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Sample records for patient call light

  1. Conduits to care: call lights and patients' perceptions of communication.

    Science.gov (United States)

    Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

    2017-01-01

    Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

  2. Conduits to care: call lights and patients’ perceptions of communication

    OpenAIRE

    Montie,Mary; Shuman,Clayton; Galinato,Jose; Patak,Lance; Anderson,Christine A; Titler,Marita

    2017-01-01

    Mary Montie,1 Clayton Shuman,1 Jose Galinato,1 Lance Patak,2 Christine A Anderson,1 Marita G Titler1 1Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, 2Department of Anesthesiology and Pain Medicine, Seattle Children’s Hospital, Seattle, WA, USA Background: Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of liter...

  3. Perspectives of staff nurses of the reasons for and the nature of patient-initiated call lights: an exploratory survey study in four USA hospitals

    Directory of Open Access Journals (Sweden)

    Tzeng Huey-Ming

    2010-02-01

    Full Text Available Abstract Background Little research has been done on patient call light use and staff response time, which were found to be associated with inpatient falls and satisfaction. Nurses' perspectives may moderate or mediate the aforementioned relationships. This exploratory study intended to understand staff's perspectives about call lights, staff responsiveness, and the reasons for and the nature of call light use. It also explored differences among hospitals and identified significant predictors of the nature of call light use. Methods This cross-sectional, multihospital survey study was conducted from September 2008 to January 2009 in four hospitals located in the Midwestern region of the United States. A brief survey was used. All 2309 licensed and unlicensed nursing staff members who provide direct patient care in 27 adult care units were invited to participate. A total of 808 completed surveys were retrieved for an overall response rate of 35%. The SPSS 16.0 Window version was used. Descriptive and binary logistic regression analyses were conducted. Results The primary reasons for patient-initiated calls were for toileting assistance, pain medication, and intravenous problems. Toileting assistance was the leading reason. Each staff responded to 6 to 7 calls per hour and a call was answered within 4 minutes (estimated. 49% of staff perceived that patient-initiated calls mattered to patient safety. 77% agreed that that these calls were meaningful. 52% thought that these calls required the attention of nursing staff. 53% thought that answering calls prevented them from doing the critical aspects of their role. Staff's perceptions about the nature of calls varied across hospitals. Junior staff tended to overlook the importance of answering calls. A nurse participant tended to perceive calls as more likely requiring nursing staff's attention than a nurse aide participant. Conclusions If answering calls was a high priority among nursing tasks, staff

  4. Conduits to care: call lights and patients’ perceptions of communication

    Science.gov (United States)

    Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

    2017-01-01

    Background Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. PMID:29075125

  5. Conduits to care: call lights and patients’ perceptions of communication

    Directory of Open Access Journals (Sweden)

    Montie M

    2017-09-01

    Full Text Available Mary Montie,1 Clayton Shuman,1 Jose Galinato,1 Lance Patak,2 Christine A Anderson,1 Marita G Titler1 1Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, 2Department of Anesthesiology and Pain Medicine, Seattle Children’s Hospital, Seattle, WA, USA Background: Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods: Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated. Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results: Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”. Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion: Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. Keywords: nurse–patient communication, medical technology, quality of care, qualitative research

  6. Should general practitioners call patients by their first names?

    Science.gov (United States)

    McKinstry, B

    1990-10-06

    To assess the acceptability to patients of the use of patients' first names by doctors and doctors' first names by patients in general practice. An administered questionnaire survey. 5 General practices in Lothian. 475 Patients consulting 30 general practitioners. Response by patients to questionnaire on attitude to use of first names. Most of the patients either liked (223) or did not mind (175) being called by their first names. Only 77 disliked it, most of whom were aged over 65. Most patients (324) did not, however, want to call the doctor by his or her first name. General practitioners should consider using patients' first names more often, particularly with younger patients.

  7. Light-emitting diode street lights reduce last-ditch evasive manoeuvres by moths to bat echolocation calls

    Science.gov (United States)

    Wakefield, Andrew; Stone, Emma L.; Jones, Gareth; Harris, Stephen

    2015-01-01

    The light-emitting diode (LED) street light market is expanding globally, and it is important to understand how LED lights affect wildlife populations. We compared evasive flight responses of moths to bat echolocation calls experimentally under LED-lit and -unlit conditions. Significantly, fewer moths performed ‘powerdive’ flight manoeuvres in response to bat calls (feeding buzz sequences from Nyctalus spp.) under an LED street light than in the dark. LED street lights reduce the anti-predator behaviour of moths, shifting the balance in favour of their predators, aerial hawking bats. PMID:26361558

  8. Call 4 Concern: patient and relative activated critical care outreach.

    Science.gov (United States)

    Odell, Mandy; Gerber, Karin; Gager, Melanie

    Patients can experience unexpected deterioration in their physiological condition that can lead to critical illness, cardiac arrest, admission to the intensive care unit and death. While ward staff can identify deterioration through monitoring physiological signs, these signs can be missed, interpreted incorrectly or mismanaged. Rapid response systems using early warning scores can fail if staff do not follow protocols or do not notice or manage deterioration adequately. Nurses often notice deterioration intuitively because of their knowledge of individual patients. Patients and their relatives have the greatest knowledge of patients, and can often pick up subtle signs physiological deterioration before this is identified by staff or monitoring systems. However, this ability has been largely overlooked. Call 4 Concern (C4C) is a scheme where patients and relatives can call critical care teams directly if they are concerned about a patient's condition- it is believed to be the first of its kind in the UK. A C4C feasibility project ran for six months, covering patients being transferred from the intensive care unit to general wards. C4C has the potential to prevent clinical deterioration and is valued by patients and relatives. Concerns of ward staff could be managed through project management. As it is relatively new, this field offers further opportunities for research.

  9. Emotional distance to so-called difficult patients

    DEFF Research Database (Denmark)

    Michaelsen, Jette Joost

    2012-01-01

    Scand J Caring Sci; 2011 Emotional distance to so-called difficult patients Purpose: To explore nurses' relationships with patients they regard as being difficult. How do nurses feel about such patients and relate to them, and what are the consequences for nurse and patient? Design and methods....... Patients' case records were studied and four meetings with the staff were arranged to discuss the findings. Data collection lasted 18 months in all. Findings: Three strategies were identified: persuasion, avoidance (emotional distance), and compromise. Interestingly, in the relationship with a particular...... patient, the avoidance strategy did not necessarily represent the terminal stage, since a nurse could revert to the compromise strategy. Some of the nurses experienced painful emotions regarding these interactions. Conclusions: The avoidance strategy (emotional distance) resulted in important social...

  10. The contribution of staff call light response time to fall and injurious fall rates: an exploratory study in four US hospitals using archived hospital data

    Directory of Open Access Journals (Sweden)

    Tzeng Huey-Ming

    2012-03-01

    Full Text Available Abstract Background Fall prevention programs for hospitalized patients have had limited success, and the effect of programs on decreasing total falls and fall-related injuries is still inconclusive. This exploratory multi-hospital study examined the unique contribution of call light response time to predicting total fall rates and injurious fall rates in inpatient acute care settings. The conceptual model was based on Donabedian's framework of structure, process, and health-care outcomes. The covariates included the hospital, unit type, total nursing hours per patient-day (HPPDs, percentage of the total nursing HPPDs supplied by registered nurses, percentage of patients aged 65 years or older, average case mix index, percentage of patients with altered mental status, percentage of patients with hearing problems, and call light use rate per patient-day. Methods We analyzed data from 28 units from 4 Michigan hospitals, using archived data and chart reviews from January 2004 to May 2009. The patient care unit-month, defined as data aggregated by month for each patient care unit, was the unit of analysis (N = 1063. Hierarchical multiple regression analyses were used. Results Faster call light response time was associated with lower total fall and injurious fall rates. Units with a higher call light use rate had lower total fall and injurious fall rates. A higher percentage of productive nursing hours provided by registered nurses was associated with lower total fall and injurious fall rates. A higher percentage of patients with altered mental status was associated with a higher total fall rate but not a higher injurious fall rate. Units with a higher percentage of patients aged 65 years or older had lower injurious fall rates. Conclusions Faster call light response time appeared to contribute to lower total fall and injurious fall rates, after controlling for the covariates. For practical relevance, hospital and nursing executives should consider

  11. In the patient's best interest--a call to action, a call to balance.

    Science.gov (United States)

    Hirsch, Norma J

    2002-01-01

    Nurses, physicians, and other healthcare professionals often complain that a loss of freedom or other obstacles hinder their ability to act in the best interest of the patient. These barriers cause professional burnout and moral outrage, and may contribute to a migration away from medicine or, more broadly, healthcare. Understanding the historical underpinnings of the phrase "in the patient's best interest," and realizing that healthcare, which is fundamentally a moral enterprise must be built on sound business principles can help healthcare professionals reframe the issue, and reclaim their original commitment to a difficult path.

  12. Patient identification and tube labelling - a call for harmonisation

    NARCIS (Netherlands)

    van Dongen-Lases, Edmée C.; Cornes, Michael P.; Grankvist, Kjell; Ibarz, Mercedes; Kristensen, Gunn B. B.; Lippi, Giuseppe; Nybo, Mads; Simundic, Ana-Maria

    2016-01-01

    Venous blood sampling (phlebotomy) is the most common invasive procedure performed in patient care. Guidelines on the correct practice of phlebotomy are available, including the H3-A6 guideline issued by the Clinical Laboratory Standards Institute (CLSI). As the quality of practices and procedures

  13. [Successful patient-activated help call for a doctor during in-hospital stay].

    Science.gov (United States)

    Hansen, Mette Mejlby; Hasselkvist, Birgith; Thordal, Sofie; Riiskjær, Erik; Kelsen, Jens

    2014-09-29

    Department of Medicine, Randers Regional Hospital, conducted a study of patient-activated help call, involving 1,050 patients with nearly 3,700 days in-hospital stay. Patients were encou-raged to bypass traditional clinical hierarchy of communication when they felt, that their concern was not met by the staff. Three help calls were related to the management of pain. In two cases it resulted in a surgical procedure. A survey including 104 patients revealed that one third reported that patient safety was improved by the initiative and nearly three quarters re-ported that they would be willing to activate the call.

  14. Light and Mediaprojections in Patient Rooms

    DEFF Research Database (Denmark)

    Bonde, Esben Oxholm Skjødt; Nielsen, Stine Maria Louring; Hansen, Ellen Kathrine

    2018-01-01

    the specific needs of the patients and thereby provide higher patient satisfaction. Hereto, the main findings suggest that the control of the lighting needs to be less complicated, the different lighting settings needs to be better tailored to the actual needs, noise from the projector and light coming from......New media and lighting technology and new ways to connect and control it has potentials to improve the environment in hospitals with the goal of increasing patient satisfaction. How should such system be designed to do so and how can it be tested? In this paper it is investigated how a specific...... case, an interactive lighting and media system installed in a patient room, can be improved to support a greater experience of patient satisfaction. Through questionnaires given to 14 mothers who have just given birth and their husbands staying in an interactive patient room, the experience of staying...

  15. Does revealing contextual knowledge of the patient's intention help nurses' handling of nurse calls?

    Science.gov (United States)

    Klemets, Joakim; Toussaint, Pieter

    2016-02-01

    An inherent part of nurses' work is to handle nurse calls that often cause challenging interruptions to ongoing activities. In situations when nurses are interrupted by a nurse call, they need to decide whether to continue focusing on the task at hand or to abort and respond to the nurse call. The difficult decision is often influenced by a number of factors and can have implications for patient safety and quality of care. The study investigates how technology could be designed to support nurses' handling of nurse calls by allowing patients to communicate a more contextualised message revealing their intention to the nurse when issuing a nurse call. Through a qualitative methodology employing a scenario-based design approach, three different nurse call system concepts are evaluated by nurses from different departments of a Norwegian university hospital. Nurses find the uncertainty of not knowing the reason behind a nurse call stressful in situations where they are required to prioritise either the calling patient or a patient they are currently nursing. Providing information about a patient's intention behind a nurse call influences the nurse's decision to various degrees depending on the situation in which they find themselves and the information that is communicated. The nurses' reflections suggested that the message communicated should be designed to contain neither too little nor too much information about the patient's needs. A nurse call system that allows nurses to discern the reason behind a nurse call allows them to make a more accurate decision and relieves stress. In particular, the information communicated would reduce uncertainty and lessen nurses' dependence on other factors in their decision. The design of such a system should, however, carefully consider the needs of the department in which it is deployed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Effect of introduction of electronic patient reporting on the duration of ambulance calls.

    Science.gov (United States)

    Kuisma, Markku; Väyrynen, Taneli; Hiltunen, Tuomas; Porthan, Kari; Aaltonen, Janne

    2009-10-01

    We examined the effect of the change from paper records to the electronic patient records (EPRs) on ambulance call duration. We retrieved call duration times 6 months before (group 1) and 6 months after (group 2) the introduction of EPR. Subgroup analysis of group 2 was fulfilled depending whether the calls were made during the first or last 3 months after EPR introduction. We analyzed 37 599 ambulance calls (17 950 were in group 1 and 19 649 were in group 2). The median call duration in group 1 was 48 minutes and in group 2 was 49 minutes (P = .008). In group 2, call duration was longer during the first 3 months after EPR introduction. In multiple linear regression analysis, urgency category (P introduction was noticed, reflecting adaptation process to a new way of working.

  17. SEE: improving nurse-patient communications and preventing software piracy in nurse call applications.

    Science.gov (United States)

    Unluturk, Mehmet S

    2012-06-01

    Nurse call system is an electrically functioning system by which patients can call upon from a bedside station or from a duty station. An intermittent tone shall be heard and a corridor lamp located outside the room starts blinking with a slow or a faster rate depending on the call origination. It is essential to alert nurses on time so that they can offer care and comfort without any delay. There are currently many devices available for a nurse call system to improve communication between nurses and patients such as pagers, RFID (radio frequency identification) badges, wireless phones and so on. To integrate all these devices into an existing nurse call system and make they communicate with each other, we propose software client applications called bridges in this paper. We also propose a window server application called SEE (Supervised Event Executive) that delivers messages among these devices. A single hardware dongle is utilized for authentication and copy protection for SEE. Protecting SEE with securities provided by dongle only is a weak defense against hackers. In this paper, we develop some defense patterns for hackers such as calculating checksums in runtime, making calls to dongle from multiple places in code and handling errors properly by logging them into database.

  18. Drivers' phone use at red traffic lights: a roadside observation study comparing calls and visual-manual interactions.

    Science.gov (United States)

    Huth, Véronique; Sanchez, Yann; Brusque, Corinne

    2015-01-01

    Phone use while driving has become one of the priority issues in road safety, given that it may lead to decreased situation awareness and deteriorated driving performance. It has been suggested that drivers can regulate their exposure to secondary tasks and seek for compatibility of phone use and driving. Phone use strategies include the choice of driving situations with low demands and interruptions of the interaction when the context changes. Traffic light situations at urban intersections imply both a temptation to use the phone while waiting at the red traffic light and a potential threat due to the incompatibility of phone use and driving when the traffic light turns green. These two situations were targeted in a roadside observation study, with the aim to investigate the existence of a phone use strategy at the red traffic light and to test its effectiveness. N=124 phone users and a corresponding control group of non-users were observed. Strategic phone use behaviour was detected for visual-manual interactions, which are more likely to be initiated at the red traffic light and tend to be stopped before the vehicle moves off, while calls are less likely to be limited to the red traffic light situation. As an indicator of impaired situation awareness, delayed start was associated to phone use and in particular to visual-manual interactions, whether phone use was interrupted before moving off or not. Traffic light situations do not seem to allow effective application of phone use strategies, although drivers attempt to do so for the most demanding phone use mode. The underlying factors of phone use need to be studied so as to reduce the temptation of phone use and facilitate exposure regulation strategies. Copyright © 2014. Published by Elsevier Ltd.

  19. IBD patients in remission strongly prefer annual telephone calls by IBD nurse - compared to outpatient visits

    DEFF Research Database (Denmark)

    Bager, Palle; Hentze, Runa; Markussen, Toto

    Aim: To investigate the willingness among IBD patients in remission to change regularly outpatient visits to annual telephone calls by an IBD nurse. To illuminate potential barriers for introducing Self Management (SM) in the handling of IBD patients. Background: Incidence of IBD is increasing...... by a telephone call by an IBD nurse. Furthermore an extended acute access to the hospital is needed if flare occurs. Patients and Methods: 150 consecutive IBD patients attending to the outpatient clinic at Aarhus University Hospital were presented to the SM approach. On a Likert scale they were asked to what...... extend they were willing to change to SM compared to current routine appointments. Results: 87 % of the patients ‘agreed’ or ‘almost agreed’ to adopt the SM approach. Many patients comment that it was an excellent and timesaving idea. Those who had doubts were mainly older males with a long history...

  20. What's in a name: what analyst and patient call each other.

    Science.gov (United States)

    Barron, Grace Caroline

    2006-01-01

    Awkward moments often arise between patient and analyst involving the question, "What do we call each other?" The manner in which the dyad address each other contains material central to the patient's inner life. Names, like dreams, deserve a privileged status as providing a royal road into the paradoxical analytic relationship and the unconscious conflicts that feed it. Whether an analyst addresses the patient formally, informally, or not at all, awareness of the issues surrounding names is important.

  1. Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?

    Science.gov (United States)

    Dexter, Eve N; Fields, Scott; Rdesinski, Rebecca E; Sachdeva, Bhavaya; Yamashita, Daisuke; Marino, Miguel

    2016-01-01

    Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital. All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload. © Copyright 2016 by the American Board of Family Medicine.

  2. Emergency team calls for critically ill non-trauma patients in the emergency department

    DEFF Research Database (Denmark)

    Jensen, Søren Marker; Do, Hien Quoc; Rasmussen, Søren W.

    2015-01-01

    BACKGROUND: Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical...... the study period. RESULTS: A total of 109 emergency team calls were triggered (79 orange and 30 red), comprising 66 (60.6 %) men and 43 women, with a median age of 64 years. Patients presented with: 4 Airway, 27 Breathing, 41 Circulation, 31 Disability, 2 Exposure and 4 Other problems. Overall, 58/109 (53.......2 %) patients were admitted to the ICU, while 20/109 (18.3 %) patients were deemed ineligible for ICU admission. 30-day mortality was 34/109 (31.2 %), and circulatory problems were the most frequent cause of death (61.8 %, p = 0.02). Patients who died were significantly older than those who survived (p = 0...

  3. The impact of post-discharge patient call back on patient satisfaction in two academic emergency departments.

    Science.gov (United States)

    Guss, David A; Leland, Hyuma; Castillo, Edward M

    2013-01-01

    Patients' satisfaction is a common parameter tracked by health care systems and Emergency Departments (EDs). To determine whether telephone calls by health care providers to patients after discharge from the ED was associated with improved patient satisfaction. Retrospective analysis of Press Ganey (PG; Press Ganey Associates, South Bend, IN) surveys from two EDs operated by the University of California San Diego Health System. Responses to the YES/NO question, "After discharge, did you receive a phone call from an ED staff member?" was compared to the responses to the question "likelihood of recommending this ED to others" (LR). This variable could be ranked with a score of 1 (very poor) to 5 (very good). Responses were dichotomized into two groups, 1-4 and 5. Chi-squared was performed to assess LR between those answering YES vs. NO to the call back question. Differences in proportion, 95% confidence interval (CI), and p-value are reported. Rankings for percentage of 5s across all EDs in the PG database were compared based upon YES/NO responses. In the 12-month study period, about 30,000 surveys were mailed and 2250 (7.5%) were returned. Three hundred forty-seven (15.4%) checked off YES for the call back question. Percentage of 5s for LR for NO call back was 51.1% and for YES call back was 70.6% (difference = 19.5; 95% CI 14.0-24.6; p < 0.001).These values correlated with an ED ranking of 14(th) and 85(th) percentile, respectively. This retrospective study demonstrated a strong association between post-visit patient call back and LR. Further prospective study with control for co-variables is warranted. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Patient satisfaction with wait times at an emergency ophthalmology on-call service.

    Science.gov (United States)

    Chan, Brian J; Barbosa, Joshua; Moinul, Prima; Sivachandran, Nirojini; Donaldson, Laura; Zhao, Lily; Mullen, Sarah J; McLaughlin, Christopher R; Chaudhary, Varun

    2018-04-01

    To assess patient satisfaction with emergency ophthalmology care and determine the effect provision of anticipated appointment wait time has on scores. Single-centre, randomized control trial. Fifty patients triaged at the Hamilton Regional Eye Institute (HREI) from November 2015 to July 2016. Fifty patients triaged for next-day appointments at the HREI were randomly assigned to receive standard-of-care preappointment information or standard-of-care information in addition to an estimated appointment wait time. Patient satisfaction with care was assessed postvisit using the modified Judgements of Hospital Quality Questionnaire (JHQQ). In determining how informing patients of typical wait times influenced satisfaction, the Mann-Whitney U test was performed. As secondary study outcomes, we sought to determine patient satisfaction with the intervention material using the Fisher exact test and the effect that wait time, age, sex, education, mobility, and number of health care providers seen had on satisfaction scores using logistic regression analysis. The median JHQQ response was "very good" (4/5) and between "very good" and "excellent" (4.5/5) in the intervention and control arms, respectively. There was no difference in patient satisfaction between the cohorts (Mann-Whitney U = 297.00, p = 0.964). Logistic regression analysis demonstrated that wait times influenced patient satisfaction (OR = 0.919, 95% CI 0.864-0.978, p = 0.008). Of the intervention arm patients, 92.0% (N = 23) found the preappointment information useful, whereas only 12.5% (N = 3) of the control cohort patients noted the same (p < 0.001). Provision of anticipated wait time information to patients in an emergency on-call ophthalmology clinic did not influence satisfaction with care as captured by the JHQQ. Copyright © 2018 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  5. Improving patient care over weekends by reducing on-call work load and better time management.

    Science.gov (United States)

    Gardezi, Syed Anjum Ali

    2014-01-01

    The Royal College of Physicians states that "handover, particularly of temporary 'on-call' responsibility, has been identified as a point at which errors are likely to occur."[1] Working a weekend on-call covering medical wards is often busy and stressful for all junior doctors. The high volume of routine and unplanned tasks make the situation even worse. In Nevill Hall hospital Abergavenny, we measured the workload on a junior doctor for medical ward cover on weekends by counting the number of times he/she was bleeped for routine tasks. Initial study demonstrated that on average 30-40% of time on a long day shift was spent on jobs which could have been done on the preceding Friday. The "FRIDAYS" checklist was introduced for clinical staff (particularly junior doctors) to identify these jobs. According to this model, all the junior doctors were encouraged to review: F: Phlebotomy R: Rewriting drug charts I: IV fluids D: discharge summaries A: Antibiotic review Y: Yellow book/Warfarin dose S: Status of resuscitation and escalation plans before leaving the wards on Friday afternoon. This implementation successfully showed reduction in weekend workload, allowing the ward cover to be focused on care and safety of comparatively sick patients while at the same time reducing the stress for the on-call team.

  6. Promoting the health of amputees: an educational action called talking with the bedridden patient

    Directory of Open Access Journals (Sweden)

    Ruy Luiz Lorenzetti Branco

    2017-09-01

    Full Text Available Objective: The aim of the present study was to report the educational activity called ‘Talking with the Bedridden Patient’ based on five themes: Rehabilitation; Empowerment; Amputation; Uncertainties and Guidance. This research was conducted as part of the outreach project Multidisciplinary Rehabilitation of Amputees of the State University of Santa Catarina. The actions of the project at hospital level included: collection of notifications; conversation with bedridden patients; delivery of a kit with informative brochures and an elastic band for the bandaging of the stump; schedule for physical therapy assessment after hospital discharge in the outreach project. Method: This qualitative case study was performed with a person who had recently undergone a lower limb amputation in a public hospital in the city of São José/Santa Catarina. Results: This project proved to be efficient mainly to empower the patient for early onset of rehabilitation. Conclusion: We call attention to the importance of training hospital multidisciplinary teams involved in providing guidelines on fitting, return to work and clarification of general doubts taking into account the patient’s wishes and family support.

  7. Assessment of clinical trial participant patient satisfaction: a call to action.

    Science.gov (United States)

    Pflugeisen, Bethann Mangel; Rebar, Stacie; Reedy, Anne; Pierce, Roslyn; Amoroso, Paul J

    2016-10-06

    As patient satisfaction scores become increasingly relevant in today's health care market, we sought to evaluate satisfaction of the unique subset of patients enrolling in clinical trials in a research facility embedded within a community hospital system. We developed and deployed a patient satisfaction survey tailored to clinical trial patients who consented to and/or completed a clinical trial in our research institute in the prior year. The survey was distributed to 222 patients. Likert scale responses were analyzed using top box and percentile rank procedures. Correlation analysis was used to evaluate associations between the clinical trial experience and intent to return to our system for routine care. Ninety surveys were returned in the 6 months following the mailing for a 41 % response rate; the bulk of these (N = 81) were returned within 6 weeks of the mailing. The questions with the highest ranking responses were related to interactions with staff (84th percentile or higher). Fifty-one point one percent of patients (64th percentile) strongly agreed that they would seek future care in our system. Patient intent to return to the provider seen during the clinical trial was most highly correlated with intent to seek future care within our system (r = 0.54, p system-based clinical trials and the relationship between clinical trial participation and perception of the healthcare system as a desirable resource for routine medical care. We argue that this work is invaluable to the research community and submit a call to action to our peers to begin systematic evaluation of clinical trial patient satisfaction.

  8. [Patient education and the use of the so called complementary or alternative medicine].

    Science.gov (United States)

    Binetti, P

    2005-01-01

    Modern cultural trends are inclined to recognise to all human beings an always more ample right to become involved directly in choices affecting them. This even when health is concerned thus requiring expertise not always accessible to all. Informed consent to often gets reduced to a mere formality, having a mostly defensive purpose for the physician. Patients' education is becoming an ever more pressing issue in order to safeguard decision rights and the effective knowledge of the implications of every decision simultaneously. Patients' education has serious ethical implications which can't be eluded nor referred outside as happens when we let mass media inform on the advantages and disadvantages of various therapies. One of the major fields were this misinformed choice right is expressed is the so called complementary and alternative medicine. Nowadays physicians have to get back their therapeutical leadership once again, with renewed responsibility and through education as well. Information as such is a necessary and not sufficient condition. A sheer education involving the physician in a deeper as well as in an extended therapeutical alliance is needed. The challenge of taking care involves the whole human being: his/her sick body, his/her wounded feelings as well as intelligence which has to understand what is happening clearly.

  9. Measurement of the potential geographic accessibility from call to definitive care for patient with acute stroke.

    Science.gov (United States)

    Freyssenge, J; Renard, F; Schott, A M; Derex, L; Nighoghossian, N; Tazarourte, K; El Khoury, C

    2018-01-12

    The World Health Organization refers to stroke, the second most frequent cause of death in the world, in terms of pandemic. Present treatments are only effective within precise time windows. Only 10% of thrombolysis patients are eligible. Late assessment of the patient resulting from admission and lack of knowledge of the symptoms is the main explanation of lack of eligibility. The aim is the measurement of the time of access to treatment facilities for stroke victims, using ambulances (firemen ambulances or EMS ambulances) and private car. The method proposed analyses the potential geographic accessibility of stroke care infrastructure in different scenarios. The study allows better considering of the issues inherent to an area: difficult weather conditions, traffic congestion and failure to respect the distance limits of emergency transport. Depending on the scenario, access times vary considerably within the same commune. For example, between the first and the second scenario for cities in the north of Rhône county, there is a 10 min difference to the nearest Primary Stroke Center (PSC). For the first scenario, 90% of the population is 20 min away of the PSC and 96% for the second scenario. Likewise, depending on the modal vector (fire brigade or emergency medical service), overall accessibility from the emergency call to admission to a Comprehensive Stroke Center (CSC) can vary by as much as 15 min. The setting up of the various scenarios and modal comparison based on the calculation of overall accessibility makes this a new method for calculating potential access to care facilities. It is important to take into account the specific pathological features and the availability of care facilities for modelling. This method is innovative and recommendable for measuring accessibility in the field of health care. This study makes possible to highlight the patients' extension of care delays. Thus, this can impact the improvement of patient care and rethink the

  10. Physics in a general length space-time geometry: Call for experimental revision of the light speed anisotropy

    OpenAIRE

    Exirifard, Qasem

    2013-01-01

    We present a phenomenological model for the nature in the Finsler and Randers space-time geometries. We show that the parity-odd light speed anisotropy perpendicular to the gravitational equipotential surfaces encodes the deviation from the Riemann geometry toward the Randers geometry. We utilize an asymmetrical ring resonator and propose a setup in order to directly measure this deviation. We address the constraints that the current technology will impose on the deviation should the anisotro...

  11. An emergency call system for patients in locked-in state using an SSVEP-based brain switch.

    Science.gov (United States)

    Lim, Jeong-Hwan; Kim, Yong-Wook; Lee, Jun-Hak; An, Kwang-Ok; Hwang, Han-Jeong; Cha, Ho-Seung; Han, Chang-Hee; Im, Chang-Hwan

    2017-11-01

    Patients in a locked-in state (LIS) due to severe neurological disorders such as amyotrophic lateral sclerosis (ALS) require seamless emergency care by their caregivers or guardians. However, it is a difficult job for the guardians to continuously monitor the patients' state, especially when direct communication is not possible. In the present study, we developed an emergency call system for such patients using a steady-state visual evoked potential (SSVEP)-based brain switch. Although there have been previous studies to implement SSVEP-based brain switch system, they have not been applied to patients in LIS, and thus their clinical value has not been validated. In this study, we verified whether the SSVEP-based brain switch system can be practically used as an emergency call system for patients in LIS. The brain switch used for our system adopted a chromatic visual stimulus, which proved to be visually less stimulating than conventional checkerboard-type stimuli but could generate SSVEP responses strong enough to be used for brain-computer interface (BCI) applications. To verify the feasibility of our emergency call system, 14 healthy participants and 3 patients with severe ALS took part in online experiments. All three ALS patients successfully called their guardians to their bedsides in about 6.56 seconds. Furthermore, additional experiments with one of these patients demonstrated that our emergency call system maintains fairly good performance even up to 4 weeks after the first experiment without renewing initial calibration data. Our results suggest that our SSVEP-based emergency call system might be successfully used in practical scenarios. © 2017 Society for Psychophysiological Research.

  12. EMERGENCY CALLS

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  13. The effect of resident physician stress, burnout, and empathy on patient-centered communication during the long-call shift.

    Science.gov (United States)

    Passalacqua, Stacey A; Segrin, Chris

    2012-01-01

    During the long-call shift medical residents experience a number of stressors that could compromise the quality of care they provide to their patients. The aim of this study was to investigate how perceived stress and burnout affect changes in empathy over the long-call shift and how those changes in empathy are associated with patient-centered communication practices. Residents (n=93) completed self-report measures of stress, burnout, and empathy at the start of their long-call shift and then completed measures of empathy and patient-centered communication at the end of the same shift. There was a significant decline in physician empathy from the beginning to the end of the long-call shift. Perceived stress was significantly associated with higher burnout, which was, in turn, significantly associated with declines in empathy from pre- to posttest. Declines in empathy predicted lower self-reported patient-centered communication during the latter half of the shift. This study suggests that residents who perceive high levels of stress are at risk for burnout and deterioration in empathy toward their patients, both of which may compromise the quality of their interactions with patients.

  14. After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients.

    Science.gov (United States)

    Kelly, Michelle M; Blunt, Elizabeth; Nestor, Kelly

    2017-12-01

    Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and postparticipation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. NP students rated the experience as an educationally valuable experience despite feeling anxious and nervous about the experience. Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources. After participation NP students were more receptive to an NP position with an on-call component. Inclusion of a simulated on-call experience is a feasible component of NP education and should be added to the NP curriculum. ©2017 American Association of Nurse Practitioners.

  15. Pitfalls when implementing nurse-led annual telephone calls to replace outpatient visits for Inflammatory Bowel Disease patients

    DEFF Research Database (Denmark)

    Jakobsen, Dorrit; Bager, Palle; Hentze, Runa

    Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both for the patie......Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both...... for the patients and for the outpatient clinic. The purpose of this study was to identify potential barriers and pitfalls in the planning and implementation phase of a nurse-led telephone service. Methods: Preparations prior to introducing the annual telephone calls were done in 2010. From January 2011 all...... eligible IBD patients were shifted from regularly visits to annual telephone calls performed by an IBD nurse. As the intervention contained of several sub-elements and the elements were subject to adjustment during implementation, the intervention was regarded as a Complex Intervention. All the elements...

  16. Consumer participation in early detection of the deteriorating patient and call activation to rapid response systems: a literature review.

    Science.gov (United States)

    Vorwerk, Jane; King, Lindy

    2016-01-01

    This review investigated the impact of consumer participation in recognition of patient deterioration and response through call activation in rapid response systems. Nurses and doctors have taken the main role in recognition and response to patient deterioration through hospital rapid response systems. Yet patients and visitors (consumers) have appeared well placed to notice early signs of deterioration. In response, many hospitals have sought to partner health professionals with consumers in detection and response to early deterioration. However, to date, there have been no published research-based reviews to establish the impact of introducing consumer involvement into rapid response systems. A critical research-based review was undertaken. A comprehensive search of databases from 2006-2014 identified 11 studies. Critical appraisal of these studies was undertaken and thematic analysis of the findings revealed four major themes. Following implementation of the consumer activation programmes, the number of calls made by the consumers following detection of deterioration increased. Interestingly, the number of staff calls also increased. Importantly, mortality numbers were found to decrease in one major study following the introduction of consumer call activation. Consumer and staff knowledge and satisfaction with the new programmes indicated mixed results. Initial concerns of the staff over consumer involvement overwhelming the rapid response systems did not eventuate. Evaluation of successful consumer-activated programmes indicated the importance of: effective staff education and training; ongoing consumer education by nurses and clear educational materials. Findings indicated positive patient outcomes following introduction of consumer call activation programmes within rapid response systems. Effective consumer programmes included information that was readily accessible, easy-to-understand and available in a range of multimedia materials accompanied by the

  17. Ocular forward light scattering and corneal backward light scattering in patients with dry eye.

    Science.gov (United States)

    Koh, Shizuka; Maeda, Naoyuki; Ikeda, Chikako; Asonuma, Sanae; Mitamura, Hayato; Oie, Yoshinori; Soma, Takeshi; Tsujikawa, Motokazu; Kawasaki, Satoshi; Nishida, Kohji

    2014-09-18

    To evaluate ocular forward light scattering and corneal backward light scattering in patients with dry eye. Thirty-five eyes in 35 patients with dry eye and 20 eyes of 20 healthy control subjects were enrolled. The 35 dry eyes were classified into two groups according to whether superficial punctate keratopathy in the central 6-mm corneal zone (cSPK) was present or not. Ocular forward light scattering was quantified with a straylight meter. Corneal backward light scattering from the anterior, middle, and posterior corneal parts was assessed with a corneal densitometry program using the Scheimpflug imaging system. Both dry eye groups had significantly higher intraocular forward light scattering than the control group (both Pdry eye group with cSPK had significantly higher values in anterior and total corneal backward light scattering than the other two groups. Moderate positive correlations were observed between the cSPK score and corneal backward light scattering from the anterior cornea (R=0.60, Pdry eyes than in normal eyes. Increased corneal backward light scattering in dry eye at least partially results from cSPK overlying the optical zone. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  18. 76 FR 29773 - Call for Participation in Pillbox Patient-Safety Initiative

    Science.gov (United States)

    2011-05-23

    ... Pillbox Patient-Safety Initiative ACTION: Notice. SUMMARY: The National Library of Medicine (NLM) invites..., production version of Pillbox. This initiative is an important element of ongoing efforts to enhance patient.... SUPPLEMENTARY INFORMATION: NLM has established Pillbox, an initiative to enhance patient safety, by making...

  19. Clues to patients' explanations and concerns about their illnesses. A call for active listening.

    Science.gov (United States)

    Lang, F; Floyd, M R; Beine, K L

    2000-03-01

    Most patients who experience illness symptoms develop an explanatory model. More frequently than physicians realize, these attributions involve serious and potentially life-threatening medical conditions. Only a minority of patients spontaneously disclose or "offer" their ideas, concerns, and expectations. Often patients suggest or imply their ideas through "clues." Active listening is a skill for recognizing and exploring patients' clues. Without this communication skill, patients' real concerns often go unrecognized by health care professionals. Qualitative techniques including videotape analysis, postinterviewing debriefing, and interpersonal process recall were used to identify types of clues. We propose a taxonomy of clues that includes (1) expression of feelings (especially concern or worry), (2) attempts to understand or explain symptoms, (3) speech clues that underscore particular concerns of the patient, (4) personal stories that link the patient with medical conditions or risks, and (5) behaviors suggestive of unresolved concerns or unmet expectations. This clue taxonomy will help physicians recognize patients' clues more readily and thereby improve their active listening skills. A deeper understanding of the true reasons for the visit should result in increased patient satisfaction and improved outcomes.

  20. Incidence of call stone in liver cirrhosis patients: comparison with genera population

    International Nuclear Information System (INIS)

    Kim, Chul Jjoong; Park, Cheol Min; Park, Seung Chul; Chung, Kyoo Byung; Suh, Won Hyuck

    1994-01-01

    We investigated the incidence of gallstone detected by ultrasound in cirrhotic patients, and it was compared with that of the general population. One hundred and seventy seven patients with proven or suspected liver cirrhosis were evaluated sonographic ally to determine the presence of gallstone. We classified 177 cirrhotic patients into A,B, and C by Child classification and investigated the incidence of gallstone for each class. The control group was 363 general population with age distribution and sex-ratio similar to cirrhotic patients.Gallstone was visualized by ultrasound in 32(18.1%) of 177 cirrhotic patients. The incidence of gallstone was 13.1% in Child A, 21.0% in child B, and 20.0% in Child C cirrhotic patients. Overall incidence of gallstone was 3.9% in 363 general population. In summary, the incidence of gallstone was significantly higher in cirrhosis patients than in general population(p<0.01). The patients with moderate and severe cirrhosis showed higher incidence of gallstone than the patients with mild cirrhosis(20.5% vs 13.1%)

  1. Patient outcome of emergency laparotomy improved with increasing "number of surgeons on-call" in a university hospital: Audit loop.

    Science.gov (United States)

    Hussain, Anwar; Mahmood, Fahad; Teng, Chui; Jafferbhoy, Sadaf; Luke, David; Tsiamis, Achilleas

    2017-11-01

    Emergency laparotomy is a commonly performed high-mortality surgical procedure. The National Emergency Laparotomy Network (NELA) published an average mortality rate of 11.1% and a median length of stay equivalent to 16.3 days in patients undergoing emergency laparotomy. This study presents a completed audit loop after implementing the change of increasing the number of on-call surgeons in the general surgery rota of a university hospital. The aim of this study was to evaluate the outcomes of emergency laparotomy in a single UK tertiary centre after addition of one more consultant in the daily on-call rota. This is a retrospective study involving patients who underwent emergency laparotomy between March to May 2013 (first audit) and June to August 2015 (second audit). The study parameters stayed the same. The adult patients undergoing emergency laparotomy under the general surgical take were included. Appendicectomy, cholecystectomy and simple inguinal hernia repair patients were excluded. Data was collected on patient demographics, ASA, morbidity, 30-day mortality and length of hospital stay. Statistical analysis including logistic regression was performed using SPSS. During the second 3-month period, 123 patients underwent laparotomy compared to 84 in the first audit. Median age was 65(23-93) years. 56.01% cases were ASA III or above in the re-audit compared to 41.9% in the initial audit. 38% patients had bowel anastomosis compared to 35.7% in the re-audit with 4.2% leak rate in the re-audit compared to 16.6% in the first audit. 30-day mortality was 10.50% in the re-audit compared to 21% and median length of hospital stay 11 days in the re-audit compared to 16 days. The lower ASA grade was significantly associated with increased likelihood of being alive, as was being female, younger age and not requiring ITU admission post-operatively. However, having a second on-call consultant was 2.231 times more likely to increase the chances of patients not dying (p = 0

  2. Out of hours care: a profile analysis of patients attending the emergency department and the general practitioner on call

    Directory of Open Access Journals (Sweden)

    Buylaert Walter

    2010-11-01

    Full Text Available Abstract Background Overuse of emergency departments (ED is of concern in Western society and it is often referred to as 'inappropriate' use. This phenomenon may compromise efficient use of health care personnel, infrastructure and financial resources of the ED. To redirect patients, an extensive knowledge of the experiences and attitudes of patients and their choice behaviour is necessary. The aim of this study is to quantify the patients and socio-economical determinants for choosing the general practitioner (GP on call or the ED. Methods Data collection was conducted simultaneously in 4 large cities in Belgium. All patients who visited EDs or used the services of the GP on call during two weekends in January 2005 were enrolled in the study in a prospective manner. We used semi-structured questionnaires to interview patients from both services. Results 1611 patient contacts were suitable for further analysis. 640 patients visited the GP and 971 went to the ED. Determinants that associated with the choice of the ED are: being male, having visited the ED during the past 12 months at least once, speaking another language than Dutch or French, being of African (sub-Saharan as well as North African nationality and no medical insurance. We also found that young men are more likely to seek help at the ED for minor trauma, compared to women. Conclusions Patients tend to seek help at the service they are acquainted with. Two populations that distinctively seek help at the ED for minor medical problems are people of foreign origin and men suffering minor trauma. Aiming at a redirection of patients, special attention should go to these patients. Informing them about the health services' specific tasks and the needlessness of technical examinations for minor trauma, might be a useful intervention.

  3. Do Hospitals Owe A So-Called 'Non-Delegable' Duty of Care to their Patients?

    Science.gov (United States)

    Beuermann, Christine

    2018-02-01

    It is not uncommon for the duty of care owed by a hospital to its patients to be described as 'non-delegable'. Use of this label suggests that a hospital may be held strictly liable to a patient for the wrongdoing of a third party beyond the circumstances in which vicarious liability might be imposed. To date, no higher court has used the label to impose such liability. Notwithstanding, it was assumed by Lord Sumption in Woodland v Swimming Teachers Association that the duty of care owed by a hospital to a patient could be so described when formulating his test for determining the existence of a 'non-delegable duty of care'. This article challenges that assumption and, in turn, the veracity of the test devised by Lord Sumption.

  4. Patient, consumer, client, or customer: what do people want to be called?

    Science.gov (United States)

    Deber, Raisa B; Kraetschmer, Nancy; Urowitz, Sara; Sharpe, Natasha

    2005-12-01

    To clarify preferred labels for people receiving health care. The proper label to describe people receiving care has evoked considerable debate among providers and bio-ethicists, but there is little evidence as to the preferences of the people involved. We analysed dictionary definitions as to the derivation and connotations of such potential labels as: patient, client, customer, consumer, partner and survivor. We then surveyed outpatients from four clinical populations in Ontario, Canada about their feelings about these labels. People from breast cancer (n = 202), prostate disease (n = 202) and fracture (n = 202) clinics in an urban Canadian teaching hospital (Sharpe study), and people with HIV/AIDS at 10 specialty care clinics and three primary care practices affiliated with the HIV Ontario Observational Database (n = 431). VARIABLES AND OUTCOME MEASURES: The survey instruments included questions about opinion of label, role in treatment decision-making (the Problem Solving Decision Making scale), trust, use of information and health status. Our respondents moderately liked the label 'patient'. The other alternatives evoked moderate to strong dislike. Many alternatives to 'patient' incorporate assumptions (e.g. a market relationship) which care recipients may also find objectionable. People who are receiving care find the label 'patient' much less objectionable than the alternatives that have been suggested.

  5. Access to Mobile Communication Technology and Willingness to Participate in Automated Telemedicine Calls Among Chronically Ill Patients in Honduras

    Science.gov (United States)

    Mendoza-Avelares, Milton O.; Milton, Evan C.; Lange, Ilta; Fajardo, Roosevelt

    2010-01-01

    Abstract Objectives: Patients in underdeveloped countries may be left behind by advances in telehealthcare. We surveyed chronically ill patients with low incomes in Honduras to measure their use of mobile technologies and willingness to participate in mobile disease management support. Materials and Methods: 624 chronically ill primary care patients in Honduras were surveyed. We examined variation in telephone access across groups defined by patients' sociodemographic characteristics, diagnoses, and access to care. Logistic regression was used to identify independent correlates of patients' interest in automated telephonic support for disease management. Results: Participants had limited education (mean 4.8 years), and 65% were unemployed. Eighty-four percent had telephone access, and 78% had cell phones. Most respondents had voicemail (61%) and text messaging (58%). Mobile technologies were particularly common among patients who had to forego clinic visits and medications due to cost concerns (each p 80%) reported that they would be willing to receive automated calls focused on appointment reminders, medication adherence, health status monitoring, and self-care education. Patients were more likely to be willing to participate in automated telemedicine services if they had to cancel a clinic appointment due to transportation problems or forego medication due to cost pressures. Conclusions: Even in this poor region of Honduras, most chronically ill patients have access to mobile technology, and most are willing to participate in automated telephone disease management support. Given barriers to in-person care, new models of mobile healthcare should be developed for chronically ill patients in developing countries. PMID:21062234

  6. Experiences of wake and light therapy in patients with depression

    DEFF Research Database (Denmark)

    Kragh, Mette; Møller, Dorthe Norden; Wihlborg, Camilla Schultz

    2017-01-01

    week, 30 min of daily light treatment for the entire 9 weeks, and ongoing psychoeducation regarding good sleep hygiene. Patients kept a diary, and individual semistructured interviews were conducted. Data were analysed using qualitative content analysis. The participants' overall experience......Wake therapy can reduce depressive symptoms within days, and response rates are high. To sustain the effect, it is often combined with light therapy. Few studies have focussed on factors related to patients' adherence to the regime, and none has used qualitative methods to examine their experience...

  7. Calling the doctor: a qualitative study of patient-initiated physician consultation among rural older adults.

    Science.gov (United States)

    Stoller, Eleanor Palo; Grzywacz, Joseph G; Quandt, Sara A; Bell, Ronny A; Chapman, Christine; Altizer, Kathryn P; Arcury, Thomas A

    2011-08-01

    Guided by Leventhal's self-regulatory model and Cockerham's theory of health lifestyles, we explore two questions regarding physician consultation among elderly rural adults: What symptom characteristics prompt patient-initiated physician consultation? Do participants' accounts of responses to symptoms, including the decision to consult a physician, incorporate descriptions of change over time? We analyze data from semistructured in-depth interviews with 62 older rural adults. Accounts of decisions to initiate contact with physicians support prior research. Some symptoms encouraged immediate consultation; others prompted periods of monitoring and lay management. Physicians were most often contacted if changes were new, unusually severe, persisted or worsened, or failed to respond to lay treatment. We characterize participants' responses to symptoms as bricolages to highlight their construction from available materials. Incorporating the integrating concept of bricolage and Cockerham's emphasis on both general dispositions and symptom-specific responses represents an important extension of Leventhal's conceptualization of illness behavior, including patient-initiated physician consultation.

  8. Outcomes of patients calling emergency medical services for suspected acute cardiovascular disease

    DEFF Research Database (Denmark)

    Schoos, Mikkel Malby; Sejersten, Maria Sejersten; Baber, Usman

    2015-01-01

    Adequate health care is increasingly dependent on prehospital systems and cardiovascular (CV) disease remains the most common cause for hospital admission. However the prevalence of CV dispatches of emergency medical services (EMS) is not well reported and survival data described in clinical trials......, this study emphasizes the need for an efficient prehospital phase with focus on CV disease and proper triage of patients suitable for invasive evaluation if the outcomes of acute heart disease are to be improved further in the current international context of hospitals merging into highly specialized...

  9. The puzzle of polymorphous light eruption : Patients and pathogenesis

    NARCIS (Netherlands)

    Schornagel, I.J.

    2007-01-01

    Polymorphous light eruption (PLE) is a photosensitivity disorder of which the pathogenesis is not fully understood. Patient history in PLE is important since lesions are transient and often not present at time of consultation. Phototesting is done to reproduce the PLE skin lesions and to obtain

  10. Serious Complication of Percutaneous Angioplasty with Stent Implantation in so Called "Chronic Cerebrospinal Venous Insufficiency" in Multiple Sclerosis Patient

    Directory of Open Access Journals (Sweden)

    Ondřej Doležal

    2012-01-01

    Full Text Available We report female patient, age 51, with clinically definitive multiple sclerosis (CDMS since 1998, who underwent two PTA procedures with stent implantation for CCSVI in 2010. Expanded disability status scale (EDSS worsened since the procedure from 4.5 to 6. Total number of three stents was implanted (two of them in the right internal jugular vein. In six month time, in 2011, patient was referred for independent examination by computer tomography (CT phlebography for right-sided neck pain. Dislocation of stents on the right side and thrombosis of left sided stent was found. Conservative approach was used so far. Our short report is showing possible complications of PTA and stenting in jugular veins in so called CCSVI and bringing information about neurological state (EDSS worsening in a subject. Continuation of stent migration in the future is probable, possibly resulting in pulmonary embolism with fatal risk for the patient. We strongly ask for restriction of PTA procedure in so called CCSVI, which concept was not proven to be relevant to MS.

