Silvestre, Maria Luisa; Quang, Ninh Nguyen

    2015-01-01

    In this paper, the structure of the highest level of a hierarchical control architecture for micro-grids is proposed. Such structure includes two sub-levels: the Energy Management System, EMS, and the tertiary regulation. The first devoted to energy resources allocation in each time slot based...

  15. Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil,

    OpenAIRE

    Schweiger, Cláudia; Manica, Denise; Becker, Carolina Fischer; Abreu, Larissa Santos Perez; Manzini, Michelle; Sekine, Leo; Kuhl, Gabriel

    2017-01-01

    Abstract Introduction: Children may require tracheostomy due to many different health conditions. Over the last 40 years, indications of tracheostomy have endorsed substantial modifications. Objective: To evaluate pediatric patients warranted tracheostomy at our Hospital, in regard to their indications, associated comorbidities, complications and decannulation rates. Methods: Retrospective study concerning patients under 18 years of age undergoing tracheostomy in a tertiary health care cen...

  16. Chinese Tertiary English Educators' Perceptions of Foreign Teacher Involvement in Their Professional Development

    Science.gov (United States)

    Bleistein, Tasha Maria

    2013-01-01

    China continues to invite expatriate tertiary-level English language educators to teach. Foreign English language teachers and local Chinese English educators who wish to develop professionally have an ever-increasing body of research regarding Chinese culture, education, professional development, and intercultural communication; however, research…

  17. Maori in Partnership: A Peer Mentoring Model for Tertiary Indigenous Staff in New Zealand

    Science.gov (United States)

    Kensington-Miller, Barbara; Ratima, Matiu

    2015-01-01

    This article presents a professional development programme which brought an indigenous minority group of tertiary staff together. We describe a peer-mentoring model, piloted in 2009 at The University of Auckland, New Zealand with university staff in order to promote staff advancement. The participants were all Maori, the indigenous people of New…

  18. Educational Online Technologies in Blended Tertiary Environments: A Review of Literature

    Science.gov (United States)

    Tuapawa, Kimberley N.

    2013-01-01

    This is a review of the literature surrounding five popular media-rich educational online technologies (EOTs) currently being used by educationalists to support blended learning within tertiary environments. This review considers the following EOTs: 1) connective media, 2) interactive gaming, 3) virtual worlds, 4) web conferencing and 5) learning…

  19. Ocular disorders in stroke patients in a tertiary hospital in Nigeria

    African Journals Online (AJOL)

    2015-08-06

    Aug 6, 2015 ... Abstract. Background: Stroke is a medical emergency of public health ... Aim: To determine the prevalence of ocular disorders in patients with stroke in a Tertiary Hospital in Nigeria. ... Risk factors include old age, high blood pressure, previous .... such as cataract, refractive errors, and age‑related changes.

  20. Prospects of Cloud Computing as Safe Haven for Improving Mathematics Education in Nigeria Tertiary Institutions

    OpenAIRE

    Iji, Clement Onwu; Abah, Joshua Abah

    2016-01-01

    International audience; Historically, mathematics education has been bedeviled by the deployment of instructional strategies that seriously stunt the growth of students. Methodologies and approaches of instructional delivery in tertiary institutions have raised the need for technological augmentation for both students and mathematics educators. Cloud computing yield itself to this quest by strengthening individualized learning via unrestricted access to infrastructure, platforms, content, and...

  1. Prevalence of obesity among diabetics seen in a tertiary health care ...

    African Journals Online (AJOL)

    Background: Obesity is a leading determinant for diabetes mellitus. The objective of this study was to assess the prevalence of overweight/obesity among diabetic patients seen at a tertiary hospital in South-South Nigeria. Methods: A retrospective study of 244 diabetic patients seen between January 2010 and June 2012.

  2. A Price Comparison of Antibiotics in a Tertiary Healthcare Facility in ...

    African Journals Online (AJOL)

    A large proportion of the population in developing countries including Nigeria lacks regular access to medicines for disease treatment. This has been linked to the high cost of these drugs, antibiotics inclusive. We undertook to compare the prices of antibiotics prescribed in the pediatric ward of a tertiary health-care facility in ...

  3. A Study of the Transition Pathways of School Level Scholarship Recipients into Work and Tertiary Education

    Science.gov (United States)

    Hobden, Sally; Hobden, Paul

    2015-01-01

    School-level educational interventions targeting learners from low socioeconomic backgrounds often have the long-term goal of enabling access to, and successful completion of tertiary studies. This study tracked the progress of alumni of an educational intervention two or three years post school, in order to investigate their pathways to their…

  4. Tertiary Student Transitions: Sectors, Fields, Impacts of and Reasons for Study--Support Document

    Science.gov (United States)

    Fredman, Nick

    2012-01-01

    This paper examines the relationships between post-school educational fields and sectors and labour market considerations that appear to shape students' study decisions. It was found that pathways taken vary considerably by age, suggesting changes over time to patterns in tertiary education towards greater participation overall, a greater extent…

  5. MONITORED NATURAL ATTENUATION OF TERTIARY BUTYL ALCOHOL (TBA) IN GROUND WATER AT GASOLINE SPILL SITES

    Science.gov (United States)

    The state agencies that implement the Underground Storage Tank program rely heavily on Monitored Natural Attenuation (MNA) to clean up contaminants such as benzene and methyl tertiary butyl ether (MTBE) at gasoline spill sites. This is possible because the contaminants are biolo...

  6. A Comparison of Mathematics Teachers' and Professors' Views on Secondary Preparation for Tertiary Calculus

    Science.gov (United States)

    Wade, Carol; Sonnert, Gerhard; Sadler, Philip M.; Hazari, Zahra; Watson, Charity

    2016-01-01

    This article compares the views of teachers and professors about the transition from secondary mathematics to tertiary calculus. Quantitative analysis revealed five categories where teachers and professors differed significantly in the relative frequency of addressing them. Using the rite of passage theory, the separation and incorporation phases…

  7. An Integrated Skills Approach Using Feature Movies in EFL at Tertiary Level

    Science.gov (United States)

    Tuncay, Hidayet

    2014-01-01

    This paper presents the results of a case study based on an integrated skills approach using feature movies (DVDs) in EFL syllabi at the tertiary level. 100 students took part in the study and the data was collected through a three - section survey questionnaire: demographic items, 18 likert scale questions and an open-ended question. The data…

  8. The profile of meningitis in a tertiary paediatric hospital in South Africa

    African Journals Online (AJOL)

    Background. Meningitis in children is a major health problem worldwide, leading to high rates of mortality and morbidity. Objectives. To describe the profile of patients treated for meningitis at a leading tertiary paediatric hospital (Red Cross War Memorial Children's Hospital) in South Africa. Methods. This study describes all ...