  11. Patient, consumer, client, or customer: what do people want to be called?

    Science.gov (United States)

    Deber, Raisa B.; Kraetschmer, Nancy; Urowitz, Sara; Sharpe, Natasha

    2005-01-01

    Abstract Objective  To clarify preferred labels for people receiving health care. Background  The proper label to describe people receiving care has evoked considerable debate among providers and bio‐ethicists, but there is little evidence as to the preferences of the people involved. Design  We analysed dictionary definitions as to the derivation and connotations of such potential labels as: patient, client, customer, consumer, partner and survivor. We then surveyed outpatients from four clinical populations in Ontario, Canada about their feelings about these labels. Setting and participants  People from breast cancer (n = 202), prostate disease (n = 202) and fracture (n = 202) clinics in an urban Canadian teaching hospital (Sharpe study), and people with HIV/AIDS at 10 specialty care clinics and three primary care practices affiliated with the HIV Ontario Observational Database (n = 431). Variables and outcome measures  The survey instruments included questions about opinion of label, role in treatment decision‐making (the Problem Solving Decision Making scale), trust, use of information and health status. Results  Our respondents moderately liked the label ‘patient’. The other alternatives evoked moderate to strong dislike. Conclusions  Many alternatives to ‘patient’ incorporate assumptions (e.g. a market relationship) which care recipients may also find objectionable. People who are receiving care find the label ‘patient’ much less objectionable than the alternatives that have been suggested. PMID:16266422

  12. Calle Blanco

    Directory of Open Access Journals (Sweden)

    Gonzalo Cerda Brintrup

    1988-06-01

    Full Text Available Importante arteria, que comunica el sector del puerto con la plaza. Las más imponentes construcciones se sucedían de un modo continuo, encaramándose a ambos lados de la empinada calle. Antes del gran incendio de 1936 grandes casonas de madera destacaban en calle Irarrázabal y en la esquina de ésta con calle Blanco, la más hermosa construcción pertenecía a don Alberto Oyarzún y la casa vecina hacia Blanco era de don Mateo Miserda, limitada por arriba con la casa de don Augusto Van Der Steldt y ésta era seguida de la casa de don David Barrientos provista de cuatro cúpulas en las esquinas y de un amplio corredor en el frontis. Todas estas construcciones de madera fueron destruidas en el gran incendio de 1936.

  13. Using an original triage and on call management tool aids identification and assessment of the acutely unwell surgical patient.

    Science.gov (United States)

    Hodge, Stacie; Helliar, Sebastian; Macdonald, Hamish Ian; Mackey, Paul

    2018-01-01

    Until now, there have been no published surgical triage tools. We have developed the first such tool with a tiered escalation policy, aiming to improve identification and management of critically unwell patients. The existing sheet which is used to track new referrals and admissions to the surgical assessment unit was reviewed. The sheet was updated and a traffic light triage tool generated using National Early Warning Scores (NEWS), sepsis criteria and user discretion. A tiered escalation policy to guide urgency of assessment was introduced and education sessions for all staff undertaken, to ensure understanding and compliance. Through multiple 'plan-do-study-act' cycles, the new system and its efficiency have been analysed. Prior to intervention, documentation of NEWS did not occur and only 13% of admission observations were communicated to the surgical team. Following multiple cycles and interventions, 93% of patients were fully triaged, and 80% of 'red' and 'amber' patients' observations were communicated to the surgical team. The average time for a registrar to review a 'red' patient was 37 min and 79% of 'green' patients were reviewed within an hour of their presentation. Rapid identification of the unwell patient is crucial. Here we publish the first triage tool that enables early assessment of septic and otherwise potentially unwell surgical patients.

  14. Lighting.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1992-09-01

    Since lighting accounts for about one-third of the energy used in commercial buildings, there is opportunity to conserve. There are two ways to reduce lighting energy use: modify lighting systems so that they used less electricity and/or reduce the number of hours the lights are used. This booklet presents a number of ways to do both. Topics covered include: reassessing lighting levels, reducing lighting levels, increasing bulb & fixture efficiency, using controls to regulate lighting, and taking advantage of daylight.

  15. The prime questions in authentic patient's consultations: a call for additional research on current and new paradigms.

    Science.gov (United States)

    Nguyen, Hanh Thi

    2013-01-01

    Although the 3 prime questions ("What did your doctor tell you the medication is for?" "How did your doctor tell you to take the medication?," and "What did your doctor tell you to expect?") have been recommended as a way to implement an interactive approach to patient's counseling in pharmacy, research examining how these questions are actually used in practice is relatively sparse. Qualitative approaches might assist to inform pertinent questions that might challenge prevailing paradigms. This commentary calls for a close look at how novice pharmacists in training manage these questions in real-life patient's consultations. These examples are aimed to provide preliminary observations about (1) how the prime questions in their original and modified forms are treated by pharmacists in training and patients, and (2) the interactional functions that the prime questions and similar questions may serve. Preliminary observations based on a conversation analysis of these examples show that the open-ended nature of the original prime questions sometimes leads to interactional problems such as delays in patients' responses and pharmacists' revision of the questions. Modified question formats that involve the use of specific knowledge expected to be possessed by a pharmacist, such as declarative questions and Q-word questions with concrete information, may lead to smoother interaction. Finally, questions about the purpose of the therapy may also be used to create opportunities to express empathy toward the patient or to shift the zone of expertise to the doctor. These initial findings suggest a more context sensitive and adaptive approach to communication in pharmacy. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Prehospital triage of patients diagnosed with perforated peptic ulcer or peptic ulcer bleeding: an observational study of patients calling 1-1-2.

    Science.gov (United States)

    Bonnesen, Kasper; Friesgaard, Kristian D; Boetker, Morten T; Nikolajsen, Lone

    2018-04-05

    Triage systems are used in emergency medical services to systematically prioritize prehospital resources according to individual patient conditions. Previous studies have shown cases of preventable deaths in emergency medical services even when triage systems are used, indicating a potential undertriage among some conditions. The aim of this study was to investigate the triage level among patients diagnosed with perforated peptic ulcer (PPU) or peptic ulcer bleeding (PUB). In a three-year period in Central Denmark Region, all patients hospitalized within 24 h after a 1-1-2 emergency call and who subsequently received either a PPU or a PUB (hereinafter combined and referred to as PPU/PUB) or a First Hour Quintet (FHQ: respiratory failure, stroke, trauma, cardiac chest pain, and cardiac arrest) diagnosis were investigated. A modified Poisson regression was used to estimate the relative risk of receiving the highest and lowest prehospital response level. Also, a linear regression analysis was used to estimate the relative risk of 30-day mortality. Of 8658 evaluated patients, 263 were diagnosed with PPU/PUB. After adjusting for relevant confounding variables, patients diagnosed with PPU/PUB were less likely to receive ambulance transportation compared to patients diagnosed with stroke, RR = 1.41 (CI: 1.28-1.56); trauma, RR = 1.28 (CI: 1.15-1.42); cardiac chest pain, RR = 1.47 (CI: 1.33-1.62); and cardiac arrest, RR = 1.44 (CI: 1.31-1.42). Among patients diagnosed with PPU/PUB, 6.5% (CI: 3.3-9.7) did not receive ambulance transportation. The proportion of patients not receiving ambulance transportation was higher among patients diagnosed with PPU/PUB compared to patients diagnosed with an FHQ diagnosis. The 30-day mortality rate among patients diagnosed with PPU/PUB was 7.8% (CI: 4.2-11.1). This was lower than the 30-day mortality rate among patients diagnosed with respiratory failure (P = 0.010), stroke (P = 0.001), and cardiac arrest (P

  17. Lighting

    Data.gov (United States)

    Federal Laboratory Consortium — Lighting Systems Test Facilities aid research that improves the energy efficiency of lighting systems. • Gonio-Photometer: Measures illuminance from each portion of...

  18. Effects of a Phone Call Intervention to Promote Adherence to Antiretroviral Therapy and Quality of Life of HIV/AIDS Patients in Baoshan, China: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Dongsheng Huang

    2013-01-01

    Full Text Available Background. Suboptimal adherence to antiretroviral therapy (ART is still pervasive. The effect of using a mobile phone call intervention to improve patient adherence is currently not known. Objective. This study aims to investigate the effects of a phone call intervention on adherence to ART and quality of life (QOL of treatment-naive and treatment-experienced patients. Methods. A randomized controlled trial was conducted in the three largest public hospitals. Adherence was measured by self-completed questionnaires. QOL was assessed by the WHOQOL-HIV BREF. Outcomes were assessed at day 15, at 1, 2, and 3 months after start of treatment for treatment-naive patients and at 3 months after study enrollment for treatment-experienced patients. Results. A total of 103 treatment-naive and 93 treatment-experienced HIV/AIDS patients were consecutively recruited. Results show that a phone call intervention could maintain high self-reported adherence among both treatment-naive and treatment-experienced patients. After three months, significant QOL improvements were observed in domains of physical health (P=0.003, level of independence (P=0.018, environment (P=0.002, and spirituality/religion/personal beliefs (P=0.021 among treatment-naive patients. Conclusion. A mobile phone call intervention to patients could maintain high adherence rates although no statistically significant differences were found. A phone call could improve some domains of QOL among treatment-naive patients.

  19. Light

    DEFF Research Database (Denmark)

    Prescott, N.B.; Kristensen, Helle Halkjær; Wathes, C.M.

    2004-01-01

    This chapter presents the effect of artificial light environments (light levels, colour, photoperiod and flicker) on the welfare of broilers in terms of vision, behaviour, lameness and mortality......This chapter presents the effect of artificial light environments (light levels, colour, photoperiod and flicker) on the welfare of broilers in terms of vision, behaviour, lameness and mortality...

  20. Bright Light Delights: Effects of Daily Light Exposure on Emotions, Restactivity Cycles, Sleep and Melatonin Secretion in Severely Demented Patients.

    Science.gov (United States)

    Münch, Mirjam; Schmieder, Michael; Bieler, Katharina; Goldbach, Rolf; Fuhrmann, Timo; Zumstein, Naomi; Vonmoos, Petra; Scartezzini, Jean-Louis; Wirz-Justice, Anna; Cajochen, Christian

    2017-01-01

    We tested whether the effects of a dynamic lighting system are superior to conventional lighting on emotions, agitation behaviour, quality of life, melatonin secretion and circadian restactivity cycles in severely demented patients. As a comparison, an age matched control patient group was exposed to conventional lighting. For none of the output measures were significant differences between the two lighting conditions found during the 8 study weeks in fall/winter. Thus, we divided the patient cohort (n = 89) into two groups, solely based on the median of their daily individual light exposure. Patients with higher average daily light exposure (>417 lx) showed significantly longer emotional expressions of pleasure and alertness per daily observations than patients with lower daily light exposure. Moreover, they had a higher quality of life, spent less time in bed, went to bed later and initiated their sleep episodes later, even though the two groups did not differ with respect to age, severity of cognitive impairment and mobility. In general, men were more agitated, had shorter sleep with more wake episodes, had a lower circadian amplitude of relative rest-wake activity and interdaily circadian stability than women. In particular, lower daily light exposures significantly predicted lower circadian amplitudes of rest-activity cycles in men but not in women. This may indicate sex specific susceptibility to daily light exposures for rest-activity regulation in older demented patients. Our results provide evidence that a higher daily light exposure has beneficial effects on emotions and thus improved quality of life in a severely demented patient group. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  1. Care and calls

    DEFF Research Database (Denmark)

    Paasch, Bettina Sletten

    -centred care through the use of tactile resources and embodied orientations while they attend to the phone call. Experienced nurses Thus perform multiactivity by distributing attention towards both the patient and the phone, and the analysis shows that their concrete ways of doing so depend on the complex...... they are telephoned during interactions with patients are not universal. Indeed different strategies have evolved in other hospital departments. Not only does this thesis contribute insights into the way nurses manage phone calls during interactions with patients, but by subscribing to a growing body of embodied...... of human interaction....

  2. Manual versus computerized filing system in nuclear medicine - a regression. A simple but effectiv system for patient calling in in-vivo diagnosis

    International Nuclear Information System (INIS)

    Spitz, J.

    1985-01-01

    A patient-filing and calling system is described which uses colour-coded data carriers and a special board. The system proved to be useful for stock display and handling of labelled activity ready for injection in patients. (orig.) [de

  3. Care and Calls

    DEFF Research Database (Denmark)

    Paasch, Bettina Sletten

    on the enactment of care but also on patient safety. Nurses working in various hospital departments have developed different strategies for handling mobile phone calls when with a patient. Additional research into the ways nurses successfully or unsuccessfully enact care and ensure patient safety when they answer......In Danish hospitals, nurses have been equipped with a mobile work phone to improve their availability and efficiency. On the phones nurses receive internal and external phone conversations, patient calls, and alarms from electronic surveillance equipment. For safety reasons the phones cannot...... be switched off or silenced; they consequently ring during all activities and also during interactions with patients. A possible tension thus arises when nurses have to be both caring and sensitive towards the patient and simultaneously be efficient and available and answer their phone. The present paper...

  4. [Remarks on the physician-patient relationship with cancer patients. Prerequisites, function, and goal of so-called Balint groups in an internal-oncological department].

    Science.gov (United States)

    Meerwein, F; Kauf, S; Schneider, G

    1976-01-01

    Drawing on their experience with their own cancer patients and with the Balint Group in the Oncological Department of Zürich's University Hospital, the authors describe the special problems arising in the doctor-patient relationship in this field. They show how the diagnosis of cancer can give rise to a feeling of sudden and complete object loss in the patient, thereby confronting the doctor with his own fear of death. The mobilization of archaic defence mechanisms in both the doctor and the patients can lead to an insoluble double-blind situation unless the doctor is able to give up his defence position and thus make it possible for the patient to give up his own fear of death and to accept the nature of his illness. The authors show how the doctor can break through the isolation of the patient in whose body-ego an archaic bad inner-object has been activated by the cancer, and build up good inner objects for him again. In the last chapter Winnicott's idea the "intermediate area" is shown to shed a new light on the phenomenon of redenial or belief in immortality.

  5. Assessment side light effects in patients after implantation of different models IOL

    Directory of Open Access Journals (Sweden)

    A. D. Chuprov

    2012-01-01

    Full Text Available Purpose: to evaluate the side effects of light in patients after implantation of IOLs of different models.Methods: the study involved 192 patients (216 eyes operated for cataract (3 groups of patients. the average age of patients was 63±0.78 years. Follow-up was 12 months. the first group included 63 patients (72 eyes after cataract extraction and implantation of the national refractive-diffractive trifocal IOL MIOL-Record 3. the second group included 64 patients (70 eyes after cataract extraction and implantation of domestic bifocal IOL refractive-diffractive MIOL-Acсord. the third group consisted of 65 patients (74 eyes after cataract extraction and IOL implantation domestic monofocal MIOL-2. the postoperative questionnaire (using a detailed oral interview was conducted after 1 week, 1, 3, 6 and 12 months. the patient is asked about the presence of these light effects: flashes of light, circles of light scatter at the sight of the light source, flash, glitter, glimmer, blindingly bright light.Results: At 2.77% (2 patients of cases in patients with MIOL-Record 3 in a detailed survey in the postoperative period revealed light effects. In patients with MIOL-Accord and MIOL-2 light effects were 2.85% (2 patients and 1.35% (1 patient. the difference between the groups was not statistically reliable.Conclusion: this study found no statistically significant increase of side light effects in patients with multifocal IOLs comparedwith monofocal IOLs.

  6. Assessment side light effects in patients after implantation of different models IOL

    Directory of Open Access Journals (Sweden)

    A. D. Chuprov

    2014-07-01

    Full Text Available Purpose: to evaluate the side effects of light in patients after implantation of IOLs of different models.Methods: the study involved 192 patients (216 eyes operated for cataract (3 groups of patients. the average age of patients was 63±0.78 years. Follow-up was 12 months. the first group included 63 patients (72 eyes after cataract extraction and implantation of the national refractive-diffractive trifocal IOL MIOL-Record 3. the second group included 64 patients (70 eyes after cataract extraction and implantation of domestic bifocal IOL refractive-diffractive MIOL-Acсord. the third group consisted of 65 patients (74 eyes after cataract extraction and IOL implantation domestic monofocal MIOL-2. the postoperative questionnaire (using a detailed oral interview was conducted after 1 week, 1, 3, 6 and 12 months. the patient is asked about the presence of these light effects: flashes of light, circles of light scatter at the sight of the light source, flash, glitter, glimmer, blindingly bright light.Results: At 2.77% (2 patients of cases in patients with MIOL-Record 3 in a detailed survey in the postoperative period revealed light effects. In patients with MIOL-Accord and MIOL-2 light effects were 2.85% (2 patients and 1.35% (1 patient. the difference between the groups was not statistically reliable.Conclusion: this study found no statistically significant increase of side light effects in patients with multifocal IOLs comparedwith monofocal IOLs.

  7. Using On-scene EMS Responders' Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers.

    Science.gov (United States)

    Scott, Greg; Clawson, Jeff; Fivaz, Mark C; McQueen, Jennie; Gardett, Marie I; Schultz, Bryon; Youngquist, Scott; Olola, Christopher H O

    2016-02-01

    Using the Medical Priority Dispatch System (MPDS) - a systematic 911 triage process - to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews. The primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews' patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN). In this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a "hot" (lights-and-siren) transport. Out of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren. With the exception of the low-acuity, ALPHA

  8. Light

    CERN Document Server

    Robertson, William C

    2003-01-01

    Why is left right and right left in the mirror? Baffled by the basics of reflection and refraction? Wondering just how the eye works? If you have trouble teaching concepts about light that you don t fully grasp yourself, get help from a book that s both scientifically accurate and entertaining with Light. By combining clear explanations, clever drawings, and activities that use easy-to-find materials, this book covers what science teachers and parents need to know to teach about light with confidence. It uses ray, wave, and particle models of light to explain the basics of reflection and refraction, optical instruments, polarization of light, and interference and diffraction. There s also an entire chapter on how the eye works. Each chapter ends with a Summary and Applications section that reinforces concepts with everyday examples. Whether you need a deeper understanding of how light bends or a good explanation of why the sky is blue, you ll find Light more illuminating and accessible than a college textbook...

  9. Evaluating the Nature of So-Called S*-State Feature in Transient Absorption of Carotenoids in Light-Harvesting Complex 2 (LH2) from Purple Photosynthetic Bacteria.

    Science.gov (United States)

    Niedzwiedzki, Dariusz M; Hunter, C Neil; Blankenship, Robert E

    2016-11-03

    Carotenoids are a class of natural pigments present in all phototrophic organisms, mainly in their light-harvesting proteins in which they play roles of accessory light absorbers and photoprotectors. Extensive time-resolved spectroscopic studies of these pigments have revealed unexpectedly complex photophysical properties, particularly for carotenoids in light-harvesting LH2 complexes from purple bacteria. An ambiguous, optically forbidden electronic excited state designated as S* has been postulated to be involved in carotenoid excitation relaxation and in an alternative carotenoid-to-bacteriochlorophyll energy transfer pathway, as well as being a precursor of the carotenoid triplet state. However, no definitive and satisfactory origin of the carotenoid S* state in these complexes has been established, despite a wide-ranging series of studies. Here, we resolve the ambiguous origin of the carotenoid S* state in LH2 complex from Rba. sphaeroides by showing that the S* feature can be seen as a combination of ground state absorption bleaching of the carotenoid pool converted to cations and the Stark spectrum of neighbor neutral carotenoids, induced by temporal electric field brought by the carotenoid cation-bacteriochlorophyll anion pair. These findings remove the need to assign an S* state, and thereby significantly simplify the photochemistry of carotenoids in these photosynthetic antenna complexes.

  10. Easing the strain of unnecessary antibiotic requests. Physicians called on to change patient expectations about antibiotic use; experts say it's about communication.

    Science.gov (United States)

    Hertz, Beth Thomas

    2014-01-10

    Antibiotic resistance is one of the world's major public health challenges, according to the Centers for Disease Control and Prevention. While medical providers are heeding the call, patient pressure about receiving antibiotic prescriptions remains a significant influencer, says the National Committee for Quality Assurance.

  11. To be called upon

    DEFF Research Database (Denmark)

    Kublitz, Anja

    2015-01-01

    When Danish Muslims explain what made them decide to travel to the Middle East and take up arms in the wake of the Arab Spring, they say that they were called upon. Displayed on videos on social media, women and sometimes children begged them to come to their rescue. In light of some...... to the mass if it is no longer a causal phenomenon that expands from small to big, but rather a simultaneous multitude of one to one relations that are neither local nor global? How are the one and the many related in this specific setting? Furthermore, many of the videos display dead bodies. How can we...

  12. Light

    CERN Document Server

    Ditchburn, R W

    1963-01-01

    This classic study, available for the first time in paperback, clearly demonstrates how quantum theory is a natural development of wave theory, and how these two theories, once thought to be irreconcilable, together comprise a single valid theory of light. Aimed at students with an intermediate-level knowledge of physics, the book first offers a historical introduction to the subject, then covers topics such as wave theory, interference, diffraction, Huygens' Principle, Fermat's Principle, and the accuracy of optical measurements. Additional topics include the velocity of light, relativistic o

  13. 99mTc-MIBI SPECT in small call lung cancer patients before chemotherapy and after unresponsive chemotherapy

    International Nuclear Information System (INIS)

    Yamamoto, Yuka; Nishiyama, Yoshihiro; Fukunaga, Kotaro; Satoh, Katashi; Fujita, Jiro; Ohkawa, Motoomi

    2001-01-01

    We evaluated the accumulation of 99m Tc-MIBI in small cell lung cancer patients before chemotherapy and after unresponsive chemotherapy. The pre-chemotherapeutic group included 22 newly diagnosed patients. These patients underwent a 99m Tc-MIBI SPECT study before starting chemotherapy. After chemotherapy, based on changes in tumor size, three different patterns of response (complete remission: CR, partial remission: PR and no change: NC) were defined. The post-chemotherapeutic group included 11 patients after chemotherapy who did not respond to chemotherapy. These patients underwent a 99m Tc-MIBI SPECT study after completion of chemotherapy. SPECT images were acquired 15 min (early) and 2 hr (delayed) after injection of 99m Tc-MIBI. With a region of interest technique, the early ratio, delayed ratio and retention index were calculated. Early and delayed ratios in pre-chemotherapeutic patients were significantly higher than those in post-chemotherapeutic patients. There were no significant differences between the pre-chemotherapeutic and post-chemotherapeutic patients in the retention index. In the pre-chemotherapeutic patients, early and delayed ratios for the CR and PR groups were significantly higher than those for the NC group. There were no significant differences in the retention index with respect to the tumor response. 99m Tc-MIBI might be useful for evaluating the tumor chemosensitivity in patients with small cell lung cancer. (author)

  14. IAEA calls for enhanced radiation protection of patients. Safety specialists warn against overuse of new imaging devices

    International Nuclear Information System (INIS)

    2009-01-01

    Advances in medical imaging techniques are allowing doctors to detect hidden diseases and make ever more accurate diagnoses. But radiation safety experts at the International Atomic Energy Agency (IAEA) say that overuse of high-tech scanning procedures may unnecessarily expose patients to increased radiation levels. The IAEA, in collaboration with other international organizations, is developing a series of measures aimed at strengthening patient protection. The focus of recent efforts is a Smart Card project, to log how much radiation a person receives in the course of a lifetime. Concern surrounds procedures such as computed tomography (CT) scans because they deliver higher doses of radiation to patients in comparison to conventional X-rays (radiographs). It's been estimated that the average radiation dose of one CT scan is equal to roughly 500 chest X-rays. And that can increase a patient's lifetime risk of cancer, particularly if CT scans are repeated. The IAEA is one of the key international players in the field of patient radiation protection. A unit dedicated to the Radiological Protection of Patients (RPoP) was established in 2001. The IAEA's activities in radiation protection of patients include training, knowledge sharing and capacity building in the medical use of radiation. Extensive, up-to-date training material for health professionals is freely available on the RPoP website. An International Action Plan on the Radiological Protection of Patients that has been established together with leading international organizations such as the World Health Organization (WHO), UNSCEAR, the International Commission on Radiological Protection (ICRP) and others to identify strategies for strengthening radiation protection of patients. Coordinating and managing technical cooperation projects with Member States on patient dose assessment. The aim is to identify the factors that contribute to unnecessary radiation dose to patients, provide guidance on dealing with

  15. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

    Directory of Open Access Journals (Sweden)

    Yen-Hsuan Hsu

    2015-06-01

    Conclusion: Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state.

  16. Call Forecasting for Inbound Call Center

    Directory of Open Access Journals (Sweden)

    Peter Vinje

    2009-01-01

    Full Text Available In a scenario of inbound call center customer service, the ability to forecast calls is a key element and advantage. By forecasting the correct number of calls a company can predict staffing needs, meet service level requirements, improve customer satisfaction, and benefit from many other optimizations. This project will show how elementary statistics can be used to predict calls for a specific company, forecast the rate at which calls are increasing/decreasing, and determine if the calls may stop at some point.

  17. The hepatitis C cascade of care among HIV infected patients: a call to address ongoing barriers to care.

    Directory of Open Access Journals (Sweden)

    Edward R Cachay

    Full Text Available The aims were to investigate the hepatitis C (HCV cascade of care among HIV-infected patients and to identify reasons for not referring for and not initiating HCV therapy after completion of HCV treatment staging.Retrospective cohort analysis of HIV-infected patients under care at the University of California, San Diego (UCSD. We identified patients screened for and diagnosed with active HCV infection. Logistic regression analyses were used to identify factors associated with lack of referral for HCV therapy. Electronic medical records were reviewed to ascertain reasons for not initiating HCV therapy.Between 2008 and 2012, 4725 HIV-infected patients received care at the UCSD Owen clinic. Most patients [4534 (96%] were screened for HCV, 748 (16% patients had reactive serum HCV antibodies but only 542 patients had active HCV infection. Lack of engagement in care was the most important predictor of non-referral for HCV therapy [odds ratio (OR: 5.08, 95% confidence interval 3.24-6.97, p<0.00001]. Other significant predictors included unstable housing (OR: 2.26, AIDS (OR: 1.83, having a detectable HIV viral load (OR: 1.98 and being non-white (OR: 1.67. The most common reason (40% for not initiating or deferring HCV therapy was the presence of ongoing barriers to care.Screening for HCV in HIV-infected patients linked to care is high but almost half of patients diagnosed with HCV are not referred for HCV therapy. Despite improvements in HCV therapy the benefits will not be realized unless effective measures for dealing with barriers to care are implemented.

  18. Using mobile phones to ensure that referred tuberculosis patients reach their treatment facilities: a call that makes a difference.

    Science.gov (United States)

    Choun, Kimcheng; Achanta, Shanta; Naik, Balaji; Tripathy, Jaya Prasad; Thai, Sopheak; Lorent, Natalie; Khun, Kim Eam; van Griensven, Johan; Kumar, Ajay M V; Zachariah, Rony

    2017-08-22

    Over the last decade, the availability and use of mobile phones have grown exponentially globally and in Cambodia. In the Sihanouk Hospital Centre of Hope(SHCH) in Cambodia about half of all tuberculosis patients referred out to peripheral health facilities for TB treatment initiation or continuation were lost to contact after referral ranging from 19 to 69% between 2008 and 2013. To address this, we implemented a mobile phone-based patient tracking intervention. Here, we report the number and proportion of referred TB patients who could be contacted through a mobile phone and retained in care after the introduction of mobile phone tracking. A descriptive study involving follow-up of TB patients referred out from SHCH to peripheral health facilities during May-October 2014. Standard operating procedures were used to contact individual patients and/or health facilities using a mobile phone. Among 109 TB patients referred to peripheral health facilities, 107(98%) had access to a mobile phone of whom, 103(97%) could be contacted directly while 5(2%) were contacted through their health care providers. A total of 108(99%) of 109 referred TB patients in intervention period were thus placed on TB treatment. This study provides preliminary, but promising evidence that using mobile phones was accompanied with improved retention of referred TB patients compared to historical cohorts. Given the limitations associated with historical controls, we need better designed studies with larger sample size to strengthen the evidence before national scale-up.

  19. Not all suffering is pain: sources of patients' suffering in the emergency department call for improvements in communication from practitioners.

    Science.gov (United States)

    Body, Richard; Kaide, Ergul; Kendal, Sarah; Foex, Bernard

    2015-01-01

    Provision of prompt, effective analgesia is rightly considered as a standard of care in the emergency department (ED). However, much suffering is not 'painful' and may be under-recognised. We sought to describe the burden of suffering in the ED and explore how this may be best addressed from a patient centred perspective. In a prospective cohort study, we included undifferentiated patients presenting to the ED. We undertook two face to face questionnaires with the first immediately following triage. We asked patients: (a) if they were 'suffering'; (b) how they were suffering; and (c) what they hoped would be done to ease this. Prior to leaving the ED, we asked patients what had been done to ease their suffering. Data were analysed thematically. Of 125 patients included, 77 (61.6%) reported suffering on direct questioning and 92 (73.6%) listed at least one way in which they were suffering. 90 (72.0%) patients had a pain score >0/10 but only 37 (29.6%) reported that pain was causing suffering. Patients reported suffering from both physical symptoms (especially pain, nausea, vomiting and dizziness) and emotional distress (notably anxiety). Treatment (to ease physical and emotional symptoms), information (particularly diagnosis, reassurance and explanation), care (notably friendly staff) and closure (being seen, resolving the problem and going home) were the key themes identified as important for relief of suffering. In seeking to ease suffering in the ED, clinicians must focus not only on providing analgesia but on treating Emotional distress, Physical symptoms, providing Information, Care and Closure (EPICC). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Acute referral of patients from general practitioners: should the hospital doctor or a nurse receive the call?

    Directory of Open Access Journals (Sweden)

    Mortensen Anne Mette M

    2011-08-01

    Full Text Available Abstract Background Surprisingly little is known about the most efficient organization of admissions to an emergency hospital. It is important to know, who should be in front when the GP requests an acute admission. The aim of the study was to analyse how experienced ED nurses perform when assessing requests for admissions, compared with hospital physicians. Methods Before- and after ED nurse assessment study, in which two cohorts of patients were followed from the time of request for admission until one month later. The first cohort of patients was included by the physicians on duty in October 2008. The admitting physicians were employed in the one of the specialized departments and only received request for admission within their speciality. The second cohort of patients was included by the ED in May 2009. They received all request from the GPs for admission, independent of the speciality in question. Results A total of 944 requests for admission were recorded. There was a non-significant trend towards the nurses admitting a smaller fraction of patients than the physicians (68 versus 74%. While the nurses almost never rejected an admission, the physicians did this in 7% of the requests. The nurses redirected 8% of the patients to another hospital, significantly more than the physicians with only 1%. (p Conclusions We found no differences in the frequency of admitted patients or unnecessary admissions, but the nurses redirected significantly more patients to the right hospital according to the catchment area, and used only half the time for the assessment. We find, that nurses, trained for the assignment, are able to handle referrals for emergency admissions, but also advise the subject to be explored in further studies including other assessment models and GP satisfaction.

  1. Decreased Time from 9-1-1 Call to PCI among Patients Experiencing STEMI Results in a Decreased One Year Mortality.

    Science.gov (United States)

    Studnek, Jonathan R; Infinger, Allison; Wilson, Hadley; Niess, Gary; Jackson, Patrick; Swanson, Doug

    2018-03-29

    The impact on mortality due to prompt recognition of ST-segment Elevation Myocardial Infarction (STEMI) patients by EMS has not been well described. The objective of this study was to describe the association between the time interval, 9-1-1 call to percutaneous intervention (PCI), and mortality at one year. This retrospective analysis included patients that were transported by EMS as a "code STEMI" and underwent PCI.  Total time from 9-1-1 call to PCI was calculated for each patient and was the independent variable of interest. Each patient's mortality status at one year was the outcome variable, collected by querying medical records and the national death index. Confounding variables were abstracted from hospital records. Logistic regression was conducted to determine the likelihood of survival given differences in time to PCI. A total of 550 patients were included in the analyses of which 68% were male with an average age 59.8 (SD 12.8). Mean reperfusion time was 81.8 min (SD 20.0) and was significantly lower in patients alive at one year (80.8 min, SD 19.7) vs. deceased at one year (93.9 min, SD 19.6), respectively. Odds of survival at one year decreased by 3% (OR 0.97; 95% CI 0.96-0.99) for every one minute increase in time to PCI. This relationship practically represents a 30% increase in mortality for every 10 minute delay from 9-1-1 call to PCI. The model produced suggests that a linear relationship exists between time to PCI and mortality in the prehospital environment with the probability of survival decreasing significantly as time to PCI increases.

  2. Attitude of Palestinian Nursing Students Toward Caring for Dying Patients: A Call for Change in Health Education Policy.

    Science.gov (United States)

    Abu-El-Noor, Nasser Ibrahim; Abu-El-Noor, Mysoon Khalikl

    2016-06-01

    Death is a natural process that occurs each day. Some nursing students may encounter the experience of taking care of a dying patient while others do not. Therefore, their attitude toward death and caring for dying patients may vary. The purpose of this study was to assess Palestinian student nurses' attitudes toward death and caring for dying patients and their families. In a cross-sectional, descriptive study, all fourth-year students at the College of Nursing, Islamic University of Gaza, Palestine, were invited to participate in this study. A total of 141 students completed the Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B). Results revealed that the mean score on the FATCOD-B was (96.96 ± 8.30). Overall, nursing students in the sample demonstrated a relatively low attitude toward caring for dying patients and their families. No statistically significant differences of students' attitudes toward caring for dying patients were found between male and female students nor between students who attended death cases and those who did not. The results suggest that theoretical nursing education should place more emphasis on palliative care to improve the quality of care at the end of life. © The Author(s) 2015.

  3. Standardized Patient Training Programs: an Efficient Solution to the Call for Quality Improvement in Oncologist Communication Skills.

    Science.gov (United States)

    Ju, Melody; Berman, Abigail T; Vapiwala, Neha

    2015-09-01

    Several key medical and oncologic professional societies have endorsed the importance of physician communication as a quality improvement metric. Despite this clear message, there remain substantial barriers to communication skills training (CST) in oncologic specialties. Herein, we describe the major barriers to communications training and propose standardized patient (SP) programs as efficient and strategic starting points and as expansion opportunities for new and existing CSTs.

  4. Who are you going to call? Primary care patients' disclosure decisions regarding direct-to-consumer genetic testing.

    Science.gov (United States)

    Wasson, Katherine; Cherny, Sara; Sanders, Tonya Nashay; Hogan, Nancy S; Helzlsouer, Kathy J

    2014-01-01

    Direct-to-consumer genetic testing (DTCGT) offers risk estimates for a variety of complex diseases and conditions, yet little is known about its impact on actual users, including their decisions about sharing the information gleaned from testing. Ethical considerations include the impact of unsolicited genetic information with variable validity and clinical utility on relatives, and the possible burden to the health care system if revealed to physicians. The qualitative study explored primary care patients' views, attitudes, and decision making considerations regarding DTCGT. This article focuses on the disclosure decisions participants made regarding participation, testing, and results of DTCGT, a topic which arose as a secondary aim of the study. Through four longitudinal interviews (pre-test, results, 3 and 12 months post-test) we examined twenty primary care patients' decisions, expressed intentions, and actions regarding disclosure to immediate and extended family, friends and coworkers, and physicians about participation in and results of DTCGT. Individual interviews were analyzed using qualitative content analysis and a summative approach to describe the global themes. Most participants disclosed to some immediate family; less than half disclosed to extended family; approximately half talked to friends. Most participants stated they would or might disclose to physicians about DTCGT and a few did. Conceptual themes that emerged from the data analysis include ambivalence about disclosure, consistency between intention and actual disclosure behavior and decisions, and conditional information sharing. Participants' intentional and actual disclosure patterns offer insight into how they view DTCGT, weigh results, and the potential impact of DTCGT.

  5. The monitoring system using laser light for the patient movement during radiation therapy

    International Nuclear Information System (INIS)

    Sano, Naoki; Onishi, Hiroshi; Yamaguchi, Motoshi; Kuriyama, Kengo; Akiyama, Saburou; Nakamura, Osamu; Araki, Tsutomu

    1997-01-01

    Purpose: The purpose of this study is to evaluate the usefulness of a newly developed real-time patient movement monitoring system built into the patient positioning light from the frontal and horizontal view. Materials and Techniques: This system is composed of 4 parts. They are a laser light projector, a retro-reflected tape, a sensor of photo-diode, and an alarm devise. First, this system projects a laser light for the patient movement monitor into the center of the crossed lines of the patient positioning light. The laser light (a diameter of 1.5mm and power of 0.5mW) for the patient movement monitor has a different wave length(633nm) from the patient positioning light. Then it is reflected into the direction of incidence with a retro-reflection tape affixed on three patient positioning points. And the system has a photo-diode which can sense the reflected laser light. This retro-reflected tape is made of tiny high reflective beads of glass which is fixed on a sheet with the thickness of 0.12mm and is able to be cut into any shape. This has a maximum retro-reflection angle of 70 degrees. We can select a tolerance of the patient movement by changing its shape and size. A buzzer strikes and a lamp is turned on to alarm for the error when the retro-reflected laser light is not sensed with the photo-diode. Results: The real-time monitoring accuracy of this system is only 0.17mm in the dimension of error for a selected tolerance of the phantom examination. Conclusion: This patient positioning system can be made simply and inexpensively and has a high monitoring accuracy. We can apply this system for a high-precision irradiation such as the three dimensional irradiation and small target irradiation

  6. Higher Serum Levels of Free ĸ plus λ Immunoglobulin Light Chains Ameliorate Survival of Hemodialysis Patients

    DEFF Research Database (Denmark)

    Thilo, Florian; Caspari, Christina; Scholze, Alexandra

    2011-01-01

    Background/Aims: Impaired immune function is common in patients with chronic renal failure. Now, we determined whether serum levels of free immunoglobulin light chains predict mortality in patients with chronic kidney disease stage 5 on hemodialysis. Methods: We performed a prospective cohort study...... of 160 hemodialysis patients with a median follow-up of 15 months (interquartile range, 3-44 months). Serum levels of free κ and λ immunoglobulin light chains were measured at the start of the study. The primary end point was mortality from any cause. Results: In survivors, median serum levels of free κ...... plus λ immunoglobulin light chains were significantly higher compared with nonsurvivors (p light chains above the median compared with patients with serum levels below the median of 210 mg...

  7. MEDICAL SERVICE - URGENT CALLS

    CERN Multimedia

    Service Médical

    2000-01-01

    IN URGENT NEED OF A DOCTOR GENEVA: EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME: Open 24h/24h 748-49-50 AMG- Association Of Geneva Doctors: Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin 719-61-11 EMERGENCIES 719-61-11 CHILDREN'S EMERGENCIES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112   FRANCE: EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ...

  8. Mutations in specific structural regions of immunoglobulin light chains are associated with free light chain levels in patients with AL amyloidosis.

    Directory of Open Access Journals (Sweden)

    Tanya L Poshusta

    Full Text Available BACKGROUND: The amyloidoses are protein misfolding diseases characterized by the deposition of amyloid that leads to cell death and tissue degeneration. In immunoglobulin light chain amyloidosis (AL, each patient has a unique monoclonal immunoglobulin light chain (LC that forms amyloid deposits. Somatic mutations in AL LCs make these proteins less thermodynamically stable than their non-amyloidogenic counterparts, leading to misfolding and ultimately the formation of amyloid fibrils. We hypothesize that location rather than number of non-conservative mutations determines the amyloidogenicity of light chains. METHODOLOGY/PRINCIPAL FINDINGS: We performed sequence alignments on the variable domain of 50 kappa and 91 lambda AL light chains and calculated the number of non-conservative mutations over total number of patients for each secondary structure element in order to identify regions that accumulate non-conservative mutations. Among patients with AL, the levels of circulating immunoglobulin free light chain varies greatly, but even patients with very low levels can have very advanced amyloid deposition. CONCLUSIONS: Our results show that in specific secondary structure elements, there are significant differences in the number of non-conservative mutations between normal and AL sequences. AL sequences from patients with different levels of secreted light chain have distinct differences in the location of non-conservative mutations, suggesting that for patients with very low levels of light chains and advanced amyloid deposition, the location of non-conservative mutations rather than the amount of free light chain in circulation may determine the amyloidogenic propensity of light chains.

  9. Impact of the Adalimumab Patient Support Program's Care Coach Calls on Persistence and Adherence in Canada: An Observational Retrospective Cohort Study.

    Science.gov (United States)

    Marshall, John K; Bessette, Louis; Thorne, Carter; Shear, Neil H; Lebovic, Gerald; Gerega, Sebastien K; Millson, Brad; Oraichi, Driss; Gaetano, Tania; Gazel, Sandra; Latour, Martin G; Laliberté, Marie-Claude

    2018-03-01

    Adalimumab (ADA) is a tumor necrosis factor-α inhibitor indicated for use in various immune-mediated inflammatory diseases. Patients receiving ADA in Canada are eligible to enroll in the AbbVie Care's Patient Support Program (PSP), which provides personalized services, including tailored interventions in the form of nurse-provided care coach calls (CCCs), with the goal of improving patients' experiences and outcomes. The primary objective of this study was to evaluate the impact of PSP services, including CCCs and patient characteristics, on persistence with and adherence to ADA for those patients enrolled in the PSP. A secondary objective was to estimate the effect of initial CCCs on treatment-initiation abandonment (ie, failure to initiate therapy after enrollment in the PSP). An observational retrospective cohort study was conducted. A patient linkage algorithm based on probabilistic matching was developed to link the AbbVie Care PSP database to the QuintilesIMS longitudinal pharmacy transaction database. Patients who started ADA therapy between July 2010 and August 2014 were selected, and their prescriptions were evaluated for 12 months after the date of ADA start to calculate days until drug discontinuation, that is, the end of persistence, defined as >90 days without therapy. Cox proportional hazards modeling was used for estimating hazard ratios for the association between persistence and patient characteristics and each PSP service. Adherence, measured by medication possession ratio, was calculated, and multivariate logistic regression provided adjusted odds ratios for the relationship between being adherent (medication possession ratio ≥80%) and patient characteristics and each PSP service. Treatment-initiation abandonment among patients who received an initial CCC compared with those who did not was analyzed using the χ 2 test. Analysis of 10,857 linked patients yielded statistically significant differences in the hazard ratio of discontinuation and

  10. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

    OpenAIRE

    Yen-Hsuan Hsu; Feng-Sheng Lin; Chi-Cheng Yang; Chih-Peng Lin; Mau-Sun Hua; Wei-Zen Sun

    2015-01-01

    Midazolam is a widely used sedative agent during colonoscopy, with cognitive toxicity. However, the potential cognitive hazard of midazolam-based light sedation has not been sufficiently examined. We aimed to examine the cognitive safety and vulnerability profile under midazolam light sedation, with a particular focus on individual variations. Methods: We conducted a prospective case-controlled study in an academic hospital. In total, 30 patients undergoing sedative colonoscopy as part of ...

  11. Impact assessment of energy-efficient lighting in patients with lupus erythematosus: a pilot study.

    Science.gov (United States)

    Fenton, L; Dawe, R; Ibbotson, S; Ferguson, J; Silburn, S; Moseley, H

    2014-03-01

    Patients with lupus erythematosus (LE) are often abnormally photosensitive. Ultraviolet (UV) exposure can not only induce cutaneous lesions but may also contribute to systemic flares and disease progression. Various forms of energy-efficient lighting have been shown to emit UV radiation. To determine the effects of these emissions on individuals with LE. This assessment investigated cutaneous responses to repeated exposures from three types of lighting: compact fluorescent lamp (CFL), light-emitting diode (LED) and energy-efficient halogen (EEH). The subjects were 15 patients with LE and a control group of five healthy volunteers. No cutaneous LE lesions were induced by any of the light sources. Delayed skin erythema was induced at the site of CFL irradiation in six of the 15 patients with LE and two of the five healthy subjects. Erythema was increased in severity and more persistent in patients with LE. One patient with LE produced a positive delayed erythema to the EEH. A single patient with LE produced immediate abnormal erythemal responses to the CFL, LED and EEH. Further investigation revealed that this patient also had solar urticaria. All other subjects had negative responses to LED exposure. Compact fluorescent lamps emit UV that can induce skin erythema in both individuals with LE and healthy individuals when situated in close proximity. However, this occurs to a greater extent and is more persistent in patients with LE. EEHs emit UVA that can induce erythema in patients with LE. LEDs provide a safer alternative light source without risk of UV exposure. © 2013 British Association of Dermatologists.

  12. The "physician on call patient engagement trial" (POPET): measuring the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis and asthma patients.

    Science.gov (United States)

    Cingi, Cemal; Yorgancioglu, Arzu; Cingi, Can Cemal; Oguzulgen, Kıvılcım; Muluk, Nuray Bayar; Ulusoy, Seçkin; Orhon, Nezih; Yumru, Cengiz; Gokdag, Dursun; Karakaya, Gul; Çelebi, Şaban; Çobanoglu, H Bengü; Unlu, Halis; Aksoy, Mehmet Akif

    2015-06-01

    In this prospective, multicenter, randomized, controlled, double-blind study, we investigated the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis (AR) and asthma patients. In total, 327 patients with diagnoses of persistent AR or mild-to-severe persistent asthma were randomized into 2 intervention groups and 2 control groups upon their admission at outpatient clinics. The intervention groups (POPET-AR and POPET-Asthma) received a mobile phone application ("physician on call patient engagement trial" [POPET]), enabling them to communicate with their physician, and record their health status and medication compliance. The AR groups completed the Rhinitis Quality of Life Questionnaire (RQLQ) at initiation and at the first month of the study. The asthma groups completed the Asthma Control Test (ACT) at initiation and at the third month of the study. The POPET-AR group showed better clinical improvement than the control group in terms of the overall RQLQ score as well in measures of general problems, activity, symptoms other than nose/eye, and emotion domains (p 19) compared with the control group (27%); this was statistically significant (p mobile engagement platform, such as POPET, can have a significant impact on health outcomes and quality of life in both AR and asthma, potentially decreasing the number of hospital admissions, repeat doctor visits, and losses in productivity. Improvements were seen in domains related to activity, productivity, perception of disease, and emotion. © 2015 ARS-AAOA, LLC.

  13. Right-to-try laws and individual patient "compassionate use" of experimental oncology medications: A call for improved provider-patient communication.

    Science.gov (United States)

    Hoerger, Michael

    2016-01-01

    The U.S. Food and Drug Administration's Expanded Access program allows patients with life-threatening diagnoses, such as advanced cancer, to use experimental medications without participating in clinical research (colloquially, "Compassionate Use"). Sixteen U.S. states recently passed "right-to-try" legislation aimed at promoting Expanded Access. Acknowledging popular support, Expanded Access could undermine clinical trials that benefit public health. Moreover, existing norms in oncologic care, for example, often lead patients to pursue intense treatments near the end of life, at the expense of palliation, and improved communication about the risks and benefits of Expanded Access would more often discourage its use.

  14. Cost-utility of COBRA-light versus COBRA therapy in patients with early rheumatoid arthritis: the COBRA-light trial

    NARCIS (Netherlands)

    ter Wee, Marieke M.; Coupé, Veerle M. H.; den Uyl, Debby; Blomjous, Birgit S.; Kooijmans, Esmee; Kerstens, Pit J. S. M.; Nurmohamed, Mike T.; van Schaardenburg, Dirkjan; Voskuyl, Alexandre E.; Boers, Maarten; Lems, Willem F.

    2017-01-01

    To evaluate if COmbinatie therapie Bij Reumatoïde Artritis (COBRA)-light therapy is cost-effective in treating patients with early rheumatoid arthritis (RA) compared with COBRA therapy. This economic evaluation was performed next to the open-label, randomised non-inferiority COBRA-light trial in 164

  15. Variation in the pattern of omissions and substitutions of grammatical morphemes in the spontaneous speech of so-called agrammatic patients.

    Science.gov (United States)

    Miceli, G; Silveri, M C; Romani, C; Caramazza, A

    1989-04-01

    We describe the patterns of omissions (and substitutions) of freestanding grammatical morphemes and the patterns of substitutions of bound grammatical morphemes in 20 so-called agrammatic patients. Extreme variation was observed in the patterns of omissions and substitutions of grammatical morphemes, both in terms of the distribution of errors for different grammatical morphemes as well as in terms of the distribution of omissions versus substitutions. Results are discussed in the context of current debates concerning the possibility of a theoretically motivated distinction between the clinical categories of agrammatism and paragrammatism and, more generally, concerning the theoretical usefulness of any clinical category. The conclusion is reached that the observed heterogeneity in the production of grammatical morphemes among putatively agrammatic patients renders the clinical category of agrammatism, and by extension all other clinical categories from the classical classification scheme (e.g., Broca's aphasia, Wernicke's aphasia, and so forth) to more recent classificatory attempts (e.g., surface dyslexia, deep dysgraphia, and so forth), theoretically useless.

  16. Experience of Southern Chinese: new challenges in treating young female breast cancer patients at child-bearing age--a call for multi-disciplinary collaboration.

    Science.gov (United States)

    Kwong, Ava; Chu, Annie Tsz-Wai

    2012-01-01

    Compared with western populations, Southern Chinese, especially those residing in Hong Kong, are experiencing increasing breast cancer incidence and also a younger onset of breast cancer. Combating this problem and treating young women with breast cancer poses specific challenges and complicated considerations. With reference to the postponement in the age of marriage and reproduction in modern societies, the issue of fertility after breast cancer, especially for high-risk young patients, is one significant quality of life concern that cannot be underestimated as a secondary medical topic. While the issue has its significance and is confronting front-line breast cancer care teams of different disciplines, related research is mostly on Caucasians. In cultures where the traditional expectation on women for child-bearing is still prominent, young breast cancer patients may endure significant distress over fertility options after breast cancer. There is a lack of related data on Asian breast cancer survivors at child-bearing age, which calls for a pressing need to encourage qualitative groundwork, case reports, and cohort experiences in hope for providing insight and arouse research interest. In order to provide a long-term comprehensive multidisciplinary management service with encouragement to encompass prospects for a positive future among young breast cancer survivors, relevant disciplines need to collaborate and work efficaciously together both on clinical and research aspects of cancer-related fertility issues.

  17. Call Center Capacity Planning

    DEFF Research Database (Denmark)

    Nielsen, Thomas Bang

    in order to relate the results to the service levels used in call centers. Furthermore, the generic nature of the approximation is demonstrated by applying it to a system incorporating a dynamic priority scheme. In the last paper Optimization of overflow policies in call centers, overflows between agent......The main topics of the thesis are theoretical and applied queueing theory within a call center setting. Call centers have in recent years become the main means of communication between customers and companies, and between citizens and public institutions. The extensively computerized infrastructure...... in modern call centers allows for a high level of customization, but also induces complicated operational processes. The size of the industry together with the complex and labor intensive nature of large call centers motivates the research carried out to understand the underlying processes. The customizable...

  18. Serum Free Light Chains in Neoplastic Monoclonal Gammopathies: Relative Under-Detection of Lambda Dominant Kappa/Lambda Ratio, and Underproduction of Free Lambda Light Chains, as Compared to Kappa Light Chains, in Patients With Neoplastic Monoclonal Gammopathies.

    Science.gov (United States)

    Lee, Won Sok; Singh, Gurmukh

    2018-07-01

    Quantitative evaluation of serum free light chains is recommended for the work up of monoclonal gammopathies. Immunoglobulin light chains are generally produced in excess of heavy chains. In patients with monoclonal gammopathy, κ/λ ratio is abnormal less frequently with lambda chain lesions. This study was undertaken to ascertain if the levels of overproduction of the two light chain types and their detection rates are different in patients with neoplastic monoclonal gammopathies. Results of serum protein electrophoresis (SPEP), serum protein immunofixation electrophoresis (SIFE), urine protein electrophoresis (UPEP), urine protein immunofixation electrophoresis (UIFE), and serum free light chain assay (SFLCA) in patients with monoclonal gammopathies were examined retrospectively. The κ/λ ratios were appropriately abnormal more often in kappa chain lesions. Ratios of κ/λ were normal in about 25% of patients with lambda chain lesions in whom free homogenous lambda light chains were detectable in urine. An illustrative case suggests underproduction of free lambda light chains, in some instances. The lower prevalence of lambda dominant κ/λ ratio in lesions with lambda light chains is estimated to be due to relative under-detection of lambda dominant κ/λ ratio in about 25% of the patients and because lambda chains are not produced in as much excess of heavy chains as are kappa chains, in about 5% of the patients. The results question the medical necessity and clinical usefulness of the serum free light chain assay. UPEP/UIFE is under-utilized.

  19. Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients

    NARCIS (Netherlands)

    van Someren, E. J.; Kessler, A.; Mirmiran, M.; Swaab, D. F.

    1997-01-01

    Light is known to be an important modulator of circadian rhythms. We tested the hypothesis than an enduring increase in the daytime environmental illumination level improves rest-activity rhythm disturbances in demented patients. Actigraphy was performed before, during, and after 4 weeks of

  20. Outsourcing an Effective Postdischarge Call Program

    Science.gov (United States)

    Meek, Kevin L.; Williams, Paula; Unterschuetz, Caryn J.

    2018-01-01

    To improve patient satisfaction ratings and decrease readmissions, many organizations utilize internal staff to complete postdischarge calls to recently released patients. Developing, implementing, monitoring, and sustaining an effective call program can be challenging and have eluded some of the renowned medical centers in the country. Using collaboration with an outsourced vendor to bring state-of-the-art call technology and staffed with specially trained callers, health systems can achieve elevated levels of engagement and satisfaction for their patients postdischarge. PMID:29494453

  1. Patient Autonomy in Talmudic Context: The Patient's "I Must Eat" on Yom Kippur in the Light of Contemporary Bioethics.

    Science.gov (United States)

    Berger, Zackary; Cahan, Rabbi Joshua

    2016-10-01

    In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment choices are sensitive to preferences. Here, we analyze a discussion in the Mishna, a foundational text of rabbinic Judaism, regarding patient autonomy in the setting of religiously mandated fasting, and commentaries in the Babylonian and Palestinian Talmuds, finding both a more expansive notion of such autonomy and a potential metaphysical grounding for it in the importance of patient self-knowledge.

  2. Callings and Organizational Behavior

    Science.gov (United States)

    Elangovan, A. R.; Pinder, Craig C.; McLean, Murdith

    2010-01-01

    Current literature on careers, social identity and meaning in work tends to understate the multiplicity, historical significance, and nuances of the concept of calling(s). In this article, we trace the evolution of the concept from its religious roots into secular realms and develop a typology of interpretations using occupation and religious…

  3. Combination treatment with excimer laser and narrowband UVB light in vitiligo patients.

    Science.gov (United States)

    Shin, Sungsik; Hann, Seung-Kyung; Oh, Sang Ho

    2016-01-01

    For the treatment of vitiligo, narrowband UVB (NBUVB) light is considered the most effective for nonsegmental vitiligo, while excimer laser treatment is commonly used for localized vitiligo. However, treatment areas may potentially be missed with excimer laser treatment. We aimed to evaluate the effect of combinational treatment with NBUVB light and excimer laser on vitiligo. All patients were first treated with NBUVB; excimer laser was then applied in conjunction with NBUVB phototherapy due to a slow response or no further improvement with continuous NBUVB treatment alone. To minimize adverse effects, a fixed dose of NBUVB was administered, and the dose of excimer laser was increased based on patient response. Among 80 patients, 54 patients showed responses after combination with excimer laser; however, 26 patients (32.5%) showed no remarkable change after combination therapy. Of the 26 patients who showed no further response, 12 patients (46.1%) presented with vitiligo on the acral areas, which are known to the least responsive sites. Our study suggests that combined treatment of NBUVB and excimer laser in vitiligo may enhance the treatment response without remarkable side effects, therefore might also increase the compliance of the patients to the treatment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Characteristics and Long-Term Outcome of Patients with Systemic Immunoglobulin Light-Chain Amyloidosis

    DEFF Research Database (Denmark)

    Nelson, Lærke Marie; Gustafsson, Finn; Gimsing, Peter

    2015-01-01

    Background/Aims: Immunoglobulin light-chain (AL) amyloidosis is a systemic disorder that causes progressive organ dysfunction. The optimal treatment strategy requires accurate patient stratification with an emphasis on the extent of cardiac involvement. Reports on its prognosis are sparse...... and predominantly originate from highly selected centers. We aimed to evaluate patient characteristics and outcomes in a cohort treated at a single center. Methods: This is a single-center retrospective study of 63 consecutive patients diagnosed with AL amyloidosis between January 2000 and December 2012. Patients...... were evaluated by treatment strategy and cardiac involvement. Results: The mean age at diagnosis was 61.4 years (±8.9), and 39 patients (62%) were male. Thirty-two (51%) patients presented with cardiac amyloid involvement (CA) and the remaining 31 (49%) had noncardiac amyloidosis (NCA). The median...

  5. Clinical assessment of serum myosin light chain I in patients with dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Takashi; Izumi, Tohru; Shibata, Akira (Niigata Univ. (Japan). School of Medicine)

    1992-08-01

    Serum cardiac myosin light chain I (LCI) levels were quantitated using a radioimmunoassay kit in patients suspected of dilated cardiomyopathy (DCM). In this study, 55 patients were evaluated between 1986 and 1991. They were composed of 40 males and 15 females, and their age was 27-75 years (51[+-]11 years). The patients with renal dysfunction were excluded due to their serum creatinine levels (>2.0 mg/dl). After cardiac catheterization, endomyocardial biopsy and echocardiography, 44 patients were diagnosed as DCM, 2 as ischemic heart disease, 2 as chronic myocarditis, 1 as restrictive cardiomyopathy, 1 as dilated hypertrophic cardiomyopathy, 1 as cardiac amyloidosis, 2 as myopathy, 1 as polymyositis and 1 as hypothyroidism. Only two patients with DCM had elevated LCI. Besides, two patients with myopathy or hypothyroidism had elevated LCI. In the follow-up, one patient died suddenly 6 months later and another showed normal value of LCI four years later. LCI elevation in DCM was not related to either the severity of heart failure or cardiac function and it showed no finding of [sup 201]Tl myocardial defect or elevated CPK. The mechanism for elevated LCI in myopathy is related to a crossreaction with myosin light chain in the skeletal muscle. In hypothyroidism, it may be related to decreased clearance of normal LCI concentration or increased myosin light chain from damaged skeletal muscle. In conclusion, it is evident that the measurement of LCI is not helpful in clinical assessment of patients with DCM, but may be useful in detection of secondary cardiomyopathy. (author).

  6. Clinical assessment of serum myosin light chain I in patients with dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Tsuda, Takashi; Izumi, Tohru; Shibata, Akira

    1992-01-01

    Serum cardiac myosin light chain I (LCI) levels were quantitated using a radioimmunoassay kit in patients suspected of dilated cardiomyopathy (DCM). In this study, 55 patients were evaluated between 1986 and 1991. They were composed of 40 males and 15 females, and their age was 27-75 years (51±11 years). The patients with renal dysfunction were excluded due to their serum creatinine levels (>2.0 mg/dl). After cardiac catheterization, endomyocardial biopsy and echocardiography, 44 patients were diagnosed as DCM, 2 as ischemic heart disease, 2 as chronic myocarditis, 1 as restrictive cardiomyopathy, 1 as dilated hypertrophic cardiomyopathy, 1 as cardiac amyloidosis, 2 as myopathy, 1 as polymyositis and 1 as hypothyroidism. Only two patients with DCM had elevated LCI. Besides, two patients with myopathy or hypothyroidism had elevated LCI. In the follow-up, one patient died suddenly 6 months later and another showed normal value of LCI four years later. LCI elevation in DCM was not related to either the severity of heart failure or cardiac function and it showed no finding of 201 Tl myocardial defect or elevated CPK. The mechanism for elevated LCI in myopathy is related to a crossreaction with myosin light chain in the skeletal muscle. In hypothyroidism, it may be related to decreased clearance of normal LCI concentration or increased myosin light chain from damaged skeletal muscle. In conclusion, it is evident that the measurement of LCI is not helpful in clinical assessment of patients with DCM, but may be useful in detection of secondary cardiomyopathy. (author)

  7. Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia

    Directory of Open Access Journals (Sweden)

    Isabela S. Oliveira

    2014-11-01

    Full Text Available Hepatitis C virus (HCV infects B-lymphocytes, provokes cellular dysfunction and causes lymphoproliferative diseases such as cryoglobulinemia and non-Hodgkin's B-cell lymphoma. In the present study, we investigated the serum levels of kappa and lambda free light chains (FLC of immunoglobulins and the kappa/lambda FLC ratio in Brazilian patients with chronic HCV infection and cryoglobulinemia. We also analyzed the immunochemical composition of the cryoglobulins in these patients. Twenty-eight cryoglobulinemic HCV patients composed the target group, while 37 HCV patients without cryoglobulinemia were included as controls. The median levels of kappa and lambda FLC were higher in patients with cryoglobulinemia compared to controls (p = 0.001 and p = 0.003, respectively, but the kappa/lambda FLC ratio was similar in patients with and without cryoglobulinemia (p > 0.05. The median FLC ratio was higher in HCV patients presenting with advanced fibrosis of the liver compared to HCV patients without fibrosis (p = 0.004. Kappa and lambda FLC levels were strongly correlated with the IgA, IgG and IgM levels in the patients with cryoglobulinemia. In patients without cryoglobulinemia, the kappa FLC level was only correlated with the IgG level, whereas the lambda FLC were weakly correlated with the IgA, IgG and IgM levels. An immunochemical pattern of mixed cryoglobulins (MC, predominantly IgM, IgG, IgA and kappa light chain, was verified in these immune complexes. We concluded that HCV-infected patients presenting cryoglobulinemia have vigorous polyclonal B-lymphocyte activation due to chronic HCV infection and persistent immune stimulation.

  8. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy.

    Science.gov (United States)

    Hsu, Yen-Hsuan; Lin, Feng-Sheng; Yang, Chi-Cheng; Lin, Chih-Peng; Hua, Mau-Sun; Sun, Wei-Zen

    2015-06-01

    Midazolam is a widely used sedative agent during colonoscopy, with cognitive toxicity. However, the potential cognitive hazard of midazolam-based light sedation has not been sufficiently examined. We aimed to examine the cognitive safety and vulnerability profile under midazolam light sedation, with a particular focus on individual variations. We conducted a prospective case-controlled study in an academic hospital. In total, 30 patients undergoing sedative colonoscopy as part of a health check-up were recruited. Neuropsychological testing on the full cognitive spectrum was evaluated at 15 minutes and 120 minutes after low-dose midazolam administration. The modified reliable change index (RCI) was used for intrapersonal comparisons and controlling for practice effects. Midazolam affected psychomotor speed (48%), memory (40%), learning (32%), working memory (17%), and sustained attention (11%), while sparing orientation and the fluency aspect of executive function at the acute stage. Residual memory (10%) and learning (10%) impairments at 2 hours after administration were evidenced in some patients. The three object recall and digit symbol coding tests can serve as useful screening tools. Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state. Copyright © 2013. Published by Elsevier B.V.

  9. Impact of Light Salt Substitution for Regular Salt on Blood Pressure of Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Carolina Lôbo de Almeida Barros

    2015-02-01

    Full Text Available Background: Studies have shown sodium restriction to have a beneficial effect on blood pressure (BP of hypertensive patients. Objective: To evaluate the impact of light salt substitution for regular salt on BP of hypertensive patients. Methods: Uncontrolled hypertensive patients of both sexes, 20 to 65 years-old, on stable doses of antihypertensive drugs were randomized into Intervention Group (IG - receiving light salt and Control Group (CG - receiving regular salt. Systolic BP (SBP and diastolic BP (DBP were analyzed by using casual BP measurements and Home Blood Pressure Monitoring (HBPM, and sodium and potassium excretion was assessed on 24-hour urine samples. The patients received 3 g of salt for daily consumption for 4 weeks. Results: The study evaluated 35 patients (65.7% women, 19 allocated to the IG and 16 to the CG. The mean age was 55.5 ± 7.4 years. Most participants had completed the Brazilian middle school (up to the 8th grade; n = 28; 80.0%, had a family income of up to US$ 600 (n = 17; 48.6% and practiced regular physical activity (n = 19; 54.3%. Two patients (5.7% were smokers and 40.0% consumed alcohol regularly (n = 14. The IG showed a significant reduction in both SBP and DBP on the casual measurements and HBPM (p < 0.05 and in sodium excretion (p = 0.016. The CG showed a significant reduction only in casual SBP (p = 0.032. Conclusions: The light salt substitution for regular salt significantly reduced BP of hypertensive patients.

  10. Impact of naturalistic lighting on hospitalized stroke patients in a rehabilitation unit

    DEFF Research Database (Denmark)

    West, Anders; Jennum, Poul; Simonsen, Sofie Amalie

    2017-01-01

    Introduction and rationale: Stroke is a major cause of acquired cerebral disability among adults, frequently accompanied by depression, anxiety, cognitive impairment, disrupted sleep and fatigue. New ways of intervention to prevent these complications are therefore needed. The major circadian...... a positive impact on the health of poststroke patients admitted to rehabilitation. We test specifically for improved sleep and less fatigue (questionnaires, polysomnography, Actiwatch), improved well-being (questionnaires), lessen anxiety and depression (questionnaires), improved cognition (tests...... on patients during long-term hospitalization in a real hospital setting. The hypotheses are based on preclinical research, as studies using naturalistic light have never been performed before. Investigating the effects of naturalistic light in a clinical setting is therefore much needed....

  11. Understanding cancer patients' reflections on good nursing care in light of Antonovsky's theory.

    Science.gov (United States)

    Kvåle, Kirsti; Synnes, Oddgeir

    2013-12-01

    Data from an empirical study about cancer patients' perception of good caring are analysed in the light of Antonovsky's theory. The aim was to reflect on whether and how health personnel by giving good care, can function as vital resources at cancer patients disposal in activating their General Resistance Resources (GRRs) in a stressful life situation, and by that contribute to promotion and maintenance of their sense of coherence. A hermeneutical approach was chosen for analysing the data. The informants were cancer patients in an oncology ward in a regional hospital in Norway. Twenty patients were interviewed, ten women and ten men. The patients had various cancer diagnoses at different stages and had different prognoses. The findings indicate that most of the patients succeeded in activating their GRRs in dealing with the stressor. Nurses, doctors, family and friends can be seen to function as vital resources at their disposal when needed. Most likely good caring supported the patient's promotion and maintenance of the components of meaningfulness, comprehensibility and manageability which form the concept sense of coherence (SOC). Health personnel can support the patients' meaningfulness by listening to the patients' stories about what still gives them meaning in life and their comprehensibility by giving good information. Alleviation of physical suffering may promote and maintain their manageability. Because all three components are intertwined, it is important to focus on all of them when caring for cancer patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. A multicenter, open-label, pilot study evaluating the functionality of an integrated call center for a digital medicine system to optimize monitoring of adherence to oral aripiprazole in adult patients with serious mental illness

    Directory of Open Access Journals (Sweden)

    Kopelowicz A

    2017-10-01

    Full Text Available Alex Kopelowicz,1 Ross A Baker,2 Cathy Zhao,2 Claudette Brewer,3 Erica Lawson,3 Timothy Peters-Strickland2 1David Geffen School of Medicine, University of California, Los Angeles, CA, 2Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ, 3Otsuka Pharmaceutical Development and Commercialization Inc., Rockville, MD, USA Background: Medication nonadherence is common in the treatment of serious mental illness (SMI and leads to poor outcomes. The digital medicine system (DMS objectively measures adherence with oral aripiprazole in near-real time, allowing recognition of adherence issues. This pilot study evaluated the functionality of an integrated call center in optimizing the use of the DMS. Materials and methods: An 8-week, open-label, single-arm trial at four US sites enrolled adults with bipolar I disorder, major depressive disorder, and schizophrenia on stable oral aripiprazole doses and willing to use the DMS (oral aripiprazole + ingestible event marker [IEM], IEM-detecting skin patch, and software application. Integrated call-center functionality was assessed based on numbers and types of calls. Ingestion adherence with prescribed treatment (aripiprazole + IEM during good patch wear and proportion of time with good patch wear (days with ≥80% patch data or detected IEM were also assessed. Results: All enrolled patients (n=49 used the DMS and were included in analyses; disease duration overall approached 10 years. For a duration of 8 weeks, 136 calls were made by patients, and a comparable 160 calls were made to patients, demonstrating interactive communication. The mean (SD number of calls made by patients was 2.8 (3.5. Approximately half of the inbound calls made by patients occurred during the first 2 weeks and were software application- or patch-related. Mean ingestion adherence was 88.6%, and corresponding good patch wear occurred on 80.1% of study days. Conclusion: In this pilot study, the integrated call center

  13. Theology links Christian ministry with God's call.

    Science.gov (United States)

    O'Connell, L J

    1984-03-01

    Catholic health care ministry originates in and is shaped by the theme of call in the Old and New Testaments. To be specifically Catholic, health professionals and facilities must define their ministries according to the values expressed in this theological tradition. Sponsorship. The opportunity to provide health care enables religious communities to contribute to God's ongoing creation process and to reiterate Christ's call to minister to others. Although health care facility sponsorship thrusts religious communities into the arena of big business, the abandonment of the health care mission could be considered a betrayal of evangelical values. Quality of life. The implicit concern for human dignity that distinguishes Catholic health care facilities should be evident in personalized patient care, just working conditions, and a commitment to healing in the civic community. Stewardship in ethics. The development of business policies and procedures and institutional responses to social change should be carefully considered in light of the Catholic understanding of loving covenant and the Christian way of life. Shared ministry. Health care facilities have played a leading role in implementing the Second Vatican Council's vision of ministry. Sponsoring communities' continued willingness to share responsibilities with laity will be imperative in meeting the health care demands of the future.

  14. The effect of polarized polychromatic noncoherent light (bioptron) therapy on patients with carpal tunnel syndrome.

    Science.gov (United States)

    Raeissadat, Seyed Ahmad; Rayegani, Seyed Mansoor; Rezaei, Sajad; Sedighipour, Leyla; Bahrami, Mohammad Hasan; Eliaspour, Dariush; Karimzadeh, Afshin

    2014-01-01

    To study the effects of Polarized Polychromatic Noncoherent Light (Bioptron) therapy on patients with carpal tunnel syndrome (CTS). This study was designed as a randomized clinical trial. Forty four patients with mild or moderate CTS (confirmed by clinical and electrodiagnostic studies) were assigned randomly into two groups (intervention and control goups). At the beginning of the study, both groups received wrist splinting for 8 weeks. Bioptron light was applied for the intervention group (eight sessions, for 3/weeks). Bioptron was applied perpendicularly to the wrist from a 10 centimeter sdistance. Pain severity and electrodiagnostic measurements were compared from before to 8 weeks after initiating each treatment. Eight weeks after starting the treatments, the mean of pain severity based on Visual Analogue Scale (VAS) scores decreased significantly in both groups. Median Sensory Nerve Action Potential (SNAP) latency decreased significantly in both groups. However, other electrophysiological findings (median Compound Motor Action Potential (CMAP) latency and amplitude, also SNAP amplitude) did not change after the therapy in both groups. There was no meaningful difference between two groups regarding the changes in the pain severity. Bioptron with the above mentioned parameters led to therapeutic effects equal to splinting alone in patients with carpal tunnel syndrome. However, applying Bioptron with different therapeutic protocols and light parameters other than used in this study, perhaps longer duration of therapy and long term assessment may reveal different results favoring Bioptron therapy.

  15. Assessing call centers’ success:

    Directory of Open Access Journals (Sweden)

    Hesham A. Baraka

    2013-07-01

    This paper introduces a model to evaluate the performance of call centers based on the Delone and McLean Information Systems success model. A number of indicators are identified to track the call center’s performance. Mapping of the proposed indicators to the six dimensions of the D&M model is presented. A Weighted Call Center Performance Index is proposed to assess the call center performance; the index is used to analyze the effect of the identified indicators. Policy-Weighted approach was used to assume the weights with an analysis of different weights for each dimension. The analysis of the different weights cases gave priority to the User satisfaction and net Benefits dimension as the two outcomes from the system. For the input dimensions, higher priority was given to the system quality and the service quality dimension. Call centers decision makers can use the tool to tune the different weights in order to reach the objectives set by the organization. Multiple linear regression analysis was used in order to provide a linear formula for the User Satisfaction dimension and the Net Benefits dimension in order to be able to forecast the values for these two dimensions as function of the other dimensions

  16. Pulmonary light-chain deposition disease: CT and pathology findings in nine patients

    International Nuclear Information System (INIS)

    Sheard, S.; Nicholson, A.G.; Edmunds, L.; Wotherspoon, A.C.; Hansell, D.M.

    2015-01-01

    Aim: To review the clinical features of nine patients with pulmonary light-chain deposition disease (LCDD) and record their high-resolution CT (HRCT) and histopathological findings. Materials and methods: Patients with a diagnosis of LCDD on lung biopsy specimen were retrospectively identified. The HRCT characteristics of nodules, cysts, and ancillary findings; change at follow-up; and histopathological findings were documented. Results: Features common to all nine cases were thin-walled cysts. In seven cases, vessels traversing the cysts were identified. The majority of patients (8/9) had at least one pulmonary nodule. There was no zonal predominance of either cysts or nodules. The disease appeared stable in the majority of cases with no serial change in HRCT appearances (5/6 cases with follow-up data, mean duration 29 months). Conclusion: To the authors' knowledge, this is the largest series of pulmonary LCDD patients in the literature, and the first systematic assessment of HRCT findings. Pulmonary cysts are a unifying feature, usually with pulmonary nodules, and serial change on HRCT is unusual. - Highlights: • Nine cases of pulmonary light chain deposition disease with high-resolution CT. • CT scans assessed for abnormal features. • Clinical data and histopathological findings obtained. • All patients had thin-walled cysts on CT, often with traversing vessels. • CT features of disease in this group are cysts, nodules and an indolent course

  17. Phenotyping polyclonal kappa and lambda light chain molecular mass distributions in patient serum using mass spectrometry.

    Science.gov (United States)

    Barnidge, David R; Dasari, Surendra; Ramirez-Alvarado, Marina; Fontan, Adrian; Willrich, Maria A V; Tschumper, Renee C; Jelinek, Diane F; Snyder, Melissa R; Dispenzieri, Angela; Katzmann, Jerry A; Murray, David L

    2014-11-07

    We previously described a microLC-ESI-Q-TOF MS method for identifying monoclonal immunoglobulins in serum and then tracking them over time using their accurate molecular mass. Here we demonstrate how the same methodology can be used to identify and characterize polyclonal immunoglobulins in serum. We establish that two molecular mass distributions observed by microLC-ESI-Q-TOF MS are from polyclonal kappa and lambda light chains using a combination of theoretical molecular masses from gene sequence data and the analysis of commercially available purified polyclonal IgG kappa and IgG lambda from normal human serum. A linear regression comparison of kappa/lambda ratios for 74 serum samples (25 hypergammaglobulinemia, 24 hypogammaglobulinemia, 25 normal) determined by microflowLC-ESI-Q-TOF MS and immunonephelometry had a slope of 1.37 and a correlation coefficient of 0.639. In addition to providing kappa/lambda ratios, the same microLC-ESI-Q-TOF MS analysis can determine the molecular mass for oligoclonal light chains observed above the polyclonal background in patient samples. In 2 patients with immune disorders and hypergammaglobulinemia, we observed a skewed polyclonal molecular mass distribution which translated into biased kappa/lambda ratios. Mass spectrometry provides a rapid and simple way to combine the polyclonal kappa/lambda light chain abundance ratios with the identification of dominant monoclonal as well as oligoclonal light chain immunoglobulins. We anticipate that this approach to evaluating immunoglobulin light chains will lead to improved understanding of immune deficiencies, autoimmune diseases, and antibody responses.

  18. Trials of bright light exposure and melatonin administration in a patient with non-24 hour sleep-wake syndrome.

    Science.gov (United States)

    Hayakawa, T; Kamei, Y; Urata, J; Shibui, K; Ozaki, S; Uchiyama, M; Okawa, M

    1998-04-01

    We report a patient with non-24 h sleep-wake syndrome (non-24) whose free-running sleep-wake cycle was successfully treated with both scheduled bright light exposure and melatonin treatment. In the present study, morning bright light as well as evening melatonin phase-advanced sleep-wake cycles and melatonin rhythm. Both these procedures achieved appropriate entrainment to a 24 h day. However, the patient did not continue morning bright light therapy after the discharge. Rising at appropriate times in the morning for bright light therapy was difficult for him to continue. Melatonin treatment was better tolerated because of its ease of application.

  19. The prevalence of antinuclear antibodies in patients with apparent polymorphic light eruption.

    Science.gov (United States)

    Murphy, G M; Hawk, J L

    1991-11-01

    Polymorphic light eruption (PLE) is a very common photosensitive disorder, the most important differential diagnosis of which is lupus erythematosus (LE). One-hundred and forty-two patients with PLE were screened for circulating antinuclear (ANA), Ro and La antibodies over a 2-year period. Results were negative in 66 patients. Sixty-two patients had low-titre ANA of various patterns, ranging from trace to 1/80 without evidence of LE although one later developed subacute cutaneous LE. Fourteen had more significant findings, six with ANA ranging from 1/160 to 1/1280 but no anti-Ro antibodies, four with ANA ranging from 1/160 to 1/1280 and also with anti-Ro antibodies and four patients with anti-Ro antibodies but low-titre ANA, one of whom later developed discoid LE. Three of these 14 patients fulfilled the American Rheumatism Association criteria for the diagnosis of systemic LE, but it was not certain in any of the patients whether the PLE-like rash represented cutaneous LE or coincidental PLE. However the overall 10% incidence of definite or possible LE in patients with suspected PLE suggests that all PLE patients should be screened for LE.

  20. Partitioning a call graph

    NARCIS (Netherlands)

    Bisseling, R.H.; Byrka, J.; Cerav-Erbas, S.; Gvozdenovic, N.; Lorenz, M.; Pendavingh, R.A.; Reeves, C.; Röger, M.; Verhoeven, A.; Berg, van den J.B.; Bhulai, S.; Hulshof, J.; Koole, G.; Quant, C.; Williams, J.F.

    2006-01-01

    Splitting a large software system into smaller and more manageable units has become an important problem for many organizations. The basic structure of a software system is given by a directed graph with vertices representing the programs of the system and arcs representing calls from one program to

  1. CALLING AQUARIUM LOVERS...

    CERN Multimedia

    2002-01-01

    CERN's anemones will soon be orphans. We are looking for someone willing to look after the aquarium in the main building, for one year. If you are interested, or if you would like more information, please call 73830. (The anemones living in the aquarium thank you in anticipation.)

  2. A call for surveys

    DEFF Research Database (Denmark)

    Bernstein, Philip A.; Jensen, Christian S.; Tan, Kian-Lee

    2012-01-01

    The database field is experiencing an increasing need for survey papers. We call on more researchers to set aside time for this important writing activity. The database field is growing in population, scope of topics covered, and the number of papers published. Each year, thousands of new papers ...

  3. Call for Research

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

    Marie-Isabelle Beyer

    2014-10-03

    Oct 3, 2014 ... 5.Submission process. 6.Eligibility criteria. 7.Selection Process. 8. Format and requirements. 9.Evaluation criteria. 10.Country clearance requirements. 11. .... It is envisaged that through this call a single consortium will undertake 6-8 projects within a total budget of up to ... principle qualify for IDRC's support.

  4. Too close to call

    DEFF Research Database (Denmark)

    Kurrild-Klitgaard, Peter

    2012-01-01

    a number of other frequent explanations and is found to be quite robust. When augmented with approval ratings for incumbent presidents, the explanatory power increases to 83 pct. and only incorrectly calls one of the last 15 US presidential elections. Applied to the 2012 election as a forecasting model...

  5. Effect of pulsed laser light in patients with dry eye syndrome.

    Science.gov (United States)

    Guilloto Caballero, S; García Madrona, J L; Colmenero Reina, E

    2017-11-01

    The objective of this study was to determine the clinical benefits of pulsed light therapy for the treatment of Dry Eye Syndrome (DES) due to the decrease in aqueous tear production (aqueous deficient DES) and/or excessive tear evaporation (evaporative DES) due to Meibomian Gland Dysfunction (MGD). A study was conducted on 72 eyes corresponding to 36 patients with DES. Out of these 72 eyes, 60 underwent refractive surgery (48 with femtosecond laser, 6 were operated with a mechanical microkeratome, and 6 with refractive photo-keratectomy[RPK], 6 treated with phacoemulsification, and 6 with no previous surgical treatment. Pulsed laser light (Intense Pulsed Light Regulated [IRPL ® ]) was use to stimulate the secretion of the Meibomian glands during 4 sessions, one every 15 days. Patients with aqueous deficient DES did not show any improvement. Eyes with no previous surgery and those treated with phacoemulsification and PRK had a favourable outcome. On the other hand, less conclusive results were observed in the eyes treated with excimer laser. This treatment could be very helpful to treat evaporative DES produced by MGD. On the other hand, it is not helpful for those cases related to an isolated damage in the aqueous phase, or the mucin phase. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Muscle pathology in myotonic dystrophy: light and electron microscopic investigation in eighteen patients.

    Science.gov (United States)

    Nadaj-Pakleza, A; Lusakowska, A; Sułek-Piątkowska, A; Krysa, W; Rajkiewicz, M; Kwieciński, H; Kamińska, A

    2011-05-01

    Myotonic dystrophy (DM) is the most common muscular dystrophy in adults. Two known genetic subtypes include DM1 (myotonic dystrophy type 1) and DM2 (myotonic dystrophy type 2). Genetic testing is considered as the only reliable diagnostic criterion in myotonic dystrophies. Relatively little is known about DM1 and DM2 myopathology. Thus, the aim of our study was to characterise light and electron microscopic features of DM1 and DM2 in patients with genetically proven types of the disease. We studied 3 DM1 cases and 15 DM2 cases from which muscle biopsies were taken for diagnostic purposes during the period from 1973 to 2006, before genetic testing became available at our hospital. The DM1 group included 3 males (age at biopsy 15-19). The DM2 group included 15 patients (5 men and 10 women, age at biopsy 26-60). The preferential type 1 fibre atrophy was seen in all three DM1 cases in light microscopy, and substantial central nucleation was present in two biopsies. Electron microscopy revealed central nuclei in all three examined muscle biopsies. No other structural or degenerative changes were detected, probably due to the young age of our patients. Central nucleation, prevalence of type 2 muscle fibres, and the presence of pyknotic nuclear clumps were observed in DM2 patients in light microscopy. Among the ultrastructural abnormalities observed in our DM2 group, the presence of internal nuclei, severely atrophied muscle fibres, and lipofuscin accumulation were consistent findings. In addition, a variety of ultrastructural abnormalities were identified by us in DM2. It appears that no single ultrastructural abnormality is characteristic for the DM2 muscle pathology. It seems, however, that certain constellations of morphological changes might be indicative of certain types of myotonic dystrophy.

  7. Antinuclear antibodies in patients with polymorphic light eruption: a long-term follow-up study.

    Science.gov (United States)

    Tzaneva, S; Volc-Platzer, B; Kittler, H; Hönigsmann, H; Tanew, A

    2008-05-01

    Previous studies have shown elevated titres of antinuclear antibodies (ANA) in 2.9-19% of patients with polymorphic light eruption (PLE). A diagnosis of lupus erythematosus (LE) was finally established in some of these ANA-positive patients. To investigate whether the presence of ANA in patients with PLE merely represents an epiphenomenon or is associated with an increased risk of eventual progression to LE. We identified 472 patients with PLE who had received prophylactic photo(chemo)therapy between 1986 and 2003 and were routinely tested for the presence of ANA. All ANA-positive (ANA titre of>or=1:80) patients were asked to attend for a follow-up examination comprising a medical history, complete skin inspection and a detailed laboratory analysis including ANA and antibodies against extractable nuclear antigens. Of all the patients, 55 (11.7%) were found to be ANA positive on one or several occasions, and three (0.6%) also had antibodies to SS-A/Ro. Thirty-nine (71%) of all ANA-positive patients including all Ro+ subjects were available for follow-up after a median follow-up period of 8 years (interquartile range 5-11.5). Twenty-five patients showed persistence of ANA positivity with a median titre of 1:160 (range 1:80-1:640), whereas in 14 patients ANA titres had returned to normal levels. None of the patients revealed additional clinical, histopathological or laboratory abnormalities suggestive of LE. After a median follow-up period of 8 years none of the ANA-positive patients developed LE. Our findings indicate that PLE is a benign disease without tendency to progress to LE.

  8. Flight calls and orientation

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Andersen, Bent Bach; Kropp, Wibke

    2008-01-01

    flight calls was simulated by sequential computer controlled activation of five loudspeakers placed in a linear array perpendicular to the bird's migration course. The bird responded to this stimulation by changing its migratory course in the direction of that of the ‘flying conspecifics' but after about......  In a pilot experiment a European Robin, Erithacus rubecula, expressing migratory restlessness with a stable orientation, was video filmed in the dark with an infrared camera and its directional migratory activity was recorded. The flight overhead of migrating conspecifics uttering nocturnal...... 30 minutes it drifted back to its original migration course. The results suggest that songbirds migrating alone at night can use the flight calls from conspecifics as additional cues for orientation and that they may compare this information with other cues to decide what course to keep....

  9. The User Knows What to Call It: Incorporating Patient Voice Through User-Contributed Tags on a Participatory Platform About Health Management.

    Science.gov (United States)

    Chen, Annie T; Carriere, Rachel M; Kaplan, Samantha Jan

    2017-09-07

    Body listening, described as the act of paying attention to the body's signals and cues, can be an important component of long-term health management. The aim of this study was to introduce and evaluate the Body Listening Project, an innovative effort to engage the public in the creation of a public resource-to leverage collective wisdom in the health domain. This project involved a website where people could contribute their experiences of and dialogue with others concerning body listening and self-management. This article presents an analysis of the tags contributed, with a focus on the value of these tags for knowledge organization and incorporation into consumer-friendly health information retrieval systems. First, we performed content analysis of the tags contributed, identifying a set of categories and refining the relational structure of the categories to develop a preliminary classification scheme, the Body Listening and Self-Management Taxonomy. Second, we compared the concepts in the Body Listening and Self-Management Taxonomy with concepts that were automatically identified from an extant health knowledge resource, the Unified Medical Language System (UMLS), to better characterize the information that participants contributed. Third, we employed visualization techniques to explore the concept space of the tags. A correlation matrix, based on the extent to which categories tended to be assigned to the same tags, was used to study the interrelatedness of the taxonomy categories. Then a network visualization was used to investigate structural relationships among the categories in the taxonomy. First, we proposed a taxonomy called the Body Listening and Self-Management Taxonomy, with four meta-level categories: (1) health management strategies, (2) concepts and states, (3) influencers, and (4) health-related information behavior. This taxonomy could inform future efforts to organize knowledge and content of this subject matter. Second, we compared the

  10. Reading performance of monofocal pseudophakic patients with and without glasses under normal and dim light conditions.

    Science.gov (United States)

    Radner, Wolfgang; Radner, Stephan; Raunig, Valerian; Diendorfer, Gabriela

    2014-03-01

    To evaluate reading performance of patients with monofocal intraocular lenses (IOLs) (Acrysof SN60WF) with or without reading glasses under bright and dim light conditions. Austrian Academy of Ophthalmology, Vienna, Austria. Evaluation of a diagnostic test or technology. In pseudophakic patients, the spherical refractive error was limited to between +0.50 diopter (D) and -0.75 D with astigmatism of 0.75 D (mean spherical equivalent: right eye, -0.08 ± 0.43 [SD]; left eye, -0.15 ± 0.35). Near addition was +2.75 D. Reading performance was assessed binocularly with or without reading glasses at an illumination of 100 candelas (cd)/m(2) and 4 cd/m(2) using the Radner Reading Charts. In the 25 patients evaluated, binocularly, the mean corrected distance visual acuity was -0.07 ± 0.06 logMAR and the mean uncorrected distance visual acuity was 0.01 ± 0.11 logMAR. The mean reading acuity with reading glasses was 0.02 ± 0.10 logRAD at 100 cd/m(2) and 0.12 ± 0.14 logRAD at 4 cd/m(2). Without reading glasses, it was 0.44 ± 0.13 logRAD and 0.56 ± 0.16 logRAD, respectively (P light conditions. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Early Prognostic Value of Monitoring Serum Free Light Chain in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation.

    Science.gov (United States)

    Özkurt, Zübeyde Nur; Sucak, Gülsan Türköz; Akı, Şahika Zeynep; Yağcı, Münci; Haznedar, Rauf

    2017-03-16

    We hypothesized the levels of free light chains obtained before and after autologous stem cell transplantation can be useful in predicting transplantation outcome. We analyzed 70 multiple myeloma patients. Abnormal free light chain ratios before stem cell transplantation were found to be associated early progression, although without any impact on overall survival. At day +30, the normalization of levels of involved free light chain related with early progression. According to these results almost one-third reduction of free light chain levels can predict favorable prognosis after autologous stem cell transplantation.

  12. FERMILAB: Call for physics

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    Several hundred physicists attended a special Fermilab 'All Experimenter's Meeting' on November 20 to hear Director John Peoples call for new Tevatron Collider proposals for the years 2000-2005, when the new Main Injector will be complete. At the Tevatron proton-antiproton collider, the CDF and DO experiments are currently completing improvements for Run II to use the Tevatron when the Main Injector is complete later in this decade. New proposals would be aimed at a Collider Run III to follow these CDF and DO efforts

  13. Implementing Distributed Algorithms using Remote Procedure Call

    NARCIS (Netherlands)

    Bal, H.E.; van Renesse, R.; Tanenbaum, A.S.

    1987-01-01

    Remote procedure call (RPC) is a simple yet powerful primitiv~ for communication and synchronization between distributed processes. A problem with RPC is that it tends to decrease the amount of parallelism in an application due to its synchronous nature. This paper shows how light-weight processes

  14. An Island Called Cuba

    Directory of Open Access Journals (Sweden)

    Jean Stubbs

    2011-06-01

    Full Text Available Review of: An Island Called Home: Returning to Jewish Cuba. Ruth Behar, photographs by Humberto Mayol. New Brunswick NJ: Rutgers University Press, 2007. xiii + 297 pp. (Cloth US$ 29.95 Fidel Castro: My Life: A Spoken Autobiography. Fidel Castro & Ignacio Ramonet. New York: Scribner/Simon & Schuster, 2008. vii + 724 pp. (Paper US$ 22.00, e-book US$ 14.99 Cuba: What Everyone Needs to Know. Julia E. Sweig. New York: Oxford University Press, 2009. xiv + 279 pp. (Paper US$ 16.95 [First paragraph] These three ostensibly very different books tell a compelling story of each author’s approach, as much as the subject matter itself. Fidel Castro: My Life: A Spoken Autobiography is based on a series of long interviews granted by the then-president of Cuba, Fidel Castro, to Spanish-Franco journalist Ignacio Ramonet. Cuba: What Everyone Needs to Know, by U.S. political analyst Julia Sweig, is one of a set country series, and, like Ramonet’s, presented in question/answer format. An Island Called Home: Returning to Jewish Cuba, with a narrative by Cuban-American anthropologist Ruth Behar and photographs by Cuban photographer Humberto Mayol, is a retrospective/introspective account of the Jewish presence in Cuba. While from Ramonet and Sweig we learn much about the revolutionary project, Behar and Mayol convey the lived experience of the small Jewish community against that backdrop.

  15. Call for volunteers

    CERN Document Server

    2008-01-01

    CERN is calling for volunteers from all members of the Laboratory for organizing the two exceptional Open days.CERN is calling for volunteers from all members of the Laboratory’s personnel to help with the organisation of these two exceptional Open Days, for the visits of CERN personnel and their families on the Saturday and above all for the major public Open Day on the Sunday. As for the 50th anniversary in 2004, the success of the Open Days will depend on a large number of volunteers. All those working for CERN as well as retired members of the personnel can contribute to making this event a success. Many guides will be needed at the LHC points, for the activities at the surface and to man the reception and information points. The aim of these major Open Days is to give the local populations the opportunity to discover the fruits of almost 20 years of work carried out at CERN. We are hoping for some 2000 volunteers for the two Open Days, on the Saturday from 9 a.m. to ...

  16. "Ultimately, mom has the call": Viewing clinical trial decision making among patients with ovarian cancer through the lens of relational autonomy.

    Science.gov (United States)

    Asiedu, Gladys B; Ridgeway, Jennifer L; Carroll, Katherine; Jatoi, Aminah; Radecki Breitkopf, Carmen

    2018-04-14

    This study employs the concept of relational autonomy to understand how relational encounters with family members (FMs) and care providers may shape decisions around ovarian cancer patients' clinical trial (CT) participation. The study also offers unique insights into how FMs view patients' decision making. In-depth interviews were conducted with 33 patients with ovarian cancer who had been offered a CT and 39 FMs. Data were inductively analysed using a thematic approach and deductively informed by constructs derived from the theory of relational autonomy (RA). Patients' relationships, experiences and social status were significant resources that shaped their decisions. Patients did not give equal weight to all relationships and created boundaries around whom to include in decision making. Doctors' recommendations and perceived enthusiasm were described as influential in CT decisions. Both patients with ovarian cancer and their FMs maintained that patients have the "final say," indicating an individualistic autonomy. However, maintaining the "final say" in the decision-making process is constitutive of patients' relationships, emphasizing a relational approach to autonomy. FMs support patients' autonomy and they do so particularly when they believe the patient is capable of making the right choices. Although ethical principles underlying informed consent for CT participation emphasize individual autonomy, greater attention to relational autonomy is warranted for a more comprehensive understanding of CT decision making. © 2018 Mayo Clinic. Health Expectations published by John Wiley & Sons Ltd.

  17. Psychometric Analysis and Qualitative Review of an Outpatient Radiology-Specific Patient Satisfaction Survey: A Call for Collaboration in Validating a Survey Instrument.

    Science.gov (United States)

    Dibble, Elizabeth H; Baird, Grayson L; Swenson, David W; Healey, Terrance T

    2017-10-01

    The aim of this study was to perform a psychometric analysis of the constructs and reliability of an outpatient radiology-specific patient satisfaction survey and identify factors that drive patient experience so that radiology practices can improve the quality of their diagnostic imaging services. This retrospective study examined responses to eight patient satisfaction questions from a survey originally developed by a nascent marketing team and then administered at five outpatient imaging centers from January 7, 2013, to November 11, 2015. Patients' responses were reviewed to identify factors that affected patient experience, and a psychometric analysis of the survey instrument itself was performed, including exploratory factor analyses and reliability testing. Patient responses were compared among sites, examination types, and questions. Free-text comments were qualitatively categorized and compared by examination type. In total, 6,512 surveys were completed among 137,059 patient encounters. Using exploratory factor analyses of the eight survey questions, three relevant patient experience constructs were derived: (1) front office experience, (2) intake experience, and (3) examination experience. Overall, good scale reliability was observed. Perceived quality of care had the most positive ratings; wait time had the most nonpositive ratings. Of 2,024 free-text comments, 1,859 were positive (most pertaining to staff), and 155 were negative (most pertaining to convenience). MRI patients were most likely to share negative comments, typically regarding the examination experience itself. Psychometric analysis of a patient survey derived three core patient experience constructs: front office experience, intake experience, and examination experience. The survey indicates the need to decrease wait times, streamline the registration process, and improve patient comfort during MRI examinations. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All

  18. Patient-reported opioid analgesic requirements after elective inguinal hernia repair: A call for procedure-specific opioid-administration strategies.

    Science.gov (United States)

    Mylonas, Konstantinos S; Reinhorn, Michael; Ott, Lauren R; Westfal, Maggie L; Masiakos, Peter T

    2017-11-01

    A better understanding of the analgesia needs of patients who undergo common operative procedures is necessary as we address the growing opioid public health crisis in the United States. The aim of this study was to evaluate patient experience with our opioid prescribing practice after elective inguinal hernia repairs. A prospective, observational study was conducted between October 1, 2015, and September 30, 2016, in a single-surgeon, high-volume, practice of inguinal hernia operation. Adult patients undergoing elective inguinal herniorrhaphy under local anesthesia with intravenous sedation were invited to participate. All patients were prescribed 10 opioid analgesic tablets postoperatively and were counseled to reserve opioids for pain not controlled by nonopioid analgesics. Their experience was captured by completing a questionnaire 2 to 3 weeks postoperatively during their postoperative visit. A total of 185 patients were surveyed. The majority of the participants were males (177, 95.7%) and ≥60 years old (96, 51.9%). Of the 185 patients, 159 (85.9%) reported using ≤4 opioid tablets; 110 patients (59.5%) reported that they used no opioid analgesics postoperatively. None of the patients was taking opioids within 7 days of their postoperative appointment. Of the 147 patients who were employed, 111 (75.5%) reported missing ≤3 work days, 57 of whom (51.4%) missed no work at all. Patients who were employed were more likely to take opioid analgesics postoperatively (P = .049). Patients who took no opioid analgesics experienced less maximum (P require any opioid analgesics, and nearly all of those who thought that they did need opioids used reserved.