  9. A study on the utilization of serial resources in selected tertiary ...

    African Journals Online (AJOL)

    A study on the utilization of serial resources in selected tertiary institutions in Ogun State. ... Lagos Journal of Library and Information Science ... Serial resources are publications either in printed form or electronic format issued in successive parts usually having numerical or chronological designations and intended to be ...

  10. Novel approach to the preparation of hemisuccinates of steroids bearing tertiary alcohol group

    Czech Academy of Sciences Publication Activity Database

    Longin, O.; Černý, Ivan; Drašar, P.

    2015-01-01

    Roč. 97, SI (2015), s. 67-71 ISSN 0039-128X Grant - others:GA MV(CZ) VG20112015045 Institutional support: RVO:61388963 Keywords : anabolic-androgenic steroid * ester formation * hemisuccinate * tertiary alcohol Subject RIV: CE - Biochemistry Impact factor: 2.513, year: 2015

  11. Differentiation and Articulation in Tertiary Education Systems : A Study of Twelve African Countries

    OpenAIRE

    Ng'ethe, Njuguna; Subotzky, George; Afeti, George

    2008-01-01

    This study strives to sketch an initial map of the extent and nature of institutional and program differentiation within African systems of tertiary education. In doing so, it also seeks to chart the patterns of articulation that have emerged or been consciously put in place between the different institutional types (such as public universities, private universities, polytechnics, training...

  12. Evaluation of the onset of tertiary creep for types 304 and 316 stainless steels

    International Nuclear Information System (INIS)

    Staerk, E.; Picker, C.; Felsen, M.F.

    1989-01-01

    Austenitic stainless steels Types 304 and 316 are used for LMFBR components. Although at high temperature many codes base the allowable stress on the stress rupture strength, some recent codes eg ASME Code Case N47 and RCC-MR also take account of the onset of tertiary creep. In order to examine this latter aspect creep deformation data on Type 304 and Type 316 steel have been collected and analysed. The ratio time to onset of tertiary creep against the time to rupture has been analysed as a function of temperature. At temperatures below 750 0 C the ratio is found to decrease slightly with increasing temperature. Monkman Grant and Lambda relationships have also been investigated. In relation to the ASME S t allowable stress criteria it is shown that below 600 0 C the allowable stress is likely to be governed by the stress rupture strength rather than the onset of tertiary creep criterion. Recommendations are given concerning the determination of the onset of tertiary creep, the fitting of the Leyda/Rowe relationship and a method to compute the maximum allowable stress S t from equation describing the time-temperature dependency of the three constituents of S t

  13. Defining English Language Proficiency for Malaysian Tertiary Education: Past, Present and Future Efforts

    Directory of Open Access Journals (Sweden)

    Chan Swee Heng

    2012-07-01

    Full Text Available Any attempt to define English language proficiency can never be divorced from the theories that describe the nature of language, language acquisition and human cognition. By virtue of such theories being socially constructed, the descriptions are necessarily value-laden. Thus, a definition of language proficiency can only, at best, be described as developmental, following changes that are linguistic, pragmatic, cultural and political. In defining English proficiency for tertiary education, the context is naturally also linked to the focus on university education. The argument has been that an ‘acceptable’ level of language competence of a university applicant is anything but constant. Tremendous social changes have seen traditional values of elitism in university education giving way to the ‘massification’ of education. As Kaplan and Baldauf (1997:257 affirms, “The principal problem in tertiary education is not declining literacy standards but rather it is about meeting changed societal, cultural and informational requirements and circumstances”. In the light of these changes, this paper attempts to trace influencing factors that help define an ‘acceptable’ level of English proficiency for Malaysian tertiary education. The paper examines past and present efforts of establishing an English language policy and assessment practice for tertiary education, and concludes with some views on future development that could evolve from the current indicative pursuits of establishing language learning and ability.

  14. Lecturers' Perception of Strategies for Enhancing Business Education Research in Tertiary Institutions in Nigeria

    Science.gov (United States)

    Okoro, James

    2013-01-01

    Business education programme seems to have been faced with inadequate qualitative research in tertiary institution in Nigeria. The study therefore, assessed the strategies for enhancing Business Education research. Two research questions and six hypotheses guided the study. A 66 item questionnaire was administered to 164 colleges of education and…

  15. The accuracy of nurse performance of the triage process in a tertiary ...

    African Journals Online (AJOL)

    The accuracy of nurse performance of the triage process in a tertiary hospital emergency department in Gauteng Province, South Africa. ... discriminator use, numerical miscalculations and other human errors. Quality control and quality assurance measures must target training in these areas to minimise mis-triage in the ED.

  16. Impact of the Introduction of Calcimimetics on Timing of Parathyroidectomy in Secondary and Tertiary Hyperparathyroidism

    NARCIS (Netherlands)

    van der Plas, Willemijn Y.; Engelsman, Anton F.; Ozyilmaz, Akin; van der Horst-Schrivers, Anouk N.; Meijer, Kornelis; van Dam, Gooitzen M.; Pol, Robert A.; de Borst, Martin H.; Kruijff, Schelto

    Hyperparathyroidism (HPT), both secondary and tertiary, is common in patients with end-stage renal disease, and is associated with severe bone disorders, cardiovascular complications, and increased mortality. Since the introduction of calcimimetics in 2004, treatment of HPT has shifted from surgery

  17. Familiarity with Technology among First-Year Students in Rwandan Tertiary Education

    Science.gov (United States)

    Byungura, Jean Claude; Hansson, Henrik; Muparasi, Mugabe; Ruhinda, Ben

    2018-01-01

    The more the students get experienced with technologies, the more the need for tertiary education systems to adopt innovative pedagogical strategies for accommodating different learning needs. Depending on students' prior experience with computer-based tools, they may have different degrees of familiarity with new technologies. At University of…

  18. Variations in Decision-Making Approach to Tertiary Teaching: A Case Study in Vietnam

    Science.gov (United States)

    Nguyen, Thanh Tien

    2016-01-01

    Although the question of what to teach and how to teach has received much attention from the literature, little was known about the way in which academics in teaching groups make decision on what and how to teach. This paper reports an analysis of variations in the decision-making approach to tertiary teaching through academics' practices of…

  19. How Do Tertiary Dropouts Fare in the Labour Market? A Comparison between EU Countries

    Science.gov (United States)

    Schnepf, Sylke V.