  19. Prognostic value of serum heavy/light chain ratios in patients with POEMS syndrome.

    Science.gov (United States)

    Wang, Chen; Su, Wei; Cai, Qian-Qian; Cai, Hao; Ji, Wei; Di, Qian; Duan, Ming-Hui; Cao, Xin-Xin; Zhou, Dao-Bin; Li, Jian

    2016-07-01

    POEMS syndrome is a rare plasma cell dyscrasia. Serum concentrations of the monoclonal protein in this disorder are typically low, and inapplicable to monitor disease activity in most cases, resulting in limited practical and prognostic values. Novel immunoassays measuring isotype-specific heavy/light chain (HLC) pairs showed its utility in disease monitoring and outcome prediction in several plasma cell dyscrasias. We report results of HLC measurements in 90 patients with POEMS syndrome. Sixty-six patients (73%; 95% confidence interval, 63-82%) had an abnormal HLC ratio at baseline. It could stratify the risk of disease relapse and was strongly associated with worse progression-free survival in a multivariate analysis (P = 0.021; hazard ratio [HR] 6.89, 95% CI 1.34-35.43). After therapy, HLC ratios improved, with 43 patients (48%) remaining abnormal. The post-therapeutic HLC ratio, if abnormal, also remained as an independent prognostic factor associated with worse progression-free survival (P = 0.019; HR 4.30, 95% CI 1.27-14.56). These results suggest the prognostic utility of HLC ratios in clinical management of POEMS patients. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Blended call center with idling times during the call service

    NARCIS (Netherlands)

    Legros, Benjamin; Jouini, Oualid; Koole, Ger

    We consider a blended call center with calls arriving over time and an infinitely backlogged amount of outbound jobs. Inbound calls have a non-preemptive priority over outbound jobs. The inbound call service is characterized by three successive stages where the second one is a break; i.e., there is

  1. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

    Science.gov (United States)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

    2018-01-05

    Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

  2. Care and calls

    DEFF Research Database (Denmark)

    Paasch, Bettina Sletten

    In this thesis, Bettina Sletten Paasch conducts research on the use of mobile work phones in the practices of nurses. On-going demands for efficiency have triggered the implementation of multiple technologies in Danish hospitals. One such technology is mobile phones. With care being a key value...... in nursing, a potential tension arises when nurses have to attend simultaneously to both a patient and a ringing mobile work phone. Using discursive and interactional approaches, this thesis explores if and how nurses are able to enact care during interactions with patients when mobile work phones intervene...

  3. Development of a patient-specific anatomical foot model from structured light scan data.

    Science.gov (United States)

    Lochner, Samuel J; Huissoon, Jan P; Bedi, Sanjeev S

    2014-01-01

    The use of anatomically accurate finite element (FE) models of the human foot in research studies has increased rapidly in recent years. Uses for FE foot models include advancing knowledge of orthotic design, shoe design, ankle-foot orthoses, pathomechanics, locomotion, plantar pressure, tissue mechanics, plantar fasciitis, joint stress and surgical interventions. Similar applications but for clinical use on a per-patient basis would also be on the rise if it were not for the high costs associated with developing patient-specific anatomical foot models. High costs arise primarily from the expense and challenges of acquiring anatomical data via magnetic resonance imaging (MRI) or computed tomography (CT) and reconstructing the three-dimensional models. The proposed solution morphs detailed anatomy from skin surface geometry and anatomical landmarks of a generic foot model (developed from CT or MRI) to surface geometry and anatomical landmarks acquired from an inexpensive structured light scan of a foot. The method yields a patient-specific anatomical foot model at a fraction of the cost of standard methods. Average error for bone surfaces was 2.53 mm for the six experiments completed. Highest accuracy occurred in the mid-foot and lowest in the forefoot due to the small, irregular bones of the toes. The method must be validated in the intended application to determine if the resulting errors are acceptable.

  4. Anxiety and depression among amyloid light-chain cardiac amyloidosis patients: The role of life satisfaction.

    Science.gov (United States)

    Smorti, Martina; Guarnieri, Silvia; Bergesio, Franco; Perfetto, Federico; Cappelli, Francesco

    2016-06-01

    The present study aimed to provide a contribution to the study of a rare disease, amyloid light-chain (AL) cardiac amyloidosis, which is the most common type of systemic amyloidosis. In AL amyloidosis prognosis is determined by cardiac involvement. Although the association between psychological distress (e.g. anxiety and depression) and AL cardiac amyloidosis is documented, very little is known about the psychosocial variables that may mediate the association. The aim of the study is therefore to examine the potential mediating role of life satisfaction in the relationship between cardiac symptom severity (independent variable) and anxious and depressive symptoms (dependent variables) in AL patients. Forty-three AL amyloidosis patients (57.1% males) with cardiac amyloidosis were administered the Satisfaction with Life Scale, the State-Trait Anxiety Inventory and the Centre for Epidemiological Study-Depression Scale. Clinical variables such as months since cardiac symptom onset and cardiac symptom severity were collected. Findings showed significant relationships between symptom severity and psychological disorders (e.g. anxiety and depression) and these were mediated by life satisfaction. Overall, findings highlight the importance of subjective well-being (e.g. life satisfaction) to reduce anxious and depressive symptoms and to improve general health in AL patients. © The European Society of Cardiology 2015.

  5. APPLICATION OF INTENSIVE LIGHT RADIATION IN THE PATIENT WITH ERYTHEMATOTELANGIECTATIC ROSACEA

    Directory of Open Access Journals (Sweden)

    T. A. Gaydina

    2018-01-01

    Full Text Available We present a description of the clinical case of a patient with an erythematotelangiectatic type of rosacea. Rosacea is a chronic recurrent dermatosis, characterized by skin lesions of the face in the  form of erythema and papulopustular elements, which has  polyethological origin. The disease occurs more frequently in women  aged 30-50 years who have a certain genetic predisposition to  transient reddening of the skin of the face or less often of the neck  and the decollete zone. It is believed that the dermatosis is more  likely to affect the I and II phototypes, but the disease can occur in  any skin phototype. The patient came to the clinic with complaints  about rashes in the chin and nasolabial triangle, flushing of the face,  accompanied by tingling and burning. The patient turned to the clinic with complaints about rashes in the chin and nasolabial triangle,  flushing of the face, accompanied by tingling and burning. She never consulted a dermatologist before. A diagnosis was made: “erythematotelangiectatic type of rosacea” (according to the  classification proposed by the USA National Rosacea Society, stage I  — persistent erythema and telangiectasia. Using the scale of diagnostic evaluation of rosacea, it was evaluated at 12 points.  There are many approaches to the treatment of rosacea. Drug  therapy is divided into systemic, external and complex. Systemic therapy has a number of side effects, so for light and medium-to- severe rosacea, only external therapy is more often prescribed.  Because of the presence of pathologically altered vessels, the low  efficacy of metronidazole, the patient was assigned a course of  phototherapy with intense incoherent pulsating light at standard  parameters. There was a significant improvement after two  procedures, but vessels smaller than 0.4 mm remained intact, so the duration of the first pulse was increased in order to influence small- caliber vessels

  6. Skin hardening effect in patients with polymorphic light eruption: comparison of UVB hardening in hospital with a novel home UV-hardening device.

    Science.gov (United States)

    Franken, S M; Genders, R E; de Gruijl, F R; Rustemeyer, T; Pavel, S

    2013-01-01

    An effective prophylactic treatment of patients with polymorphic light eruption (PLE) consists of repeated low, gradually increasing exposures to UVB radiation. This so-called UV(B) hardening induces better tolerance of the skin to sunlight. SunshowerMedical company (Amsterdam) has developed an UV (B) source that can be used during taking shower. The low UV fluence of this apparatus makes it an interesting device for UV hardening. In a group of PLE patients, we compared the effectiveness of the irradiation with SunshowerMedical at home with that of the UVB treatment in the hospital. The PLE patients were randomized for one of the treatments. The hospital treatment consisted of irradiations with broad-band UVB (Waldmann 85/UV21 lamps) twice a week during 6 weeks. The home UV-device was used each day with the maximal irradiation time of 6 min. The outcome assessment was based on the information obtained from patients' dermatological quality of life (DLQI) questionnaires, the ability of both phototherapies to reduce the provocation reaction and from the patients' evaluation of the long-term benefits of their phototherapies. Sixteen patients completed treatment with SunshowerMedical and thirteen completed treatment in hospital. Both types of phototherapy were effective. There was a highly significant improvement in DLQI with either treatment. In most cases, the hardening reduced or even completely suppressed clinical UV provocation of PLE. The patients using SunshowerMedical at home were, however, much more content with the treatment procedure than the patients visiting the dermatological units. Both treatments were equally effective in the induction of skin tolerance to sunlight in PLE patients. However, the home treatment was much better accepted than the treatment in the hospital. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

  7. Call-to-balloon time dashboard in patients with ST-segment elevation myocardial infarction results in significant improvement in the logistic chain.

    Science.gov (United States)

    Hermans, Maaike P J; Velders, Matthijs A; Smeekes, Martin; Drexhage, Olivier S; Hautvast, Raymond W M; Ytsma, Timon; Schalij, Martin J; Umans, Victor A W M

    2017-08-04

    Timely reperfusion with primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) patients is associated with superior clinical outcomes. Aiming to reduce ischaemic time, an innovative system for home-to-hospital (H2H) time monitoring was implemented, which enabled real-time evaluation of ischaemic time intervals, regular feedback and improvements in the logistic chain. The objective of this study was to assess the results after implementation of the H2H dashboard for monitoring and evaluation of ischaemic time in STEMI patients. Ischaemic time in STEMI patients transported by emergency medical services (EMS) and treated with pPCI in the Noordwest Ziekenhuis, Alkmaar before (2008-2009; n=495) and after the implementation of the H2H dashboard (2011-2014; n=441) was compared. Median time intervals were significantly shorter in the H2H group (door-to-balloon time 32 [IQR 25-43] vs. 40 [IQR 28-55] minutes, p-value dashboard was independently associated with shorter time delays. Real-time monitoring and feedback on time delay with the H2H dashboard improves the logistic chain in STEMI patients, resulting in shorter ischaemic time intervals.

  8. Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME.

    Science.gov (United States)

    Vanderbilt, Allison A; Pappada, Scott M; Stein, Howard; Harper, David; Papadimos, Thomas J

    2017-01-01

    Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting. Teamwork and effective communication across the health care continuum are essential for providing efficient, quality care that leads to favorable patient outcomes. Interprofessional simulation and team training can benefit health care professionals by improving interprofessional competence, defined as one's knowledge of other professionals including an understanding of their training and skillsets, and role clarity. Interprofessional teams that include members with specialization in obstetrics, gynecology, and neonatology have the potential to considerably benefit from training effective handoff and communication practices that would ensure the safety of the neonate upon birth. We must strive to provide the most comprehensive systematic, standardized, interprofessional handoff communication training sessions for such teams, through Graduate Medical Education and Continuing Medical Education that will meet the needs across the educational continuum.

  9. The laboratory-clinician team: a professional call to action to improve communication and collaboration for optimal patient care in chromosomal microarray testing.

    Science.gov (United States)

    Wain, Karen E; Riggs, Erin; Hanson, Karen; Savage, Melissa; Riethmaier, Darlene; Muirhead, Andrea; Mitchell, Elyse; Packard, Bethanny Smith; Faucett, W Andrew

    2012-10-01

    The International Standards for Cytogenomic Arrays (ISCA) Consortium is a worldwide collaborative effort dedicated to optimizing patient care by improving the quality of chromosomal microarray testing. The primary effort of the ISCA Consortium has been the development of a database of copy number variants (CNVs) identified during the course of clinical microarray testing. This database is a powerful resource for clinicians, laboratories, and researchers, and can be utilized for a variety of applications, such as facilitating standardized interpretations of certain CNVs across laboratories or providing phenotypic information for counseling purposes when published data is sparse. A recognized limitation to the clinical utility of this database, however, is the quality of clinical information available for each patient. Clinical genetic counselors are uniquely suited to facilitate the communication of this information to the laboratory by virtue of their existing clinical responsibilities, case management skills, and appreciation of the evolving nature of scientific knowledge. We intend to highlight the critical role that genetic counselors play in ensuring optimal patient care through contributing to the clinical utility of the ISCA Consortium's database, as well as the quality of individual patient microarray reports provided by contributing laboratories. Current tools, paper and electronic forms, created to maximize this collaboration are shared. In addition to making a professional commitment to providing complete clinical information, genetic counselors are invited to become ISCA members and to become involved in the discussions and initiatives within the Consortium.

  10. Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME

    Directory of Open Access Journals (Sweden)

    Vanderbilt AA

    2017-06-01

    Full Text Available Allison A Vanderbilt,1 Scott M Pappada,2 Howard Stein,3 David Harper,4 Thomas J Papadimos5 1Department of Family Medicine, 2Department of Anesthesiology, College of Medicine and Life Sciences, University of Toledo, 3Department of Pediatrics, ProMedica Toledo Children’s Hospital, 4Department of Obstetrics and Gynecology, ProMedica Toledo Hospital, 5Department of Anesthesiology, College of Medicine and the Life Sciences, University of Toledo, Toledo, OH, USA Abstract: Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting. Teamwork and effective communication across the health care continuum are essential for providing efficient, quality care that leads to favorable patient outcomes. Interprofessional simulation and team training can benefit health care professionals by improving interprofessional competence, defined as one’s knowledge of other professionals including an understanding of their training and skillsets, and role clarity. Interprofessional teams that include members with specialization in obstetrics, gynecology, and neonatology have the potential to considerably benefit from training effective handoff and communication practices that would ensure the safety of the neonate upon birth. We must strive to provide the most comprehensive systematic, standardized, interprofessional handoff communication training sessions for such teams, through Graduate Medical Education and Continuing Medical Education that will meet the needs across the educational continuum. Keywords

  11. Levels and function of regulatory T cells in patients with polymorphic light eruption: relation to photohardening.

    Science.gov (United States)

    Schweintzger, N; Gruber-Wackernagel, A; Reginato, E; Bambach, I; Quehenberger, F; Byrne, S N; Wolf, P

    2015-08-01

    We hypothesized that regulatory T cells (Tregs) are involved in the immunological abnormalities seen in patients with polymorphic light eruption (PLE). To investigate the number and suppressive function of peripheral Tregs in patients with PLE compared with healthy controls. Blood sampling was done in 30 patients with PLE [seeking or not seeking 311-nm ultraviolet (UV)B photohardening] as well as 19 healthy controls at two time points: TP1, March to June (before phototherapy); and TP2, May to August (after phototherapy). We compared the number of CD4(+) CD25(high) CD127(-) FoxP3(+) Tregs by flow cytometry and their function by assessing FoxP3 mRNA levels and effector T cell/Treg suppression assays. Tregs isolated from healthy controls significantly suppressed the proliferation of effector T cells at TP1 by 68% (P = 0·0156). In contrast, Tregs from patients with PLE entirely lacked the capacity to suppress effector T-cell proliferation at that time point. The medical photohardening seen in 23 patients with PLE resulted in a significant increase in the median percentage of circulating Tregs [both as a proportion of all lymphocytes; 65 6% increase (P = 0·0049), and as a proportion of CD4(+) T cells; 32.5% increase (P = 0·0049)]. This was accompanied by an increase in the expression of FoxP3 mRNA (P = 0·0083) and relative immunosuppressive function of Tregs (P = 0·083) comparing the two time points in representative subsets of patients with healthy controls tested. Seven patients with PLE not receiving 311-nm UVB also exhibited an increase in the number of Tregs but this was not statistically significant. No significant differences in Treg numbers were observed in healthy subjects between the two time points. An impaired Treg function is likely to play a role in PLE pathogenesis. A UV-induced increase in the number of Tregs (either naturally or therapeutically) may be a compensatory mechanism by which the immune system counteracts the susceptibility to

  12. Perspective: Does medical education promote professional alexithymia? A call for attending to the emotions of patients and self in medical training.

    Science.gov (United States)

    Shapiro, Johanna

    2011-03-01

    Emotions--one's own and others'--play a large role in the lives of medical students. Students must deal with their emotional reactions to intellectual and physical stress, the demanding clinical situations to which they are witness, as well as patients' and patients' family members' often intense feelings. Yet, currently few components in formal medical training--in either direct curricular instruction or physician role modeling--focus on the emotional lives of students. In this article, the author examines patients', medical students', and physician role models' emotions in the clinical context, highlighting challenges in all three of these arenas. Next, the author asserts that the preponderance of medical education continues to address the emotional realm through ignoring, detaching from, and distancing from emotions. Finally, she presents not only possible theoretical and conceptual models for developing ways of understanding, attending to, and ultimately "working with" emotions in medical education but also examples of innovative curricular efforts to incorporate emotional awareness into medical student training. The author concludes with the hope that medical educators will consider making a concerted effort to acknowledge emotions and their importance in medicine and medical training.

  13. Quality of life and functional capacity outcomes in the MOMENTUM 3 trial at 6 months: A call for new metrics for left ventricular assist device patients.

    Science.gov (United States)

    Cowger, Jennifer A; Naka, Yoshifumi; Aaronson, Keith D; Horstmanshof, Douglas; Gulati, Sanjeev; Rinde-Hoffman, Debbie; Pinney, Sean; Adatya, Sirtaz; Farrar, David J; Jorde, Ulrich P

    2018-01-01

    The Multicenter Study of MAGLEV Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 (MOMENTUM 3) clinical trial demonstrated improved 6-month event-free survival, but a detailed analysis of health-related quality of life (HR-QOL) and functional capacity (FC) was not presented. Further, the effect of early serious adverse events (SAEs) on these metrics and on the general ability to live well while supported with a left ventricular assist system (LVAS) warrants evaluation. FC (New York Heart Association [NYHA] and 6-minute walk test [6MWT]) and HR-QOL (European Quality of Life [EQ-5D-5L] and the Kansas City Cardiomyopathy [KCCQ]) assessments were obtained at baseline and 6 months after HeartMate 3 (HM3, n = 151; Abbott, Abbott Park, IL) or HeartMate II (HMII, n = 138; Abbott) implant as part of the MOMENTUM 3 clinical trial. Metrics were compared between devices and in those with and without events. The proportion of patients "living well on an LVAS" at 6 months, defined as alive with satisfactory FC (NYHA I/II or 6MWT > 300 meters) and HR-QOL (overall KCCQ > 50), was evaluated. Although the median (25th-75th percentile) patient KCCQ (change for HM3: +28 [10-46]; HMII: +29 [9-48]) and EQ-5D-5L (change for HM3: -1 [-5 to 0]; HMII: -2 [-6 to 0]) scores improved from baseline to 6 months (p 0.05). Likewise, there was an equivalent improvement in 6MWT distance at 6 months in HM3 (+94 [1-274] meters] and HMII (+188[43-340 meters]) from baseline. In patients with SAEs (n = 188), 6MWTs increased from baseline (p < 0.001), but gains for both devices were less than those without SAE (HM3: +74 [-9 to 183] meters with SAE vs +140 [35-329] meters without SAE; HMII: +177 [47-356] meters with SAE vs +192 [23-337] meters without SAE, both p < 0.003). SAEs did not affect the 6-month HR-QOL scores. The "living well" end point was achieved in 145 HM3 (63%) and 120 HMII (68%) patients (p = 0.44). Gains in HR-QOL and FC were similar early after HM3

  14. Lightness functions

    DEFF Research Database (Denmark)

    Campi, Stefano; Gardner, Richard; Gronchi, Paolo

    2012-01-01

    Variants of the brightness function of a convex body K in n-dimensional Euclidean are investigated. The Lambertian lightness function L(K; v , w ) gives the total reflected light resulting from illumination by a light source at infinity in the direction w that is visible when looking...... in the direction v . The partial brightness function R( K ; v , w ) gives the area of the projection orthogonal to v of the portion of the surface of K that is both illuminated by a light source from the direction w and visible when looking in the direction v . A class of functions called lightness functions...... is introduced that includes L(K;.) and R(K;.) as special cases. Much of the theory of the brightness function like uniqueness, stability, and the existence and properties of convex bodies of maximal and minimal volume with finitely many function values equal to those of a given convex body, is extended...

  15. Reducing hospital-acquired pressure ulcers using bundle methodology in pediatric and neonatal patients receiving extracorporeal membrane oxygenation therapy: An integrative review and call to action.

    Science.gov (United States)

    Courtwright, Suzanne E; Mastro, Kari A; Preuster, Christa; Dardashti, Navid; McGill, Sandra; Madelon, Myrlene; Johnson, Donna

    2017-10-01

    This review focuses on identifying (1) evidence of the effectiveness of care bundle methodology to reduce hospital-acquired pressure ulcers (HAPUs) in pediatric and neonatal patients receiving extracorporeal membrane oxygenation (ECMO) therapy and (2) barriers to implementing HAPU care bundles in this at-risk population. An integrative review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search of the scientific literature was performed. Studies included were published between January 2011 and February 2016. A total of seven articles met inclusion criteria. Data were extracted from each published article and analyzed to identify common themes, specifically bundle methodology and barriers to implementing HAPU bundles, in this population. There is limited research on effectiveness of care bundle methodology in reducing HAPUs in children, and no research specific to its effectiveness in pediatric or neonatal ECMO patients. No research was identified studying barriers to implementation of HAPU care bundles in this population. Nurses are well poised to test innovative strategies to prevent HAPUs. Nurses should consider implementing and testing bundle methodology to reduce HAPU in this at-risk population, and conduct research to identify any barriers to implementing this strategy. There is literature to support the use of nurses as unit-based skin care champions to facilitate teamwork and reliable use of the bundle, both critical components to the success of bundle methodology. © 2017 Wiley Periodicals, Inc.

  16. Changes in blood pressure and sleep duration in patients with blue light-blocking/yellow-tinted intraocular lens (CHUKYO study).

    Science.gov (United States)

    Ichikawa, Kazuo

    2014-07-01

    Blood pressure and sleep duration may be influenced by retinal light exposure. Cataracts may exert such an influence by decreasing the transparency of the crystalline lens. A large-scale clinical study was conducted to examine changes in blood pressure and sleep duration after intraocular lens (IOL) implantation during cataract surgery and to investigate how different types of IOL influence the degree of these effects. Using a questionnaire, we collected information, including blood pressure measurement and sleep duration, from 1367 patients (1367 eyes) before IOL implantation, 1 week after IOL implantation and 1 month after IOL implantation. Systolic and diastolic blood pressures were significantly decreased in the total patient group after implantation. The decrease in systolic blood pressure 1 month after implantation was significantly more in patients who received a yellow-tinted IOL than it was in those who received an ultraviolet (UV) light-filtering IOL. The post-implantation sleep duration, including naps, became shorter in patients who had slept too much and became longer in those who had slept too little before IOL implantation. Our observations suggest that a yellow-tinted IOL is better for patients with high blood pressure than a UV light-filtering IOL. Furthermore, the yellow-tinted IOL is as good as the UV light-filtering IOL for improving sleep duration. A pale yellow-tinted IOL is likely to be superior to a moderate yellow-tinted IOL in terms of allowing patients to discriminate different colors. Thus, the pale yellow-tinted IOL appears to be better for patients than the UV light-filtering IOL and the moderate yellow-tinted IOL.

  17. Improvement in depression scores after 1 hour of light therapy treatment in patients with seasonal affective disorder.

    Science.gov (United States)

    Reeves, Gloria M; Nijjar, Gagan Virk; Langenberg, Patricia; Johnson, Mary A; Khabazghazvini, Baharak; Sleemi, Aamar; Vaswani, Dipika; Lapidus, Manana; Manalai, Partam; Tariq, Muhammad; Acharya, Monika; Cabassa, Johanna; Snitker, Soren; Postolache, Teodor T

    2012-01-01

    The purpose of this study was to investigate possible rapid effects of light therapy on depressed mood in patients with seasonal affective disorder. Participants received 1 hour of bright light therapy and 1 hour of placebo dim red light in a randomized order crossover design. Depressed mood was measured at baseline and after each hour of light treatment using two self-report depression scales (Profile of Mood States-Depression-Dejection [POMS-D] subscale and the Beck Depression Inventory II [BDI-II]). When light effects were grouped for the two sessions, there was significantly greater reduction in self-report depression scores by -1.3 (p = 0.02) on the BDI-II and -1.2 (p = 0.02) on the POMS-D. A significant but modest improvement was detected after a single active light session. This is the first study, to our knowledge, to document an immediate improvement with light treatment using a placebo-controlled design with a clinical sample of depressed individuals.

  18. Study of light scattering using C-Quant® in patients with Fuchs' endothelial dystrophy: A pilot study.

    Science.gov (United States)

    Castaño-Martín, B; Gros-Otero, J; Martínez, J; Teus, M

    2017-11-01

    The purpose of this study was to determine the light scattering in patients with Fuchs' endothelial dystrophy without clinically significant corneal oedema, and evaluate its relationship with endothelial cell count, corneal thickness, and corneal biomechanical parameters. The values of light scattering were measured by C-Quant ® (Oculus Optikgeräte GmbH, Germany) in 32 eyes of 17 patients diagnosed with Fuchs' endothelial dystrophy without clinically significant corneal oedema. Corneal biomechanical properties were determined using ORA (ocular response) and Corvis ST ® (tonometry). A light scattering value outside the normal range was observed in 93.8% of eyes studied. No statistically significant association (P>.05) was found between the values of the measured light scattering by C-Quant ® and endothelial count, pachymetry, or corneal biomechanical properties. In this study, changes were found in the values of light scattering values of patients with corneal Fuchs' endothelial dystrophy. This change does not appear to correlate significantly with disease severity. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Call Centre- Computer Telephone Integration

    Directory of Open Access Journals (Sweden)

    Dražen Kovačević

    2012-10-01

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

  20. Enhancement of carer skills and patient function in the non-pharmacological management of frontotemporal dementia (FTD): A call for randomised controlled studies

    Science.gov (United States)

    O'Connor, Claire M.; Clemson, Lindy; da Silva, Thaís Bento Lima; Piguet, Olivier; Hodges, John R.; Mioshi, Eneida

    2013-01-01

    FTD is a unique condition which manifests with a range of behavioural symptoms, marked dysfunction in activities of daily living (ADL) and increased levels of carer burden as compared to carers of other dementias. No efficacious pharmacological interventions to treat FTD currently exist, and research on pharmacological symptom management is variable. The few studies on non-pharmacological interventions in FTD focus on either the carer or the patients' symptoms, and lack methodological rigour. This paper reviews and discusses current studies utilising non-pharmacological approaches, exposing the clear need for more rigorous methodologies to be applied in this field. Finally, a successful randomised controlled trial helped reduce behaviours of concern in dementia, and through implementing participation in tailored activities, the FTD-specific Tailored Activities Program (TAP) is presented. Crucially, this protocol has scope to target both the person with FTD and their carer. This paper highlights that studies in this area would help to elucidate the potential for using activities to reduce characteristic behaviours in FTD, improving quality of life and the caregiving experience in FTD. PMID:29213832

  1. Influence exerted by risk factors of space and erath weather on frequency of emergency calls from patients with acute cerebral circulation disorders

    Directory of Open Access Journals (Sweden)

    V.A. Belyaeva

    2017-12-01

    Full Text Available High morbidity with cardiovascular pathology increases loads on a public healthcare system and is not only social but also an economic problem. To optimize cardiovascular pathology prevention, it is necessary to thoroughly analyze risk factors which cause its occurrence. Our research goal was to examine a dynamics of acute cerebral circulation disorders depending on meteorological factors and heliofactors allowing for a seasonal component. We performed a retrospective analysis of morbidity with acute cerebral circulation disorders in winter, spring, and summer in 2012 on the basis of the archives obtained from an emergency station in Vladikavkaz. We analyzed 509 cases of the disease (294 women and 215 men. On the basis of our analysis results we assessed influence exerted by external factors on frequency of applications to emergency from patients with acute cerebral circulation disorders. We analyzed meteorological factors and heliofactors and their derivatives: average daily temperature, air pressure, relative humidity, wind speed, cloud coverage, weather pathogenicity, Sun radiation flux density at a wave length equal to 10.7, and a number of sunspots. We detected that in winter negative influence was exerted by temperature; there was also a multi-factor dependence between frequency of acute cerebral circulation disorders and such predictors as temperature pathogenicity index and speed of changes in Sun radiation flux density during a day (Rmulti = 0.50; R2 = 0.25. Drastic temperature fluctuations make for increase in morbidity in spring. Morbidity cases frequency in women in this period correlates not only with temperature pathogenicity index but also with pathogenicity index of air pressure changes. Morbidity increase in summer is caused by simultaneous drop both in air pressure and relative humidity (Rmulti = 0.59; R2 = 0.35. Overall, correlation between external factors and morbidity with acute cerebral circulation disorder has seasonal

  2. Melatonin and bright-light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease

    NARCIS (Netherlands)

    Dowling, G.A.; Burr, R.L.; van Someren, E.J.W.; Hubbard, E.M.; Luxenberg, J.S.; Mastick, J.; Cooper, B.A.

    2008-01-01

    OBJECTIVES: To test whether the addition of melatonin to bright-light therapy enhances the efficacy in treating rest-activity (circadian) disruption in institutionalized patients with Alzheimer's disease (AD). DESIGN: Randomized, controlled trial. SETTING: Two nursing homes in San Francisco,

  3. Methods for assessing forward and backward light scatter in patients with cataract.

    Science.gov (United States)

    Crnej, Alja; Hirnschall, Nino; Petsoglou, Con; Findl, Oliver

    2017-08-01

    To compare objective methods for assessing backward and forward light scatter and psychophysical tests in patients with cataracts. Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Prospective case series. This study included patients scheduled for cataract surgery. Lens opacities were grouped into predominantly nuclear sclerotic, cortical, posterior subcapsular, and mixed cataracts. Backward light scatter was assessed using a rotating Scheimpflug imaging technique (Pentacam HR), forward light scatter using a straylight meter (C-Quant), and straylight using the double-pass method (Optical Quality Analysis System, point-spread function [PSF] meter). The results were correlated with visual acuity under photopic conditions as well as photopic and mesopic contrast sensitivity. The study comprised 56 eyes of 56 patients. The mean age of the 23 men and 33 women was 71 years (range 48 to 84 years). Two patients were excluded. Of the remaining, 15 patients had predominantly nuclear sclerotic cataracts, 13 had cortical cataracts, 11 had posterior subcapsular cataracts, and 15 had mixed cataracts. Correlations between devices were low. The highest correlation was between PSF meter measurements and Scheimpflug measurements (r = 0.32). The best correlation between corrected distance visual acuity was with the PSF meter (r = 0.45). Forward and backward light-scatter measurements cannot be used interchangeably. Scatter as an aspect of quality of vision was independent of acuity. Measuring forward light scatter with the straylight meter can be a useful additional tool in preoperative decision-making. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. The Laser in Glaucoma and Ocular Hypertension (LiGHT) trial. A multicentre randomised controlled trial: baseline patient characteristics.

    Science.gov (United States)

    Konstantakopoulou, Evgenia; Gazzard, Gus; Vickerstaff, Victoria; Jiang, Yuzhen; Nathwani, Neil; Hunter, Rachael; Ambler, Gareth; Bunce, Catey

    2018-05-01

    The laser in glaucoma and ocular hypertension (LiGHT) trial aims to establish whether initial treatment with selective laser trabeculoplasty (SLT) is superior to initial treatment with topical medication for primary open angle glaucoma (POAG) or ocular hypertension (OHT). LiGHT is a prospective unmasked, multicentre, pragmatic, randomised controlled trial (RCT). 718 previously untreated patients with POAG or OHT were recruited at 6 UK centres between 2012 and 2014. Patients were randomised to initial SLT followed by medical therapy or medical therapy without laser. Participants will be monitored for 3 years, according to routine clinical practice. The primary outcome is EQ-5D-5L. Secondary outcomes are treatment pathway cost and cost-effectiveness, Glaucoma Utility Index (GUI), Glaucoma Symptom Scale, Glaucoma Quality of Life (GQL), pathway effectiveness, visual function, safety and concordance. A total of 555 patients had POAG and 163 OHT; 518 patients had both eyes eligible. The mean age for patients with POAG was 64 years and for OHT 58 years. 70% of all participants were white. Median IOP for OHT eyes was 26 mm Hg and 23 mm Hg for POAG eyes. Median baseline visual field mean deviation was -0.81 dB for OHT eyes and -2.82 dB for POAG eyes. There was no difference between patients with POAG and patients with OHT on the EQ-5D-5DL; the difference between OHT and POAG on the GUI was -0.02 and 1.23 on the GQL. The LiGHT trial is the first RCT to compare the two treatment options in a real-world setting. The baseline characteristics of the LiGHT cohort compare well with other landmark glaucoma studies. ISRCTN32038223, Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Why the dim light melatonin onset (DLMO) should be measured before treatment of patients with circadian rhythm sleep disorders.

    Science.gov (United States)

    Keijzer, Henry; Smits, Marcel G; Duffy, Jeanne F; Curfs, Leopold M G

    2014-08-01

    Treatment of circadian rhythm sleep disorders (CRSD) may include light therapy, chronotherapy and melatonin. Exogenous melatonin is increasingly being used in patients with insomnia or CRSD. Although pharmacopoeias and the European food safety authority (EFSA) recommend administering melatonin 1-2 h before desired bedtime, several studies have shown that melatonin is not always effective if administered according to that recommendation. Crucial for optimal treatment of CRSD, melatonin and other treatments should be administered at a time related to individual circadian timing (typically assessed using the dim light melatonin onset (DLMO)). If not administered according to the individual patient's circadian timing, melatonin and other treatments may not only be ineffective, they may even result in contrary effects. Endogenous melatonin levels can be measured reliably in saliva collected at the patient's home. A clinically reliably DLMO can be calculated using a fixed threshold. Diary and polysomnographic sleep-onset time do not reliably predict DLMO or circadian timing in patients with CRSD. Knowing the patient's individual circadian timing by assessing DLMO can improve diagnosis and treatment of CRSD with melatonin as well as other therapies such as light or chronotherapy, and optimizing treatment timing will shorten the time required to achieve results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Systematic Evaluation of Desmopressin Applied to the Patients with Aneurysmal Subarachnoid Haemorrhage in the light of the Literature.

    Science.gov (United States)

    Karaarslan, Numan; Yilmaz, Ibrahim; Akgun, Feride Sinem; Caliskan, Tezcan; Ozbek, Hanefi; Ates, Ozkan

    2018-04-09

    This study discusses the management of patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH), developed after subarachnoid hemorrhage, in a comparative manner in light of the literature. Without country or language restrictions, articles with high evidential value found in electronic databases were compared to our patients' data. After the literature review, three articles were included for systematic evaluation. Desmopressin was applied to the patients for the treatment of hyponatremia, volume contraction, and negative sodium balance caused by SIADH. However, it was not used for preventing re-bleeding. To prevent the development of this complication (SIADH), the use of desmopressin, an analogue of vasopressin, is important in routine clinical practice.

  7. 3D light robotics

    DEFF Research Database (Denmark)

    Glückstad, Jesper; Palima, Darwin; Villangca, Mark Jayson

    2016-01-01

    As celebrated by the Nobel Prize 2014 in Chemistry light-based technologies can now overcome the diffraction barrier for imaging with nanoscopic resolution by so-called super-resolution microscopy1. However, interactive investigations coupled with advanced imaging modalities at these small scale ...... research discipline that could potentially be able to offer the full packet needed for true "active nanoscopy" by use of so-called light-driven micro-robotics or Light Robotics in short....

  8. Calculus light

    CERN Document Server

    Friedman, Menahem

    2011-01-01

    Another Calculus book? As long as students find calculus scary, the failure rate in mathematics is higher than in all other subjects, and as long as most people mistakenly believe that only geniuses can learn and understand mathematics, there will always be room for a new book of Calculus. We call it Calculus Light. This book is designed for a one semester course in ""light"" calculus -- mostly single variable, meant to be used by undergraduate students without a wide mathematical background and who do not major in mathematics but study subjects such as engineering, biology or management infor

  9. Prediction of outcome of bright light treatment in patients with seasonal affective disorder: Discarding the early response, confirming a higher atypical balance, and uncovering a higher body mass index at baseline as predictors of endpoint outcome.

    Science.gov (United States)

    Dimitrova, Tzvetelina D; Reeves, Gloria M; Snitker, Soren; Lapidus, Manana; Sleemi, Aamar R; Balis, Theodora G; Manalai, Partam; Tariq, Muhammad M; Cabassa, Johanna A; Karim, Naila N; Johnson, Mary A; Langenberg, Patricia; Rohan, Kelly J; Miller, Michael; Stiller, John W; Postolache, Teodor T

    2017-11-01

    We tested the hypothesis that the early improvement in mood after the first hour of bright light treatment compared to control dim-red light would predict the outcome at six weeks of bright light treatment for depressed mood in patients with Seasonal Affective Disorder (SAD). We also analyzed the value of Body Mass Index (BMI) and atypical symptoms of depression at baseline in predicting treatment outcome. Seventy-eight adult participants were enrolled. The first treatment was controlled crossover, with randomized order, and included one hour of active bright light treatment and one hour of control dim-red light, with one-hour washout. Depression was measured on the Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD version (SIGH-SAD). The predictive association of depression scores changes after the first session. BMI and atypical score balance with treatment outcomes at endpoint were assessed using multivariable linear and logistic regressions. No significant prediction by changes in depression scores after the first session was found. However, higher atypical balance scores and BMI positively predicted treatment outcome. Absence of a control intervention for the six-weeks of treatment (only the first session in the laboratory was controlled). Exclusion of patients with comorbid substance abuse, suicidality and bipolar I disorder, and patients on antidepressant medications, reducing the generalizability of the study. Prediction of outcome by early response to light treatment was not replicated, and the previously reported prediction of baseline atypical balance was confirmed. BMI, a parameter routinely calculated in primary care, was identified as a novel predictor, and calls for replication and then exploration of possible mediating mechanisms. Published by Elsevier B.V.

  10. Light sources and light pollution

    International Nuclear Information System (INIS)

    Pichler, G.

    2005-01-01

    From the dawn of mankind fire and light sources in general played an essential role in everyday life and protection over night. The development of new light sources went through many stages and is now an immense technological achievement, but also a threat for the wildlife at night, mainly because of the so-called light pollution. This paper discusses several very successful light sources connected with low pressure mercury and sodium vapour electric discharges. The luminous efficacy, colour rendering index and other lighting features cannot be always satisfactory, but at least some of the features can be much better than those met by the standard tungsten filament bulbs. High-pressure metal-vapour discharge lamps definitely have a good colour rendering index and a relatively high luminosity. Different light sources with burners at high pressure are discussed, paying special attention to their spectrum. The paper investigates new trends in development through a number of examples with non-toxic elements and pulsed electric discharge, which may be good news in terms of clean environment and energy savings. Light emitting diodes have recently appeared as worthy competitors to conventional light sources. White LEDs have approached 100 lumen/Watt efficacy in laboratories. This suggests that in some not very distant future they could completely replace high-pressure lamps, at least in indoor lighting. The article speculates on new developments which combine trends in nano technology and material science. The paper concludes with light pollution in view of several recent observations of plant and animal life at night in the vicinity of strong light sources. Photo-induced changes at the cell level may completely alter the normal life of plants and animals.(author)

  11. Value of the free light chain analysis in the clinical evaluation of response in multiple myeloma patients receiving anti-myeloma therapy

    DEFF Research Database (Denmark)

    Toftmann Hansen, Charlotte; Pedersen, Per T.; Jensen, Bo Amdi

    Value of the free light chain analysis in the clinical evaluation of response in multiple myeloma patients receiving anti-myeloma therapy.......Value of the free light chain analysis in the clinical evaluation of response in multiple myeloma patients receiving anti-myeloma therapy....

  12. The difficult medical emergency call

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren

    2017-01-01

    BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the ......BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories...... and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data. Logistic regression analysis (N = 78,040 individuals) was used for identification...

  13. WOW: light print, light propel, light point

    Science.gov (United States)

    Glückstad, Jesper; Bañas, Andrew; Aabo, Thomas; Palima, Darwin

    2012-10-01

    We are presenting so-called Wave-guided Optical Waveguides (WOWs) fabricated by two-photon polymerization and capable of being optically manipulated into any arbitrary orientation. By integrating optical waveguides into the structures we have created freestanding waveguides which can be positioned anywhere in a sample at any orientation using real-time 3D optical micromanipulation with six degrees of freedom. One of the key aspects of our demonstrated WOWs is the change in direction of in-coupled light and the marked increase in numerical aperture of the out-coupled light. Hence, each light propelled WOW can tap from a relatively broad incident beam and generate a much more tightly confined light at its tip. The presentation contains both numerical simulations related to the propagation of light through a WOW and preliminary experimental demonstrations on our BioPhotonics Workstation. In a broader context, this research shows that optically trapped micro-fabricated structures can potentially help bridge the diffraction barrier. This structure-mediated paradigm may be carried forward to open new possibilities for exploiting beams from far-field optics down to the sub-wavelength domain.

  14. [Ozone therapy and phototherapy with polarized polychromatic light in treatment of patients suffering from lower limb critical ischaemia].

    Science.gov (United States)

    Drozhzhin, E V; Sidorkina, O N

    2012-01-01

    The authors generalized their experience in treating a total of 77 patients presenting with atherosclerosis of the arteries of lower limbs with degree III-IV ischaemia according to the A.V. Pokrovsky-Fontain classification. The patients were subjected to comprehensive treatment including the impact of piler-light (apparatus Bioptron 2) and ozone therapy. The control group was composed of 66 people receiving conventional therapy. The two groups were comparable by the nosological entity of the disease, gender, age, and the nature of accompanying pathology. Despite carried out classical anticoagulation therapy there was a tendency towards hypercoagulation in phase I (formation of prothrombinase) and phase III (formation of fibrin) of plasma haemostasis, as well as insufficiency of the fibrinolytic system. The obtained results showed direct influence of ozone therapy and piler light on phase I and III plasmatic haemostasis, as well as enhanced fibrinolytic activity of blood on the background of their administration thereof.

  15. House Calls in Private Practice.

    Science.gov (United States)

    Whittington, Ronaele

    1985-01-01

    Relates the experiences of a social worker in private practice who offered house calls as an ongoing setting for counseling and psychotherapy to individuals and families. Describes advantages and disadvantages, liability, and target populations. (JAC)

  16. Telephone calls by individuals with cancer.

    Science.gov (United States)

    Flannery, Marie; McAndrews, Leanne; Stein, Karen F

    2013-09-01

    To describe symptom type and reporting patterns found in spontaneously initiated telephone calls placed to an ambulatory cancer center practice. Retrospective, descriptive. Adult hematology oncology cancer center. 563 individuals with a wide range of oncology diagnoses who initiated 1,229 telephone calls to report symptoms. Raw data were extracted from telephone forms using a data collection sheet with 23 variables obtained for each phone call, using pre-established coding criteria. A literature-based, investigator-developed instrument was used for the coding criteria and selection of which variables to extract. Symptom reporting, telephone calls, pain, and symptoms. A total of 2,378 symptoms were reported by telephone during the four months. At least 10% of the sample reported pain (38%), fatigue (16%), nausea (16%), swelling (12%), diarrhea (12%), dyspnea (10%), and anorexia (10%). The modal response was to call only one time and to report only one symptom (55%). Pain emerged as the symptom that most often prompted an individual to pick up the telephone and call. Although variation was seen in symptom reporting, an interesting pattern emerged with an individual reporting on a solitary symptom in a single telephone call. The emergence of pain as the primary symptom reported by telephone prompted educational efforts for both in-person clinic visit management of pain and prioritizing nursing education and protocol management of pain reported by telephone. Report of symptoms by telephone can provide nurses unique insight into patient-centered needs. Although pain has been an important focus of education and research for decades, it remains a priority for individuals with cancer. A wide range in symptom reporting by telephone was evident.

  17. The significance and predictive value of free light chains in the urine of patients with chronic inflammatory rheumatic disease.

    Science.gov (United States)

    Bramlage, Carsten Paul; Froelich, Britta; Wallbach, Manuel; Minguet, Joan; Grupp, Clemens; Deutsch, Cornelia; Bramlage, Peter; Koziolek, Michael; Müller, Gerhard Anton

    2016-12-01

    In patients with rheumatic diseases, reliable markers for determining disease activity are scarce. One potential parameter is the level of immunoglobulin free light chains (FLCs), which is known to be elevated in the blood of patients with certain rheumatic diseases. Few studies have quantified FLCs in urine, a convenient source of test sample, in patients with different rheumatic diseases. We carried out a retrospective analysis of patients with rheumatic disease attending the University hospital of Goettingen, Germany. Subjects were included if they had urine levels of both κ and λ FLCs available and did not have myeloma. Data regarding systemic inflammation and kidney function were recorded, and FLC levels were correlated with inflammatory markers. Of the 382 patients with rheumatic disease, 40.1 % had chronic polyarthritis, 21.2 % connective tissue disease, 18.6 % spondyloarthritis and 15.7 % vasculitis. Elevated levels of κ FLCs were found for 84 % of patients and elevated λ for 52.7 %. For the patients with rheumatoid arthritis, FLCs correlated with C-reactive protein (κ, r = 0.368, p rheumatic disease, but not in κ/λ ratio. The correlation between FLCs and inflammatory markers in patients with rheumatoid arthritis demonstrates their potential for predicting disease activity.

  18. Bundling the value of discharge telephone calls and leader rounding.

    Science.gov (United States)

    Setia, Nina; Meade, Christine

    2009-03-01

    Discharge telephone calls made by hospital staff provide invaluable opportunities to prevent adverse events, improve quality of care, and increase patient satisfaction. Similarly, the effect of rounding on patients can improve clinical quality and improve both patient and staff satisfaction. The author discusses how the combination of implementing both nurse leader rounding and discharge telephone calls simultaneously produced powerful positive outcomes in satisfaction and patient quality of care.

  19. Calling 911! What role does the pediatrician play?

    Science.gov (United States)

    Grossman, Devin; Kunkov, Sergey; Kaplan, Carl; Crain, Ellen F

    2013-06-01

    The objective of this study was to compare admission rates and medical interventions among children whose caregivers called their child's primary care provider (PCP) before taking an ambulance to the pediatric emergency department (PED) versus those who did not. This was a prospective cohort study of patients brought to an urban, public hospital PED via emergency medical system (EMS). Children were included if the caregiver called 911 to have them transported via EMS and was present in the PED. The main variable was whether the child's PCP was called before EMS utilization. Study outcomes were medical interventions, such as intravenous line insertion or laboratory tests, and hospital admission. χ Test and logistic regression were used to evaluate the relationship of the main variable to the study outcomes. Six hundred fourteen patients met inclusion criteria and were enrolled. Five hundred eighty-five patients (95.3%) were reported to have a PCP. Seventy-four caregivers (12.1%) called their child's PCP before calling EMS. Two hundred seventy-seven patients (45.1%) had medical interventions performed; of these, 42 (15.2%) called their PCP (P = 0.03). Forty-two patients (6.8%) were admitted; among these, 14 (33.3%) called their PCP (P < 0.01). Adjusting for triage level, patients whose caregiver called the PCP before calling EMS were 3.2 times (95% confidence interval, 1.9-5.2 times) more likely to be admitted and 1.7 times (95% confidence interval, 1.1-2.9 times) more likely to have a medical intervention compared with patients whose caregivers did not call their child's PCP. Children were more likely to be admitted or require a medical intervention if their caregiver called their PCP before calling EMS. The availability of a PCP for telephone triage may help to optimize EMS utilization.

  20. Abnormally dark or light skin

    Science.gov (United States)

    Hyperpigmentation; Hypopigmentation; Skin - abnormally light or dark ... Normal skin contains cells called melanocytes. These cells produce melanin , the substance that gives skin its color. Skin with ...

  1. Lamps and lighting

    CERN Document Server

    Cayless, MA; Marsden, A M

    2012-01-01

    This book is a comprehensive guide to the theory and practice of lighting. Covering the physics of light production, light sources, circuits and a wide variety of lighting applications, it is both suitable as a detailed textbook and as thoroughly practical guide for practising lighting engineers. This fourth edition of Lamps and Lighting has been completely updated with new chapters on the latest lamp technology and applications. The editors ahve called upon a wide range of expertise and as a result many sections have been broadened to include both European and US practice.The book begins with

  2. The Wireless Nursing Call System

    DEFF Research Database (Denmark)

    Jensen, Casper Bruun

    2006-01-01

    This paper discusses a research project in which social scientists were involved both as analysts and supporters during a pilot with a new wireless nursing call system. The case thus exemplifies an attempt to participate in developing dependable health care systems and offers insight into the cha......This paper discusses a research project in which social scientists were involved both as analysts and supporters during a pilot with a new wireless nursing call system. The case thus exemplifies an attempt to participate in developing dependable health care systems and offers insight...

  3. Perpetual Cancellable American Call Option

    OpenAIRE

    Emmerling, Thomas J.

    2010-01-01

    This paper examines the valuation of a generalized American-style option known as a Game-style call option in an infinite time horizon setting. The specifications of this contract allow the writer to terminate the call option at any point in time for a fixed penalty amount paid directly to the holder. Valuation of a perpetual Game-style put option was addressed by Kyprianou (2004) in a Black-Scholes setting on a non-dividend paying asset. Here, we undertake a similar analysis for the perpetua...

  4. Integrating heterogeneous healthcare call centers.

    Science.gov (United States)

    Peschel, K M; Reed, W C; Salter, K

    1998-01-01

    In a relatively short period, OHS has absorbed multiple call centers supporting different LOBs from various acquisitions, functioning with diverse standards, processes, and technologies. However, customer and employee satisfaction is predicated on OHS's ability to thoroughly integrate these heterogeneous call centers. The integration was initiated and has successfully progressed through a balanced program of focused leadership and a defined strategy which includes site consolidation, sound performance management philosophies, and enabling technology. Benefits have already been achieved with even more substantive ones to occur as the integration continues to evolve.