    2017-01-01

    Dropping out of university is regularly discussed as a negative indicator. However, research on actual career trajectories of dropouts is virtually non-existent. This study estimates the association between tertiary dropouts and career chances in 15 European countries. Using data from the 2011 Programme for the International Assessment of Adult…

  20. DERMAL, ORAL, AND INHALATION PHARMACOKINETICS OF METHYL TERTIARY BUTYL ETHER (MTBE) IN HUMAN VOLUNTEERS

    Science.gov (United States)

    Methyl tertiary butyl ether (MTBE), a gasoline additive, used to increase octane and reduce carbon monoxide emissions and ozone precursors has contaminated drinking water leading to exposure by oral, inhalation, and dermal routes. To determine its dermal, oral, and inhalation ki...

  1. DERMAL, ORAL AND INHALATION PHARMACOKINETICS OF METHYL TERTIARY-BUTYL ETHER (MTBE) IN HUMAN VOLUNTEERS

    Science.gov (United States)

    Methyl tertiary butyl ether (MTBE), a gasoline additive used to increase octane and reduce carbon monoxide emissions and ozone precursors, has contaminated drinking water and can lead to exposure by oral, inhalation, and dermal routes. To determine its dermal, oral, and inhal...

  2. Pattern of neuro-opthalmic disorders in a tertiary eye centre in Nigeria

    African Journals Online (AJOL)

    Pattern of neuro-opthalmic disorders in a tertiary eye centre in Nigeria. AE Omoti, MJM Waziri-Erameh. Abstract. No Abstract. Nigrian Journal of Clinical Practice Vol. 10 (2) 2007: pp. 147-151. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics.

  3. Pattern of neuro-opthalmic disorders in a tertiary eye centre in Nigeria

    African Journals Online (AJOL)

    Pattern of neuro-opthalmic disorders in a tertiary eye centre in Nigeria. AE Omoti, MJM Waziri-Erameh. Abstract. No Abstract. Nigrian Journal of Clinical Practice Vol. 10 (2) 2007: pp. 147-151. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African ...

  4. Synthesis of benzannelated sultams by intramolecular Pd-catalyzed arylation of tertiary sulfonamides

    Directory of Open Access Journals (Sweden)

    Valentin A. Rassadin

    2017-09-01

    Full Text Available A new and efficient approach to five- and six-membered benzannelated sultams by intramolecular C-arylation of tertiary 1-(methoxycarbonylmethanesulfonamides under palladium catalysis is described. In case of the α-toluenesulfonamide derivative, an unexpected formation of a 2,3-diarylindole was observed under the same conditions.

  5. The Simple Analysis on Motivation and Attitude in Tertiary College Students' English Study

    Institute of Scientific and Technical Information of China (English)

    盛洁瑾

    2008-01-01

    In psycholinguisties,motivation and attitude have much effect on students'English study.Because there ale different individuals among students,different students have different study motivations and attitudes.Directed against these individuals in tertiary colleges,we formulate different methods to help students study English well.

  6. Emotions or Science? Pre-Tertiary Males' Accounts of Psychology as a Subject Choice

    Science.gov (United States)

    Mercer, Jenny; Sander, Paul; Williams, Stella; Jones, Tim

    2013-01-01

    It is well established that the number of males studying psychology in the UK, both at A-level and on degree courses, is disproportionately low compared to females. There is a paucity of research, however, which discusses how psychology is viewed by this group. The present study employed focus groups with 35 pre-tertiary males (some of whom were…

  7. Nature of work and Librarians' choice of library profession in tertiary ...

    African Journals Online (AJOL)

    The study investigated the nature of work and Librarians' choice of library profession as a career in tertiary institutions in Akwa Ibom and Cross River States of Nigeria . It also investigated nature of work as it relates with librarians' choice of library profession as a career. The survey design was used for the study.

  8. Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital

    Directory of Open Access Journals (Sweden)

    Colin Lee

    2015-06-01

    Conclusion: This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.

  9. Long-term satisfaction after neurological second opinions and tertiary referrals

    NARCIS (Netherlands)

    Wieske, L.; Richard, E.; Wijers, D.; Stam, J.; Smets, E. M. A.; Vergouwen, M. D. I.

    2011-01-01

    The number of second opinions (SO) and tertiary referrals (TR) in neurology is increasing. Previously, we showed that a day-care admission for neurological SO's and TR's often results in a new diagnosis and/or treatment advice and increases patient satisfaction. However, long-term satisfaction for

  10. Identifying Key Stakeholders in Blended Tertiary Environments: Experts' Perspectives

    Science.gov (United States)

    Tuapawa, Kimberley

    2017-01-01

    Although key stakeholders in blended tertiary environments (BTEs) fulfil an extraordinary role in higher education, significant gaps in knowledge about their identities may be impeding the provision of stakeholder support, limiting their ability to promote effective learning and teaching. As online growth intensifies, it is critical that tertiary…

  11. Smoke-Free Policies in New Zealand Public Tertiary Education Institutions

    Science.gov (United States)

    Robertson, Lindsay A.; Marsh, L.

    2015-01-01

    The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process.…

  12. Profile of Microvascular Disease in Type 2 Diabetes in a Tertiary ...

    African Journals Online (AJOL)

    Background: Diabetes mellitus (DM) is a metabolic disorder complicated by microvascular and macrovascular diseases. The clinical profile of these complications has not been adequately studied in many tertiary health care centers in India. Aim: The authors studied the clinical profile of microvascular diabetes ...

  13. PHYSIOLOGICALLY BASED PHARMACOKINETIC MODEL FOR HUMAN EXPOSURES TO METHYL TERTIARY-BUTYL ETHER

    Science.gov (United States)

    Humans can be exposed by inhalation, ingestion, or dermal absorption to methyl tertiary-butyl ether (MTBE), an oxygenated fuel additive, from contaminated water sources. The purpose of this research was to develop a physiologically based pharmacokinetic model describing in human...