  5. Calling to Nursing: Concept Analysis.

    Science.gov (United States)

    Emerson, Christie

    The aims of this article are (a) to analyze the concept of a calling as it relates nursing and (b) to develop a definition of calling to nursing with the detail and clarity needed to guide reliable and valid research. The classic steps described by Walker and Avant are used for the analysis. Literature from several disciplines is reviewed including vocational psychology, Christian career counseling, sociology, organizational management, and nursing. The analysis provides an operational definition of a calling to nursing and establishes 3 defining attributes of the concept: (a) a passionate intrinsic motivation or desire (perhaps with a religious component), (b) an aspiration to engage in nursing practice, as a means of fulfilling one's purpose in life, and (c) the desire to help others as one's purpose in life. Antecedents to the concept are personal introspection and cognitive awareness. Positive consequences to the concept are improved work meaningfulness, work engagement, career commitment, personal well-being, and satisfaction. Negative consequences of having a calling might include willingness to sacrifice well-being for work and problems with work-life balance. Following the concept analysis, philosophical assumptions, contextual factors, interdisciplinary work, research opportunities, and practice implications are discussed.

  6. An Evaluation Framework for CALL

    Science.gov (United States)

    McMurry, Benjamin L.; Williams, David Dwayne; Rich, Peter J.; Hartshorn, K. James

    2016-01-01

    Searching prestigious Computer-assisted Language Learning (CALL) journals for references to key publications and authors in the field of evaluation yields a short list. The "American Journal of Evaluation"--the flagship journal of the American Evaluation Association--is only cited once in both the "CALICO Journal and Language…

  7. News Education: Physics Education Networks meeting has global scale Competition: Competition seeks the next Brian Cox Experiment: New measurement of neutrino time-of-flight consistent with the speed of light Event: A day for all those who teach physics Conference: Students attend first Anglo-Japanese international science conference Celebration: Will 2015 be the 'Year of Light'? Teachers: Challenging our intuition in spectacular fashion: the fascinating world of quantum physics awaits Research: Science sharpens up sport Learning: Kittinger and Baumgartner: on a mission to the edge of space International: London International Youth Science Forum calls for leading young scientists Competition: Physics paralympian challenge needs inquisitive, analytical, artistic and eloquent pupils Forthcoming events

    Science.gov (United States)

    2012-05-01

    Education: Physics Education Networks meeting has global scale Competition: Competition seeks the next Brian Cox Experiment: New measurement of neutrino time-of-flight consistent with the speed of light Event: A day for all those who teach physics Conference: Students attend first Anglo-Japanese international science conference Celebration: Will 2015 be the 'Year of Light'? Teachers: Challenging our intuition in spectacular fashion: the fascinating world of quantum physics awaits Research: Science sharpens up sport Learning: Kittinger and Baumgartner: on a mission to the edge of space International: London International Youth Science Forum calls for leading young scientists Competition: Physics paralympian challenge needs inquisitive, analytical, artistic and eloquent pupils Forthcoming events

  8. Trust in the doctor-patient relationship in the light of the latest research

    Directory of Open Access Journals (Sweden)

    Pawlikowska-Łagód Katarzyna

    2017-03-01

    Full Text Available Introduction. Trusting the medical staff, especially the doctor is a fundamental part of the success of the treatment process. Appropriate level of trust in a doctor-patient relationship affects the patient’s compliance with the physician’s recommendations and motivates patient to fight the disease. Over the last few years, numerous studies have been conducted on the level of trust in medical staff, especially doctors.

  9. Calle y Saberes en Movimiento

    Directory of Open Access Journals (Sweden)

    Laura Daniela Aguirre Aguilar

    2010-01-01

    Full Text Available En México el rezago, el ausentismo, la deserción escolar, el trabajo a temprana edad y el inicio de una vida en la calle, en repetidas ocasiones son consecuencia de un núcleo familiar desarticulado o de una débil relación intrafamiliar, así como de una condición socioeconómica en desventaja. Ante esta problemática, la Secretaría de Educación Pública, instancia gubernamental encargada de garantizar una educación de calidad para la población, trabaja coordinadamente con organizaciones de la sociedad civil e instancias públicas, para la reintegración a los espacios educativos de los niños, niñas y jóvenes en situación de calle.

  10. Clinical study on the time courses of serum myosin light chain I levels in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Nakanishi, Masako; Saiki, Yasuhiko; Ui, Kazuyo

    1992-01-01

    Changes of serum myosin light chain I (Myosin LCI) concentrations and creatine kinase (CK) activities were serially measured in 23 patients with acute myocardial infarction. Intracoronary thrombolysis was performed in 14 patients (ICT group) while the remaining 9 patients were treated in the conventional manner (non ICT group). The relationships between the maximum levels of serum Myosin LCI or CK and a myocardial infarct size index or left ventricular function were evaluated in 18 patients. The myocardial infarct size index was determined by 201 Tl myocardial scintigrams performed in the chronic phase. Multiple peaks of Myosin LCI were observed in 64% (9/14) of the ICT group and the first peak in 6 of these patients appeared much earlier in the same time as CK peak than in the non-ICT group, while multiple peaks were seen only in one case in the non-ICT group. The infarct size index by 201 Tl myocardial SPECT correlated with maximum Myosin LCI levels (r=0.88, p<0.001, n=10) and CK activities (r=0.67, p<0.05, n=10). These results indicate that the measurement of serum Myosin LCI is very useful for estimating the extent of myocardial damage and suggest that myocardial degeneration occurs at a very early phase of myocardial infarction. (author)

  11. Nutritional status independently affects quality of life of patients with systemic immunoglobulin light-chain (AL) amyloidosis.

    Science.gov (United States)

    Caccialanza, Riccardo; Palladini, Giovanni; Klersy, Catherine; Cereda, Emanuele; Bonardi, Chiara; Cameletti, Barbara; Montagna, Elisabetta; Russo, Paola; Foli, Andrea; Milani, Paolo; Lavatelli, Francesca; Merlini, Giampaolo

    2012-03-01

    Nutritional status is an independent prognostic factor in immunoglobulin light-chain amyloidosis (AL), but its influence on quality of life (QoL) is unknown. The aim of this cross-sectional study was to investigate the association between nutritional status and QoL in AL patients at diagnosis. One hundred and fifty consecutive patients with biopsy-proven AL were assessed for nutritional status by anthropometry [body mass index, unintentional weight loss (WL) in the previous 6 months and mid-arm muscle circumference (MAMC)], biochemistry (serum prealbumin), and semiquantitative food intake at referral. QoL was assessed by the Medical Outcomes Study 36-item Short Form General Health Survey. The composite physical component summary (PCS) and the mental component summary (MCS) for AL outpatients were 36.2 ± 10.1 and 44.9 ± 11.3, respectively (p performance status, the number of organs involved, the severity of cardiac damage, C-reactive protein, energy intake, and WL, PCS was significantly lower for serum prealbumin Nutritional status independently affects QoL in AL patients since diagnosis. Nutritional evaluation should be integral part of the clinical assessment of AL patients. Nutritional support intervention trials are warranted in such patients' population.

  12. Ultrasound call detection in capybara

    Directory of Open Access Journals (Sweden)

    Selene S.C. Nogueira

    2012-07-01

    Full Text Available The vocal repertoire of some animal species has been considered a non-invasive tool to predict distress reactivity. In rats ultrasound emissions were reported as distress indicator. Capybaras[ vocal repertoire was reported recently and seems to have ultrasound calls, but this has not yet been confirmed. Thus, in order to check if a poor state of welfare was linked to ultrasound calls in the capybara vocal repertoire, the aim of this study was to track the presence of ultrasound emissions in 11 animals under three conditions: 1 unrestrained; 2 intermediately restrained, and 3 highly restrained. The ultrasound track identified frequencies in the range of 31.8±3.5 kHz in adults and 33.2±8.5 kHz in juveniles. These ultrasound frequencies occurred only when animals were highly restrained, physically restrained or injured during handling. We concluded that these calls with ultrasound components are related to pain and restraint because they did not occur when animals were free of restraint. Thus we suggest that this vocalization may be used as an additional tool to assess capybaras[ welfare.

  13. Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial.

    Science.gov (United States)

    Lieverse, Ritsaert; Van Someren, Eus J W; Nielen, Marjan M A; Uitdehaag, Bernard M J; Smit, Jan H; Hoogendijk, Witte J G

    2011-01-01

    Major depressive disorder (MDD) in elderly individuals is prevalent and debilitating. It is accompanied by circadian rhythm disturbances associated with impaired functioning of the suprachiasmatic nucleus, the biological clock of the brain. Circadian rhythm disturbances are common in the elderly. Suprachiasmatic nucleus stimulation using bright light treatment (BLT) may, therefore, improve mood, sleep, and hormonal rhythms in elderly patients with MDD. To determine the efficacy of BLT in elderly patients with MDD. Double-blind, placebo-controlled randomized clinical trial. Home-based treatment in patients recruited from outpatient clinics and from case-finding using general practitioners' offices in the Amsterdam region. Eighty-nine outpatients 60 years or older who had MDD underwent assessment at baseline (T0), after 3 weeks of treatment (T1), and 3 weeks after the end of treatment (T2). Intervention Three weeks of 1-hour early-morning BLT (pale blue, approximately 7500 lux) vs placebo (dim red light, approximately 50 lux). Mean improvement in Hamilton Scale for Depression scores at T1 and T2 using parameters of sleep and cortisol and melatonin levels. Intention-to-treat analysis showed Hamilton Scale for Depression scores to improve with BLT more than placebo from T0 to T1 (7%; 95% confidence interval, 4%-23%; P = .03) and from T0 to T2 (21%; 7%-31%; P = .001). At T1 relative to T0, get-up time after final awakening in the BLT group advanced by 7% (P hour urinary free cortisol level was 37% lower (P = .003) compared with the placebo group. The evening salivary cortisol level had decreased by 34% in the BLT group compared with an increase of 7% in the placebo group (P = .02). In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment. clinicaltrials

  14. Gross and microscopic findings in patients submitted to nonablative full-face resurfacing using intense pulsed light: a preliminary study.

    Science.gov (United States)

    Hernández-Pérez, Enrique; Ibiett, Erick Valencia

    2002-08-01

    Intense pulsed light (IPL) is a noncoherent, nonlaser, filtered flashlamp emitting a broadband visible light that has been shown to be effective in photoepilation, as well as in a number of vascular and pigmented lesions of the skin. Their efficacy has also been reported recently in the treatment of photodamaged facial skin. In the last condition, however, there are few studies showing the clinical and microscopic changes produced by IPL. To assess the gross and microscopic changes that occur in photodamaged skin submitted to nonablative full-face resurfacing (NAFFR) using IPL. Five women were submitted to five NAFFR sessions using IPL, one every 2 weeks. Skin biopsies and photographs were taken on all of the patients before the first procedure and after the last one, as well as weekly clinical assessment. Data concerning skin features (wrinkles, oiliness, thickness, dilated pores, and general appearance) were all assessed. Microscopic improvement of the aging features in the epidermis and dermis were all assessed. For the statistical analysis a t test for small samples was used. All the patients showed clinical and microscopic improvement in every one of the parameters assessed. The t test for small samples showed a statistically significant difference (P Facial photodamage was clinically and microscopically improved using IPL. Use of IPL as a rejuvenating method seems to be promising, with minimal side effects, a wide safety margin, and minimal downtime.

  15. Intelligent outdoor lighting systems

    NARCIS (Netherlands)

    Özçelebi, T.

    2014-01-01

    Cities understand the advantages of branding themselves as unique, beautiful and secure places. Lighting plays a special part in establishing that identity. In 2014, TU/e Intelligent Lighting Institute, Philips Research and ST Microelectronics are collaborating in an EIT ICT Labs project called

  16. Urinary free light chains may help to identify infection in patients with elevated systemic inflammation due to rheumatic disease.

    Science.gov (United States)

    Bramlage, Carsten P; Froelich, Britta; Wallbach, Manuel; Minguet, Joan; Grupp, Clemens; Deutsch, Cornelia; Bramlage, Peter; Müller, Gerhard A; Koziolek, Michael

    2017-04-01

    The risk of infection in patients with rheumatic diseases is elevated, but a clear marker to differentiate the cause of the systemic inflammation is missing. We assessed the ability urinary immunoglobulin free light chains (FLCs) to indicate the presence of infection in patients with rheumatic disease. We performed a retrospective analysis of patients with rheumatic disease attending the Georg-August University Hospital in Goettingen, Germany, from January 2011 to December 2013. Subjects were included if they had urine levels of κ and λ FLCs available. A reference group of patients without autoimmune disease, but with documented infection, was constructed. A total of 1500 patients had their urinary FLCs quantified during the study period. Of the 382 patients with rheumatic disease, 172 (45%) displayed no systemic inflammation, 162 (42%) had inflammation due to the underlying disease activity, and 48 (13%) had inflammation due to a confirmed infection. Urinary FLC concentrations were much higher in patients with rheumatic diseases and infection (κ 68.8 ± 81.8 mg/L, λ 31.4 ± 53.5 mg/L) compared to those with inflammation due to rheumatic disease activity (κ 22.7 ± 26.3 mg/L, λ 8.1 ± 9.1 mg/L, κ p rheumatic disease activity from that due to the additional presence of infection. The ability to quantify these proteins in urine provides a simple alternative to the use of blood.

  17. [The value of serum heavy/light chain immunoassay to assess therapeutic response in patients with multiple myeloma].

    Science.gov (United States)

    Yu, X C; Su, W; Zhuang, J L

    2018-04-14

    Objective: To assess the value of immunoglobulin heavy/light chain (HLC) immunoassay on therapeutic response in patients with multiple myeloma(MM). Methods: A total of 45 newly diagnosed MM patients were retrospectively enrolled in Peking Union Medical College Hospital from 2013 to 2016, whose 115 serum samples were consecutively collected. HLC was tested to evaluate response and compare with other methods for M protein detection. Results: ①There were 30 males and 15 females in total of whom the monoclonal immunoglobulin was IgG in 27 (IgGκ∶IgGλ 12∶15) and IgA (IgAκ∶IgAλ 9∶9) in 18. The arerage age of the studied population was 59 (range 43-80) . ② In 34 patients with serum sample at diagnosis, 32 (94.1%) had abnormal HLC ratio (rHLC) while 2 patients with IgG had normal rHLC. The percentages of abnormal rHLC was 81.8% (18/22) at partial response、50.0%(9/18) at very good complete response and 16.0%(4/25) at complete response. ③In 25 patients reaching CR, there were 13 with IgG and 12 with IgA. 4 patients equally split of IgG and IgA had abnormal rHLC at complete response. ④By monitoring the rHLC of some patients consecutively, we found that the remission of rHLC was to some extent behind the remission of SPE and IEF, or even rFLC. Conclusion: Immunoglobulin HLC detection is one feasible method for minimal residual disease detection.

  18. A Light in the Darkness?

    DEFF Research Database (Denmark)

    Brudholm, Thomas

    2007-01-01

    The article considers the implications of how we remember and commemorate so-called "lights in the darkness," such as the rescue of the Jews in Denmark in 1943.......The article considers the implications of how we remember and commemorate so-called "lights in the darkness," such as the rescue of the Jews in Denmark in 1943....

  19. Efficacy of oral exfoliative cytology in diabetes mellitus patients: a light microscopic and confocal microscopic study.

    Science.gov (United States)

    Gopal, Deepika; Malathi, N; Reddy, B Thirupathi

    2015-03-01

    Diabetes mellitus (DM) has become a global problem. By monitoring the health status of these individuals, diabetic complications can be prevented. We aimed to analyze alterations in the morphology and cytomorphometry of buccal epithelial cells of type 2 DM patients using oral exfoliative cytology technique and determine its importance in public health screening, diagnosis and monitoring of diabetes mellitus. The study was carried out in 100 type 2 DM patients and 30 healthy individuals. Smears were taken from the right buccal mucosa and stained by the Papanicolaou technique. Staining with Acridine orange was carried out to view qualitative changes with confocal laser scanning microscope (LSM-510 Meta). The cytomorphometry was evaluated using IMAGE PRO PLUS 5.5 software with Evolution LC camera. All findings were statistically analyzed. The results showed that with increase in fasting plasma glucose levels, there is significant increase in nuclear area, decrease in cytoplasmic area, and increase in nuclear cytoplasmic ratio (p inclusion, candida and keratinization. In the present study, we found significant alterations in the cytomorphometry and cytomorphology of buccal epithelial cells of type 2 DM patients. This study supports and extends the view that these cellular changes can alert the clinician to the possibility of diabetes and aid in monitoring of diabetes throughout the lifetime of the patient.

  20. A study of so-called hypochondriasis.

    Science.gov (United States)

    von Scheele, C; Nordgren, L; Kempi, V; Hetta, J; Hallborg, A

    1990-01-01

    Twenty-four patients with unexplained somatic complaints were subjected to a thorough somatic examination. Only when the examination proved negative was the patient entered into the study. The patients were clinically appraised according to criteria given in DSM-III. Generalized anxiety disorder (GAD) was diagnosed in 12, somatization disorder (SD) in 8, and hypochondriasis in 4 patients. Seventeen of the 24 patients agreed to participate in biochemical investigations including a TRH load, a dexamethasone test, and a determination of the monoamine metabolites 5-HIAA and HVA in cerebrospinal fluid (CSF). A normal TSH increase and a normal suppression of cortisol were registered. The HVA values correlated significantly with the 5-HIAA values as well as with the alexithymia scores. Concerning alexithymia and maturity level, no difference as to social class was found. The patients filled in a Zung depression chart. The Zung scale and the 5-HIAA values were both inconsistent with depressive illness. In so-called hypochondriasis a long-term relationship, including selected somatic and biochemical examinations and thorough information, was crucial in abating the patient's distrust and thus the need for health care.

  1. Reciprocity of mobile phone calls

    OpenAIRE

    Kovanen, Lauri; Saramaki, Jari; Kaski, Kimmo

    2010-01-01

    We present a study of the reciprocity of human behaviour based on mobile phone usage records. The underlying question is whether human relationships are mutual, in the sense that both are equally active in keeping up the relationship, or is it on the contrary typical that relationships are lopsided, with one party being significantly more active than the other. We study this question with the help of a mobile phone data set consisting of all mobile phone calls between 5.3 million customers of...

  2. What Do Monkey Calls Mean?

    Science.gov (United States)

    Schlenker, Philippe; Chemla, Emmanuel; Zuberbühler, Klaus

    2016-12-01

    A field of primate linguistics is gradually emerging. It combines general questions and tools from theoretical linguistics with rich data gathered in experimental primatology. Analyses of several monkey systems have uncovered very simple morphological and syntactic rules and have led to the development of a primate semantics that asks new questions about the division of semantic labor between the literal meaning of monkey calls, additional mechanisms of pragmatic enrichment, and the environmental context. We show that comparative studies across species may validate this program and may in some cases help in reconstructing the evolution of monkey communication over millions of years. Copyright © 2016. Published by Elsevier Ltd.

  3. Influence of an irregular surface and low light on the step variability of patients with peripheral neuropathy during level gait.

    Science.gov (United States)

    Thies, Sibylle B; Richardson, James K; Demott, Trina; Ashton-Miller, James A

    2005-08-01

    Patients with peripheral neuropathy (PN) report greater difficulty walking on irregular surfaces with low light (IL) than on flat surfaces with regular lighting (FR). We tested the primary hypothesis that older PN patients would demonstrate greater step width and step width variability under IL conditions than under FR conditions. Forty-two subjects (22 male, 20 female: mean +/- S.D.: 64.7 +/- 9.8 years) with PN underwent history, physical examination, and electrodiagnostic testing. Subjects were asked to walk 10 m at a comfortable speed while kinematic and force data were measured at 100 Hz using optoelectronic markers and foot switches. Ten trials were conducted under both IL and FR conditions. Step width, time, length, and speed were calculated with a MATLAB algorithm, with the standard deviation serving as the measure of variability. The results showed that under IL, as compared to FR, conditions subjects demonstrated greater step width (197.1 +/- 40.8 mm versus 180.5 +/- 32.4 mm; P < 0.001) and step width variability (40.4 +/- 9.0 mm versus 34.5 +/- 8.4 mm; P < 0.001), step time and its variability (P < 0.001 and P = 0.003, respectively), and step length variability (P < 0.001). Average step length and gait speed decreased under IL conditions (P < 0.001 for both). Step width variability and step time variability correlated best under IL conditions with a clinical measure of PN severity and fall history, respectively. We conclude that IL conditions cause PN patients to increase the variability of their step width and other gait parameters.

  4. On-call emergency workload of a general surgical team

    Directory of Open Access Journals (Sweden)

    Jawaid Masood

    2009-01-01

    Full Text Available Background: To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. Patients and Methods: During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Results: Total 456 patients (326 males and 130 females were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9% were received from 8 am to 5 pm. 224 (49.1% calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0% patients. Total 73 (16.0% calls were received for trauma. Total 131 (28.7% patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5% patients were discharged from A and E. 92 (20.1% patients were referred to other units with medical referral accounts for 45 (9.8% patients. Total 104 (22.8% emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7% patients. Conclusion: Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

  5. Independent Prognostic Value of Stroke Volume Index in Patients With Immunoglobulin Light Chain Amyloidosis.

    Science.gov (United States)

    2018-05-01

    Heart involvement is the most important prognostic determinant in AL amyloidosis patients. Echocardiography is a cornerstone for the diagnosis and provides important prognostic information. We studied 754 patients with AL amyloidosis who underwent echocardiographic assessment at the Mayo Clinic, including a Doppler-derived measurement of stroke volume (SV) within 30 days of their diagnosis to explore the prognostic role of echocardiographic variables in the context of a well-established soluble cardiac biomarker staging system. Reproducibility of SV, myocardial contraction fraction, and left ventricular strain was assessed in a separate, yet comparable, study cohort of 150 patients from the Pavia Amyloidosis Center. The echocardiographic measures most predictive for overall survival were SV index <33 mL/min, myocardial contraction fraction <34%, and cardiac index <2.4 L/min/m 2 with respective hazard ratios (95% confidence intervals) of 2.95 (2.37-3.66), 2.36 (1.96-2.85), and 2.32 (1.91-2.80). For the subset that had left ventricular strain performed, the prognostic cut point was -14% (hazard ratios, 2.70; 95% confidence intervals, 1.84-3.96). Each parameter was independent of systolic blood pressure, Mayo staging system (NT-proBNP [N-terminal pro-B-type natriuretic peptide] and troponin), and ejection fraction on multivariable analysis. Simple predictive models for survival, including biomarker staging along with SV index or left ventricular strain, were generated. SV index prognostic performance was similar to left ventricular strain in predicting survival in AL amyloidosis, independently of biomarker staging. Because SV index is routinely calculated and widely available, it could serve as the preferred echocardiographic measure to predict outcomes in AL amyloidosis patients. © 2018 American Heart Association, Inc.

  6. LIGHT/TNFSF14 is increased in patients with type 2 diabetes mellitus and promotes islet cell dysfunction and endothelial cell inflammation in vitro.

    Science.gov (United States)

    Halvorsen, Bente; Santilli, Francesca; Scholz, Hanne; Sahraoui, Afaf; Gulseth, Hanne L; Wium, Cecilie; Lattanzio, Stefano; Formoso, Gloria; Di Fulvio, Patrizia; Otterdal, Kari; Retterstøl, Kjetil; Holven, Kirsten B; Gregersen, Ida; Stavik, Benedicte; Bjerkeli, Vigdis; Michelsen, Annika E; Ueland, Thor; Liani, Rossella; Davi, Giovanni; Aukrust, Pål

    2016-10-01

    Activation of inflammatory pathways is involved in the pathogenesis of type 2 diabetes mellitus. On the basis of its role in vascular inflammation and in metabolic disorders, we hypothesised that the TNF superfamily (TNFSF) member 14 (LIGHT/TNFSF14) could be involved in the pathogenesis of type 2 diabetes mellitus. Plasma levels of LIGHT were measured in two cohorts of type 2 diabetes mellitus patients (191 Italian and 40 Norwegian). Human pancreatic islet cells and arterial endothelial cells were used to explore regulation and relevant effects of LIGHT in vitro. Our major findings were: (1) in both diabetic cohorts, plasma levels of LIGHT were significantly raised compared with sex- and age-matched healthy controls (n = 32); (2) enhanced release from activated platelets seems to be an important contributor to the raised LIGHT levels in type 2 diabetes mellitus; (3) in human pancreatic islet cells, inflammatory cytokines increased the release of LIGHT and upregulated mRNA and protein levels of the LIGHT receptors lymphotoxin β receptor (LTβR) and TNF receptor superfamily member 14 (HVEM/TNFRSF14); (4) in these cells, LIGHT attenuated the insulin release in response to high glucose at least partly via pro-apoptotic effects; and (5) in human arterial endothelial cells, glucose boosted inflammatory response to LIGHT, accompanied by an upregulation of mRNA levels of HVEM (also known as TNFRSF14) and LTβR (also known as LTBR). Our findings show that patients with type 2 diabetes mellitus are characterised by increased plasma LIGHT levels. Our in vitro findings suggest that LIGHT may contribute to the progression of type 2 diabetes mellitus by attenuating insulin secretion in pancreatic islet cells and by contributing to vascular inflammation.

  7. Effectiveness of aromatherapy with light thai massage for cellular immunity improvement in colorectal cancer patients receiving chemotherapy.

    Science.gov (United States)

    Khiewkhern, Santisith; Promthet, Supannee; Sukprasert, Aemkhea; Eunhpinitpong, Wichai; Bradshaw, Peter

    2013-01-01

    Patients with colorectal cancer are usually treated with chemotherapy, which reduces the number of blood cells, especially white blood cells, and consequently increases the risk of infections. Some research studies have reported that aromatherapy massage affects the immune system and improves immune function by, for example, increasing the numbers of natural killer cells and peripheral blood lymphocytes. However, there has been no report of any study which provided good evidence as to whether aromatherapy with Thai massage could improve the immune system in patients with colorectal cancer. The objectives of this study were to determine whether the use of aromatherapy with light Thai massage in patients with colorectal cancer, who have received chemotherapy, can result in improvement of the cellular immunity and reduce the severity of the common symptoms of side effects. Sixty-six patients with colorectal cancer in Phichit Hospital, Thailand, were enrolled in a single-blind, randomised-controlled trial. The intervention consisted of three massage sessions with ginger and coconut oil over a 1-week period. The control group received standard supportive care only. Assessments were conducted at pre-assessment and at the end of one week of massage or standard care. Changes from pre-assessment to the end of treatment were measured in terms of white blood cells, neutrophils, lymphocytes, CD4 and CD8 cells and the CD4/CD8 ratio and also the severity of self-rated symptom scores. The main finding was that after adjusting for pre-assessment values the mean lymphocyte count at the post-assessment was significantly higher (P=0.04) in the treatment group than in the controls. The size of this difference suggested that aromatherapy with Thai massage could boost lymphocyte numbers by 11%. The secondary outcomes were that at the post assessment the symptom severity scores for fatigue, presenting symptom, pain and stress were significantly lower in the massage group than in the

  8. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

    Science.gov (United States)

    Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

    2015-01-01

    High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time. © 2014 International Society for Diseases of the Esophagus.

  9. Patients with schizophrenia do not preserve automatic grouping when mentally re-grouping figures: shedding light on an ignored difficulty

    Directory of Open Access Journals (Sweden)

    Anne eGiersch

    2012-08-01

    Full Text Available Looking at a pair of objects is easy when automatic grouping mechanisms bind these objects together, but visual exploration can also be more flexible. It is possible to mentally ‘re-group’ two objects that are not only separate but belong to different pairs of objects. ‘Re-grouping’ is in conflict with automatic grouping, since it entails a separation of each item from the set it belongs to. This ability appears to be impaired in patients with schizophrenia. Here we check if this impairment is selective, which would suggest a dissociation between grouping and ‘re-grouping’, or if it impacts on usual, automatic grouping, which would call for a better understanding of the interactions between automatic grouping and ‘re-grouping’. Sixteen outpatients with schizophrenia and healthy controls had to identify two identical and contiguous target figures within a display of circles and squares alternating around a fixation point. Eye-tracking was used to check central fixation. The target pair could be located in the same or separate hemifields. Identical figures were grouped by a connector (grouped automatically or not (to be re-grouped. Attention modulation of automatic grouping was tested by manipulating the proportion of connected and unconnected targets, thus prompting subjects to focalize on either connected or unconnected pairs. Both groups were sensitive to automatic grouping in most conditions, but patients were unusually slowed down for connected targets while focalizing on unconnected pairs. In addition, this unusual effect occurred only when target were presented within the same hemifield. Patients and controls differed on this asymmetry between within- and across-hemifield presentation, suggesting that patients with schizophrenia do not re-group figures in the same way as controls do. We discuss possible implications on how ‘re-grouping’ ties in with ongoing, automatic perception in healthy volunteers.

  10. On-call emergency workload of a general surgical team.

    Science.gov (United States)

    Jawaid, Masood; Raza, Syed Muhammad; Alam, Shams Nadeem; Manzar, S

    2009-01-01

    To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E) and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Total 456 patients (326 males and 130 females) were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9%) were received from 8 am to 5 pm. 224 (49.1%) calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0%) patients. Total 73 (16.0%) calls were received for trauma. Total 131 (28.7%) patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5%) patients were discharged from A and E. 92 (20.1%) patients were referred to other units with medical referral accounts for 45 (9.8%) patients. Total 104 (22.8%) emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7%) patients. Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

  11. Clinical usefulness of serum free light chains measurement in patients with multiple myeloma: comparative analysis of two different tests

    Directory of Open Access Journals (Sweden)

    Tadeusz Kubicki

    2017-01-01

    Full Text Available Introduction: There are two commercially available tests for measurement of serum free light chains (sFLC in multiple myeloma (MM patients – Freelite and N Latex FLC. The aim of this study was to perform an assessment and direct comparison of the usefulness of the methods in routine clinical practice.Methods: 40 refractory/relapsed MM patients underwent routine disease activity assessment studies, along with sFLC analysis using both assays. Correlation and concordance between the tests and sensitivity of studied methods of sFLC assessment were established. Special attention was focused on sFLC results in patients finally evaluated after completing the treatment. Results: A weak correlation for the measurement of both κ [Passing–Bablok slope (PB = 0.7681] and λ chains [(PB = 1.542] was found. Using Bland–Altman plots, a bias of 0.0467 (κ and -0.2133 (λ between the measurements was documented. The concordance coefficient equaled 0.87 for κ, 0.62 for λ and 0.52 for κ/λ ratio. Ten patients had an abnormal Freelite assay κ/λ ratio and normal N Latex FLC κ/λ ratio. Three of these patients had negative serum protein electrophoresis results and fulfilled diagnostic criteria of stringent complete remission (sCR according to N Latex FLC (but not according to Freelite. When the κ/λ ratio obtained by both methods was compared to patients’ serum/urine protein electrophoresis and immunofixation results, sensitivity of Freelite and N Latex FLC was established to be 62.5% and 41%, respectively. Conclusions: There was no strong correlation or concordance between the two assays, and the sensitivity in terms of sFLC detection was different. This may cause problems when diagnosis of sCR is considered.

  12. Depressive symptoms among patients at a clinic in the Red Light District of Tijuana, Mexico.

    Science.gov (United States)

    Ferraiolo, Natalie; Pinedo, Miguel; McCurley, Jessica; Burgos, Jose Luis; Vargas-Ojeda, Adriana Carolina; Rodriguez, Michael A; Ojeda, Victoria D

    2016-01-01

    Little is known about depression among structurally vulnerable groups living in Tijuana (e.g., migrants, deportees, substance users, sex workers, homeless) who may be at high risk for poor mental health. This study investigates the prevalence and correlates of depressive symptoms among vulnerable patients receiving services at a free clinic in Tijuana, Mexico. A convenience sample of 584 adult Mexican patients completed an interviewer-administered questionnaire in English or Spanish that included the 8-item NIH PROMIS depression short form and measures of individual, social, and structural factors affecting health. The prevalence of clinically significant depressive symptoms in our sample was 55%. In the multivariate analysis, female gender, poor/fair self-rated health, recent illicit drug use (past six months), feeling rejected (past six months), history of forced sex, and history of violence were independently associated with increased odds of experiencing depressive symptoms. When stratified by gender, we found important differences in significant factors, including recent illicit drug use in men and deportation in women. Among study participants, prevalence of depressive symptoms exceeds prevalence rates reported elsewhere in the U.S.-Mexico border region. These findings suggest that public health efforts to support mental health services in the border region are needed.

  13. Depressive symptoms among patients at a clinic in the Red Light District of Tijuana, Mexico

    Science.gov (United States)

    Ferraiolo, Natalie; Pinedo, Miguel; McCurley, Jessica; Burgos, Jose Luis; Vargas-Ojeda, Adriana Carolina; Rodriguez, Michael A.; Ojeda, Victoria D.

    2016-01-01

    Little is known about depression among structurally vulnerable groups living in Tijuana (e.g., migrants, deportees, substance users, sex workers, homeless) who may be at high risk for poor mental health. This study investigates the prevalence and correlates of depressive symptoms among vulnerable patients receiving services at a free clinic in Tijuana, Mexico. A convenience sample of 584 adult Mexican patients completed an interviewer-administered questionnaire in English or Spanish that included the 8-item NIH PROMIS depression short form and measures of individual, social, and structural factors affecting health. The prevalence of clinically significant depressive symptoms in our sample was 55%. In the multivariate analysis, female gender, poor/fair self-rated health, recent illicit drug use (past six months), feeling rejected (past six months), history of forced sex, and history of violence were independently associated with increased odds of experiencing depressive symptoms. When stratified by gender, we found important differences in significant factors, including recent illicit drug use in men and deportation in women. Among study participants, prevalence of depressive symptoms exceeds prevalence rates reported elsewhere in the U.S.-Mexico border region. These findings suggest that public health efforts to support mental health services in the border region are needed. PMID:28042307

  14. Differential recruitment efficacy of patient-derived amyloidogenic and myeloma light chain proteins by synthetic fibrils-A metric for predicting amyloid propensity.

    Directory of Open Access Journals (Sweden)

    Emily B Martin

    Full Text Available Monoclonal free light chain (LC proteins are present in the circulation of patients with immunoproliferative disorders such as light chain (AL amyloidosis and multiple myeloma (MM. Light chain-associated amyloid is a complex pathology composed of proteinaceous fibrils and extracellular matrix proteins found in all patients with AL and in ~10-30% of patients who presented with MM. Amyloid deposits systemically in multiple organs and tissues leading to dysfunction and ultimately death. The overall survival of patients with amyloidosis is worse than for those with early stage MM.We have developed a sensitive binding assay quantifying the recruitment of full length, patient-derived LC proteins by synthetic amyloid fibrils, as a method for studying their amyloidogenic potential. In a survey of eight urinary LC, both AL and MM-associated proteins were recruited by synthetic amyloid fibrils; however, AL-associated LC bound significantly more efficiently (p < 0.05 than did MM LCs. The LC proteins used in this study were isolated from urine and presumed to represent a surrogate of serum free light chains.The binding of LC to synthetic fibrils in this assay accurately differentiated LC with amyloidogenic propensity from MM LC that were not associated with clinical amyloid disease. Notably, the LC from a MM patient who subsequently developed amyloid behaved as an AL-associated protein in the assay, indicating the possibility for identifying MM patients at risk for developing amyloidosis based on the light chain recruitment efficacy. With this information, at risk patients can be monitored more closely for the development of amyloidosis, allowing timely administration of novel, amyloid-directed immunotherapies-this approach may improve the prognosis for these patients.

  15. Reducing Short-Wavelength Blue Light in Dry Eye Patients with Unstable Tear Film Improves Performance on Tests of Visual Acuity.

    Science.gov (United States)

    Kaido, Minako; Toda, Ikuko; Oobayashi, Tomoo; Kawashima, Motoko; Katada, Yusaku; Tsubota, Kazuo

    2016-01-01

    To investigate whether suppression of blue light can improve visual function in patients with short tear break up time (BUT) dry eye (DE). Twenty-two patients with short BUT DE (10 men, 12 women; mean age, 32.4 ± 6.4 years; age range, 23-43 years) and 18 healthy controls (10 men, 8 women; mean age, 30.1 ± 7.4 years; age range, 20-49 years) underwent functional visual acuity (VA) examinations with and without wearing eyeglasses with 50% blue light blocked lenses. The functional VA parameters were starting VA, functional VA, and visual maintenance ratio. The baseline mean values (logarithm of the minimum angle of resolution, logMAR) of functional VA and the visual maintenance ratio were significantly worse in the DE patients than in the controls (P 0.05). The DE patients had significant improvement in mean functional VA and visual maintenance ratio while wearing the glasses (P 0.05). Protecting the eyes from short-wavelength blue light may help to ameliorate visual impairment associated with tear instability in patients with DE. This finding represents a new concept, which is that the blue light exposure might be harmful to visual function in patients with short BUT DE.

  16. Reducing Short-Wavelength Blue Light in Dry Eye Patients with Unstable Tear Film Improves Performance on Tests of Visual Acuity.

    Directory of Open Access Journals (Sweden)

    Minako Kaido

    Full Text Available To investigate whether suppression of blue light can improve visual function in patients with short tear break up time (BUT dry eye (DE.Twenty-two patients with short BUT DE (10 men, 12 women; mean age, 32.4 ± 6.4 years; age range, 23-43 years and 18 healthy controls (10 men, 8 women; mean age, 30.1 ± 7.4 years; age range, 20-49 years underwent functional visual acuity (VA examinations with and without wearing eyeglasses with 50% blue light blocked lenses. The functional VA parameters were starting VA, functional VA, and visual maintenance ratio.The baseline mean values (logarithm of the minimum angle of resolution, logMAR of functional VA and the visual maintenance ratio were significantly worse in the DE patients than in the controls (P 0.05. The DE patients had significant improvement in mean functional VA and visual maintenance ratio while wearing the glasses (P 0.05.Protecting the eyes from short-wavelength blue light may help to ameliorate visual impairment associated with tear instability in patients with DE. This finding represents a new concept, which is that the blue light exposure might be harmful to visual function in patients with short BUT DE.

  17. BUFO PARDALIS (ANURA: BUFONIDAE): MATING CALL AND ...

    African Journals Online (AJOL)

    the calls of one of these species, Bufo pardalis. Hewitt, were not analysed by Tandy & Keith. (1972). Furthennore there is some confusion in the literature regarding the mating call of this species. For these reasons this mating call is here clarified. The mating call of B. pardaiis was first described by Ranger (in Hewitt 1935) as ...

  18. 78 FR 76218 - Rural Call Completion

    Science.gov (United States)

    2013-12-17

    ... calls to rural areas, and enforce restrictions against blocking, choking, reducing, or restricting calls... to alert the Commission of systemic problems receiving calls from a particular originating long... associated with completing calls to rural areas. These rules will also enhance our ability to enforce...

  19. Rapid diagnosis of retina and optic nerve abnormalities in canine patients with and without cataracts using chromatic pupil light reflex testing.

    Science.gov (United States)

    Grozdanic, Sinisa D; Kecova, Helga; Lazic, Tatjana

    2013-09-01

    To develop fast and reliable testing routines for diagnosing retina and optic nerve diseases in canine cataract patients based on chromatic properties of the pupillary light reflex response. Seventy-seven canine patients with a history of cataract and decreased vision (43 patients with cataracts and no evidence of retina or optic nerve disease, 21 patients with cataracts and retinal degeneration [RD], 13 patients with cataracts and retinal detachment [RDT]), 11 canine patients with optic neuritis (ON) and 23 healthy dogs were examined using chromatic pupillary light reflex (cPLR) analysis with red and blue light and electroretinography. Electroretinography analysis showed statistically significant deficits in a- and b-wave amplitudes in dogs with cataracts and RD, or cataracts and RDT, when compared to dogs with cataracts without evidence of retinal abnormalities. Evaluation of b-wave amplitudes showed that presence of 78.5-μV (or lower) amplitudes had high sensitivity of 100% (95% CI: 87.2-100%) and high specificity of 96.7% (95% CI: 88.4-100%) in RD and RDT. Evaluation of cPLR responses using red light showed that presence of the pupil end constriction diameter of 5.5 mm (or higher) had moderately high sensitivity of 76.5% (95% CI: 50.1-93.2%) and high specificity of 100% (95% CI: 91.2-100%) in detecting RD and RDT. Optic neuritis patients had absent cPLR responses, regardless of the visual status. Chromatic evaluation of the pupillary light reflex is a rapid and accurate test for diagnosing retina and optic nerve diseases in canine patients. © 2012 American College of Veterinary Ophthalmologists.

  20. Detection of novel visible-light region absorbance peaks in the urine after alkalization in patients with alkaptonuria.

    Science.gov (United States)

    Tokuhara, Yasunori; Shukuya, Kenichi; Tanaka, Masami; Mouri, Mariko; Ohkawa, Ryunosuke; Fujishiro, Midori; Takahashi, Tomoo; Okubo, Shigeo; Yokota, Hiromitsu; Kurano, Makoto; Ikeda, Hitoshi; Yamaguchi, Seiji; Inagaki, Shinobu; Ishige-Wada, Mika; Usui, Hiromi; Yatomi, Yutaka; Shimosawa, Tatsuo

    2014-01-01

    Alkaptonuria, caused by a deficiency of homogentisate 1,2-dioxygenase, results in the accumulation of homogentisic acid (2,5-dihydroxyphenylacetic acid, HGA) in the urine. Alkaptonuria is suspected when the urine changes color after it is left to stand at room temperature for several hours to days; oxidation of homogentisic acid to benzoquinone acetic acid underlies this color change, which is accelerated by the addition of alkali. In an attempt to develop a facile screening test for alkaptonuria, we added alkali to urine samples obtained from patients with alkaptonuria and measured the absorbance spectra in the visible light region. We evaluated the characteristics of the absorption spectra of urine samples obtained from patients with alkaptonuria (n = 2) and compared them with those of urine specimens obtained from healthy volunteers (n = 5) and patients with phenylketonuria (n = 3), and also of synthetic homogentisic acid solution after alkalization. Alkalization of the urine samples and HGA solution was carried out by the addition of NaOH, KOH or NH4OH. The sample solutions were incubated at room temperature for 1 min, followed by measurement of the absorption spectra. Addition of alkali to alkaptonuric urine yielded characteristic absorption peaks at 406 nm and 430 nm; an identical result was obtained from HGA solution after alkalization. The absorbance values at both 406 nm and 430 nm increased in a time-dependent manner. In addition, the absorbance values at these peaks were greater in strongly alkaline samples (NaOH- KOH-added) as compared with those in weakly alkaline samples (NH4OH-added). In addition, the peaks disappeared following the addition of ascorbic acid to the samples. We found two characteristic peaks at 406 nm and 430 nm in both alkaptonuric urine and HGA solution after alkalization. This new quick and easy method may pave the way for the development of an easy method for the diagnosis of alkaptonuria.

  1. Detection of novel visible-light region absorbance peaks in the urine after alkalization in patients with alkaptonuria.

    Directory of Open Access Journals (Sweden)

    Yasunori Tokuhara

    Full Text Available BACKGROUND: Alkaptonuria, caused by a deficiency of homogentisate 1,2-dioxygenase, results in the accumulation of homogentisic acid (2,5-dihydroxyphenylacetic acid, HGA in the urine. Alkaptonuria is suspected when the urine changes color after it is left to stand at room temperature for several hours to days; oxidation of homogentisic acid to benzoquinone acetic acid underlies this color change, which is accelerated by the addition of alkali. In an attempt to develop a facile screening test for alkaptonuria, we added alkali to urine samples obtained from patients with alkaptonuria and measured the absorbance spectra in the visible light region. METHODS: We evaluated the characteristics of the absorption spectra of urine samples obtained from patients with alkaptonuria (n = 2 and compared them with those of urine specimens obtained from healthy volunteers (n = 5 and patients with phenylketonuria (n = 3, and also of synthetic homogentisic acid solution after alkalization. Alkalization of the urine samples and HGA solution was carried out by the addition of NaOH, KOH or NH4OH. The sample solutions were incubated at room temperature for 1 min, followed by measurement of the absorption spectra. RESULTS: Addition of alkali to alkaptonuric urine yielded characteristic absorption peaks at 406 nm and 430 nm; an identical result was obtained from HGA solution after alkalization. The absorbance values at both 406 nm and 430 nm increased in a time-dependent manner. In addition, the absorbance values at these peaks were greater in strongly alkaline samples (NaOH- KOH-added as compared with those in weakly alkaline samples (NH4OH-added. In addition, the peaks disappeared following the addition of ascorbic acid to the samples. CONCLUSIONS: We found two characteristic peaks at 406 nm and 430 nm in both alkaptonuric urine and HGA solution after alkalization. This new quick and easy method may pave the way for the development of an easy method for the

  2. Augmentation of light therapy in difficult-to-treat depressed patients: an open-label trial in both unipolar and bipolar patients

    Science.gov (United States)

    Camardese, Giovanni; Leone, Beniamino; Serrani, Riccardo; Walstra, Coco; Di Nicola, Marco; Della Marca, Giacomo; Bria, Pietro; Janiri, Luigi

    2015-01-01

    Objectives We investigated the clinical benefits of bright light therapy (BLT) as an adjunct treatment to ongoing psychopharmacotherapy, both in unipolar and bipolar difficult-to-treat depressed (DTD) outpatients. Methods In an open-label study, 31 depressed outpatients (16 unipolar and 15 bipolar) were included to undergo 3 weeks of BLT. Twenty-five completed the treatment and 5-week follow-up. Main outcome measures Clinical outcomes were evaluated by the Hamilton Depression Rating Scale (HDRS). The Snaith–Hamilton Pleasure Scale and the Depression Retardation Rating Scale were used to assess changes in anhedonia and psychomotor retardation, respectively. Results The adjunctive BLT seemed to influence the course of the depressive episode, and a statistically significant reduction in HDRS scores was reported since the first week of therapy. The treatment was well-tolerated, and no patients presented clinical signs of (hypo)manic switch during the overall treatment period. At the end of the study (after 5 weeks from BLT discontinuation), nine patients (36%, eight unipolar and one bipolar) still showed a treatment response. BLT augmentation also led to a significant improvement of psychomotor retardation. Conclusion BLT combined with the ongoing pharmacological treatment offers a simple approach, and it might be effective in rapidly ameliorating depressive core symptoms of vulnerable DTD outpatients. These preliminary results need to be confirmed in placebo-controlled, randomized, double-blind clinical trial on larger samples. PMID:26396517

  3. Detection of the value of consecutive serum total light chain (sTLC) in patients diagnosed with diffuse large B cell lymphoma.

    Science.gov (United States)

    Zhai, Linzhu; Zhao, Yuanyuan; Peng, Songguo; Zhu, Ke; Yu, Rongjian; Chen, Hailong; Lin, Tongyu; Lin, Lizhu

    2016-12-01

    There are limited data on serum total light chain (sTLC) in lymphoma and its relative role on the outcome of diffuse large B cell lymphoma (DLBCL) patients. Blood samples from 46 cases newly diagnosed with DLBCL were collected consecutively during chemotherapy to detect sTLC, IgG, IgA, and IgM levels. Clinical data and survival outcomes were analyzed according to the results of sTLC measurements. In summary, 22 patients (47.8 %) had abnormal k or λ light chain, respectively, and 6 patients (13.0 %) had both abnormal k and λ light chains before chemotherapy. Patients with elevated k light chain more frequently displayed multiple extra-nodal organ involvement (P = 0.01) and had an inferior overall survival (OS) (P = 0.041) and progression-free survival (PFS) (P = 0.044) compared to patients with normal level of k light chain. Furthermore, patients with elevated level of both k and λ also exhibited significant association with shorter OS (P = 0.002) and PFS (P = 0.009). Both elevated k alone and concurrent elevated k and λ had independent adverse effects on PFS (P = 0.031 and P = 0.019, respectively). sTLC level was reduced gradually by treatment in this study and reached the lowest point after the fourth cycle of chemotherapy, which was consistent with the disease behavior during chemotherapy. Considering the small sample size of this study, these results should be confirmed in a larger prospective study.

  4. [A relational database to store Poison Centers calls].

    Science.gov (United States)

    Barelli, Alessandro; Biondi, Immacolata; Tafani, Chiara; Pellegrini, Aristide; Soave, Maurizio; Gaspari, Rita; Annetta, Maria Giuseppina

    2006-01-01

    Italian Poison Centers answer to approximately 100,000 calls per year. Potentially, this activity is a huge source of data for toxicovigilance and for syndromic surveillance. During the last decade, surveillance systems for early detection of outbreaks have drawn the attention of public health institutions due to the threat of terrorism and high-profile disease outbreaks. Poisoning surveillance needs the ongoing, systematic collection, analysis, interpretation, and dissemination of harmonised data about poisonings from all Poison Centers for use in public health action to reduce morbidity and mortality and to improve health. The entity-relationship model for a Poison Center relational database is extremely complex and not studied in detail. For this reason, not harmonised data collection happens among Italian Poison Centers. Entities are recognizable concepts, either concrete or abstract, such as patients and poisons, or events which have relevance to the database, such as calls. Connectivity and cardinality of relationships are complex as well. A one-to-many relationship exist between calls and patients: for one instance of entity calls, there are zero, one, or many instances of entity patients. At the same time, a one-to-many relationship exist between patients and poisons: for one instance of entity patients, there are zero, one, or many instances of entity poisons. This paper shows a relational model for a poison center database which allows the harmonised data collection of poison centers calls.