  14. Review of six year cardiovascular mortality at a tertiary hospital in ...

    African Journals Online (AJOL)

    Review of six year cardiovascular mortality at a tertiary hospital in south-east Nigeria. ... E Iheanyi, OM Oghale, K Uwanuruochi, CO Odigwe, A Chuku ... The mean age at death was highest for stroke, 65.0years, likewise the mean duration of ...

  15. Incidence of dog bite injuries and clinical rabies in a tertiary health ...

    African Journals Online (AJOL)

    Background: It is widely recognized that rabies is grossly under-reported even though it is a notifiable disease and a lack of accurate figures has rendered rabies a low public health and veterinary priority. This study aimed at determining the incidence of dog bite injuries and clinical rabies in a tertiary health care centre.

  16. Level of health care and services in a tertiary health setting in Nigeria

    African Journals Online (AJOL)

    Level of health care and services in a tertiary health setting in Nigeria. ... Background: There is a growing awareness and demand for quality health care across the world; hence the ... Doctors and nurses formed 64.3% of the study population.

  17. Iodine catalyzed and tertiary butyl ammonium bromide promoted p reparation of b enzoxazaphosphininyl phenylboronates

    Directory of Open Access Journals (Sweden)

    K. R. Kishore K. Reddy,

    2009-05-01

    Full Text Available Benzoxazaphosphininyl Phenylboronates were prepared by O-Phosphorylation of potassium salt ofphenylboronic acid with cyclic phosphoromonochloridates in the presence of stoichiometric amount of Iodineand catalytic amount of tertiary butyl ammonium bromide at 50-60 °C in dry toluene.

  18. 26 CFR 1.193-1 - Deduction for tertiary injectant expenses.

    Science.gov (United States)

    2010-04-01

    ... in which the expenses are paid or incurred. (b) Definitions—(1) Qualified tertiary injectant expenses... Chief Counsel (Technical) for purposes of section 193. (c) Special rules for hydrocarbons—(1) In general. If an injectant contains more than an insignificant amount of recoverable hydrocarbons, the amount...

  19. Pattern of Eclampsia in a Tertiary Health Facility Situated in a Semi ...

    African Journals Online (AJOL)

    ANNALS

    Annals of African Medicine. Vol. 6, No.4; 2007:164 – 167. Pattern of Eclampsia in a Tertiary Health Facility Situated in a Semi-Rural ... In Kano State (which is in the same zone as the place where this study was conducted), eclampsia .... eclampsia. RHL commentary. The WHO. Reproductive Health Library No 8. Update Soft.

  20. The Perception of Malaysian ESL Tertiary Level Students on the IELTS Test

    Science.gov (United States)

    Zahari, Dhiya Amalina; Dhayaalan, Jeremiah Dhayaalan Jackson

    2016-01-01

    Currently, the most acknowledged test to qualify for overseas universities is the IELTS test which is referred to as the International English Language Testing System. It is implemented as an accreditation tool and is believed to be a reputable and trustworthy tool of language competence by tertiary institutions which employ its use. Regardless of…

  1. Recovery of uranium and lanthanides during the production of nitrophosphate fertilizers using tertiary amyl alcohol

    Energy Technology Data Exchange (ETDEWEB)

    Habashi, F; Awadalla, F T

    1986-01-01

    When phosphate rock is dissolved in nitric acid, phosphoric acid and uranium can be selectively extracted by tertiary amyl alcohol; other impurities including the lanthanides remain in the aqueous phase. Uranium can be recovered from the alcohol phase by selective stripping and the lanthanides from the raffinate by extraction with tributyl phosphate.

  2. Master Learning: A Way to Manage Tertiary Education in Small Island Jurisdictions

    Science.gov (United States)

    Hovgaard, Gestur

    2016-01-01

    As a consequence of globalisation, there is now a general trend among hesitant small island jurisdictions to focus on educational planning in the tertiary sector. The question therefore is how smart solutions adapted to the specific contexts can be developed. This article argues for the need to innovate the societal role of the smaller state…

  3. Maternal near miss and mortality in a tertiary care hospital in Rwanda

    NARCIS (Netherlands)

    Rulisa, S.; Umuziranenge, I.; Small, M; van Roosmalen, J.

    2015-01-01

    Background: To determine the prevalence and factors associated with severe ('near miss') maternal morbidity and mortality in the University Teaching Hospital of Kigali - Rwanda. Methods: We performed a cross sectional study of all women admitted to the tertiary care University Hospital in Kigali

  4. An isotope trace element study of the East Greenland Tertiary dyke swarm

    DEFF Research Database (Denmark)

    Hanghøj, Karen; Storey, Michael; Stecher, Ole

    2003-01-01

    Dykes of the East Greenland Tertiary dyke swarm can be divided into pre- and syn-break-up tholeiitic dykes, and post-break-up transitional dykes. Of the pre- and syn-break-up dykes, the most abundant group (Tholeiitic Series; TS) has major element compositions similar to the main part of the East...

  5. The effect of tertiary study at an English medium university on the ...

    African Journals Online (AJOL)

    The effect of tertiary study at an English medium university on the written English of speakers of Black South African English. J Parkinson. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/tvl.v37i2.53847.

  6. The effect of tertiary study at an English medium university on the ...

    African Journals Online (AJOL)

    The effect of tertiary study at an English medium university on the written English. Jean Parkinson. Abstract. Increasing numbers of South African students speak a variety of English known as Black South African English (BSAfE). Lectures, notes and textbooks are in Standard English, and might be expected to influence the ...

  7. Audit of the referred patients to a tertiary centre: a tool for need ...

    African Journals Online (AJOL)

    Audit of the referred patients to a tertiary centre: a tool for need assessment. ... Open Access DOWNLOAD FULL TEXT ... There was no statistical significance between fetal and maternal outcome and the source of referral (P> 0.05). The reason ...

  8. Online Computer Games as Collaborative Learning Environments: Prospects and Challenges for Tertiary Education

    Science.gov (United States)

    Papastergiou, Marina

    2009-01-01

    This study is aimed at presenting a critical overview of recent research studies on the use of educational online games as collaborative learning environments in Tertiary Education (TE), namely higher education and vocational training, with a view to identifying: a) the elements that online games should include in order to support fruitful and…

  9. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (External Review Draft)

    Science.gov (United States)

    The IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) was released for external peer review in June 2017. EPA’s Science Advisory Board’s (SAB) Chemical Assessment Advisory Committee (CAAC) will conduct a peer review of the scientific basis supporting the ETB...