  5. Light localization with low-contrast targets in a patient implanted with a suprachoroidal-transretinal stimulation retinal prosthesis.

    Science.gov (United States)

    Endo, Takao; Fujikado, Takashi; Hirota, Masakazu; Kanda, Hiroyuki; Morimoto, Takeshi; Nishida, Kohji

    2018-04-20

    To evaluate the improvement in targeted reaching movements toward targets of various contrasts in a patient implanted with a suprachoroidal-transretinal stimulation (STS) retinal prosthesis. An STS retinal prosthesis was implanted in the right eye of a 42-year-old man with advanced Stargardt disease (visual acuity: right eye, light perception; left eye, hand motion). In localization tests during the 1-year follow-up period, the patient attempted to touch the center of a white square target (visual angle, 10°; contrast, 96, 85, or 74%) displayed at a random position on a monitor. The distance between the touched point and the center of the target (the absolute deviation) was averaged over 20 trials with the STS system on or off. With the left eye occluded, the absolute deviation was not consistently lower with the system on than off for high-contrast (96%) targets, but was consistently lower with the system on for low-contrast (74%) targets. With both eyes open, the absolute deviation was consistently lower with the system on than off for 85%-contrast targets. With the system on and 96%-contrast targets, we detected a shorter response time while covering the right eye, which was being implanted with the STS, compared to covering the left eye (2.41 ± 2.52 vs 8.45 ± 3.78 s, p trial: Feb. 20, 2014 Date of registration: Jan. 4, 2014 Trial registration number: UMIN000012754 Registration site: UMIN Clinical Trials Registry (UMIN-CTR) http://www.umin.ac.jp/ctr/index.htm.

  6. Sensitivity of cultured lymphocytes from patients with nevoid basal cell carcinoma syndrome to ultraviolet light and phytohemagglutinin stimulation

    International Nuclear Information System (INIS)

    Ferraro, P.; Celotti, L.; Furlan, D.; Pattarello, I.; Peserico, A.

    1990-01-01

    DNA repair and replication after in vitro UV irradiation were determined in cultured peripheral blood lymphocytes from 6 patients with nevoid basal cell carcinoma syndrome (NBCCS) and from a group of control donors. DNA repair synthesis (UDS) was measured in unstimulated lymphocytes by incubation with 3H-TdR in the presence of hydroxyurea for 3 and 6 h after UV irradiation (6-48 J/m2). DNA replication was measured in PHA-stimulated lymphocytes, UV-irradiated or mock-irradiated, by incubation with 3H-TdR for 24 h. The effect of the mitogen was followed during 5 days after stimulation by determining the incorporation of 3H-TdR, the increase of cell number, and the mitotic index. NBCCS and control lymphocytes showed equal sensitivity to UV light in terms of UDS and reduced response to PHA. On the contrary, the mitotic index and the number of cells in stimulated cultures were significantly lower in the affected subjects. These data suggest an altered progression along the cell cycle, which could be characteristic of stimulated NBCCS lymphocytes

  7. Hornbills can distinguish between primate alarm calls.

    Science.gov (United States)

    Rainey, Hugo J.; Zuberbühler, Klaus; Slater, Peter J. B.

    2004-01-01

    Some mammals distinguish between and respond appropriately to the alarm calls of other mammal and bird species. However, the ability of birds to distinguish between mammal alarm calls has not been investigated. Diana monkeys (Cercopithecus diana) produce different alarm calls to two predators: crowned eagles (Stephanoaetus coronatus) and leopards (Panthera pardus). Yellow-casqued hornbills (Ceratogymna elata) are vulnerable to predation by crowned eagles but are not preyed on by leopards and might therefore be expected to respond to the Diana monkey eagle alarm call but not to the leopard alarm call. We compared responses of hornbills to playback of eagle shrieks, leopard growls, Diana monkey eagle alarm calls and Diana monkey leopard alarm calls and found that they distinguished appropriately between the two predator vocalizations as well as between the two Diana monkey alarm calls. We discuss possible mechanisms leading to these responses. PMID:15209110

  8. Calling in Work: Secular or Sacred?

    Science.gov (United States)

    Steger, Michael F.; Pickering, N. K.; Shin, J. Y.; Dik, B. J.

    2010-01-01

    Recent scholarship indicates that people who view their work as a calling are more satisfied with their work and their lives. Historically, calling has been regarded as a religious experience, although modern researchers frequently have adopted a more expansive and secular conceptualization of calling, emphasizing meaning and personal fulfillment…

  9. Indico CONFERENCE: Define the Call for Abstracts

    CERN Multimedia

    CERN. Geneva; Ferreira, Pedro

    2017-01-01

    In this tutorial, you will learn how to define and open a call for abstracts. When defining a call for abstracts, you will be able to define settings related to the type of questions asked during a review of an abstract, select the users who will review the abstracts, decide when to open the call for abstracts, and more.

  10. Do market participants learn from conference calls?

    NARCIS (Netherlands)

    Roelofsen, E.; Verbeeten, F.; Mertens, G.

    2014-01-01

    We examine whether market participants learn from the information that is disseminated during the Q-and-A section of conference calls. Specifically, we investigate whether stock prices react to information on intangible assets provided during conference calls, and whether conference calls

  11. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2001-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.

  12. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2001-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note: the number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.

  13. How to call the Fire Brigade

    CERN Multimedia

    2003-01-01

    The telephone numbers for the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from "wired" telephones, however, from mobile phones it leads to non-CERN emergency services.

  14. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2002-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.  

  15. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2002-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.

  16. Dynamic call center routing policies using call waiting and agent idle times

    NARCIS (Netherlands)

    Chan, W.; Koole, G.M.; L'Ecuyer, P.

    2014-01-01

    We study call routing policies for call centers with multiple call types and multiple agent groups. We introduce new weight-based routing policies where each pair (call type, agent group) is given a matching priority defined as an affine combination of the longest waiting time for that call type and

  17. Perceiving a Calling, Living a Calling, and Job Satisfaction: Testing a Moderated, Multiple Mediator Model

    Science.gov (United States)

    Duffy, Ryan D.; Bott, Elizabeth M.; Allan, Blake A.; Torrey, Carrie L.; Dik, Bryan J.

    2012-01-01

    The current study examined the relation between perceiving a calling, living a calling, and job satisfaction among a diverse group of employed adults who completed an online survey (N = 201). Perceiving a calling and living a calling were positively correlated with career commitment, work meaning, and job satisfaction. Living a calling moderated…

  18. Contrast sensitivity to spatial gratings in moderate and dim light conditions in patients with diabetes in the absence of diabetic retinopathy.

    Science.gov (United States)

    Safi, Sare; Rahimi, Anoushiravan; Raeesi, Afsaneh; Safi, Hamid; Aghazadeh Amiri, Mohammad; Malek, Mojtaba; Yaseri, Mehdi; Haeri, Mohammad; Middleton, Frank A; Solessio, Eduardo; Ahmadieh, Hamid

    2017-01-01

    To evaluate the ability of contrast sensitivity (CS) to discriminate loss of visual function in diabetic subjects with no clinical signs of retinopathy relative to that of normal subjects. In this prospective cross-sectional study, we measured CS in 46 diabetic subjects with a mean age of 48±6 years, a best-corrected visual acuity of 20/20 and no signs of diabetic retinopathy. The CS in these subjects was compared with CS measurements in 46 normal control subjects at four spatial frequencies (3, 6, 12, 18 cycles per degree) under moderate (500 lux) and dim (less than 2 lux) background light conditions. CS was approximately 0.16 log units lower in patients with diabetes relative to controls both in moderate and in dim background light conditions. Logistic regression classification and receiver operating characteristic curve analysis indicated that CS analysis using two light conditions was more accurate (0.78) overall compared with CS analysis using only a single illumination condition (accuracy values were 0.67 and 0.70 in moderate and dim light conditions, respectively). Our results showed that patients with diabetes without clinical signs of retinopathy exhibit a uniform loss in CS at all spatial frequencies tested. Measuring the loss in CS at two spatial frequencies (3 and 6 cycles per degree) and two light conditions (moderate and dim) is sufficiently robust to classify diabetic subjects with no retinopathy versus control subjects.

  19. Quantifying the radiant exposure and effective dose in patients treated for actinic keratoses with topical photodynamic therapy using daylight and LED white light

    Science.gov (United States)

    Manley, M.; Collins, P.; Gray, L.; O'Gorman, S.; McCavana, J.

    2018-02-01

    Daylight photodynamic therapy (dl-PDT) is as effective as conventional PDT (c-PDT) for treating actinic keratoses but has the advantage of reducing patient discomfort significantly. Topical dl-PDT and white light-PDT (wl-PDT) differ from c-PDT by way of light sources and methodology. We measured the variables associated with light dose delivery to skin surface and influence of geometry using a radiometer, a spectral radiometer and an illuminance meter. The associated errors of the measurement methods were assessed. The spectral and spatial distribution of the radiant energy from the LED white light source was evaluated in order to define the maximum treatment area, setup and treatment protocol for wl-PDT. We compared the data with two red LED light sources we use for c-PDT. The calculated effective light dose is the product of the normalised absorption spectrum of the photosensitizer, protoporphyrin IX (PpIX), the irradiance spectrum and the treatment time. The effective light dose from daylight ranged from 3  ±  0.4 to 44  ±  6 J cm-2due to varying weather conditions. The effective light dose for wl-PDT was reproducible for treatments but it varied across the treatment area between 4  ±  0.1 J cm-2 at the edge and 9  ±  0.1 J cm-2 centrally. The effective light dose for the red waveband (615-645 nm) was 0.42  ±  0.05 J cm-2 on a clear day, 0.05  ±  0.01 J cm-2 on an overcast day and 0.9  ±  0.01 J cm-2 using the white light. This compares with 0.95  ±  0.01 and 0.84  ±  0.01 J cm-2 for c-PDT devices. Estimated errors associated with indirect determination of daylight effective light dose were very significant, particularly for effective light doses less than 5 J cm-2 (up to 83% for irradiance calculations). The primary source of error is in establishment of the relationship between irradiance or illuminance and effective dose. Use of the O’Mahoney model is recommended using a

  20. A double-blind randomized controlled trial to assess the effect of bright light therapy on depression in patients with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Sonja Rutten

    2016-10-01

    Full Text Available Abstract Background A disturbed circadian rhythm seems to be a causal factor in the occurrence of depressive disorders in patients with Parkinson’s disease (PD. The circadian rhythm can be restored with light. Therefore, Bright Light Therapy (BLT might be a new treatment option for depression in PD patients. Methods/design In this double-blind controlled trial, 84 subjects with idiopathic PD are randomized to either BLT or a control light condition. The BLT condition emits white light with an intensity of 10,000 Lux, while the control device emits dim white light of 200 Lux, which is presumed to be too low to influence the circadian rhythm. Subjects receive 30 min of home treatment twice daily for three months. Timing of treatment is based on the individual chronotype. After finishing treatment, subjects enter a follow-up period of six months. The primary outcome of the study is the severity of depressive symptoms, as measured with the Hamilton Depression Rating Scale. Secondary outcomes are alternative depression measures, objective and subjective sleep measures, and salivary melatonin and cortisol concentrations. For exploratory purposes, we also assess the effects on motor symptoms, global cognitive function, comorbid psychiatric disorders, quality of life and caregiver burden. Data will be analyzed using a linear mixed models analysis. Discussion Performing a placebo-controlled trial on the effects of BLT in PD patients is challenging, as the appearance of the light may provide clues on the treatment condition. Moreover, fixed treatment times lead to an improved sleep-wake rhythm, which also influences the circadian system. With our study design, we do not compare BLT to placebo treatment, i.e. an ineffective control treatment. Rather, we compare structuring of the sleep-wake cycle in both conditions with additional BLT in the experimental condition, and additional dim light in the control condition. Participants are not informed about

  1. Long-distance calls in Neotropical primates

    Directory of Open Access Journals (Sweden)

    Oliveira Dilmar A.G.

    2004-01-01

    Full Text Available Long-distance calls are widespread among primates. Several studies concentrate on such calls in just one or in few species, while few studies have treated more general trends within the order. The common features that usually characterize these vocalizations are related to long-distance propagation of sounds. The proposed functions of primate long-distance calls can be divided into extragroup and intragroup ones. Extragroup functions relate to mate defense, mate attraction or resource defense, while intragroup functions involve group coordination or alarm. Among Neotropical primates, several species perform long-distance calls that seem more related to intragroup coordination, markedly in atelines. Callitrichids present long-distance calls that are employed both in intragroup coordination and intergroup contests or spacing. Examples of extragroup directed long-distance calls are the duets of titi monkeys and the roars and barks of howler monkeys. Considerable complexity and gradation exist in the long-distance call repertoires of some Neotropical primates, and female long-distance calls are probably more important in non-duetting species than usually thought. Future research must focus on larger trends in the evolution of primate long-distance calls, including the phylogeny of calling repertoires and the relationships between form and function in these signals.

  2. Randomized Phase II Trial of Erlotinib Alone or With Carboplatin and Paclitaxel in Patients Who Were Never or Light Former Smokers With Advanced Lung Adenocarcinoma: CALGB 30406 Trial

    Science.gov (United States)

    Jänne, Pasi A.; Wang, Xiaofei; Socinski, Mark A.; Crawford, Jeffrey; Stinchcombe, Thomas E.; Gu, Lin; Capelletti, Marzia; Edelman, Martin J.; Villalona-Calero, Miguel A.; Kratzke, Robert; Vokes, Everett E.; Miller, Vincent A.

    2012-01-01

    Purpose Erlotinib is clinically effective in patients with non–small-cell lung cancer (NSCLC) who have adenocarcinoma, are never or limited former smokers, or have EGFR mutant tumors. We investigated the efficacy of erlotinib alone or in combination with chemotherapy in patients with these characteristics. Patients and Methods Patients with advanced NSCLC (adenocarcinoma) who were epidermal growth factor receptor tyrosine kinase inhibitor and chemotherapy naive never or light former smokers (smokers of > 100 cigarettes and ≤ 10 pack years and quit ≥ 1 year ago) were randomly assigned to continuous erlotinib or in combination with carboplatin and paclitaxel (ECP) for six cycles followed by erlotinib alone. The primary end point was progression-free survival (PFS). Tissue collection was mandatory. Results PFS was similar (5.0 v 6.6 months; P = .1988) in patients randomly assigned to erlotinib alone (arm A; n = 81) or to ECP (arm B; n = 100). EGFR mutation analysis was possible in 91% (164 of 181) of patients, and EGFR mutations were detected in 40% (51 of 128) of never smokers and in 42% (15 of 36) of light former smokers. In arm A, response rate (70% v 9%), PFS (14.1 v 2.6 months), and overall survival (OS; 31.3 v 18.1 month) favored EGFR-mutant patients. In arm B, response rate (73% v 30%), PFS (17.2 v 4.8 months), and OS (38.1 v 14.4 months) favored EGFR-mutant patients. Incidence of grades 3 to 4 hematologic (2% v 49%; P < .001) and nonhematologic (24% v 52%; P < .001) toxicity was greater in patients treated with ECP. Conclusion Erlotinib and erlotinib plus chemotherapy have similar efficacy in clinically selected populations of patients with advanced NSCLC. EGFR mutations identify patients most likely to benefit. PMID:22547605

  3. Call Duration Characteristics based on Customers Location

    Directory of Open Access Journals (Sweden)

    Žvinys Karolis

    2014-05-01

    Full Text Available Nowadays a lot of different researches are performed based on call duration distributions (CDD analysis. However, the majority of studies are linked with social relationships between the people. Therefore the scarcity of information, how the call duration is associated with a user's location, is appreciable. The goal of this paper is to reveal the ties between user's voice call duration and the location of call. For this reason we analyzed more than 5 million calls from real mobile network, which were made over the base stations located in rural areas, roads, small towns, business and entertainment centers, residential districts. According to these site types CDD’s and characteristic features for call durations are given and discussed. Submitted analysis presents the users habits and behavior as a group (not an individual. The research showed that CDD’s of customers being them in different locations are not equal. It has been found that users at entertainment, business centers are tend to talk much shortly, than people being at home. Even more CDD can be distorted strongly, when machinery calls are evaluated. Hence to apply a common CDD for a whole network it is not recommended. The study also deals with specific parameters of call duration for distinguished user groups, the influence of network technology for call duration is considered.

  4. Public lighting.

    NARCIS (Netherlands)

    Schreuder, D.A.

    1986-01-01

    The function of public lighting and the relationship between public lighting and accidents are considered briefly as aspects of effective countermeasures. Research needs and recent developments in installation and operational described. Public lighting is an efficient accident countermeasure, but

  5. Light Pollution

    Science.gov (United States)

    Riegel, Kurt W.

    1973-01-01

    Outdoor lighting is light pollution which handicaps certain astronomical programs. Protective measures must be adopted by the government to aid observational astronomy without sacrificing legitimate outdoor lighting needs. (PS)

  6. 47 CFR 22.921 - 911 call processing procedures; 911-only calling mode.

    Science.gov (United States)

    2010-10-01

    ... programming in the mobile unit that determines the handling of a non-911 call and permit the call to be... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.921 911 call processing procedures; 911-only calling mode. Mobile telephones manufactured after February 13, 2000 that are capable of...

  7. Confocal Cornea Microscopy Detects Involvement of Corneal Nerve Fibers in a Patient with Light-Chain Amyloid Neuropathy Caused by Multiple Myeloma: A Case Report

    Directory of Open Access Journals (Sweden)

    Dietrich Sturm

    2016-06-01

    Full Text Available Changes in the subbasal corneal plexus detected by confocal cornea microscopy (CCM have been described for various types of neuropathy. An involvement of these nerves within light-chain (AL amyloid neuropathy (a rare cause of polyneuropathy has never been shown. Here, we report on a case of a patient suffering from neuropathy caused by AL amyloidosis and underlying multiple myeloma. Small-fiber damage was detected by CCM.

  8. Help Options in CALL: A Systematic Review

    Science.gov (United States)

    Cardenas-Claros, Monica S.; Gruba, Paul A.

    2009-01-01

    This paper is a systematic review of research investigating help options in the different language skills in computer-assisted language learning (CALL). In this review, emerging themes along with is-sues affecting help option research are identified and discussed. We argue that help options in CALL are application resources that do not only seem…

  9. Coaching "Callings" throughout the Adult Life Cycle.

    Science.gov (United States)

    Hudson, Frederic M.

    2001-01-01

    The process of "callings" continues throughout life. Coaching can connect the present to the future in a meaningful way. Callings represent a value shift requiring revision of the nature and scope of one's central purpose in life and meaningful activities. (JOW)

  10. Performance indicators for call centers with impatience

    NARCIS (Netherlands)

    Jouini, O.; Koole, G.M.; Roubos, A.

    2013-01-01

    An important feature of call center modeling is the presence of impatient customers. This article considers single-skill call centers including customer abandonments. A number of different service-level definitions are structured, including all those used in practice, and the explicit computation of

  11. Call centers with a postponed callback offer

    NARCIS (Netherlands)

    B. Legros (Benjamin); S. Ding (Sihan); R.D. van der Mei (Rob); O. Jouini (Oualid)

    2017-01-01

    textabstractWe study a call center model with a postponed callback option. A customer at the head of the queue whose elapsed waiting time achieves a given threshold receives a voice message mentioning the option to be called back later. This callback option differs from the traditional ones found in

  12. Peafowl antipredator calls encode information about signalers.

    Science.gov (United States)

    Yorzinski, Jessica L

    2014-02-01

    Animals emit vocalizations that convey information about external events. Many of these vocalizations, including those emitted in response to predators, also encode information about the individual that produced the call. The relationship between acoustic features of antipredator calls and information relating to signalers (including sex, identity, body size, and social rank) were examined in peafowl (Pavo cristatus). The "bu-girk" antipredator calls of male and female peafowl were recorded and 20 acoustic parameters were automatically extracted from each call. Both the bu and girk elements of the antipredator call were individually distinctive and calls were classified to the correct signaler with over 90% and 70% accuracy in females and males, respectively. Females produced calls with a higher fundamental frequency (F0) than males. In both females and males, body size was negatively correlated with F0. In addition, peahen rank was related to the duration, end mean frequency, and start harmonicity of the bu element. Peafowl antipredator calls contain detailed information about the signaler and can potentially be used by receivers to respond to dangerous situations.

  13. Calling, is there anything special about it?

    African Journals Online (AJOL)

    2016-07-15

    Jul 15, 2016 ... when a pastor is installed or a new candidate is ordained, 'The one who calls you is faithful .... extension to secular work of the dignity of a calling' (Fowler ... For Luther, therefore, the private life of devotion exercised in the.

  14. The Call to Teach and Teacher Hopefulness

    Science.gov (United States)

    Bullough, Robert V., Jr.; Hall-Kenyon, Kendra M.

    2011-01-01

    The purpose of this paper is to explore teacher motivation and well-being. Our analysis focuses on two central concepts, the notion of a "calling to teach" and of teacher "hopefulness." Data from 205 preservice and inservice teachers were collected to determine teachers' sense of calling and level of hope. Results indicate that overwhelmingly,…

  15. Call center performance with direct response advertising

    NARCIS (Netherlands)

    M. Kiygi Calli (Meltem); M. Weverbergh (Marcel); Ph.H.B.F. Franses (Philip Hans)

    2017-01-01

    textabstractThis study investigates the manpower planning and the performance of a national call center dealing with car repairs and on the road interventions. We model the impact of advertising on the capacity required. The starting point is a forecasting model for the incoming calls, where we take

  16. WOW: light print, light propel, light point

    DEFF Research Database (Denmark)

    Glückstad, Jesper; Bañas, Andrew Rafael; Aabo, Thomas

    2012-01-01

    anywhere in a sample at any orientation using real-time 3D optical micromanipulation with six degrees of freedom. One of the key aspects of our demonstrated WOWs is the change in direction of in-coupled light and the marked increase in numerical aperture of the out-coupled light. Hence, each light...... propelled WOW can tap from a relatively broad incident beam and generate a much more tightly confined light at its tip. The presentation contains both numerical simulations related to the propagation of light through a WOW and preliminary experimental demonstrations on our BioPhotonics Workstation...

  17. Perceived Calling and Work Engagement Among Nurses.

    Science.gov (United States)

    Ziedelis, Arunas

    2018-03-01

    The purpose of this study was to explore the relationship of perceived calling and work engagement in nursing over and above major work environment factors. In all, 351 nurses from various health care institutions completed the survey. Data were collected about the most demanding aspects of nursing, major job resources, the degree to which nursing is perceived as a meaningful calling, work engagement, and main demographic information. Hierarchical linear regression was applied to assess the relation between perceived calling and work engagement, while controlling for demographic and work environment factors, and perceived calling was significantly related to two out of three components of nurses' work engagement. The highest association was found with dedication component, and vigor component was related insignificantly. Results have shown that perceived calling might motivate nurses to engage in their work even in burdensome environment, although possible implications for the occupational well-being of nurses themselves remains unclear.

  18. Call cultures in orang-utans?

    Directory of Open Access Journals (Sweden)

    Serge A Wich

    Full Text Available BACKGROUND: Several studies suggested great ape cultures, arguing that human cumulative culture presumably evolved from such a foundation. These focused on conspicuous behaviours, and showed rich geographic variation, which could not be attributed to known ecological or genetic differences. Although geographic variation within call types (accents has previously been reported for orang-utans and other primate species, we examine geographic variation in the presence/absence of discrete call types (dialects. Because orang-utans have been shown to have geographic variation that is not completely explicable by genetic or ecological factors we hypothesized that this will be similar in the call domain and predict that discrete call type variation between populations will be found. METHODOLOGY/PRINCIPAL FINDINGS: We examined long-term behavioural data from five orang-utan populations and collected fecal samples for genetic analyses. We show that there is geographic variation in the presence of discrete types of calls. In exactly the same behavioural context (nest building and infant retrieval, individuals in different wild populations customarily emit either qualitatively different calls or calls in some but not in others. By comparing patterns in call-type and genetic similarity, we suggest that the observed variation is not likely to be explained by genetic or ecological differences. CONCLUSION/SIGNIFICANCE: These results are consistent with the potential presence of 'call cultures' and suggest that wild orang-utans possess the ability to invent arbitrary calls, which spread through social learning. These findings differ substantially from those that have been reported for primates before. First, the results reported here are on dialect and not on accent. Second, this study presents cases of production learning whereas most primate studies on vocal learning were cases of contextual learning. We conclude with speculating on how these findings might

  19. Tracking urban human activity from mobile phone calling patterns.

    Science.gov (United States)

    Monsivais, Daniel; Ghosh, Asim; Bhattacharya, Kunal; Dunbar, Robin I M; Kaski, Kimmo

    2017-11-01

    Timings of human activities are marked by circadian clocks which in turn are entrained to different environmental signals. In an urban environment the presence of artificial lighting and various social cues tend to disrupt the natural entrainment with the sunlight. However, it is not completely understood to what extent this is the case. Here we exploit the large-scale data analysis techniques to study the mobile phone calling activity of people in large cities to infer the dynamics of urban daily rhythms. From the calling patterns of about 1,000,000 users spread over different cities but lying inside the same time-zone, we show that the onset and termination of the calling activity synchronizes with the east-west progression of the sun. We also find that the onset and termination of the calling activity of users follows a yearly dynamics, varying across seasons, and that its timings are entrained to solar midnight. Furthermore, we show that the average mid-sleep time of people living in urban areas depends on the age and gender of each cohort as a result of biological and social factors.

  20. Tracking urban human activity from mobile phone calling patterns.

    Directory of Open Access Journals (Sweden)

    Daniel Monsivais

    2017-11-01

    Full Text Available Timings of human activities are marked by circadian clocks which in turn are entrained to different environmental signals. In an urban environment the presence of artificial lighting and various social cues tend to disrupt the natural entrainment with the sunlight. However, it is not completely understood to what extent this is the case. Here we exploit the large-scale data analysis techniques to study the mobile phone calling activity of people in large cities to infer the dynamics of urban daily rhythms. From the calling patterns of about 1,000,000 users spread over different cities but lying inside the same time-zone, we show that the onset and termination of the calling activity synchronizes with the east-west progression of the sun. We also find that the onset and termination of the calling activity of users follows a yearly dynamics, varying across seasons, and that its timings are entrained to solar midnight. Furthermore, we show that the average mid-sleep time of people living in urban areas depends on the age and gender of each cohort as a result of biological and social factors.

  1. Light contamination

    International Nuclear Information System (INIS)

    Cepeda Pena, William Enrique

    1998-01-01

    The article tries on the wrong use of the artificial light, of the main problems of the light contamination, dispersion of the light, noxious effects of the light contamination, ecological effects, effects on the man's biological rhythm, economic effects and effects about the civic and vial security, among other topics

  2. External GSM phone calls now made simpler

    CERN Multimedia

    2007-01-01

    On 2 July, the IT/CS Telecom Service introduced a new service making external calls from CERN GSM phones easier. A specific prefix is no longer needed for calls outside CERN. External calls from CERN GSM phones are to be simplified. It is no longer necessary to use a special prefix to call an external number from the CERN GSM network.The Telecom Section of the IT/CS Group is introducing a new system that will make life easier for GSM users. It is no longer necessary to use a special prefix (333) to call an external number from the CERN GSM network. Simply dial the number directly like any other Swiss GSM customer. CERN currently has its own private GSM network with the Swiss mobile operator, Sunrise, covering the whole of Switzerland. This network was initially intended exclusively for calls between CERN numbers (replacing the old beeper system). A special system was later introduced for external calls, allowing them to pass thr...

  3. Reduced IL-1Ra/IL-1 ratio in ultraviolet B-exposed skin of patients with polymorphic light eruption

    NARCIS (Netherlands)

    Janssens, A. S.; Pavel, S.; Tensen, C. P.; Teunissen, M. B. M.; Out-Luiting, J. J.; Willemze, R.; de Gruijl, F. R.

    2009-01-01

    Polymorphic light eruption (PLE) is a putative delayed-type allergic reaction to (solar) ultraviolet (UV) exposure. Inadequate immune suppression after UVB-induced sunburn appears to be associated with reduced trafficking of Langerhans cells (LCs) out of and neutrophils into the epidermis of

  4. Attitude of Farmers towards Kisan Call Centres

    Directory of Open Access Journals (Sweden)

    Shely Mary Koshy

    2017-09-01

    Full Text Available The present study was conducted to measure the attitude of farmers in Kerala, India towards Kisan Call Centre (KCC. Kisan Call Centre provides free agricultural advisory services to every citizen involved in agriculture through a toll free number. One hundred and fifty farmers who have utilized the Kisan Call Centre service were selected from the database of KCC. The results showed that the respondents had moderately favourable attitude towards KCC followed by highly favourable attitude. The variables digital divide, temporal awareness on KCC, satisfaction towards KCC and utilization of KCC were found to have a positive correlation with the attitude of respondents towards KCC.

  5. Lunar phases and crisis center telephone calls.

    Science.gov (United States)

    Wilson, J E; Tobacyk, J J

    1990-02-01

    The lunar hypothesis, that is, the notion that lunar phases can directly affect human behavior, was tested by time-series analysis of 4,575 crisis center telephone calls (all calls recorded for a 6-month interval). As expected, the lunar hypothesis was not supported. The 28-day lunar cycle accounted for less than 1% of the variance of the frequency of crisis center calls. Also, as hypothesized from an attribution theory framework, crisis center workers reported significantly greater belief in lunar effects than a non-crisis-center-worker comparison group.

  6. Polychromatic light (480-3400nm) similar to the terrestrial solar spectrum without its UV component in post-surgical immunorehabilitation of breast cancer patients.

    Science.gov (United States)

    Zhevago, Natalia A; Zimin, Alexander A; Glazanova, Tatyana V; Davydova, Natalia I; Bychkova, Natalia V; Chubukina, Zhanna V; Buinyakova, Anna I; Ballyuzek, Marina F; Samoilova, Kira A

    2017-01-01

    To this day, two methods of phototherapy (PT) have been successfully used in post-surgical immunorehabilitation of patients with breast cancer (BC): intravenous laser irradiation of the patients' blood and reinfusion of lympholeukosuspension of BC patients after single irradiation with HeNe laser. The objective of this pilot experimental study was to verify the effectiveness of the percutaneous use of polychromatic visible light combined with polychromatic infrared (pVIS+pIR) radiation similar to the major components of natural solar spectrum in post-surgical management of BC patients. Patients with BC (adenocarcinoma) of I-II stages, n=19 who had undergone mastectomy, were divided into 2 groups. The control group of patients (n=8) underwent a conventional course of post-surgical rehabilitation and sham irradiation. Patients of the PT group (n=11) additionally received 7days of daily treatment with polychromatic light on the sacral area, D=15cm. The PT course began on the day after mastectomy (Bioptron-2 device; Switzerland, 480-3400nm, 95% polarization, 40mW/cm 2 , 24J/cm 2 ). Mastectomy produced many changes in cellular and humoral immunity, which was recorded on the 1st and 8th post-surgical days. The PT course resulted in a faster normalization of post-surgical leukocytosis and activation of cytotoxic CD8 + T-lymphocytes (Lym), reduced the elevated concentration in blood of immune complexes and in parallel promoted cytotoxic activity of CD16 + /CD56 + NK-cells. The PT up-regulated the number of NK-cells in patients with its decrease on the 1st post-surgical day and prevented the decrease in the amount of monocytes, CD19 + B-Lym, CD3 + T-Lym, CD4 + T-helpers, activated CD3 + /HLADR + T-Lym, and the decrease of the phagocytotic capability of neutrophils. PT blocked the down-regulation of the IgM, IgA concentration and abnormally sharp increase of the proinflammatory cytokine IFN-γ content. Therefore, a 7-day course with polychromatic light prevented the

  7. Perceiving a calling, living a calling, and job satisfaction: testing a moderated, multiple mediator model.

    Science.gov (United States)

    Duffy, Ryan D; Bott, Elizabeth M; Allan, Blake A; Torrey, Carrie L; Dik, Bryan J

    2012-01-01

    The current study examined the relation between perceiving a calling, living a calling, and job satisfaction among a diverse group of employed adults who completed an online survey (N = 201). Perceiving a calling and living a calling were positively correlated with career commitment, work meaning, and job satisfaction. Living a calling moderated the relations of perceiving a calling with career commitment and work meaning, such that these relations were more robust for those with a stronger sense they were living their calling. Additionally, a moderated, multiple mediator model was run to examine the mediating role of career commitment and work meaning in the relation of perceiving a calling and job satisfaction, while accounting for the moderating role of living a calling. Results indicated that work meaning and career commitment fully mediated the relation between perceiving a calling and job satisfaction. However, the indirect effects of work meaning and career commitment were only significant for individuals with high levels of living a calling, indicating the importance of living a calling in the link between perceiving a calling and job satisfaction. Implications for research and practice are discussed. (c) 2012 APA, all rights reserved.

  8. 2A4 binds soluble and insoluble light chain aggregates from AL amyloidosis patients and promotes clearance of amyloid deposits by phagocytosis †.

    Science.gov (United States)

    Renz, Mark; Torres, Ronald; Dolan, Philip J; Tam, Stephen J; Tapia, Jose R; Li, Lauri; Salmans, Joshua R; Barbour, Robin M; Shughrue, Paul J; Nijjar, Tarlochan; Schenk, Dale; Kinney, Gene G; Zago, Wagner

    2016-09-01

    Amyloid light chain (AL) amyloidosis is characterized by misfolded light chain (LC) (amyloid) deposition in various peripheral organs, leading to progressive dysfunction and death. There are no regulatory agency-approved treatments for AL amyloidosis, and none of the available standard of care approaches directly targets the LC protein that constitutes the amyloid. NEOD001, currently in late-stage clinical trials, is a conformation-specific, anti-LC antibody designed to specifically target misfolded LC aggregates and promote phagocytic clearance of AL amyloid deposits. The present study demonstrated that the monoclonal antibody 2A4, the murine form of NEOD001, binds to patient-derived soluble and insoluble LC aggregates and induces phagocytic clearance of AL amyloid in vitro. 2A4 specifically labeled all 21 fresh-frozen organ samples studied, which were derived from 10 patients representing both κ and λ LC amyloidosis subtypes. 2A4 immunoreactivity largely overlapped with thioflavin T-positive labeling, and 2A4 bound both soluble and insoluble LC aggregates extracted from patient tissue. Finally, 2A4 induced macrophage engagement and phagocytic clearance of AL amyloid deposits in vitro. These findings provide further evidence that 2A4/NEOD001 can effectively clear and remove human AL-amyloid from tissue and further support the rationale for the evaluation of NEOD001 in patients with AL amyloidosis.

  9. 2A4 binds soluble and insoluble light chain aggregates from AL amyloidosis patients and promotes clearance of amyloid deposits by phagocytosis †

    Science.gov (United States)

    Renz, Mark; Torres, Ronald; Dolan, Philip J.; Tam, Stephen J.; Tapia, Jose R.; Li, Lauri; Salmans, Joshua R.; Barbour, Robin M.; Shughrue, Paul J.; Nijjar, Tarlochan; Schenk, Dale; Kinney, Gene G.; Zago, Wagner

    2016-01-01

    Abstract Amyloid light chain (AL) amyloidosis is characterized by misfolded light chain (LC) (amyloid) deposition in various peripheral organs, leading to progressive dysfunction and death. There are no regulatory agency–approved treatments for AL amyloidosis, and none of the available standard of care approaches directly targets the LC protein that constitutes the amyloid. NEOD001, currently in late-stage clinical trials, is a conformation-specific, anti-LC antibody designed to specifically target misfolded LC aggregates and promote phagocytic clearance of AL amyloid deposits. The present study demonstrated that the monoclonal antibody 2A4, the murine form of NEOD001, binds to patient-derived soluble and insoluble LC aggregates and induces phagocytic clearance of AL amyloid in vitro. 2A4 specifically labeled all 21 fresh-frozen organ samples studied, which were derived from 10 patients representing both κ and λ LC amyloidosis subtypes. 2A4 immunoreactivity largely overlapped with thioflavin T–positive labeling, and 2A4 bound both soluble and insoluble LC aggregates extracted from patient tissue. Finally, 2A4 induced macrophage engagement and phagocytic clearance of AL amyloid deposits in vitro. These findings provide further evidence that 2A4/NEOD001 can effectively clear and remove human AL-amyloid from tissue and further support the rationale for the evaluation of NEOD001 in patients with AL amyloidosis. PMID:27494229

  10. Light and electron microscopic observation of regenerated fungiform taste buds in patients with recovered taste function after severing chorda tympani nerve.

    Science.gov (United States)

    Saito, Takehisa; Ito, Tetsufumi; Narita, Norihiko; Yamada, Takechiyo; Manabe, Yasuhiro

    2011-11-01

    The aim of this study was to evaluate the mean number of regenerated fungiform taste buds per papilla and perform light and electron microscopic observation of taste buds in patients with recovered taste function after severing the chorda tympani nerve during middle ear surgery. We performed a biopsy on the fungiform papillae (FP) in the midlateral region of the dorsal surface of the tongue from 5 control volunteers (33 total FP) and from 7 and 5 patients with and without taste recovery (34 and 29 FP, respectively) 3 years 6 months to 18 years after surgery. The specimens were observed by light and transmission electron microscopy. The taste function was evaluated by electrogustometry. The mean number of taste buds in the FP of patients with completely recovered taste function was significantly smaller (1.9 +/- 1.4 per papilla; p taste buds. Nerve fibers and nerve terminals were also found in the taste buds. It was clarified that taste buds containing taste cells and nerve endings do regenerate in the FP of patients with recovered taste function.

  11. The function of migratory bird calls

    DEFF Research Database (Denmark)

    Reichl, Thomas; Andersen, Bent Bach; Larsen, Ole Næsbye

    The function of migratory bird calls: do they influence orientation and navigation?   Thomas Reichl1, Bent Bach Andersen2, Ole Naesbye Larsen2, Henrik Mouritsen1   1Institute of Biology, University of Oldenburg, Oldenburg, D-26111 Oldenburg, Germany 2Institute of Biology, University of Southern...... migration and to stimulate migratory restlessness in conspecifics. We wished to test if conspecific flight calls influence the flight direction of a nocturnal migrant, the European Robin (Erithacus rubecula), i.e. if flight calls help migrants keeping course. Wild caught birds showing migratory restlessness...... the experimental bird could be activated successively to simulate a migrating Robin cruising E-W, W-E, S-N or N-S at a chosen height (mostly about 40 m), at 10 m/s and emitting Robin flight calls of 80 dB(A) at 1 m. The simulated flight of a "ding" sound served as a control. During an experiment the bird was first...

  12. 76 FR 4896 - Call for Candidates

    Science.gov (United States)

    2011-01-27

    ... designated to establish generally accepted accounting principles for federal government entities. Generally, non-federal Board members are selected from the general financial community, the accounting and... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Call for Candidates AGENCY: Federal Accounting...

  13. Reflections … they called it 'restructuring'[1

    African Journals Online (AJOL)

    turnaround strategy with the appointment of a CEO to implement such strategy in ... found herself accepting so-called 'native' advertising (the practice of publishing an ... preferring to receive their reading 'lite' on mobile platforms. According.

  14. The Role of Calling in Military Engagement

    Science.gov (United States)

    2017-06-01

    depression , hopelessness, emotional and behavior problems , and have lower levels of neuroticism (Oladipo et al., 2013; Suldo & Huebner, 2004; Gilman...retention? Data from surveys of Naval Postgraduate School students reveal many work-related correlations with calling and calling’s positive effects. My...retention? Data from surveys of Naval Postgraduate School students reveal many work-related correlations with calling and calling’s positive effects

  15. Behavioral Preferences for Individual Securities : The Case for Call Warrants and Call Options

    NARCIS (Netherlands)

    Ter Horst, J.R.; Veld, C.H.

    2002-01-01

    Since 1998, large investment banks have flooded the European capital markets with issues of call warrants.This has led to a unique situation in the Netherlands, where now call warrants, traded on the stock exchange, and long-term call options, traded on the options exchange, exist.Both entitle their

  16. Heat-cured acrylic resin versus light-activated resin: a patient, professional and technician-based evaluation of mandibular implant-supported overdentures.

    Science.gov (United States)

    Asal, S A; Al-AlShiekh, H M

    2017-12-01

    Although light-activated resins (Eclipse) have been reported to possess superior physical and mechanical properties compared with the heat-cured acrylic resins (Lucitone-199), a few studies have compared overdentures with a locator attachment constructed from heat-cured acrylic resins with those constructed from light-activated resins. This clinical study was designed to compare the performance of a mandibular implant-supported overdenture constructed from a heat-cured acrylic resin (Lucitone-199) with that of an overdenture constructed from a light-activated resin (Eclipse). Ten participants received two identical mandibular implant-retained overdentures (Lucitone-199 and Eclipse) opposing one maxillary denture in a random order. Each mandibular overdenture was delivered and worn for 6 months, and two weeks of rest was advised between wears to minimize any carryover effects. Three questionnaires were devised. The first questionnaire (patient evaluation) focused on evaluating different aspects of the denture and overall satisfaction. The second questionnaire (professional dentist evaluation) was based on a clinical evaluation of soft tissues, complications, and the applied technique. The third questionnaire (technician evaluation) involved ranking the different manufacturing steps of the denture and overall preferences. The obtained data was statistically analyzed using an independent sample t-test and the Wilcoxon rank-sum test. The clinician and technician preferred the Eclipse dentures because of their technical aspects, whereas the patients preferred the Lucitone-199 dentures for their aesthetic properties. Implant-supported overdentures constructed from a heat-cured acrylic resin showed superior aesthetics and had a better odor compared with those constructed from a light-cured resin.

  17. "Tangible Lights"

    DEFF Research Database (Denmark)

    Sørensen, Tor; Merritt, Timothy; Andersen, Oskar

    2015-01-01

    While there has been much focus on tangible lighting interfaces embedded in physical objects and smartphones as remote control, there has not been sufficient attention on how the expressivity of bodily movement can be used when designing interactions with light. Therefore, we investigate...... interaction with lighting technology beyond the smartphone and physical controllers. We examine the usefulness of the in-air gestural interaction style for lighting control. We bring forward "Tangible Lights", which serves as a novel interface for in-air interaction with lighting, drawing on existing...

  18. Social learning: medical student perceptions of geriatric house calls.

    Science.gov (United States)

    Abbey, Linda; Willett, Rita; Selby-Penczak, Rachel; McKnight, Roberta

    2010-01-01

    Bandura's social learning theory provides a useful conceptual framework to understand medical students' perceptions of a house calls experience at Virginia Commonwealth University School of Medicine. Social learning and role modeling reflect Liaison Committee on Medical Education guidelines for "Medical schools (to) ensure that the learning environment for medical students promotes the development of explicit and appropriate professional attributes (attitudes, behaviors, and identity) in their medical students." This qualitative study reports findings from open-ended survey questions from 123 medical students who observed a preceptor during house calls to elderly homebound patients. Their comments included reflections on the medical treatment as well as interactions with family and professional care providers. Student insights about the social learning process they experienced during house calls to geriatric patients characterized physician role models as dedicated, compassionate, and communicative. They also described patient care in the home environment as comprehensive, personalized, more relaxed, and comfortable. Student perceptions reflect an appreciation of the richness and complexity of details learned from home visits and social interaction with patients, families, and caregivers.

  19. Application of a smartphone nurse call system for nursing care.

    Science.gov (United States)

    Chuang, Shu-Ting; Liu, Yi-Fang; Fu, Zi-Xuan; Liu, Kuang-Chung; Chien, Sou-Hsin; Lin, Chin-Lon; Lin, Pi-Yu

    2015-02-01

    Traditionally, a patient presses the nurse call button and alerts the central nursing station. This system cannot reach the primary care nurse directly. The aim of this study was to apply a new smartphone system through the cloud system and information technology that linked a smartphone and a mobile nursing station for nursing care service. A smartphone and mobile nursing station were integrated into a smartphone nurse call system through the cloud and information technology for better nursing care. Waiting time for a patient to contact the most responsible nurse was reduced from 3.8 min to 6 s. The average time for pharmacists to locate the nurse for medication problem was reduced from 4.2 min to 1.8 min by the new system. After implementation of the smartphone nurse call system, patients received a more rapid response. This improved patients' satisfaction and reduced the number of complaints about longer waiting time due to the shortage of nurses.

  20. Sedentary Behavior and Light Physical Activity Are Associated with Brachial and Central Blood Pressure in Hypertensive Patients

    DEFF Research Database (Denmark)

    Gerage, A. M.; Benedetti, T. R. B.; Farah, B. Q.

    2015-01-01

    of this study was to investigate the association between the time spent in physical activities of different intensities and blood pressure levels, arterial stiffness and autonomic modulation in hypertensive patients. Methods In this cross-sectional study, 87 hypertensive patients (57.5 +/- 9.9 years of age) had...... are associated with lower blood pressure, without affecting arterial stiffness and cardiac autonomic modulation in hypertensive patients.......Background Physical activity is recommended as a part of a comprehensive lifestyle approach in the treatment of hypertension, but there is a lack of data about the relationship between different intensities of physical activity and cardiovascular parameters in hypertensive patients. The purpose...

  1. Evaluation of the serum free light chain (sFLC) analysis in prediction of response in symptomatic multiple myeloma patients

    DEFF Research Database (Denmark)

    Toftmann Hansen, Charlotte; Pedersen, Per T; Nielsen, Lars C

    2014-01-01

    BACKGROUND: Observational data from clinical studies indicate that the goal of first-line therapy in newly diagnosed patients with symptomatic multiple myeloma (MM) should be very good partial response (VGPR) or better, preferably before high-dose treatment. We evaluated the value of early...... patients with no response to treatment. The mean per cent reduction in iFLC 3 d after start of treatment was 52.3% and 23.6% (P = 0.021) in patients achieving ≥VGPR and PR, respectively. The mean per cent reduction in M-protein in patients achieving ≥VGPR and PR was not significantly different in the 6-wk...

  2. Where do out-of-hours calls to a consultant microbiologist come from?

    LENUS (Irish Health Repository)

    Humphreys, H

    2009-08-01

    There is little in the literature about out-of-hours calls to medical microbiologists. The calls taken by a consultant medical microbiologist over a five-year period in an Irish tertiary referral hospital were reviewed. Excluding calls on weekend mornings and significant evening positive blood cultures, the mean annual number of calls on a one-in-four rota was 89 (range 70-111). Over 90% of calls were received before midnight and 51% were from specialist registrars. Medical specialties, neurosurgery and intensive care were the most common departments seeking advice. Two-thirds of calls related to the management of an individual patient, but advice on infection prevention and control is increasingly requested. Calls out-of-hours are not insignificant but little is known about how these vary between hospitals and what contribution they make to patient care.

  3. Light Robotics

    DEFF Research Database (Denmark)

    Glückstad, Jesper; Palima, Darwin

    Light Robotics - Structure-Mediated Nanobiophotonics covers the latest means of sculpting of both light and matter for achieving bioprobing and manipulation at the smallest scales. The synergy between photonics, nanotechnology and biotechnology spans the rapidly growing field of nanobiophotonics...

  4. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  5. Twisted light

    CSIR Research Space (South Africa)

    Forbes, A

    2010-12-01

    Full Text Available Research at the Mathematical Optics Group uses "twisted" light to study new quatum-based information security systems. In order to understand the structure of "twisted" light, it is useful to start with an ordinary light beam with zero twist, namely...

  6. A lipohydroxyacid-containing shampoo improves scalp condition and quality of life in patients with seborrheic dermatitis and light-to-moderate scalp psoriasis.

    Science.gov (United States)

    Seité, S; Paries, J; Reygagne, P; Hamidou, Z; Jouanique, C; Perez-Pala, G; Rougier, A

    2009-06-01

    Dandruff is a common scalp disorder affecting almost half of the post-pubertal population of any ethnicity and both genders. It is one of the major reasons for patients to consult a dermatologist and it is the cause of significant psychological and social distress. The aim of this open study was to evaluate the benefit of a 4-week treatment with a shampoo containing 0.1% lipohydroxyacid (LHA) and 1.3% salicylic acid on the scalp condition and on the quality of life of 275 volunteers with seborrheic dermatitis (SD) (n = 226) or light-to-moderate scalp psoriasis (SP) (n = 49). The clinical benefit of the treatment was assessed by scoring the following parameters, i.e., severity of the dermatosis, scaling, itching, excoriations, and superficial burning sensation. The impact on the quality of life was assessed using the Scalpdex, a questionnaire specially developed by Chen et al. for patients with scalp dermatitis, which includes 23 questions regarding the symptoms, functioning and emotions affected by scalp dermatosis. The shampoo used in this study was well tolerated. After a 4-week treatment, dermatologists noticed a significant clinical improvement of all the scalp parameters evaluated (i.e., the composite lesional score was improved in 91% and 77% of the patients with SD or SP respectively). The symptoms, functioning and emotions scores of quality of life were also significantly improved in relation to the improvement of scalp condition. This study not only allowed a better understanding of the SD and SP patient's profile but also demonstrated that the shampoo evaluated is a convenient, efficient, safe, and well-tolerated cosmetic treatment of SD and light-to-moderate SP improving greatly the quality of life of the treated patients.

  7. SPECIFIC FEATURES OF ANTI-TUBERCULOSIS CHEMOTHERAPY TOLERANCE IN THE LIGHT OF PSYCHOLOGICAL STATUS OF PATIENTS

    Directory of Open Access Journals (Sweden)

    N. V. Zolotova

    2017-01-01

    Full Text Available Specific features of psychological state were studied in 295 pulmonary tuberculosis patients with satisfactory tolerance to anti-tuberculosis medications and 75 patients poorly tolerating the treatment.Before the treatment start the patients who later demonstrated adverse reactions to treatment were diagnosed with more intense neurotic and hypochondriac personal features, destructive reactions and higher level of emotional tension and frustration – all the above promote dysregulation of the host adaptation. The research demonstrated the need to consider psychological aspects when studying the tolerance to anti-tuberculosis chemotherapy. 

  8. Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

    Science.gov (United States)

    Johnson, Bill

    2014-01-01

    Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.

  9. Adaptive Lighting

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve; Søndergaard, Karin; Kongshaug, Jesper

    2015-01-01

    the investigations of lighting scenarios carried out in two test installations: White Cube and White Box. The test installations are discussed as large-scale experiential instruments. In these test installations we examine what could potentially occur when light using LED technology is integrated and distributed......Adaptive Lighting Adaptive lighting is based on a partial automation of the possibilities to adjust the colour tone and brightness levels of light in order to adapt to people’s needs and desires. IT support is key to the technical developments that afford adaptive control systems. The possibilities...... differently into an architectural body. We also examine what might occur when light is dynamic and able to change colour, intensity and direction, and when it is adaptive and can be brought into interaction with its surroundings. In short, what happens to an architectural space when artificial lighting ceases...

  10. Prospective analysis of the port-wine stain patient population in the Netherlands in light of novel treatment modalities.

    Science.gov (United States)

    van Raath, M Ingmar; Bambach, Caroline A; Dijksman, Lea M; Wolkerstorfer, Albert; Heger, Michal

    2018-04-01

    Pulsed dye laser is the gold standard for port-wine stain (PWS) treatment. However, pulsed dye lasers achieve suboptimal clinical results in a majority of patients. Patient demand for novel therapies and willingness to participate in clinical studies is currently unknown, yet, imperative for steering R&D activity. The objective of this study was to evaluate these two factors in relation to PWS patient demographics. A questionnaire was used to assess patient and PWS characteristics, treatment history, efficacy, and satisfaction, stress level, willingness to travel and pay for an effective treatment, participation in clinical studies, and amenability to intravenous drug administration. Descriptive statistics and correlation analysis were performed. Of the respondents (N = 108), 65% would participate in clinical studies and 49% would accept intravenous drugs. For an effective treatment, 58% was prepared to pay over €2,000 and 48% would travel more than 6 h. Travel time was inversely correlated with age, clearance rate, and satisfaction. Facial PWS patients had undergone more treatments, were less satisfied, and less willing to participate in studies or accept intravenous drugs. Stress levels were higher in females. There is considerable demand for new PWS therapies, and a substantial proportion of patients are willing to participate in clinical studies.

  11. Glasbury Bridge 1: The Jumper. Close Call.

    Science.gov (United States)

    Journal of Adventure Education and Outdoor Leadership, 1994

    1994-01-01

    Describes an incident in which a group of 10th-grade students in a 1-week outdoor residential program in the Wye Valley (Great Britain) defied program rules, drank alcohol, and had a close call with a near-drowning. Discusses five strategies for dealing with such groups coalesced around a rebellious leader. (SV)

  12. Calle San Martín

    Directory of Open Access Journals (Sweden)

    Gonzalo Cerda Brintrup

    1988-06-01

    Full Text Available En la década del 30 era un barrizal transitado por carretas, caballos y peatones, flanqueada por unas veredas algo más altas que la calle, limitadas por gruesos tablones que la Municipalidad reparaba de año en año.

  13. Inhibitors of calling behavior of Plodia interpunctella.

    Science.gov (United States)

    Hirashima, Akinori; Shigeta, Yoko; Eiraku, Tomohiko; Kuwano, Eiichi

    2003-01-01

    Some octopamine agonists were found to suppress the calling behavior of the stored product Indian meal moth, Plodia interpunctella. Compounds were screened using a calling behavior bioassay using female P. interpunctella. Four active derivatives, with inhibitory activity at the nanomolar range, were identified in order of decreasing activity: 2-(1-phenylethylamino)-2-oxazoline > 2-(2-ethyl,6-methylanilino)oxazolidine > 2-(2-methyl benzylamino)-2-thiazoline > 2-(2,6-diethylanilino)thiazolidine. Three-dimensional pharmacophore hypotheses were built from a set of 15 compounds. Among the ten common-featured models generated by the program Catalyst/HipHop, a hypothesis including a hydrogen-bond acceptor lipid, a hydrophobic aromatic and two hydrophobic aliphatic features was considered to be essential for inhibitory activity in the calling behavior. Active compounds mapped well onto all the hydrogen-bond acceptor lipid, hydrophobic aromatic and hydrophobic aliphatic features of the hypothesis. On the other hand, less active compounds were shown not to achieve the energetically favorable conformation that is found in the active molecules in order to fit the 3D common-feature pharmacophore models. The present studies demonstrate that inhibition of calling behavior is via an octopamine receptor.

  14. Inhibitors of calling behavior of Plodia interpunctella

    Directory of Open Access Journals (Sweden)

    Akinori Hirashima

    2003-01-01

    Full Text Available Some octopamine agonists were found to suppress the calling behavior of the stored product Indian meal moth, Plodia interpunctella. Compounds were screened using a calling behavior bioassay using female P. interpunctella. Four active derivatives, with inhibitory activity at the nanomolar range, were identified in order of decreasing activity: 2-(1-phenylethylamino-2-oxazoline > 2-(2-ethyl,6-methylanilinooxazolidine > 2-(2-methyl benzylamino-2-thiazoline > 2-(2,6-diethylanilinothiazolidine. Three-dimensional pharmacophore hypotheses were built from a set of 15 compounds. Among the ten common-featured models generated by the program Catalyst/HipHop, a hypothesis including a hydrogen-bond acceptor lipid, a hydrophobic aromatic and two hydrophobic aliphatic features was considered to be essential for inhibitory activity in the calling behavior. Active compounds mapped well onto all the hydrogen-bond acceptor lipid, hydrophobic aromatic and hydrophobic aliphatic features of the hypothesis. On the other hand, less active compounds were shown not to achieve the energetically favorable conformation that is found in the active molecules in order to fit the 3D common-feature pharmacophore models. The present studies demonstrate that inhibition of calling behavior is via an octopamine receptor.

  15. Computer Assisted Language Learning (CALL) Software: Evaluation ...

    African Journals Online (AJOL)

    Evaluating the nature and extent of the influence of Computer Assisted Language Learning (CALL) on the quality of language learning is highly problematic. This is owing to the number and complexity of interacting variables involved in setting the items for teaching and learning languages. This paper identified and ...

  16. What is this thing called growth?

    Science.gov (United States)

    Adrian M. Gilbert

    1954-01-01

    What is this thing called "growth"? We foresters are constantly thinking in terms of growth. We use growth data to evaluate a forest property. We use them to determine how much we can cut. We use them to weigh the results of a type of cutting.

  17. CIFSRF Concept Notes Call 2013 Instructions

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

    IDRC CRDI

    Cc: (the other principal investigators and third-party organisations). Subject: CultiAF 2013 Call for Concept Notes Submitted by (names of all principal ..... clerical, accounting, or secretarial help, general office expenses, office rental and utility ... Please provide the details of financial contributions that will be made to the ...

  18. Relabeling the Medications We Call Antidepressants

    Directory of Open Access Journals (Sweden)

    David Antonuccio

    2012-01-01

    Full Text Available This paper raises the question about whether the data on the medications we call antidepressants justify the label of antidepressant. The authors argue that a true antidepressant should be clearly superior to placebo, should offer a risk/benefit balance that exceeds that of alternative treatments, should not increase suicidality, should not increase anxiety and agitation, should not interfere with sexual functioning, and should not increase depression chronicity. Unfortunately, these medications appear to fall short on all of these dimensions. Many of the “side effects” of these medications have larger effect sizes than the antidepressant effect size. To call these medications antidepressants may make sense from a marketing standpoint but may be misleading from a scientific perspective. Consumers deserve a label that more accurately reflects the data on the largest effects and helps them understand the range of effects from these medications. In other words, it may make just as much sense to call these medications antiaphrodisiacs as antidepressants because the negative effects on libido and sexual functioning are so common. It can be argued that a misleading label may interfere with our commitment to informed consent. Therefore, it may be time to stop calling these medications antidepressants.

  19. 76 FR 36130 - Call for Candidates

    Science.gov (United States)

    2011-06-21

    ... financial information in decision-making. The Board meets in Washington, DC, for two days every other month... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Call for Candidates AGENCY: Federal Accounting... candidates. Any applicant who provided the Federal Accounting Standards Advisory Board (FASAB or the Board...

  20. 78 FR 76257 - Rural Call Completion

    Science.gov (United States)

    2013-12-17

    ... must be held together with rubber bands or fasteners. Any envelopes must be disposed of before entering... Completion/Call Termination Handbook outlining standards and practices of the industry relevant to ensuring... telecommunications networks. Transmission facilities may be based on a single technology or a combination of...

  1. 17 CFR 31.18 - Margin calls.

    Science.gov (United States)

    2010-04-01

    ... transaction merchant is unable to effect personal contact with a leverage customer, a telegram sent to the....18 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION LEVERAGE TRANSACTIONS § 31.18 Margin calls. (a) No leverage transaction merchant shall liquidate a leverage contract because of...

  2. Make a 21st century phone call

    CERN Multimedia

    Katarina Anthony

    2014-01-01

    Want to avoid roaming charges? Click to call anyone at CERN? How about merging your CERN landline with your existing smartphone? That's all easily done with Lync, CERN's new opt-in service that can take your calls to the next level.   The Lync application on Windows (left) and iPhone (right). Lync unites CERN's traditional telephone service with the digital sphere. "Lync gives you the gift of mobility, by letting you access your CERN landline on the go," explains Pawel Grzywaczewski, service manager of the Lync system. "Once you've registered your CERN telephone with the service, you can run the Lync application and make calls from a range of supported devices. No matter where you are in the world - be it simply out to lunch or off at an international conference - you can make a CERN call as though you were in the office. All you need is an Internet connection!" Following a recent upgrade, CERN's Lync service now has...

  3. When to call a linear system nonnegative

    NARCIS (Netherlands)

    Nieuwenhuis, J.W.

    1998-01-01

    In this paper we will consider discrete time invariant linear systems that allow for an input-state-output representation with a finite dimensional state space, and that have a finite number of inputs and outputs. The basic issue in this paper is when to call these systems nonnegative. An important

  4. Don't Call It School

    Science.gov (United States)

    Robb, Daniel

    2006-01-01

    "Homeschooling," "deschooling," and "unschooling" are commonly used terms in the alternative-education world, but each lacks specificity. In this article, the author describes what he discovered during several visits to North Star. Known officially as North Star: Self-Directed Learning for Teens, it is not as structured as a so-called "free"…

  5. Optimization of Overflow Policies in Call Centers

    DEFF Research Database (Denmark)

    Koole, G.M.; Nielsen, B.F.; Nielsen, T.B.

    2015-01-01

    . A Markov decision chain is used to determine the optimal policy. This policy outperforms considerably the ones used most often in practice, which use a fixed threshold. The present method can be used also for other call-center models and other situations where performance is based on actual waiting times...

  6. Japanese electric utilities call for IPP capacity

    Energy Technology Data Exchange (ETDEWEB)

    Jeffs, E.

    1997-03-01

    Japan`s ten power utilities have finally grasped the nettle, and called in IPPs to supply at least 3 GW of new capacity in each of the next ten years. The first twenty schemes awarded last year are all based on existing industrial energy producers, and consist mainly of coal- or oil-fired plants of 150 MW or less. 1 tab.

  7. Impact of mobility on call block, call drops and optimal cell size in small cell networks

    OpenAIRE

    Ramanath , Sreenath; Voleti , Veeraruna Kavitha; Altman , Eitan

    2011-01-01

    We consider small cell networks and study the impact of user mobility. Assuming Poisson call arrivals at random positions with random velocities, we discuss the characterization of handovers at the boundaries. We derive explicit expressions for call block and call drop probabilities using tools from spatial queuing theory. We also derive expressions for the average virtual server held up time. These expressions are used to derive optimal cell sizes for various profile of velocities in small c...

  8. Light-induced racemization: artifacts in the analysis of the diastereoisomeric pairs of thioridazine 5-sulfoxide in the plasma and urine of patients treated with thioridazine.

    Science.gov (United States)

    Eap, C B; Souche, A; Koeb, L; Baumann, P

    1991-07-01

    The ring sulfoxidation of thioridazine (THD), a widely used neuroleptic agent, yields two diastereoisomeric pairs, fast- and slow-eluting (FE and SE) thioridazine 5-sulfoxide (THD 5-SO). Until now, studies in which concentrations of these metabolites were measured in THD-treated patients have revealed no significant differences in their concentrations. Preliminary experiments in our laboratory had shown that sunlight and, to a lesser extent, dim daylight led to racemization and probably also to photolysis of the diastereoisomeric pairs as measured by high-performance liquid chromatography. Similar results were also obtained with direct UV light (UV lamp). In appropriate light-protected conditions, THD, northioridazine, mesoridazine, sulforidazine, and FE and SE THD 5-SO were measured in 11 patients treated with various doses of THD for at least 1 week. Significantly higher concentrations of the FE stereoisomeric pair were found. The concentration ratios THD 5-SO (FE)/THD 5-SO (SE) ranged from 0.89 to 1.75 in plasma and from 1.15 to 2.05 in urine. Because it is known that the ring sulfoxide contributes to the cardiotoxicity of the drug even more potently than the parent compound does, these results justify further studies to determine whether there is stereoselectivity in the cardiotoxicity of THD 5-SO.

  9. Abnormal responses to mid-ultraviolet light of cultured fibroblasts from patients with disorders featuring sunlight sensitivity

    International Nuclear Information System (INIS)

    Smith, P.J.; Paterson, M.C.

    1982-01-01

    The postultraviolet light (UV) colony-forming ability and DNA repair properties were examined of human skin fibroblasts derived from two groups of donors at high risk of cancer; (a) persons exhibiting sensitivity to sunlight; and (b) persons with conditions possibly associated with an underlying defect in the repair of radiogenic DNA damage. A comparison was made between the effects of far UV (254 nm) and mid UV (313 nm). Biochemical studies performed on strains sensitive to 313-nm UV alone suggest that their unusual photoresponse is not attributable to defective repair of cyclobutyl pyrimidine dimers. Furthermore, our data imply that thymine glycols are unlikely candidates for the critical lethal lesions in 313-nm UV-sensitive strains. Evidence is presented in support of the contention that mid UV may be partially radiomimetic, thus extending our understanding of the deleterious biological effects of this ubiquitous environmental carcinogen

  10. Effects of international football matches on ambulance call profiles and volumes during the 2006 World Cup.

    Science.gov (United States)

    Deakin, Charles D; Thompson, Fizz; Gibson, Caroline; Green, Mark

    2007-06-01

    Prompt ambulance attendance is aimed at improving patient care. With finite resources struggling to meet performance targets, unforeseen demand precludes the ability to tailor resources to cope with increased call volumes, and can have a marked detrimental effect on performance and hence patient care. The effects of the 2006 World Cup football matches on call volumes and profiles were analysed to understand how public events can influence demands on the ambulance service. All emergency calls to the Hampshire Ambulance Service NHS Trust (currently the Hampshire Division of South Central Ambulance Service, Winchester, UK) during the first weekend of the 2006 World Cup football matches were analysed by call volume and classification of call (call type). On the day of the first football match, call volume was over 50% higher than that on a typical Saturday, with distinct peaks before and after the inaugural match. Call profile analysis showed increases in alcohol-related emergencies, including collapse, unconsciousness, assault and road traffic accidents. The increase in assaults was particularly marked at the end of each match and increased again into the late evening. A detailed mapping of call volumes and profiles during the World Cup football shows a significant increase in overall emergency calls, mostly alcohol related. Mapping of limited resources to these patterns will allow improved responses to emergency calls.

  11. Lighting. Eclairage

    Energy Technology Data Exchange (ETDEWEB)

    1989-01-01

    Increasing energy costs have led to a review of the high costs of lighting. The use of new energy-efficient lighting equipment, coupled with the use of the proper quantity and quality of lighting only where it is needed, creates a potential for cost reduction. A manual is provided to aid the process of adapting Canadian industrial, commercial, and institutional enterprises to these higher costs. An introductory review of lighting fundamentals is presented, providing a basic understanding of concepts such as illumination, light output measurements, power requirements, lighting quality, and energy audit methods. The currently available lighting equipment used to achieve cost savings is then reviewed, including energy saving lamps and ballasts, controls, and automatic energy control systems. A number of energy management opportunities are identified, such as modification of lighting usage patterns, calculation of the optimum number of lighting fixtures, replacement of existing lamps, and the application of task lighting. Examples are included to show the cost savings possible when applying some of the techniques suggested. 27 figs., 11 tabs.

  12. Special features of old patients suffering from hyperthyroidism and clinical application of 131I therapy

    International Nuclear Information System (INIS)

    Deng Jinglan; Cheng Shiwu; Hou Yingping; Lin Guocheng; Wang Jing

    2005-01-01

    The special features of old patients suffering from hyperthyroidism are atypical. With light symptoms and light signs, it's called apathetic hyperthyroidism. Usually cardiovascular abnormality and concomitant atrial fibrillation are initial symptoms. Therefore, both early diagnosis and therapy in time are important. This paper reports the clinical data and the 131 I therapeutic results for 30 hyperthyroidism patients aged over 60 years and 30 patients aged 20-53 as control group, who were followed-up for 2-25 years. (authors)

  13. Patient release criteria following radioactive iodine-131 treatment in the light of international practice: where does South Africa fit in?

    Science.gov (United States)

    Mongane, Modisenyane S; Rae, William I D

    2017-10-01

    The release from hospital of patients treated with radioactive iodine-131 (I) remains a controversial issue as a result of the range of guidelines implemented by national regulatory bodies responsible for radiation protection in various countries worldwide. The aim of this study was to review and analyse the literature on patient release criteria (PRC) applied internationally in an attempt to achieve a justifiable approach to setting equivalent criteria in South Africa. In 2016, the South African Department of Health, Directorate: Radiation Control added conditions (numbers 50 and 90), to licences to use radioactive nuclides. These conditions state that patients must be hospitalized when the dose rate at 1 m is above 25 μSv/h, or more than 555 MBq of iodine-131 was administered to the patient. However, these criteria do not consider patients' socioeconomic conditions. A literature survey was carried out of articles detailing PRC from high-income countries as well as those in the middle-income and lower-income groups. Socioeconomic conditions within countries were determined using the International Monetary Fund lists of gross domestic product. The results from the literature have shown that in setting PRC, several countries have considered the socioeconomic conditions prevailing in their countries to achieve harmony between public protection and cost associated with hospitalization. The South African authority conditions must be seen in the context of the approach followed by other countries. Considering the international context, a justifiable, and potentially implementable, guideline or policy for improving individualized and more caring patient management is advocated.

  14. Nordic Lighting?

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2018-01-01

    The Danish designer Poul Henningsen wrote very elaborated theories of interior lighting from the mid-1920s on. He fought against the cold and reduced light quality of electric bulbs and tried to tame and cultivate this technology by design. He wanted a more rich light for domestic purpose...... worthwhile discussing than other design categories to interpret, whether experience of nature and climatic conditions play a role in Scandinavian Design, as repeatedly stated. This discussion contributes both to understanding of interior lighting and the historiographical critique of Scandinavian Design...... and shaped it through lamp design, colour reflections and differentiated use of several lamps in the room to make a more dim lighting, but with greater variation and softer contrasts. It was a ‘culture’ of lighting, he promoted, but he didn’t saw it as linked to the Nordic countries. His sensibility...

  15. Adaptive Lighting

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve; Søndergaard, Karin; Kongshaug, Jesper

    2015-01-01

    Adaptive Lighting Adaptive lighting is based on a partial automation of the possibilities to adjust the colour tone and brightness levels of light in order to adapt to people’s needs and desires. IT support is key to the technical developments that afford adaptive control systems. The possibilities...... offered by adaptive lighting control are created by the ways that the system components, the network and data flow can be coordinated through software so that the dynamic variations are controlled in ways that meaningfully adapt according to people’s situations and design intentions. This book discusses...... differently into an architectural body. We also examine what might occur when light is dynamic and able to change colour, intensity and direction, and when it is adaptive and can be brought into interaction with its surroundings. In short, what happens to an architectural space when artificial lighting ceases...

  16. [Posttraumatic disturbances in patients with light craniocerebral injury and their correction via various variants of dynamic magnetotherapy].

    Science.gov (United States)

    Cherevashchenko, L A; Moliavchikova, O V; Zhuravlev, M E

    2008-01-01

    Examination of 90 patients in intermediate period of slight craniocerebral injury before and after use of curative technologies with including of dynamic magnetotherapy suboccipitally or transcranially. It is established, that choosing rehabilitation methods, it is necessary to take into consideration clinical manifestation of disease, state of cerebral blood circulation, vegetative nervous system, bioelectrogenesis of cerebrum.

  17. Within-patient right-left blinded comparison of diode (810 nm) laser therapy and intense pulsed light therapy for hair removal.

    Science.gov (United States)

    Cameron, H; Ibbotson, S H; Dawe, R S; Ferguson, J; Moseley, H

    2008-10-01

    Excessive facial hair in women can cause significant psychological distress. A variety of treatment methods are available, including lasers and, more recently, intense pulsed light (IPL) sources. There are very few studies comparing laser and IPL devices. The purpose of our study was to compare a laser diode device with an IPL, using a within-patient, right-left, assessor-blinded, controlled, study design. Hair counts were made, using coded close-up photographs. Treatments were carried out on three occasions at 6-week intervals, and a final assessment was made 6 weeks following the third treatment. Patient self-assessment was also included. Nine women were recruited, and seven completed the study. Average hair counts in a 16 cm(2) area before and after treatment were, respectively, 42.4 and 10.4 (laser), 38.1 and 20.4 (IPL), 45.3 and 44.7 (control). Both laser and IPL reduced the hair count substantially; laser vs control was significant at P=0.028, but IPL vs control had P=0.13, suggesting that more subjects or more treatments were required if statistical significance were to be achieved. Despite subjecting the patients to higher pain scores and more inflammation, laser was preferred by five patients; two preferred IPL and one had no preference.

  18. Adaptive Lighting

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve; Kongshaug, Jesper; Søndergaard, Karin

    2015-01-01

    offered by adaptive lighting control are created by the ways that the system components, the network and data flow can be coordinated through software so that the dynamic variations are controlled in ways that meaningfully adapt according to people’s situations and design intentions. This book discusses...... to be static, and no longer acts as a kind of spatial constancy maintaining stability and order? Moreover, what new potentials open in lighting design? This book is one of four books that is published in connection with the research project entitled LED Lighting; Interdisciplinary LED Lighting Research...

  19. Hospital emergency on-call coverage: is there a doctor in the house?

    Science.gov (United States)

    O'Malley, Ann S; Draper, Debra A; Felland, Laurie E

    2007-11-01

    The nation's community hospitals face increasing problems obtaining emergency on-call coverage from specialist physicians, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. The diminished willingness of specialist physicians to provide on-call coverage is occurring as hospital emergency departments confront an ever-increasing demand for services. Factors influencing physician reluctance to provide on-call coverage include decreased dependence on hospital admitting privileges as more services shift to non-hospital settings; payment for emergency care, especially for uninsured patients; and medical liability concerns. Hospital strategies to secure on-call coverage include enforcing hospital medical staff bylaws that require physicians to take call, contracting with physicians to provide coverage, paying physicians stipends, and employing physicians. Nonetheless, many hospitals continue to struggle with inadequate on-call coverage, which threatens patients' timely access to high-quality emergency care and may raise health care costs.

  20. Changes in blood glucose level during and after light sedations using propofol-fentanyl and midazolam-fentanyl in diabetic patients who underwent cataract surgery.

    Science.gov (United States)

    Khalighinejad, Pooyan; Rahimi, Mojtaba; Naghibi, Khosro; Niknam, Negar

    2015-01-01

    Surgeries may trigger the stress response which leads to changes in blood glucose level, and studies suggest that different sedation and anesthesia methods have different effects on blood glucose level. The aim of this study was to investigate changes of blood glucose levels in diabetic patients and compare them in two sedation methods of propofol + fentanyl and midazolam + fentanyl. Totally, 80 diabetic candidates for cataract surgery who had all the inclusion criteria, underwent cataract surgery using two methods of propofol (1 mg/kg/h) + fentanyl (2 μg/kg) (Group P) and midazolam (0.03 mg/kg) + fentanyl (2 μg/kg) (Group M) for light sedation. In the end, 70 patients (Group P n = 35 and Group M n = 35) remained in the study. Patients' blood glucose levels, vital signs, and hemodynamic data were assessed 30 min prior to the surgery, each 15 min during surgery and at the end of surgery. Hemodynamic parameters did not have a statistically significant difference between the two groups mean blood glucose level in Group M was 149.15 mg/dl and in Group P was 149.2 mg/dl, and based on repeated measures analysis of variance test, significant differences were not observed between the two groups (P = 0.99). T-test showed no significant differences in the blood glucose level at any time of the study between the two groups. Light sedation methods of propofol + fentanyl and midazolam + fentanyl did not have any differences in alteration of blood glucose level.

  1. An ontology-based nurse call management system (oNCS) with probabilistic priority assessment

    Science.gov (United States)

    2011-01-01

    Background The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call. The aim of this research is (1) the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2) the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient. Methods The ontology-based Nurse Call System (oNCS) was developed as an extension of a Context-Aware Service Platform. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient. Results The oNCS system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the oNCS system and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed. Conclusions The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the oNCS system significantly improves the assignment of nurses

  2. An ontology-based nurse call management system (oNCS with probabilistic priority assessment

    Directory of Open Access Journals (Sweden)

    Verhoeve Piet

    2011-02-01

    Full Text Available Abstract Background The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call. The aim of this research is (1 the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2 the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient. Methods The ontology-based Nurse Call System (oNCS was developed as an extension of a Context-Aware Service Platform. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient. Results The oNCS system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the oNCS system and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed. Conclusions The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the oNCS system significantly improves

  3. US calls for CO2 cut

    International Nuclear Information System (INIS)

    Roberts, M.

    1996-01-01

    The US Government has outraged energy-intensive industries by calling for an international agreement to reduce global emissions of carbon dioxide (CO 2 ) and other greenhouse gases. In a clear policy shift, the US--the world's largest emitter of greenhouse gases and not previously an advocate of curbing them--says it now intends to lead moves to prevent global warming. At last week's Second Conference of the Parties (COP-2) to the United Nations Framework Convention on Climate Change (FCCC), US Undersecretary for Global Affairs Timothy Wirth called for open-quotes an agreement that sets a realistic, verifiable, and binding medium-term emissions target.close quotes Individual countries should be free to choose how to meet targets, and the US favors market-based mechanisms, he says. open-quotes Climate change is a serious problem and will require sustained long-term investment to be addressed successfully,close quotes Wirth says

  4. Eight Leadership Emergency Codes Worth Calling.

    Science.gov (United States)

    Freed, David H

    Hospitals have a contemporary opportunity to change themselves before attempting to transform the larger US health care system. However, actually implementing change is much more easily described than accomplished in practice. This article calls out 8 dysfunctional behaviors that compromise professional standards at the ground level of the hospital. The construct of calling a code when one witnesses such behaviors is intended to make it safe for leaders to "See something, say something" and confront them in real time. The coordinated continuum of services that health care reform seeks to attain will not emerge until individual hospital organizations prepare themselves to operate better in their own spaces and the ones that immediately surround them.

  5. BUSINESS MODELS FOR EXTENDING OF 112 EMERGENCY CALL CENTER CAPABILITIES WITH E-CALL FUNCTION INSERTION

    Directory of Open Access Journals (Sweden)

    Pop Dragos Paul

    2010-12-01

    Full Text Available The present article concerns present status of implementation in Romania and Europe of eCall service and the proposed business models regarding eCall function implementation in Romania. eCall system is used for reliable transmission in case of crush between In Vehicle System and Public Service Answering Point, via the voice channel of cellular and Public Switched Telephone Network (PSTN. eCall service could be initiated automatically or manual the driver. All data presented in this article are part of researches made by authors in the Sectorial Contract Implementation study regarding eCall system, having as partners ITS Romania and Electronic Solution, with the Romanian Ministry of Communication and Information Technology as beneficiary.

  6. Circadian phase typing in idiopathic generalized epilepsy: Dim light melatonin onset and patterns of melatonin secretion-Semicurve findings in adult patients.

    Science.gov (United States)

    Manni, Raffaele; De Icco, Roberto; Cremascoli, Riccardo; Ferrera, Giulia; Furia, Francesca; Zambrelli, Elena; Canevini, Maria Paola; Terzaghi, Michele

    2016-08-01

    It has been debated in the literature whether patients with idiopathic generalized epilepsy (IGE) have a distinctive, evening-oriented chronotype. The few questionnaire-based studies that are available in the literature have conflicting results. The aim of our study was to define chronotype in patients with IGE by determining dim light melatonin onset (DLMO). Twenty adults diagnosed with IGE (grand mal on awakening [GM] in 7 cases and juvenile myoclonic epilepsy in 13 cases) were investigated by means of a face-to-face semistructured sleep interview, Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI) questionnaire, and a melatonin salivary test with DLMO determination. Eighteen healthy subjects (HC) and 28 patients affected with cryptogenic focal epilepsy (FE) served as controls. The mean MEQ score was significantly lower in patients with IGE than that in patients with FE (49.1±5.9 versus 56.1±8.7 P<0.01) but not significantly lower than that in HC (49.1±5.9 versus 49.3±8.6). Midsleep on free days corrected for sleep duration did not differ significantly between the three subject groups (04:59±01:21h, 04:37±01:17h, 04:29±00:52h). The mean DLMO time in patients with IGE (22:13±01:34h) occurred 49min later than that in HC (21.24±1h), and the melatonin surge within the 30-minute time interval after DLMO in patients with IGE was significantly lower than that in HC (1.51±2.7 versus 3.8±3.6pg/mL P=0.045). Subjective measures of chronotype do not indicate a definite evening-oriented chronotype in patients with IGE. However, the data concerning endogenous melatonin secretion indicate that patients with IGE tend to have a late circadian phase. Further studies are warranted in order to better define the late pattern of endogenous melatonin secretion in patients with IGE and to ascertain the role of this pattern in influencing behavioral chronotype in these subjects. Copyright © 2016. Published by Elsevier Inc.

  7. Prognostic and Added Value of Two-Dimensional Global Longitudinal Strain for Prediction of Survival in Patients with Light Chain Amyloidosis Undergoing Autologous Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Pun, Shawn C; Landau, Heather J; Riedel, Elyn R; Jordan, Jonathan; Yu, Anthony F; Hassoun, Hani; Chen, Carol L; Steingart, Richard M; Liu, Jennifer E

    2018-01-01

    Autologous hematopoietic cell transplantation (HCT) is a first-line therapy for prolonging survival in patients with light-chain (AL) amyloidosis. Cardiac involvement is the most important determinant of survival. However, patients with advanced cardiac involvement have often been excluded from HCT because of high risk for transplantation-related mortality and poor overall survival. Whether baseline left ventricular global longitudinal strain (GLS) can provide additional risk stratification and predict survival after HCT in this high-risk population remains unclear. The aim of this study was to evaluate the prognostic implication of baseline GLS and the added value of GLS beyond circulating cardiac biomarkers for risk stratification in patients with AL amyloidosis undergoing HCT. Eighty-two patients with newly diagnosed AL amyloidosis who underwent upfront HCT between January 2007 and April 2014 were included in the study. Clinical, echocardiographic, and serum cardiac biomarker data were collected at baseline and 12 months following HCT. GLS measurements were performed using a vendor-independent offline system. The median follow-up time for survivors was 58 months. Sixty-four percent of patients were in biomarker-based Mayo stage II or III. GLS, brain natriuretic peptide, troponin, and mitral E/A ratio were identified as the strongest predictors of survival (P value that best discriminated survivors from nonsurvivors, and the application of this cutoff value provided further mortality risk stratification within each Mayo stage. GLS is a strong predictor of survival in patients with AL amyloidosis undergoing HCT, potentially providing incremental value over serum cardiac biomarkers for risk stratification. GLS should be considered as a standard parameter along with serum cardiac biomarkers when evaluating eligibility for HCT or other investigational therapies. Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  8. Circus: A Replicated Procedure Call Facility

    Science.gov (United States)

    1984-08-01

    298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 client client stubs ...... ...... ..... ..... runtime libary stub compiler binding agent...runtime libary Figure 1: Structure of the Circus system replicated procedure call paired message protocol unreliable datagrams Figure 2: Circus...114-121. [11) Digit &! Equipment Corporation, Intel Corporation, a.nd Xerox Corporation. The Ethernet: A Local Area Networlc. September 1080. [12

  9. Beware of the Spirits that You Call!

    DEFF Research Database (Denmark)

    Vasquez, Consuelo; Schoeneborn, Dennis; Sergi, Viviane

    This article proposes to study the constitution of organization by acknowledging the fundamentally intertwined nature of order and disorder. Adopting a dialectical lens, we explore the (dis)ordering properties of communication by focusing on both the symbolic and the material dimensions of language...... plays a key role in the development of projects (and more broadly organizations), keeping them in motion by calling forth continuous processes of meaning negotiation....

  10. [Work-family conflict in call center].

    Science.gov (United States)

    Ghislieri, Chiara; Ricotta, Simona; Colombo, Lara

    2012-01-01

    The working environment of call centers, which have seen a significant growth in recent years, has been the subject of several studies aiming at understanding its specific dynamics, with particular attention to the possible causes of stress and discomfort. Despite the fact that the work-family conflict is considered a source of stress responsible for undermining workers' well-being, and as such has been explored in many work environments, there is still very little research specific to call centers. This study had the following aims: to explore work-family conflict perceived by call-center operators taking account of any differences related to respondents'professional and personal characteristics; to understand which demands and resources can have an impact on work-family conflict in this context. The study was carried out on a sample of 898 call center operators in a telecommunications company through the administration of a self-reporting questionnaire. Data analysis included: t-test, one-way analysis of variance, linear correlations and multiple regressions. A higher perception of work-family conflict among workers having a full-time contract was observed compared to those having part-time contracts. Multiple regression analysis identified as sources of influence on work-family conflict: emotional dissonance, uneasiness due customer dissatisfaction, workload, avoidance coping and working hours. Work-family conflict in the context studied is not particularly critical: it is in part influenced by professional and personal characteristics of respondents and primarily caused by work demands. Managerial implications are discussed, especially referred to training activities.

  11. “Computer Assisted Language Learning” (CALL

    Directory of Open Access Journals (Sweden)

    Nazlı Gündüz

    2005-10-01

    Full Text Available This article will provide an overview of computers; an overview of the history of CALL, itspros and cons, the internet, World Wide Web, Multimedia, and research related to the uses of computers in the language classroom. Also, it also aims to provide some background for the beginnerson using the Internet in language classes today. It discusses some of the common types of Internetactivities that are being used today, what the minimum requirements are for using the Internet forlanguage learning, and some easy activities you can adapt for your classes. Some special terminology related to computers will also be used in this paper. For example, computer assisted language learning(CALL refers to the sets of instructions which need to be loaded into the computer for it to be able to work in the language classroom. It should be borne in mind that CALL does not refer to the use of acomputer by a teacher to type out a worksheet or a class list or preparing his/her own teaching alone.Hardware refers to any computer equipment used, including the computer itself, the keyboard, screen (or the monitor, the disc-drive, and the printer. Software (computer programs refers to the sets of instructions which need to be loaded into the computer for it to be able to work.

  12. Most important needs of family members of critical patients in light of the critical care family needs inventory.

    Science.gov (United States)

    Padilla Fortunatti, Cristóbal Felipe

    2014-01-01

    This work sought to identify the most important needs for family members of adult critical patients as described in the literature pursuant to the dimensions established in the "Critical Care Family Needs Inventory" (CCFNI) by Molter and Leske. A literature review was carried out by using the CCFNI instrument. The databases used were: Pubmed, CINAHL, Proquest Nursing & Allied Health Source, Proquest Psychology Journals, LILACS, Science Direct, Ovid SP, PsyicINFO, and SciELO. The following limitations for the search were identified: adult patients, articles in English and Spanish, with abstract and complete text available and which had been published from 2003 to June 2013; 15 articles were included. The family's hope on desired results and sincere communication with the healthcare staff turned out to be the most relevant needs, while the least important were related to comfort and having support structures or systems. Most of the studies were conducted in Asia and North America revealing differences in the order of importance assigned to each necessity. Certain sociodemographic and cultural characteristics impact upon how family members rank their needs; this also occurs with the nature of the most important needs for the family and the factors determining their prioritization. The articles included in this review mention the frequent interaction with the family and their holistic view of the person beyond the illness, determine that nurses are the most appropriate professionals to know and satisfy the family needs of critical patients.

  13. Most Important Needs of Family Members of Critical Patients in Light of the Critical Care Family Needs Inventory

    Directory of Open Access Journals (Sweden)

    Cristóbal Felipe Padilla Fortunatti

    2014-07-01

    Full Text Available Objective. This work sought to identify the most important needs for family members of adult critical patients as described in the literature pursuant to the dimensions established in the "Critical Care Family Needs Inventory" (CCFNI by Molter and Leske. Methodology. A literature review was carried out by using the CCFNI instrument. The databases used were: Pubmed, CINAHL, Proquest Nursing & Allied Health Source, Proquest Psychology Journals, LILACS, Science Direct, Ovid SP, PsyicINFO, and SciELO. The following limitations for the search were identified: adult patients, articles in English and Spanish, with abstract and complete text available and which had been published from 2003 to June 2013; 15 articles were included. Results. The family's hope on desired results and sincere communication with the healthcare staff turned out to be the most relevant needs, while the least important were related to comfort and having support structures or systems. Most of the studies were conducted in Asia and North America revealing differences in the order of importance assigned to each necessity. Certain sociodemographic and cultural characteristics impact upon how family members rank their needs; this also occurs with the nature of the most important needs for the family and the factors determining their prioritization. Conclusion. The articles included in this review mention the frequent interaction with the family and their holistic view of the person beyond the illness, determine that nurses are the most appropriate professionals to know and satisfy the family needs of critical patients.

  14. Acoustic monitoring indicates a correlation between calling and spawning in captive spotted seatrout (Cynoscion nebulosus

    Directory of Open Access Journals (Sweden)

    Eric W. Montie

    2017-02-01

    Full Text Available Background Fish sound production is widespread throughout many families. Territorial displays and courtship are the most common reasons for fish sound production. Yet, there is still some questions on how acoustic signaling and reproduction are correlated in many sound-producing species. In the present study, our aim was to determine if a quantitative relationship exists between calling and egg deposition in captive spotted seatrout (Cynoscion nebulosus. This type of data is essential if passive acoustics is to be used to identify spawning aggregations over large spatial scales and monitor reproductive activity over annual and decadal timeframes. Methods Acoustic recorders (i.e., DSG-Oceans were placed in three laboratory tanks to record underwater sound over an entire, simulated reproductive season. We enumerated the number of calls, calculated the received sound pressure level, and counted the number of eggs every morning in each tank. Results Spotted seatrout produced three distinct call types characterized as “drums,” “grunts,” and “staccatos.” Spotted seatrout calling increased as the light cycle shifted from 13.5 to 14.5 h of light, and the temperature increased to 27.7 °C. Calling decreased once the temperature fell below 27.7 °C, and the light cycle shifted to 12 h of light. These temperature and light patterns followed the natural reproductive season observed in wild spotted seatrout in the Southeast United States. Spotted seatrout exhibited daily rhythms in calling. Acoustic signaling began once the lights turned off, and calling reached maximum activity approximately 3 h later. Eggs were released only on evenings in which spotted seatrout were calling. In all tanks, spotted seatrout were more likely to spawn when male fish called more frequently. A positive relationship between SPL and the number of eggs collected was found in Tanks 1 and 3. Discussion Our findings indicate that acoustic metrics can predict spawning

  15. Therapy of psoriasis with narrowband ultraviolet-B light influences plasma concentrations of MMP-2 and TIMP-2 in patients

    Directory of Open Access Journals (Sweden)

    Głażewska EK

    2016-10-01

    Full Text Available Edyta Katarzyna Głażewska,1 Marek Niczyporuk,1 Sławomir Ławicki,2 Maciej Szmitkowski,2 Monika Zajkowska,2 Grażyna Ewa Będkowska,3 Andrzej Przylipiak1 1Department of Esthetic Medicine, 2Department of Biochemical Diagnostics, 3Department of Haematological Diagnostics, Medical University, Białystok, Poland Background: Matrix metalloproteinases (MMPs, which show a significant ability to cleave the components of extracellular matrix, and tissue inhibitors of metalloproteinases (TIMPs, which slow down the activity of those enzymes, may be implicated in the pathogenesis and spread of psoriatic disease. This study aims to analyze plasma levels of MMP-2 and TIMP-2 in plaque psoriasis patients before and after the course of narrowband ultraviolet-B (NBUVB therapy with respect to disease advancement. Patients and methods: A total of 49 patients suffering from plaque psoriasis and 40 healthy volunteers were enrolled into the study. Plasma levels of MMP-2 and TIMP-2 were determined using enzyme-linked immunosorbent assay, while Psoriasis Area and Severity Index (PASI was used to define the disease advancement. Results: The results showed increased plasma levels of MMP-2 and TIMP-2, but this change was significant only in case of MMP-2 in total psoriatic group compared to healthy subjects. Moreover, there was an increase in the concentrations of chosen factors with an increase in the severity of the disease. The NBUVB therapy causes a decline in the concentration of the analyzed enzyme and its inhibitor, although this change was statistically significant in the total psoriatic group only in case of MMP-2. There was also a positive correlation between MMP-2, TIMP-2, and PASI score value. Conclusion: Our study highlights a possible important role of MMP-2 in the activity of psoriasis and clearance of disease symptoms. Moreover, plasma MMP-2 seems to be a valuable psoriasis biomarker. Keywords: gelatinase A, matrix metalloproteinases, tissue inhibitor of

  16. Hospital Readmissions Following Physician Call System Change: A Comparison of Concentrated and Distributed Schedules.

    Science.gov (United States)

    Yarnell, Christopher J; Shadowitz, Steven; Redelmeier, Donald A

    2016-07-01

    Physician call schedules are a critical element for medical practice and hospital efficiency. We compared readmission rates prior to and after a change in physician call system at Sunnybrook Health Sciences Centre. We studied patients discharged over a decade (2004 through 2013) and identified whether or not each patient was readmitted within the subsequent 28 days. We excluded patients discharged for a surgical, obstetrical, or psychiatric diagnosis. We used time-to-event analysis and time-series analysis to compare rates of readmission prior to and after the physician call system change (January 1, 2009). A total of 89,697 patients were discharged, of whom 10,001 (11%) were subsequently readmitted and 4280 died. The risk of readmission was increased by about 26% following physician call system change (9.7% vs 12.2%, P system change (95% confidence interval, 22%-31%; P system change persisted across patients with diverse ages, estimated readmission risks, and medical diagnoses. The net effect was equal to 7240 additional patient days in the hospital following call system change. A modest increase was observed at a nearby acute care hospital that did not change physician call system, and no increase in risk of death was observed with increased hospital readmissions. We suggest that changes in physician call systems sometimes increase subsequent hospital readmission rates. Further reductions in readmissions may instead require additional resources or ingenuity. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Do infrared light-emitting diodes have a stimulatory effect on wound healing? From an in-vitro trial to patient treatment

    Science.gov (United States)

    Vinck, Elke; Cagnie, B.; Cambier, D.; Cornelissen, M.

    2002-10-01

    Variable effects of different forms of light therapy on wound healing have been reported. This preliminary study covers the efficacy of infrared light emitting diodes (LED) in this domain. Cultured embryonic chicken fibroblasts were treated in a controlled, radomised manner. LED irradiation was performed three consecutive days with a wavelength of 950 nm and a power output of 160 mW, at 0,6 cm distance from the fibroblasts. Each treatment lasted 6 minutes, resulting in a surface energy denstiy of 3,2 J/cm2. The results indicated that LED treatment does not influence fibroblast proliferation at the applied energy density and irradiation frequency (p=0,474). Meanwhile the effects of LED on wound healing in vivo were studied by treating a surgical incision (6 cm) on the lateral side of the right foot in a male patient. The treatment started after 13 days, when initial stitches were being removed. The same parameters as in the in vitro study were used but the treatment was performed five times. The healing could only be evaluated clinically, the irradiated area (2,6 cm) showed a more appropriate contraction, less discoloration and a less hypertrophic scar than the control area (3,4 cm). The used parameters failed to demonstrate any biological effect of LED irradiation in vitro, although the case study on the other hand illustrated a beneficial effect.

  18. Transforming trauma healthcare delivery in rural areas by use of an integrated call center.

    Science.gov (United States)

    Agrawal, Deepak

    2012-01-01

    There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital's electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000), with a recurring cost of Rs 80,000 (US$ 2000) per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305) were from rural areas. Patients' overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to rural areas in an extremely cost-effective manner.

  19. Evaluation of a Postdischarge Call System Using the Logic Model.

    Science.gov (United States)

    Frye, Timothy C; Poe, Terri L; Wilson, Marisa L; Milligan, Gary

    2018-02-01

    This mixed-method study was conducted to evaluate a postdischarge call program for congestive heart failure patients at a major teaching hospital in the southeastern United States. The program was implemented based on the premise that it would improve patient outcomes and overall quality of life, but it had never been evaluated for effectiveness. The Logic Model was used to evaluate the input of key staff members to determine whether the outputs and results of the program matched the expectations of the organization. Interviews, online surveys, reviews of existing patient outcome data, and reviews of publicly available program marketing materials were used to ascertain current program output. After analyzing both qualitative and quantitative data from the evaluation, recommendations were made to the organization to improve the effectiveness of the program.

  20. Sophie Calle. Autoritratto allo specchio: abbi cura di te

    Directory of Open Access Journals (Sweden)

    Elisabetta Modena

    2014-07-01

    Full Text Available In 2007 the France Pavilion in Giardini of the Biennale di Venezia was occupied by Prenez soin de vous, a work by Sophie Calle. This project was based on an email received by the artist from her lover (in which the man puts an end to their relationship that Calle submits to one hundred and seven women, asking them to analyze and interpret it according to their specific professional skills. We chose this installation to propose an insight into the French artist's research by reading and interpreting it in the light of our theme, the mirror: "reflections and doublings". Our aim is to contextualize this work in her artistic production in relation to the role of writing and storytelling and the use of art as a therapeutic tool, underlining how Prenez soin de vous represents a fundamental fragment key to understand and reconstruct the big and elusive self-portrait painted and repainted, written and rewritten, which characterizes, through the autobiographical trigger, a significant part of her research in a contemporary anamorphosis.

  1. Flavour democracy calls for the fourth generation

    International Nuclear Information System (INIS)

    Datta, A.

    1992-07-01

    It is argued with the help of an illustrative mode, that the inter species hierarchy among the fermion masses and the quark mixing angles can be accommodated naturally in the standard model with (approximate) flavour democracy provided there are four families of sequential quark-leptons with all members of the fourth family having roughly equal masses. The special problem of light neutrino masses (if any) and possible solutions are also discussed. (author). 15 refs

  2. Calling patterns in human communication dynamics.

    Science.gov (United States)

    Jiang, Zhi-Qiang; Xie, Wen-Jie; Li, Ming-Xia; Podobnik, Boris; Zhou, Wei-Xing; Stanley, H Eugene

    2013-01-29

    Modern technologies not only provide a variety of communication modes (e.g., texting, cell phone conversation, and online instant messaging), but also detailed electronic traces of these communications between individuals. These electronic traces indicate that the interactions occur in temporal bursts. Here, we study intercall duration of communications of the 100,000 most active cell phone users of a Chinese mobile phone operator. We confirm that the intercall durations follow a power-law distribution with an exponential cutoff at the population level but find differences when focusing on individual users. We apply statistical tests at the individual level and find that the intercall durations follow a power-law distribution for only 3,460 individuals (3.46%). The intercall durations for the majority (73.34%) follow a Weibull distribution. We quantify individual users using three measures: out-degree, percentage of outgoing calls, and communication diversity. We find that the cell phone users with a power-law duration distribution fall into three anomalous clusters: robot-based callers, telecom fraud, and telephone sales. This information is of interest to both academics and practitioners, mobile telecom operators in particular. In contrast, the individual users with a Weibull duration distribution form the fourth cluster of ordinary cell phone users. We also discover more information about the calling patterns of these four clusters (e.g., the probability that a user will call the c(r)-th most contact and the probability distribution of burst sizes). Our findings may enable a more detailed analysis of the huge body of data contained in the logs of massive users.