  10. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (Public Comment Draft)

    Science.gov (United States)

    In September 2016, the U.S. Environmental Protection Agency's (USEPA) released the draft Integrated Risk Information System (IRIS) Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE). Consistent with the 2013 IRIS Enhancements, draft IRIS assessments are released prior to e...

  11. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (External Review Draft, 2009)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of ethyl tertiary butyl ether (ETBE) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  12. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (Interagency Science Consultation Draft)

    Science.gov (United States)

    In September 2016, EPA released the draft IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) for public comment and discussion. The draft assessment was reviewed internally by EPA and by other federal agencies and White House Offices before public release. Consistent ...

  13. Characterisation of Teacher Professional Knowledge and Skill through Content Representations from Tertiary Chemistry Educators

    Science.gov (United States)

    Schultz, M.; Lawrie, G. A.; Bailey, C. H.; Dargaville, B. L.

    2018-01-01

    An established tool for collating secondary teachers' pedagogical content knowledge (Loughran's CoRe) has been adapted for use by tertiary educators. Chemistry lecturers with a range of levels of experience were invited to participate in workshops through which the tool was piloted, refined and applied. We now present this refined tool for the…

  14. Azobisisobutyronitrile initiated aerobic oxidative transformation of amines: coupling of primary amines and cyanation of tertiary amines.

    Science.gov (United States)

    Liu, Lianghui; Wang, Zikuan; Fu, Xuefeng; Yan, Chun-Hua

    2012-11-16

    In the presence of a catalytic amount of radical initiator AIBN, primary amines are oxidatively coupled to imines and tertiary amines are cyanated to α-aminonitriles. These "metal-free" aerobic oxidative coupling reactions may find applications in a wide range of "green" oxidation chemistry.

  15. Adapting the Academic Motivation Scale for Use in Pre-Tertiary Mathematics Classrooms

    Science.gov (United States)

    Lim, Siew Yee; Chapman, Elaine

    2015-01-01

    The Academic Motivation Scale (AMS) is a comprehensive and widely used instrument for assessing motivation based on the self-determination theory. Currently, no such comprehensive instrument exists to assess the different domains of motivation (stipulated by the self-determination theory) in mathematics education at the pre-tertiary level (grades…

  16. Culture of Safety among Nurses in a Tertiary Teaching Hospital in ...

    African Journals Online (AJOL)

    Purpose: To assess the culture of safety among nurses in a tertiary teaching hospital in Saudi Arabia. Methods: A cross-sectional survey was conducted in King Khaled University Hospital in Riyadh, Saudi Arabia. A random sample of 492 nurses was included in the survey using a pre-validated instrument, Safety Attitudes ...

  17. Enhanced diisobutene production in the presence of methyl tertiary butyl ether

    Science.gov (United States)

    Smith, L.A. Jr.

    1983-03-01

    In the liquid phase reaction of isobutene in the presence of resin cation exchange resins with itself in a C[sub 4] hydrocarbon stream to form dimers, the formation of higher polymers, oligomers, and co-dimer by-products is suppressed by the presence of 0.0001 to 1 mole per mole of isobutene of methyl tertiary butyl ether. 1 fig.

  18. Getting the Most from Google Classroom: A Pedagogical Framework for Tertiary Educators

    Science.gov (United States)

    Heggart, Keith R.; Yoo, Joanne

    2018-01-01

    Many tertiary institutions have embraced digital learning through the use of online learning platforms and social networks. However, the research about the efficacy of such platforms is confused, as is the field itself, in part because of the rapidly evolving technology, and also because of a lack of clarity about what constitutes a learning…

  19. Tertiary Students' Entrepreneurial Career Intentions of Entrepreneurship-Embedded Internship Programs

    Science.gov (United States)

    Chou, Chun-Mei; Shen, Chien-Hua; Hsiao, Hsi-Chi; Chen, Su-Chang

    2017-01-01

    This study examines 1630 tertiary students in regard to their entrepreneurial career intentions (ECIs) and their influencing factors. The findings may serve as academic reference for the development of entrepreneurship-related education. The results show that students' computer self-efficacy (CSE) has a significant direct effect on ECIs, and…

  20. Strategies for Teaching Business Education Students in Nigerian Tertiary Institutions for Cooperate Governance

    Science.gov (United States)

    Obiete, Innocent Anthony; Nwazor, Joseph Chukwudi; Ifeoma, Vin-Mbah Fidelia

    2015-01-01

    In recent time, graduates from the nation's tertiary institution of learning most especially the business education graduates have been plagued by the inability to get jobs in corporate industries and companies in Nigeria. Many authors and researchers have related this problem to the quality of training received by these graduates while in school…

  1. Influence Factor of Tertiary Students’ Employability Awareness Adjust Industry 4.0

    Directory of Open Access Journals (Sweden)

    Chun-Mei Chou

    2017-09-01

    Full Text Available This study aims to analyze the correlation (N=621 among tertiary students’ career planning, erecruiting adoption acceptance, and employability awareness in Taiwan. Tertiary students’ perceived career planning includes four factors, namely, self-appraisal, job expectancy, goal selection, and problem solving. E-recruiting adoption acceptance includes four factors, namely, playfulness, ease of use, effectiveness, and usefulness. Employability awareness includes four factors, namely, personal adaptability, employability ambition, career identity, and labour market. Participants responded to a 5-point Likert-type scale for each factor. Analysis was conducted using the structural equation modeling (SEM, and a good model fit was found for both the measurement and structural models. Research findings demonstrate that tertiary students’ career planning significantly and directly influences employability awareness. Career planning significantly and indirectly influences employability awareness by e-recruiting adoption acceptance. Tertiary students’ career planning and e-recruiting adoption acceptance fit the influence model and empirical data of employability awareness. Implications of this study, including the value of student self-assessment of their skills and utility of the e-recruiting to underpin personal career development planning and inform graduate recruitment processes, are discussed and recommendations made.

  2. National Research Priorities for Tertiary Education and Training: 2011-13

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2010

    2010-01-01

    The objective of a national government-funded research program for tertiary education and training is to support the achievement of major social and economic goals. These include increased opportunities for participation in the labour market, improvements in productivity and enhanced social inclusion. In essence, the overarching lens is to…

  3. Utility of an intraoperabive gamma probe in the surgical management of secondary or tertiary hyperparathyroidism

    NARCIS (Netherlands)

    Jorna, Francisca H.; Jager, Pieter L.; Lemstra, Clara; Wiggers, Theo; Stegeman, Coen A.; Plukker, John T. M.

    BACKGROUND: In primary hyperparathyroidism the gamma probe is effective, but its role in secondary hyperparathyroidism is unclear. We investigated the utility of the probe in the surgical management of secondary and tertiary hyperparathyroidism. METHODS: The value of the probe in guiding resection

  4. Bilingualism in the English of tertiary students: A sine-qua-non for ...

    African Journals Online (AJOL)

    Effects of Bilingualism on the English of Tertiary Students as a mentorship and entrepreneurial tool were investigated. The term bilingualism is the use of two languages (repertoire) of an individual or a speech community. An important feature of bilingualism is that it is a consequence of language in contact which deals with ...

  5. Storage facilities for radioactive waste in tertiary education environment

    International Nuclear Information System (INIS)

    Sinclair, G.; Benke, G.

    1994-01-01

    The research and teaching endeavors of the university environment generate an assortment of radioactive waste that is unique in the range of isotopes and activities present, although the physical quantities of the waste may not be large. Universities may also be subject to unexpected, close public scrutiny of their operations due to the diverse nature of the university campus. This is rarely the case for other generators of radioactive waste. The experience of Monash University in formulating solutions for long term storage of radioactive waste is examined with respect to design, location and administration of the waste stores that were finally constructed. 7 refs., 1 tab., 1 fig

  6. Ileostomy in a Tertiary Care Hospital in India

    Directory of Open Access Journals (Sweden)

    Hemkant Verma

    2015-01-01

    Full Text Available Introduction. Ileal perforation peritonitis is a frequently encountered surgical emergency in the developing countries. The choice of a procedure for source control depends on the patient condition as well as the surgeon preference. Material and Methods. This was a prospective observational study including 41 patients presenting with perforation peritonitis due to ileal perforation and managed with ileostomy. Demographic profile and operative findings in terms of number of perforations, site, and size of perforation along with histopathological findings of all the cases were recorded. Results. The majority of patients were male. Pain abdomen and fever were the most common presenting complaints. Body mass index of the patients was in the range of 15.4–25.3 while comorbidities were present in 43% cases. Mean duration of preoperative resuscitation was 14.73+13.77 hours. Operative findings showed that 78% patients had a single perforation; most perforations were 0.6–1 cm in size and within 15 cm proximal to ileocecal junction. Mesenteric lymphadenopathy was seen in 29.2% patients. On histopathological examination, nonspecific perforations followed by typhoid and tubercular perforations respectively were the most common. Conclusion. Patients with ileal perforations are routinely seen in surgical emergencies and their demography, clinical profile, and intraoperative findings may guide the choice of procedure to be performed.

  7. Diagnostic indicators for peptic ulcer perforation at a tertiary care hospital in Thailand

    Directory of Open Access Journals (Sweden)

    Suriya C

    2011-12-01

    Full Text Available Chutikarn Suriya1, Nongyao Kasatpibal2, Wipada Kunaviktikul2, Toranee Kayee31Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, 2Faculty of Nursing, Chiang Mai University, 3Department of Surgery, Nakornping Hospital, Chiang Mai, ThailandIntroduction: Limited data currently exists regarding the diagnostic indicators of peptic ulcer perforation for early detection among patients in Thailand. Delayed diagnosis and treatment for an ulcer can be life-threatening, resulting in shock or death.Objective: To determine the diagnostic indicators of peptic ulcer perforation.Material and methods: A cohort study was conducted in a tertiary care hospital in Thailand from 2005 to 2009. Peptic ulcer patients aged 15 years and over admitted to the surgical department were included. The diagnostic indicators used criteria of the patients' final diagnoses and operations, coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, which included patient profiles, gender, age, coexisting illnesses, personal habits, signs and symptoms, laboratory investigations, radiological finding, and treatment role. Exponential risk regression analyses to obtain relative risk (RR estimates for diagnostic indicators were analyzed using Stata® statistical software package, version 11 (StataCorp LP, College Station, TX.Results: The study included 1290 patients. Of these, 57% reported perforated peptic ulcer. Multivariate analysis showed five diagnostic indicators: signs and symptoms including intense abdominal pain (RR = 1.53, 95% confidence interval [CI] 1.14–2.06, tenderness (RR = 1.94, 95% CI 1.17–3.21, and guarding (RR = 1.52, 95% CI 1.05–2.20; X-ray with free air (RR = 2.80, 95% CI 2.08–3.77; and referral from other hospitals (RR = 1.37, 95% CI 1.03–1.82.Conclusion: Five diagnostic indicators for peptic ulcer perforation monitoring were suggested from this study. Improving diagnostic

  8. Young Vs Old Colorectal Cancer in Indian Subcontinent: a Tertiary Care Center Experience.

    Science.gov (United States)

    Pokharkar, Ashish B; Bhandare, Manish; Patil, Prachi; Mehta, Shaesta; Engineer, Reena; Saklani, Avanish P

    2017-12-01

    This study aims to compare patient, tumor, treatment-related factors and survival between young (45 years) Indian colorectal cancer (CRC) patients. Total 778 patients of CRC were registered at tertiary cancer center in India between 1 August 2013 and 31 July 2014. Patients were followed up for median period of 27.73 months. Data regarding patient, tumor, treatment and survival-related factors were collected. Patients were divided in young (≤45 years) and old (>45 years) age groups. Statistical analysis was done with SPSS software version 23. Young age group patients presented more commonly with poor histology, node-positive disease, and rectal site. Younger age group patients received multiple lines of neoadjuvant treatment. There was no significant overall survival difference in both groups of patients. On stratified stage-wise analysis, no significant overall survival (OS) difference was found between two groups (young vs old-1- and 3-year OS: 85.2 and 61.5% vs 81.5 and 64.5%, respectively; P  = 0.881). On univariate analysis, gender, performance status, site, stage, differentiation, TRG, CRM status, signet ring type, and CEA level were significant prognostic factors. In disease-free survival (DFS) analysis, it is found that there is statistically significant difference in DFS (young vs old: 1 and 3 years; 77.6 and 62.8% vs 85.8 and 74.1%, respectively; P value, 0.02), but when OS was analyzed for same group of patient, there was no statistical difference ( P  = 0.302). This study confirms the high incidence rates of CRC in young Indian patients. There is no OS difference between two age groups. In operated group of patients, there is higher DFS in older patients but no OS advantage at 3 years follow-up. Further long-term follow-up is required to see any OS difference.

  9. The roles of tertiary amine structure, background organic matter and chloramine species on NDMA formation.

    Science.gov (United States)

    Selbes, Meric; Kim, Daekyun; Ates, Nuray; Karanfil, Tanju

    2013-02-01

    N-nitrosodimethylamine (NDMA), a probable human carcinogen, is a disinfection by-product that has been detected in chloraminated and chlorinated drinking waters and wastewaters. Formation mechanisms and precursors of NDMA are still not well understood. The main objectives of this study were to systematically investigate (i) the effect of tertiary amine structure, (ii) the effect of background natural organic matter (NOM), and (iii) the roles of mono vs. dichloramine species on the NDMA formation. Dimethylamine (DMA) and 20 different tertiary aliphatic and aromatic amines were carefully examined based on their functional groups attached to the basic DMA structure. The wide range (0.02-83.9%) of observed NDMA yields indicated the importance of the structure of tertiary amines, and both stability and electron distribution of the leaving group of tertiary amines on NDMA formation. DMA associated with branched alkyl groups or benzyl like structures having only one carbon between the ring and DMA structure consistently gave higher NDMA yields. Compounds with electron withdrawing groups (EWG) reacted preferentially with monochloramine, whereas compounds with electron donating group (EDG) showed tendency to react with dichloramine to form NDMA. When the selected amines were present in NOM solutions, NDMA formation increased for compounds with EWG while decreased for compounds with EDG. This impact was attributed to the competitions between NOM and amines for chloramine species. The results provided additional information to the commonly accepted mechanism for NDMA formation including chloramine species reacting with tertiary amines and the role of the leaving group on overall NDMA conversion. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

    2011-01-01

    Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

  11. Peracetic acid (PAA) disinfection of primary, secondary and tertiary treated municipal wastewaters.

    Science.gov (United States)

    Koivunen, J; Heinonen-Tanski, H

    2005-11-01

    The efficiency of peracetic acid (PAA) disinfection against enteric bacteria and viruses in municipal wastewaters was studied in pilot-scale. Disinfection pilot-plant was fed with the primary or secondary effluent of Kuopio municipal wastewater treatment plant or tertiary effluent from the pilot-scale dissolved air flotation (DAF) unit. Disinfectant doses ranged from 2 to 7 mg/l PAA in the secondary and tertiary effluents, and from 5 to 15 mg/l PAA in the primary effluents. Disinfection contact times were 4-27 min. Disinfection of secondary and tertiary effluents with 2-7 mg/l PAA and 27 min contact time achieved around 3 log reductions of total coliforms (TC) and enterococci (EC). PAA disinfection also significantly improved the hygienic quality of the primary effluents: 10-15 mg/l PAA achieved 3-4 log reductions of TC and EC, 5 mg/l PAA resulting in below 2 log reductions. F-RNA coliphages were more resistant against the PAA disinfection and around 1 log reductions of these enteric viruses were typically achieved in the disinfection treatments of the primary, secondary and tertiary effluents. Most of the microbial reductions occurred during the first 4-18 min of contact time, depending on the PAA dose and microorganism. The PAA disinfection efficiency remained relatively constant in the secondary and tertiary effluents, despite of small changes of wastewater quality (COD, SS, turbidity, 253.7 nm transmittance) or temperature. The disinfection efficiency clearly decreased in the primary effluents with substantially higher microbial, organic matter and suspended solids concentrations. The results demonstrated that PAA could be a good alternative disinfection method for elimination of enteric microbes from different wastewaters.

  12. Geochemical characteristics of Tertiary saline lacustrine oils in the Western Qaidam Basin, northwest China

    International Nuclear Information System (INIS)

    Zhu Yangming; Weng Huanxin; Su Aiguo; Liang Digang; Peng Dehua

    2005-01-01

    Based on the systematic analyses of light hydrocarbon, saturate, aromatic fractions and C isotopes of over 40 oil samples along with related Tertiary source rocks collected from the western Qaidam basin, the geochemical characteristics of the Tertiary saline lacustrine oils in this region was investigated. The oils are characterized by bimodal n-alkane distributions with odd-to-even (C 11 -C 17 ) and even-to-odd (C 18 -C 28 ) predominance, low Pr/Ph (mostly lower than 0.6), high concentration of gammacerane, C 35 hopane and methylated MTTCs, reflecting the high salinity and anoxic setting typical of a saline lacustrine depositional environment. Mango's K 1 values in the saline oils are highly variable (0.99-1.63), and could be associated with the facies-dependent parameters such as Pr/Ph and gammacerane indexes. Compared with other Tertiary oils, the studied Tertiary saline oils are marked by enhanced C 28 sterane abundance (30% or more of C 27 -C 29 homologues), possibly derived from halophilic algae. It is noted that the geochemical parameters of the oils in various oilfields exhibit regular spatial changes, which are consistent with the depositional phase variations of the source rocks. The oils have uncommon heavy C isotopic ratios (-24%o to -26%o) and a flat shape of the individual n-alkane isotope profile, and show isotopic characteristics similar to marine organic matter. The appearance of oleanane and high 24/(24 + 27)-norcholestane ratios (0.57-0.87) in the saline oils and source rocks confirm a Tertiary organic source

  13. Antibiotic use in acute pancreatitis: An audit of current practice in a tertiary centre.

    Science.gov (United States)

    Baltatzis, Minas; Mason, J M; Chandrabalan, Vishnu; Stathakis, Panagiotis; McIntyre, Ben; Jegatheeswaran, Santhalingam; Jamdar, Saurabh; O'Reilly, Derek A; Siriwardena, Ajith K

    Intravenous antibiotic prophylaxis is not recommended in acute pancreatitis. According to current international guidelines antibiotics together with further intervention should be considered in the setting of infected necrosis. Appropriate antibiotic therapy particularly avoiding over-prescription is important. This study examines antibiotic use in acute pancreatitis in a tertiary centre using the current IAP/APA guidelines for reference. Data were collected on a consecutive series of patients admitted with acute pancreatitis over a 12 month period. Data were dichotomized by patients admitted directly to the centre and tertiary transfers. Information was collected on clinical course with specific reference to antibiotic use, episode severity, intervention and outcome. 111 consecutive episodes of acute pancreatitis constitute the reported population. 31 (28%) were tertiary transfers. Overall 65 (58.5%) patients received antibiotics. Significantly more tertiary transfer patients received antibiotics. Mean person-days of antibiotic use was 23.9 (sd 29.7) days in the overall study group but there was significantly more use in the tertiary transfer group as compared to patients having their index admission to the centre (40.9 sd 37.1 vs 10.2 sd 8.9; P < 0.005). Thirty four (44%) of patients with clinically mild acute pancreatitis received antibiotics. There is substantial use of antibiotics in acute pancreatitis, in particular in patients with severe disease. Over-use is seen in mild acute pancreatitis. Better consideration must be given to identification of prophylaxis or therapy as indication. In relation to repeated courses of antibiotics in severe disease there must be clear indications for use. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  14. Operator errors

    International Nuclear Information System (INIS)

    Knuefer; Lindauer

    1980-01-01

    Besides that at spectacular events a combination of component failure and human error is often found. Especially the Rasmussen-Report and the German Risk Assessment Study show for pressurised water reactors that human error must not be underestimated. Although operator errors as a form of human error can never be eliminated entirely, they can be minimized and their effects kept within acceptable limits if a thorough training of personnel is combined with an adequate design of the plant against accidents. Contrary to the investigation of engineering errors, the investigation of human errors has so far been carried out with relatively small budgets. Intensified investigations in this field appear to be a worthwhile effort. (orig.)

  15. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Lung Operation After Your Operation Your Discharge and Recovery Complete Video After Your Operation Guidance for after ... Your Lung Operation Read Next Your Discharge and Recovery Back to Top Find A Surgeon Find A ...

  16. FAT MYRINGOPLASTY IN A TERTIARY CARE GOVERNMENT HOSPITAL

    Directory of Open Access Journals (Sweden)

    Paidi Ramesh Chandra

    2017-12-01

    Full Text Available BACKGROUND Myringoplasty is the surgical procedure performed for the closure of perforations of pars tensa of the tympanic membrane. Various graft materials are used such as temporalis fascia, periosteum, perichondrium, vein, dura and adipose tissue (fat. Fat myringoplasty is a simple, cost effective and outpatient procedure. This study is performed to evaluate the operative outcome of fat myringoplasty in patients with Chronic Suppurative Otitis Media (CSOM. The aim of the study is to assess graft uptake to assess hearing improvement and to assess the operative outcome in relation to the site of perforation after fat myringoplasty. MATERIALS AND METHODS This study was performed in Government ENT Hospital, Andhra Medical College, Visakhapatnam. A total of 20 patients between the age group of 18-50 years suffering from tubotympanic type of chronic suppurative otitis media were taken up for study. The study period was for 18 months from October 2015 to March 2017. RESULTS Results were analysed in terms of graft uptake and hearing improvement. Average audiometric gain after 6 months was 10.58 dB. Successful closure of perforation was achieved in 90% cases. Perforations involving posterior quadrant showed 100% graft uptake, compared to anterior quadrant perforations, which showed 75% graft uptake. No major postoperative complications were noted. CONCLUSION Fat myringoplasty can be safely performed in dry, small central perforations of tympanic membrane especially belonging to posterior quadrant. Ear lobule constitutes convenient source of fat graft. The procedure can be performed as a day care surgery. Proper selection of cases is necessary to obtain good results.

  17. Gender norms in South Africa: Implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution

    Science.gov (United States)

    Mantell, Joanne E.; Needham, Sarah L.; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M.; Mabude, Zonke; Beksinska, Mags; Stein, Zena A.; Milford, Cecilia

    2009-01-01

    In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women’s ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students who are a relatively ‘privileged’ group, there is little information on gender norms that might shape responses to HIV prevention programmes. To elicit gender norms regarding women’s and men’s roles, condom and contraceptive use, sexual communication, and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students so as to understand how norms might be used to buttress HIV and pregnancy prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women’s rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women’s freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women’s protection against unintended pregnancy and HIV/STIs. PMID:19247859

  18. Gender norms in South Africa: implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution.

    Science.gov (United States)

    Mantell, Joanne E; Needham, Sarah L; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M; Mabude, Zonke; Beksinska, Mags; Stein, Zena A; Milford, Cecilia

    2009-02-01

    In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women's ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students, who are a relatively 'privileged' group, there is little information on gender norms that might shape responses to HIV-prevention programmes. To elicit gender norms regarding women's and men's roles, condom and contraceptive use, sexual communication and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students in order to understand how norms might be used to buttress HIV- and pregnancy-prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women's rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women's freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women's protection against unintended pregnancy and HIV/STIs.

  19. Major limb amputations: A tertiary hospital experience in northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-05-01

    Full Text Available Abstract Background Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Methods This was a descriptive cross-sectional study that was conducted at Bugando Medical Centre between March 2008 and February 2010. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS version 11.5 computer software. Results A total of 162 patients were entered into the study. Their ages ranged between 2–78 years (mean 28.30 ± 13.72 days. Males outnumbered females by a ratio of 2:1. The majority of patients (76.5% had primary or no formal education. One hundred and twelve (69.1% patients were unemployed. The most common indication for major limb amputation was diabetic foot complications in 41.9%, followed by trauma in 38.4% and vascular disease in 8.6% respectively. Lower limbs were involved in 86.4% of cases and upper limbs in 13.6% of cases giving a lower limb to upper limb ratio of 6.4:1 Below knee amputation was the most common procedure performed in 46.3%. There was no bilateral limb amputation. The most common additional procedures performed were wound debridement, secondary suture and skin grafting in 42.3%, 34.5% and 23.2% respectively. Two-stage operation was required in 45.4% of patients. Revision amputation rate was 29.6%. Post-operative complication rate was 33.3% and surgical site infection was the most common complication accounting for 21.0%. The mean length of hospital stay was 22.4 days and mortality

  20. Operational Law Handbook,2007

    National Research Council Canada - National Science Library

    2007-01-01

    ... & SOFAs, legal assistance, combating terrorism, domestic operations, noncombatant evacuation operations, special operations, civil affairs, air, sea, and space law, detainee operations, reserve...