  3. Call for another special issue / book

    Science.gov (United States)

    Bostenaru Dan, M.

    2009-04-01

    We would like to continue the series of special issue or maybe edit a book on this topic. To complete the formerly edited special issues we would like to link natural hazards research to cultural heritage research. We see a way of doing this connected to "integrated conservation", which sees the involvment of urban planning in conservation, as well as the (urban) sociology, the integration of the user, the participatism. We further call for investigation of GIS applications for the investigation of natural hazards' impact in this field. We are open for further ideas and wait for you at the Splinter meeting.

  4. Call center. Centrados en el cliente

    OpenAIRE

    Leal-Alonso-de-Castañeda, José Enrique

    2003-01-01

    La empresa actual ha de estar preparada para responder al Cliente tal y como éste espera, porque no se busca un cliente puntual, sino un cliente fiel. La globalización de la economía y del acceso a los mercados exige que la empresa sea capaz de atraer al cliente no sólo con un servicio de calidad, sino además con una atención de calidad. La implantación de un Call Center (Centro de Atención al Cliente, Centro de Atención de Llamadas) constituye por todo ello una estrategia de negocio qu...

  5. JPEG XS call for proposals subjective evaluations

    Science.gov (United States)

    McNally, David; Bruylants, Tim; Willème, Alexandre; Ebrahimi, Touradj; Schelkens, Peter; Macq, Benoit

    2017-09-01

    In March 2016 the Joint Photographic Experts Group (JPEG), formally known as ISO/IEC SC29 WG1, issued a call for proposals soliciting compression technologies for a low-latency, lightweight and visually transparent video compression scheme. Within the JPEG family of standards, this scheme was denominated JPEG XS. The subjective evaluation of visually lossless compressed video sequences at high resolutions and bit depths poses particular challenges. This paper describes the adopted procedures, the subjective evaluation setup, the evaluation process and summarizes the obtained results which were achieved in the context of the JPEG XS standardization process.

  6. First Class Call Stacks: Exploring Head Reduction

    Directory of Open Access Journals (Sweden)

    Philip Johnson-Freyd

    2016-06-01

    Full Text Available Weak-head normalization is inconsistent with functional extensionality in the call-by-name λ-calculus. We explore this problem from a new angle via the conflict between extensionality and effects. Leveraging ideas from work on the λ-calculus with control, we derive and justify alternative operational semantics and a sequence of abstract machines for performing head reduction. Head reduction avoids the problems with weak-head reduction and extensionality, while our operational semantics and associated abstract machines show us how to retain weak-head reduction's ease of implementation.

  7. What Is This Thing Called Learner's Lexicography?

    DEFF Research Database (Denmark)

    Nielsen, Sandro

    2010-01-01

    Learner lexicography as a research area has attracted increased attention during the past decades, but what is actually the true nature of learner lexicography? This question calls for a complex answer. Learner lexicography has as its objective to develop principles that help practitioners......, namely its functions, data and structures, as this strengthens the basis of learner lexicography because it leads to a proper study and understanding of the competences and needs of learners. Finally, the modern theory of dictionary functions encourages theoretical and practical lexicographers to adopt...

  8. Descriptions of new Genera and species of the so-called Glyphipterygidae Sensu Meyrick, 1913 (Lepidoptera)

    NARCIS (Netherlands)

    Diakonoff, A.

    1978-01-01

    In the course of a revision of the so-called family Glyphipterygidae sensu Meyrick, 1913, for the series "Microlepidoptera Palaearctica", several new taxa came to light. In order to facilitate the edition of the revision and to publish these new taxa without further delay, they are being described

  9. The Unreasonable Effectiveness of CALL: What Have We Learned in Two Decades of Research?

    Science.gov (United States)

    Felix, Uschi

    2008-01-01

    This paper presents a comprehensive picture of what has been investigated in terms of CALL effectiveness over the period 1981-2005 throwing light on why this question is still such a difficult one to answer unequivocally. The author looks at both strengths and weaknesses in this body of work, highlighting pitfalls and paradoxes in research…

  10. Thoughts on the so-called 'radius-capitellum axis'

    International Nuclear Information System (INIS)

    Schild, H.; Mueller, H.A.; Wagner, H.; Baetz, W.; Mainz Univ.

    1982-01-01

    We have studied 438 patients radiologically in order to observe the so-called 'radius-capitellum axis'. In about a quarter of people with normal elbows the axis passes lateral to the middle portion of the capitellum, so that even when there is marked deviation, there is no certainty that the humero-radial joint is abnormal. Deviation of the axis can be caused by changes in the shape of the capitellum or of the radius, or by distension of the capsule of the elbow joint, or by various changes in muscular pull. (orig.) [de

  11. Thoughts on the so-called radius-capitellum axis

    Energy Technology Data Exchange (ETDEWEB)

    Schild, H; Mueller, H A; Wagner, H; Baetz, W

    1982-02-01

    We have studied 438 patients radiologically in order to observe the so-called 'radius-capitellum axis'. In about a quarter of people with normal elbows the axis passes lateral to the middle portion of the capitellum, so that even when there is marked deviation, there is no certainty that the humero-radial joint is abnormal. Deviation of the axis can be caused by changes in the shape of the capitellum or of the radius, or by distension of the capsule of the elbow joint, or by various changes in muscular pull.

  12. [Once again the so-called Testament of Hippocrates].

    Science.gov (United States)

    Sideras, Alexander

    2006-01-01

    This study is dealing with the so-called Testament of Hippocrates, a short ethic about the doctor's background, knowledge, character, appearance and behaviour towards the patient. Along with the three well-known Greek manuscripts the author is looking at two other by now unknown codices, so that the two Greek versions are accompanied by a third and larger version. After a careful consideration of the relations between the different versions he is discussing all readings of the codices explaining the terms within the background of the history of medicine. At the end he is presenting a reconstruction of the Greek original together with a German translation.

  13. Interactionability in Computer Game: Call of Duty

    Directory of Open Access Journals (Sweden)

    masoud Kowsari

    2009-11-01

    Full Text Available For a long time communication theorists have criticized public media for being unilateral. What they prescript is to transform pattern of communication into bilateral one; in other words, to make media interactional. Telephone is the first fully interactional, however, there was a long road to the contemporary communication and information media which are highly interactional. Nevertheless, not all the modern media are equally interactional. Therefore, it is necessary to evaluate levels of interactionability in modern media and strength them. As other concepts in communication, interaction has different definitions, implying various aspects of the audience-media relation. And this feature of multi-dimensionality is to be considered. Quistis (2002 suggests a model in which all the technical, social, and comprehensive aspects of interaction are inherent. In other words, not only the technical aspect of media, but also audience’s perception plays a key role in the model. Visual-computer games are good instance of interactionability in modern media. However, not all games are equally interactional. Analyzing a well-known computer game “Call of Duty”, this article attempts to study different levels of interactionability. The main question is: how can one offer a pragmatic definition of three dimensions of interactionability to study computer games; and how this features are in Call of Duty applied?

  14. Circadian light

    Directory of Open Access Journals (Sweden)

    Bierman Andrew

    2010-02-01

    Full Text Available Abstract The present paper reflects a work in progress toward a definition of circadian light, one that should be informed by the thoughtful, century-old evolution of our present definition of light as a stimulus for the human visual system. This work in progress is based upon the functional relationship between optical radiation and its effects on nocturnal melatonin suppression, in large part because the basic data are available in the literature. Discussed here are the fundamental differences between responses by the visual and circadian systems to optical radiation. Brief reviews of photometry, colorimetry, and brightness perception are presented as a foundation for the discussion of circadian light. Finally, circadian light (CLA and circadian stimulus (CS calculation procedures based on a published mathematical model of human circadian phototransduction are presented with an example.

  15. Bili lights

    Science.gov (United States)

    ... 3 things: Gestational age Bilirubin level in the blood Newborn's age (in hours) In severe cases of increased bilirubin, an exchange transfusion may be done instead. Alternative Names Phototherapy for jaundice; Bilirubin - bili lights; Neonatal ...

  16. A comparative analysis of the statistical properties of large mobile phone calling networks.

    Science.gov (United States)

    Li, Ming-Xia; Jiang, Zhi-Qiang; Xie, Wen-Jie; Miccichè, Salvatore; Tumminello, Michele; Zhou, Wei-Xing; Mantegna, Rosario N

    2014-05-30

    Mobile phone calling is one of the most widely used communication methods in modern society. The records of calls among mobile phone users provide us a valuable proxy for the understanding of human communication patterns embedded in social networks. Mobile phone users call each other forming a directed calling network. If only reciprocal calls are considered, we obtain an undirected mutual calling network. The preferential communication behavior between two connected users can be statistically tested and it results in two Bonferroni networks with statistically validated edges. We perform a comparative analysis of the statistical properties of these four networks, which are constructed from the calling records of more than nine million individuals in Shanghai over a period of 110 days. We find that these networks share many common structural properties and also exhibit idiosyncratic features when compared with previously studied large mobile calling networks. The empirical findings provide us an intriguing picture of a representative large social network that might shed new lights on the modelling of large social networks.

  17. NUESTRA PORTADA. Jugar en la calle

    Directory of Open Access Journals (Sweden)

    Ramon Balius i Juli

    2008-06-01

    Full Text Available Esta vez Nuestra Portada tiene un carácter excepcional. La ocupan dos obras del que fue el “ninotaire” (dibujante de humor inteligente más importante de nuestro país: Francesc Vila i Rufas, conocido por todos como Cesc (1927–2006. Ambos dibujos destacan por sus inconfundibles características de sencillez y, a la vez, de grandeza argumental, que nos han movido a titular este comentario como “Jugar en la calle”. Comenzaré recordando mi precaria experiencia de infancia y primera juventud en esta actividad de índole “suburbana”. Son muchas las personas de mi edad que en algún momento de sus primeros años han jugado en la calle. Recuerdo que la primera vez que lo hice fue hacia 1938, en Sant Boi de Llobregat (denominado entonces Vilaboi, jugando al fútbol. Pasé unos meses en este pueblo huyendo de las bombas que caían sobre Barcelona. También por aquel tiempo, o quizá uno o dos años después, tuve el deseo, que no he podido satisfacer, de deslizarme sobre unos artefactos de madera con ruedas de cojinetes de bolas por la calle de Enric Granados, donde vivía (los construían los chicos del barrio, en formas rudimentarias, que hoy recordarían a los patinetes o los “skateboards”. Durante el bachillerato, al salir de la Escuela Pia de Balmes esquina con Travesera de Gracia, algunas veces había jugado también a fútbol en la calle Tuset, que por aquellos años no estaba bien urbanizada y tenía unas aceras amplísimas sin asfaltar. En los primeros cursos de la carrera de Medicina, participé en unos continuos e inacabables partidos de fútbol que, desde primera hora de la mañana y hasta el mediodía, se organizaban diariamente en el patio claustrado de la Facultad. Generalmente jugábamos entre clase y clase, aunque existía un núcleo de jugadores entusiastas que no entraban en las aulas en ningún momento. Esta competición se clausuró al cabo de bastantes años, cuando el Decano decidió adornar el patio con

  18. Light Atmosphere in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone Mandrup

    by the patients in the ward. The project is based on the Danish Regulation for light in hospitals (DS703), which is a supplement to the regulation of artificial lighting in workplaces (DS700). The kick-off to the project was reading the DS703, second paragraph, chapter 2 about general requirements for lighting...... group has quite diverse needs and preferences, while the staff needs task lighting and the patient a space experienced as homely and pleasant. Categories such as ‘pleasure’ and ‘activities’ are also a part of the user aspect. The space is divided into subcategories as ‘location of the space...

  19. Comprometimento organizacional de trabalhadores de call center

    Directory of Open Access Journals (Sweden)

    Kely César Martins Paiva

    2015-09-01

    Full Text Available RESUMOO Neste artigo, analisa-se como se apresenta o comprometimento organizacional de trabalhadores de um call center, localizado em Belo (A Horizonte (Minas Gerais, Brasil. Após o delineamento conceitual UJ do tema central, são expostos os resultados de um estudo de caso descritivo, realizado com abordagens quantitativa e qualitativa. Os dados de 399 questionários e 22 entrevistas são, respectivamente, tratados estatisticamente e submetidos à análise de conteúdo. A base de comprometimento que predominou entre esses infoproletários foi "obrigação pelo desempenho" e, em menor grau, "afetiva". Foi observado que quanto maior é o seu tempo de experiência nesse tipo de organização, menores são os níveis de comprometimento de modo geral, fatos esclarecidos, parcialmente, por meio das entrevistas.

  20. Quantifying and Reducing Light Pollution

    Science.gov (United States)

    Gokhale, Vayujeet; Caples, David; Goins, Jordan; Herdman, Ashley; Pankey, Steven; Wren, Emily

    2018-06-01

    We describe the current level of light pollution in and around Kirksville, Missouri and around Anderson Mesa near Flagstaff, Arizona. We quantify the amount of light that is projected up towards the sky, instead of the ground, using Unihedron sky quality meters installed at various locations. We also present results from DSLR photometry of several standard stars, and compare the photometric quality of the data collected at locations with varying levels of light pollution. Presently, light fixture shields and ‘warm-colored’ lights are being installed on Truman State University’s campus in order to reduce light pollution. We discuss the experimental procedure we use to test the effectiveness of the different light fixtures shields in a controlled setting inside the Del and Norma Robison Planetarium.Apart from negatively affecting the quality of the night sky for astronomers, light pollution adversely affects migratory patterns of some animals and sleep-patterns in humans, increases our carbon footprint, and wastes resources and money. This problem threatens to get particularly acute with the increasing use of outdoor LED lamps. We conclude with a call to action to all professional and amateur astronomers to act against the growing nuisance of light pollution.

  1. Call for human contact and support

    DEFF Research Database (Denmark)

    Loft, Mia Ingerslev; Martinsen, Bente; Esbensen, Bente Appel

    2017-01-01

    and helpful, but were unclear about the nursing staff’s function in rehabilitation which, in the patients’ perspective, equals physical training.Implications for RehabilitationNursing staff need to pay attention to the patients’ needs, existential thoughts and concerns during inpatient rehabilitation.......Meaningful goals for the rehabilitation of stroke patients are crucial, and it is vital that the patients commit to the goals.Patients expected polite and helpful nurses, but did not see them as therapeutic and active stakeholders, thus it is important that nursing staff present themselves as part...

  2. Museo a todo pedal: Calle 26

    Directory of Open Access Journals (Sweden)

    Catalina Delgado

    2018-05-01

    Full Text Available Este texto reseña el proyecto urbano “MUSEO A TODO PEDAL: CALLE 26” realizado con la intención de promover el conocimiento y la apropiación crítica del patrimonio escultórico de la Avenida El Dorado en la ciudad de Bogotá, Colombia. La gestión dio inicio en octubre de 2014 con una serie de actividades, entre ellas, el lanzamiento oficial de la Guía de Monumentos y Sitios y la organización de una carrera ciclística de observación. Es del interés de RevistArquis, publicar este proyecto en diálogo con el ensayo de uno de los autores publicado en el Vol. 1 (2015 Número 07 “Usos Cotidianos y Populares de la Bicicleta en Bogotá”. This paper reviews the urban project “MUSEO A TODO PEDAL: CALLE 26” held to promote awareness and critical appropriation of the sculptural heritage of Avenida El Dorado in Bogota, Colombia. The urban project began in October 2014 with a series of activities including the official launch of the Guide on Monuments and Sites and the organization of a watching cycling road race. RevistArquis is honored to publish this project in dialogue with the essay by the same author published in Vol. 1 (2015 Number 07 “Usos Cotidianos y Populares de la Bicicleta en Bogotá”.

  3. Controlling Light Harvesting with Light

    NARCIS (Netherlands)

    Gwizdala, M.S.; Berera, R.; Kirilovsky, D.; van Grondelle, R.; Kruger, T.P.J.

    2016-01-01

    When exposed to intense sunlight, all organisms performing oxygenic photosynthesis implement various photoprotective strategies to prevent potentially lethal photodamage. The rapidly responding photoprotective mechanisms, occurring in the light-harvesting pigment-protein antennae, take effect within

  4. From nestling calls to fledgling silence: adaptive timing of change in response to aerial alarm calls.

    Science.gov (United States)

    Magrath, Robert D; Platzen, Dirk; Kondo, Junko

    2006-09-22

    Young birds and mammals are extremely vulnerable to predators and so should benefit from responding to parental alarm calls warning of danger. However, young often respond differently from adults. This difference may reflect: (i) an imperfect stage in the gradual development of adult behaviour or (ii) an adaptation to different vulnerability. Altricial birds provide an excellent model to test for adaptive changes with age in response to alarm calls, because fledglings are vulnerable to a different range of predators than nestlings. For example, a flying hawk is irrelevant to a nestling in a enclosed nest, but is dangerous to that individual once it has left the nest, so we predict that young develop a response to aerial alarm calls to coincide with fledging. Supporting our prediction, recently fledged white-browed scrubwrens, Sericornis frontalis, fell silent immediately after playback of their parents' aerial alarm call, whereas nestlings continued to calling despite hearing the playback. Young scrubwrens are therefore exquisitely adapted to the changing risks faced during development.

  5. Psychological benefits 2 and 4 weeks after a single treatment with near infrared light to the forehead: a pilot study of 10 patients with major depression and anxiety

    Directory of Open Access Journals (Sweden)

    Teicher Martin H

    2009-12-01

    Full Text Available Abstract Background Many studies have reported beneficial effects from the application of near-infrared (NIR light photobiomodulation (PBM to the body, and one group has reported beneficial effects applying it to the brain in stroke patients. We have reported that the measurement of a patient's left and right hemispheric emotional valence (HEV may clarify data and guide lateralized treatments. We sought to test whether a NIR treatment could 1. improve the psychological status of patients, 2. show a relationship between immediate psychological improvements when HEV was taken into account, and 3. show an increase in frontal pole regional cerebral blood flow (rCBF, and 4. be applied without side effects. Methods We gave 10 patients, (5 M/5 F with major depression, including 9 with anxiety, 7 with a past history of substance abuse (6 with an opiate abuse and 1 with an alcohol abuse history, and 3 with post traumatic stress disorder, a baseline standard diagnostic interview, a Hamilton Depression Rating Scale (HAM-D, a Hamilton Anxiety Rating Scale (HAM-A, and a Positive and Negative Affect Scale (PANAS. We then gave four 4-minute treatments in a random order: NIR to left forehead at F3, to right forehead at F4, and placebo treatments (light off at the same sites. Immediately following each treatment we repeated the PANAS, and at 2-weeks and at 4-weeks post treatment we repeated all 3 rating scales. During all treatments we recorded total hemoglobin (cHb, as a measure of rCBF with a commercial NIR spectroscopy device over the left and the right frontal poles of the brain. Results At 2-weeks post treatment 6 of 10 patients had a remission (a score ≤ 10 on the HAM-D and 7 of 10 achieved this on the HAM-A. Patients experienced highly significant reductions in both HAM-D and HAM-A scores following treatment, with the greatest reductions occurring at 2 weeks. Mean rCBF across hemispheres increased from 0.011 units in the off condition to 0.043 units in

  6. Investigation of CT picture in so-called loose shoulder

    International Nuclear Information System (INIS)

    Kuroda, Shigehito; Sakamaki, Hiroshi; Matsuoka, Akira; Moriishi, Takeji; Takada, Keiichi.

    1985-01-01

    CT picture of the shoulder joint was analyzed in 124 shoulders (114 patients). A line perpendicular to a given line between the precornu of acetabular tegmen (A) and the postcornu of acetabular tegmen (B) was drawn and the intersection where the line and the caput humeri meet (C) was obtained. The angle of CAB was defined as the backward angular aperture of the acetabular tegmen. The angular aperture was 26.2 0 +-1.9 in 16 so-called loose shoulders, 17.3 0 +-1.0 in 28 loose shoulders restricted to the inward rotation, and 12.2 0 +-0.4 in 80 normal shoulders, showing a distinct correlation between the angular aperture and the degree of loose shoulder. An increased backward angular aperture of the acetabular tegmen was considered greatly attributable to the forward glenohumeral movement resulting from malformation of the acetabular tegmen and flaccidity of the joint. Glenoid osteotomy was thus performed in 9 patients, 6 of whom underwent CT scanning before and after osteotomy. Coronal and transverse CT images of the shoulder joint disclosed a noticeable improvement of the glenohumeral alignment. The angular aperture shown on CT seems to be of major importance not only in the diagnosis of so-called loose shoulder but also in surgical choice. (Namekawa, K.)

  7. Prospective Randomized Controlled Study on the Efficacy of Multimedia Informed Consent for Patients Scheduled to Undergo Green-Light High-Performance System Photoselective Vaporization of the Prostate

    Directory of Open Access Journals (Sweden)

    Dong Yeub Ham

    2016-04-01

    Full Text Available Purpose: The aim of this study was to evaluate the efficacy of a multimedia informed consent (IC presentation on the understanding and satisfaction of patients who were scheduled to receive 120-W green-light high-performance system photoselective vaporization of the prostate (HPS-PVP. Materials and Methods: A multimedia IC (M-IC presentation for HPS-PVP was developed. Forty men with benign prostatic hyperplasia who were scheduled to undergo HPS-PVP were prospectively randomized to a conventional written IC group (W-IC group, n=20 or the M-IC group (n=20. The allocated IC was obtained by one certified urologist, followed by a 15-question test (maximum score, 15 to evaluate objective understanding, and questionnaires on subjective understanding (range, 0∼10 and satisfaction (range, 0∼10 using a visual analogue scale. Results: Demographic characteristics, including age and the highest level of education, did not significantly differ between the two groups. No significant differences were found in scores reflecting the objective understanding of HPS-PVP (9.9±2.3 vs. 10.6±2.8, p=0.332 or in subjective understanding scores (7.5±2.1 vs. 8.6±1.7, p=0.122; however, the M-IC group showed higher satisfaction scores than the W-IC group (7.4±1.7 vs. 8.4±1.5, p=0.033. After adjusting for age and educational level, the M-IC group still had significantly higher satisfaction scores. Conclusions: M-IC did not enhance the objective knowledge of patients regarding this surgical procedure. However, it improved the satisfaction of patients with the IC process itself.

  8. Prospective Randomized Controlled Study on the Efficacy of Multimedia Informed Consent for Patients Scheduled to Undergo Green-Light High-Performance System Photoselective Vaporization of the Prostate

    Science.gov (United States)

    Ham, Dong Yeub; Choi, Woo Suk; Song, Sang Hoon; Ahn, Young-Joon; Park, Hyoung Keun; Kim, Hyeong Gon

    2016-01-01

    Purpose The aim of this study was to evaluate the efficacy of a multimedia informed consent (IC) presentation on the understanding and satisfaction of patients who were scheduled to receive 120-W green-light high-performance system photoselective vaporization of the prostate (HPS-PVP). Materials and Methods A multimedia IC (M-IC) presentation for HPS-PVP was developed. Forty men with benign prostatic hyperplasia who were scheduled to undergo HPS-PVP were prospectively randomized to a conventional written IC group (W-IC group, n=20) or the M-IC group (n=20). The allocated IC was obtained by one certified urologist, followed by a 15-question test (maximum score, 15) to evaluate objective understanding, and questionnaires on subjective understanding (range, 0~10) and satisfaction (range, 0~10) using a visual analogue scale. Results Demographic characteristics, including age and the highest level of education, did not significantly differ between the two groups. No significant differences were found in scores reflecting the objective understanding of HPS-PVP (9.9±2.3 vs. 10.6±2.8, p=0.332) or in subjective understanding scores (7.5±2.1 vs. 8.6±1.7, p=0.122); however, the M-IC group showed higher satisfaction scores than the W-IC group (7.4±1.7 vs. 8.4±1.5, p=0.033). After adjusting for age and educational level, the M-IC group still had significantly higher satisfaction scores. Conclusions M-IC did not enhance the objective knowledge of patients regarding this surgical procedure. However, it improved the satisfaction of patients with the IC process itself. PMID:27169129

  9. Synchrotron light

    International Nuclear Information System (INIS)

    2001-01-01

    'Synchrotron Light' is an interactive and detailed introduction to the physics and technology of the generation of coherent radiation from accelerators as well as to its widespread high-tech applications in science, medicine and engineering. The topics covered are the interaction of light and matter, the technology of synchrotron light sources, spectroscopy, imaging, scattering and diffraction of X-rays, and applications to materials science, biology, biochemistry, medicine, chemistry, food and pharmaceutical technology. All synchrotron light facilities are introduced with their home-page addresses. 'Synchrotron Light' provides an instructive and comprehensive multimedia learning tool for students, experienced practitioners and novices wishing to apply synchrotron radiation in their future work. Its multiple-entry points permit an easy exploration of the CD-Rom according to the users knowledge and interest. 2-D and 3-D animations and virtual reconstruction with computer-generated images guide visitors into the scientific and technical world of a synchrotron and into the applications of synchrotron radiation. This bilingual (English and French) CD-Rom can be used for self-teaching and in courses at various levels in physics, chemistry, engineering, and biology. (author)

  10. Sharing programming resources between Bio* projects through remote procedure call and native call stack strategies

    DEFF Research Database (Denmark)

    Prins, Pjotr; Goto, Naohisa; Yates, Andrew

    2012-01-01

    Open-source software (OSS) encourages computer programmers to reuse software components written by others. In evolutionary bioinformatics, OSS comes in a broad range of programming languages, including C/C++, Perl, Python, Ruby, Java, and R. To avoid writing the same functionality multiple times...... for different languages, it is possible to share components by bridging computer languages and Bio* projects, such as BioPerl, Biopython, BioRuby, BioJava, and R/Bioconductor. In this chapter, we compare the two principal approaches for sharing software between different programming languages: either by remote...... procedure call (RPC) or by sharing a local call stack. RPC provides a language-independent protocol over a network interface; examples are RSOAP and Rserve. The local call stack provides a between-language mapping not over the network interface, but directly in computer memory; examples are R bindings, RPy...

  11. Staffing to Maximize Profit for Call Centers with Impatient and Repeat-Calling Customers

    Directory of Open Access Journals (Sweden)

    Jun Gong

    2015-01-01

    Full Text Available Motivated by call center practice, we study the optimal staffing of many-server queues with impatient and repeat-calling customers. A call center is modeled as an M/M/s+M queue, which is developed to a behavioral queuing model in which customers come and go based on their satisfaction with waiting time. We explicitly take into account customer repeat behavior, which implies that satisfied customers might return and have an impact on the arrival rate. Optimality is defined as the number of agents that maximize revenues net of staffing costs, and we account for the characteristic that revenues are a direct function of staffing. Finally, we use numerical experiments to make certain comparisons with traditional models that do not consider customer repeat behavior. Furthermore, we indicate how managers might allocate staffing optimally with various customer behavior mechanisms.

  12. Sharing programming resources between Bio* projects through remote procedure call and native call stack strategies.

    Science.gov (United States)

    Prins, Pjotr; Goto, Naohisa; Yates, Andrew; Gautier, Laurent; Willis, Scooter; Fields, Christopher; Katayama, Toshiaki

    2012-01-01

    Open-source software (OSS) encourages computer programmers to reuse software components written by others. In evolutionary bioinformatics, OSS comes in a broad range of programming languages, including C/C++, Perl, Python, Ruby, Java, and R. To avoid writing the same functionality multiple times for different languages, it is possible to share components by bridging computer languages and Bio* projects, such as BioPerl, Biopython, BioRuby, BioJava, and R/Bioconductor. In this chapter, we compare the two principal approaches for sharing software between different programming languages: either by remote procedure call (RPC) or by sharing a local call stack. RPC provides a language-independent protocol over a network interface; examples are RSOAP and Rserve. The local call stack provides a between-language mapping not over the network interface, but directly in computer memory; examples are R bindings, RPy, and languages sharing the Java Virtual Machine stack. This functionality provides strategies for sharing of software between Bio* projects, which can be exploited more often. Here, we present cross-language examples for sequence translation, and measure throughput of the different options. We compare calling into R through native R, RSOAP, Rserve, and RPy interfaces, with the performance of native BioPerl, Biopython, BioJava, and BioRuby implementations, and with call stack bindings to BioJava and the European Molecular Biology Open Software Suite. In general, call stack approaches outperform native Bio* implementations and these, in turn, outperform RPC-based approaches. To test and compare strategies, we provide a downloadable BioNode image with all examples, tools, and libraries included. The BioNode image can be run on VirtualBox-supported operating systems, including Windows, OSX, and Linux.

  13. Lighting and public health.

    NARCIS (Netherlands)

    Ierland, J. van & Schreuder, D.A.

    1969-01-01

    The following topics; are discussed with respect to public health: - the effect of visible and ultraviolet radiation upon man. - vision with respect to lighting. interior lighting. - artificial lighting of work environments. - day light and windows. - recommendations for lighting. public lighting. -

  14. Lighting Design

    DEFF Research Database (Denmark)

    Hansen, Ellen Kathrine; Mullins, Michael

    2014-01-01

    of design developed from three experiments show how distinct qualitative and quantitative criteria in different disciplinary traditions can be integrated successfully, despite disparate technical/scientific, social scientific and art/humanities backgrounds. The model is applied to a pedagogical curriculum......Light as a multi-dimensional design element has fundamental importance for a sustainable environment. The paper discusses the need for an integration of scientific, technical and creative approaches to light and presents theory, methods and applications toward fulfilling this need. A theory...

  15. Pathological aspects of so called "hilar cholangiocarcinoma".

    Science.gov (United States)

    Castellano-Megías, Víctor M; Ibarrola-de Andrés, Carolina; Colina-Ruizdelgado, Francisco

    2013-07-15

    Cholangiocarcinoma (CC) arising from the large intrahepatic bile ducts and extrahepatic hilar bile ducts share clinicopathological features and have been called hilar and perihilar CC as a group. However, "hilar and perihilar CC" are also used to refer exclusively to the intrahepatic hilar type CC or, more commonly, the extrahepatic hilar CC. Grossly, a major distinction can be made between papillary and non-papillary tumors. Histologically, most hilar CCs are well to moderately differentiated conventional type (biliary) carcinomas. Immunohistochemically, CK7, CK20, CEA and MUC1 are normally expressed, being MUC2 positive in less than 50% of cases. Two main premalignant lesions are known: biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the biliary tract (IPNB). IPNB includes the lesions previously named biliary papillomatosis and papillary carcinoma. A series of 29 resected hilar CC from our archives is reviewed. Most (82.8%) were conventional type adenocarcinomas, mostly well to moderately differentiated, although with a broad morphological spectrum; three cases exhibited a poorly differentiated cell component resembling signet ring cells. IPNB was observed in 5 (17.2%), four of them with an associated invasive carcinoma. A clear cell type carcinoma, an adenosquamous carcinoma and two gastric foveolar type carcinomas were observed.

  16. From Systematic Review to Call for Action.

    Science.gov (United States)

    Sawin, Erika Metzler; Sobel, Linda L; Annan, Sandra L; Schminkey, Donna L

    2017-06-01

    Intimate partner violence (IPV) is a global public health and criminal justice concern with significant impacts; especially high rates are seen among rural Hispanic American (HA) communities, the fastest growing population in the United States. They experience additional barriers to care including extreme poverty, lesser education, gender norms, and language and immigration issues. A systematic literature review was conducted using Cooper's framework to identify evidence supporting associations between interventions and prevention, reduction, and elimination of IPV among rural HA women. Searches conducted on databases including CINAHL, PubMed, Medline, Women's Studies International, MedicLatina, and JSTOR used the MeSH terms Hispanic Americans (Latino/a and Hispanic), domestic violence, and intimate partner violence. Selected studies were published between January 1, 2000, and January 1, 2014. Of the 617 yielded articles, only 6 met the inclusion criteria. Of these, none closely examined rurality or provided valid and reliable measures of outcomes, instead reporting program descriptions and suggested interventions. We identify key findings to guide program, screening, and tool development. Our study identifies a gap in knowledge, research, and effective practices and issues a call for action to create evidence-based tools to prevent, reduce, and eliminate IPV in these underserved populations.

  17. REMINDER: In a medical emergency call 74444

    CERN Multimedia

    2005-01-01

    What happened? A CERN colleague, complaining of pains that might indicate serious heart problem, went to the ?infirmary' on the Prévessin site for medical aid. He was unaware that the ?infirmary' was in fact no such thing, but the office of the French contractors' medical practitioner, and, on top of that, it was closed. He therefore took his own car and went to the CERN Fire Station on the Meyrin Site (Building 65). The firemen and the CERN medical team took care of him and requested helicopter transport to the Geneva cantonal hospital, where he responded well to medical treatment. What do we learn from this event? You must call the CERN internal number 74444 in the event of serious and acute illness, and do not have to present yourself in person or get somebody to go with you. This number is not reserved exclusively for accident, pollution, fire etc. The Firemen can prodice professional assistance at all times as required: first aid on the spot, amulance transport and medical assistance as necessary. ...

  18. Individual and contextual variation in Thomas langur male loud calls

    NARCIS (Netherlands)

    Wich, S.A.; Koski, S.; Vries, Han de; Schaik, Carel P. van

    2003-01-01

    Individual and contextual differences in male loud calls of wild Thomas langurs (Presbytis thomasi) were studied in northern Sumatra, Indonesia. Loud calls were given in the following contexts: morning calls, vocal responses to other groups, between-group encounter calls and alarmcalls. Loud

  19. Linking Calling Orientations to Organizational Attachment via Organizational Instrumentality

    Science.gov (United States)

    Cardador, M. Teresa; Dane, Erik; Pratt, Michael G.

    2011-01-01

    Despite an emerging interest in callings, researchers know little about whether calling orientations matter in the workplace. We explore the under-examined relationship between a calling orientation and employees' attachment to their organizations. Although some theory suggests that callings may be negatively related to organizational attachment,…

  20. Calling under pressure: short-finned pilot whales make social calls during deep foraging dives.

    Science.gov (United States)

    Jensen, Frants H; Perez, Jacobo Marrero; Johnson, Mark; Soto, Natacha Aguilar; Madsen, Peter T

    2011-10-22

    Toothed whales rely on sound to echolocate prey and communicate with conspecifics, but little is known about how extreme pressure affects pneumatic sound production in deep-diving species with a limited air supply. The short-finned pilot whale (Globicephala macrorhynchus) is a highly social species among the deep-diving toothed whales, in which individuals socialize at the surface but leave their social group in pursuit of prey at depths of up to 1000 m. To investigate if these animals communicate acoustically at depth and test whether hydrostatic pressure affects communication signals, acoustic DTAGs logging sound, depth and orientation were attached to 12 pilot whales. Tagged whales produced tonal calls during deep foraging dives at depths of up to 800 m. Mean call output and duration decreased with depth despite the increased distance to conspecifics at the surface. This shows that the energy content of calls is lower at depths where lungs are collapsed and where the air volume available for sound generation is limited by ambient pressure. Frequency content was unaffected, providing a possible cue for group or species identification of diving whales. Social calls may be important to maintain social ties for foraging animals, but may be impacted adversely by vessel noise.

  1. Hypothermia for Stroke: call to action 2010

    DEFF Research Database (Denmark)

    Macleod, Malcolm R; Petersson, Jesper; Norrving, Bo

    2010-01-01

    The European Hypothermia Stroke Research Workshop was held in January 2010, in response to the alarming prospects of a significant increase of stroke expected in the coming years globally. Considering that a minority of patients (around 10%) are currently eligible for thrombolytic treatment, ther...

  2. LIGHT TITRATIONS

    Science.gov (United States)

    Field, John; Baas-Becking, Lourens G. M.

    1926-01-01

    1. The usefulness of the radiomicrometer in titration work has been pointed out. The authors suggest that light titration may also be used where a reaction mixture changes its absorption in the (near) infra-red. 2. The applicability of this method to the starch-iodine reaction has been demonstrated. PMID:19872266

  3. Barriers and opportunities in assessing calls to emergency medical communication centre--a qualitative study.

    Science.gov (United States)

    Lindström, Veronica; Heikkilä, Kristiina; Bohm, Katarina; Castrèn, Maaret; Falk, Ann-Charlotte

    2014-11-11

    Previous studies have described the difficulties and the complexity of assessing an emergency call, and assessment protocols intended to support the emergency medical dispatcher's (EMD) assessment have been developed and evaluated in recent years. At present, the EMD identifies about 50-70 % of patients suffering from cardiac arrest, acute myocardial infarction or stroke. The previous research has primarily been focused on specific conditions, and it is still unclear whether there are any overall factors that may influence the assessment of the call to the emergency medical communication centre (EMCC). The aim of the study was to identify overall factors influencing the registered nurses' (RNs) assessment of calls to the EMCC. A qualitative study design was used; a purposeful selection of calls to the EMCC was analysed by content analysis. One hundred calls to the EMCC were analysed. Barriers and opportunities related to the RN or the caller were identified as the main factors influencing the RN's assessment of calls to the EMCC. The opportunities appeared in the callers' symptom description and the communication strategies used by the RN. The barriers appeared in callers' descriptions of unclear symptoms, paradoxes and the RN's lack of communication strategies during the call. Barriers in assessing the call to the EMCC were associated with contradictory information, the absence of a primary problem, or the structure of the call. Opportunities were associated with a clear symptom description that was also repeated, and the RN's use of different communication strategies such as closed loop communication.

  4. Optimal scheduling in call centers with a callback option

    OpenAIRE

    Legros , Benjamin; Jouini , Oualid; Koole , Ger

    2016-01-01

    International audience; We consider a call center model with a callback option, which allows to transform an inbound call into an outbound one. A delayed call, with a long anticipated waiting time, receives the option to be called back. We assume a probabilistic customer reaction to the callback offer (option). The objective of the system manager is to characterize the optimal call scheduling that minimizes the expected waiting and abandonment costs. For the single-server case, we prove that ...

  5. Perfect Lighting for Facial Photography in Aesthetic Surgery: Ring Light.

    Science.gov (United States)

    Dölen, Utku Can; Çınar, Selçuk

    2016-04-01

    Photography is indispensable for plastic surgery. On-camera flashes can result in bleached out detail and colour. This is why most of the plastic surgery clinics prefer studio lighting similar to professional photographers'. In this article, we want to share a simple alternative to studio lighting that does not need extra space: Ring light. We took five different photographs of the same person with five different camera and lighting settings: Smartphone and ring light; point and shoot camera and on-camera flash; point and shoot camera and studio lighting; digital single-lens reflex (DLSR) camera and studio lighting; DSLR and ring light. Then, those photographs were assessed objectively with an online survey of five questions answered by three distinct populations: plastic surgeons (n: 28), professional portrait photographers (n: 24) and patients (n: 22) who had facial aesthetic procedures. Compared to the on-camera flash, studio lighting better showed the wrinkles of the subject. The ring light facilitated the perception of the wrinkles by providing homogenous soft light in a circular shape rather than bursting flashes. The combination of a DSLR camera and ring light gave the oldest looking subject according to 64 % of responders. The DSLR camera and the studio lighting demonstrated the youngest looking subject according to 70 % of the responders. The majority of the responders (78 %) chose the combination of DSLR camera and ring light that exhibited the wrinkles the most. We suggest using a ring light to obtain well-lit photographs without loss of detail, with any type of cameras. However, smartphones must be avoided if standard pictures are desired. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  6. Differential effects of treatment with UV-light (365 nm) and 8-methoxypsoralen on chromosomes of healthy persons and psoriatic patients

    International Nuclear Information System (INIS)

    Loeber, G.; Kittler, L.

    1986-01-01

    The effect of 8-methoxypsoralen (8-MOP, 5 x 10 -5 M), near UV-light of 365 nm wavelength (UVA, 1.5 J/cm 2 ) and the combination of both (PUVA treatment) were studied on lymphocytes in vitro taken from healthy persons and patients with psoriasis vulgaris and psoriasis arthritis (psoriasis arthropathica). Chromosomes isolated from cell nuclei were visualized by means of Giemsa staining technique and analyzed for induction of chromosomal defects, i.e. premature centromere division (PCD), major coiling (MC), and formation of gaps and fragile sites. Exposure of nonpsoriatic lymphocytes to 8-MOP, UVA or PUVA increased the rate of PCD or MC generation. In experiments with psoriatic lymphocytes a much weaker effect was found, with a moderate increase of PCD and MC after UVA or PUVA treatment in the case of psoriasis vulgaris, and of MC after UVA treatment of psoriasis arthritis. On the average the number of chromosomes per metaphase plate displaying PCD did not exceed 10. No indication was obtained for the preference of certain chromosome groups or the appearance of 'fragile sites'. Under all experimental conditions the number of chromosome gaps ranged in the order of their spontaneous induction. The findings suggest PCD and MC investigations as possible sensitive tools for diagnosing latent psoriasis and for refined analysis of psoriatic cells or chromosomes. (author)

  7. Ultraviolet light and cutaneous lupus

    NARCIS (Netherlands)

    Bijl, Marc; Kallenberg, Cees G. M.

    2006-01-01

    Exposure to ultraviolet (UV) light is one of the major factors known to trigger cutaneous disease activity in (systemic) lupus erythematosus patients. UV light, UVB in particular, is a potent inducer of apoptosis. Currently, disturbed clearance of apoptotic cells is one of the concepts explaining

  8. Indoor Lighting Facilities

    Science.gov (United States)

    Matsushima, Koji; Saito, Yoshinori; Ichikawa, Shigenori; Kawauchi, Takao; Tanaka, Tsuneo; Hirano, Rika; Tazuke, Fuyuki

    According to the statistics by the Ministry of Land, Infrastructure and Transport, the total floor space of all building construction started was 188.87 million m2 (1.5% increase y/y), marking the fourth straight year of increase. Many large-scale buildings under construction in central Tokyo become fully occupied by tenants before completion. As for office buildings, it is required to develop comfortable and functional office spaces as working styles are becoming more and more diversified, and lighting is also an element of such functionalities. The total floor space of construction started for exhibition pavilions, multipurpose halls, conference halls and religious architectures decreased 11.1% against the previous year. This marked a decline for 10 consecutive years and the downward trend continues. In exhibition pavilions, the light radiation is measured and adjusted throughout the year so as not to damage the artworks by lighting. Hospitals, while providing higher quality medical services and enhancing the dwelling environment of patients, are expected to meet various restrictions and requirements, including the respect for privacy. Meanwhile, lighting designs for school classrooms tend to be homogeneous, yet new ideas are being promoted to strike a balance between the economical and functional aspects. The severe economic environment continues to be hampering the growth of theaters and halls in both the private and public sectors. Contrary to the downsizing trend of such facilities, additional installations of lighting equipment were conspicuous, and the adoption of high efficacy lighting appliances and intelligent function control circuits are becoming popular. In the category of stores/commercial facilities, the construction of complex facilities is a continuing trend. Indirect lighting, high luminance discharge lamps with excellent color rendition and LEDs are being effectively used in these facilities, together with the introduction of lighting designs

  9. Young doctors' problem solving strategies on call may be improved.

    Science.gov (United States)

    Michelsen, Jens; Malchow-Møller, Axel; Charles, Peder; Eika, Berit

    2013-03-01

    The first year following graduation from medical school is challenging as learning from books changes to workplace-based learning. Analysis and reflection on experience may ease this transition. We used Significant Event Analysis (SEA) as a tool to explore what pre-registration house officers (PRHOs) consider successful and problematic events, and to identify what problem-solving strategies they employ. A senior house officer systematically led the PRHO through the SEA of one successful and one problematic event following a night call. The PRHO wrote answers to questions about diagnosis, what happened, how he or she contributed and what knowledge-gaining activities the PRHO would prioritise before the next call. By using an inductive, thematic data analysis, we identified five problem-solving strategies: non-analytical reasoning, analytical reasoning, communication with patients, communication with colleagues and professional behaviour. On average, 1.5 strategies were used in the successful events and 1.2 strategies in the problematic events. Most PRHOs were unable to suggest activities other than reading textbooks. SEA was valuable for the identification of PRHOs' problem-solving strategies in a natural setting. PRHOs should be assisted in increasing their repertoire of strategies, and they should also be helped to "learn to learn" as they were largely unable to point to new learning strategies. not relevant. not relevant.

  10. Light shining through walls

    International Nuclear Information System (INIS)

    Redondo, Javier; Ringwald, Andreas

    2010-11-01

    Shining light through walls? At first glance this sounds crazy. However, very feeble gravitational and electroweak effects allow for this exotic possibility. Unfortunately, with present and near future technologies the opportunity to observe light shining through walls via these effects is completely out of question. Nevertheless there are quite a number of experimental collaborations around the globe involved in this quest. Why are they doing it? Are there additional ways of sending photons through opaque matter? Indeed, various extensions of the standard model of particle physics predict the existence of new particles called WISPs - extremely weakly interacting slim particles. Photons can convert into these hypothetical particles, which have no problems to penetrate very dense materials, and these can reconvert into photons after their passage - as if light was effectively traversing walls. We review this exciting field of research, describing the most important WISPs, the present and future experiments, the indirect hints from astrophysics and cosmology pointing to the existence of WISPs, and finally outlining the consequences that the discovery of WISPs would have. (orig.)

  11. Light shining through walls

    Energy Technology Data Exchange (ETDEWEB)

    Redondo, Javier [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Max-Planck-Institut fuer Physik, Muenchen (Germany); Ringwald, Andreas [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2010-11-15

    Shining light through walls? At first glance this sounds crazy. However, very feeble gravitational and electroweak effects allow for this exotic possibility. Unfortunately, with present and near future technologies the opportunity to observe light shining through walls via these effects is completely out of question. Nevertheless there are quite a number of experimental collaborations around the globe involved in this quest. Why are they doing it? Are there additional ways of sending photons through opaque matter? Indeed, various extensions of the standard model of particle physics predict the existence of new particles called WISPs - extremely weakly interacting slim particles. Photons can convert into these hypothetical particles, which have no problems to penetrate very dense materials, and these can reconvert into photons after their passage - as if light was effectively traversing walls. We review this exciting field of research, describing the most important WISPs, the present and future experiments, the indirect hints from astrophysics and cosmology pointing to the existence of WISPs, and finally outlining the consequences that the discovery of WISPs would have. (orig.)

  12. Light Sources and Lighting Circuits

    Science.gov (United States)

    Honda, Hisashi; Suwa, Takumi; Yasuda, Takeo; Ohtani, Yoshihiko; Maehara, Akiyoshi; Okada, Atsunori; Komatsu, Naoki; Mannami, Tomoaki

    According to the Machinery Statistics of the Ministry of Economy, Trade and Industry, the production of incandescent lamps in Japan in 2007 was 990 million units (90.0% of the previous year's total), in which the production of incandescent lamps for general lighting was 110 million units (90.0% of the previous year's total) and of tungsten-halogen lamps was 44 million units (96.6% of the previous year's total). The production of fluorescent lamps was 927 million units (93.9% of the previous year's total), in which general fluorescent lamps, excluding those for LCD back lighting, was 320 million units (87.2% of the previous year's total). Also, the production of HID lamps was 10 million units (101.5% of the previous year's total). On the other hand, when the numbers of sales are compared with the sales of the previous year, incandescent lamps for general use was 99.8%, tungsten-halogen lamps was 96.9%, fluorescent lamps was 95.9%, and HID lamps was 98.9%. Self-ballasted fluorescent lamps alone showed an increase in sales as strong as 29 million units, or 121.7% of the previous year's sales. It is considered that the switchover of incandescent lamps to HID lamps was promoted for energy conservation and carbon dioxide reduction with the problem of global warming in the background. In regard to exhibitions, Lighting Fair 2007 was held in Tokyo in March, and LIGHTFAIR INTERNATIONAL 2007 was held in New York in May. Regarding academic conferences, LS:11 (the 11th International Symposium on the Science & Technology of Light Sources) was held in Shanghai in May, and the First International Conference on White LEDs and Solid State Lighting was held in Tokyo in November. Both conferences suggested that there are strong needs and concerns now about energy conservation, saving natural resources, and restrictions of hazardous materials. In regard to incandescent lamps, the development of products aiming at higher efficacy, electric power savings, and longer life was advanced by

  13. Call for Papers: Photonics in Switching

    Science.gov (United States)

    Wosinska, Lena; Glick, Madeleine

    2006-04-01

    Call for Papers: Photonics in Switching Guest Editors: Lena Wosinska, Royal Institute of Technology (KTH) / ICT Sweden Madeleine Glick, Intel Research, Cambridge, UK Technologies based on DWDM systems allow data transmission with bit rates of Tbit/s on a single fiber. To facilitate this enormous transmission volume, high-capacity and high-speed network nodes become inevitable in the optical network. Wideband switching, WDM switching, optical burst switching (OBS), and optical packet switching (OPS) are promising technologies for harnessing the bandwidth of WDM optical fiber networks in a highly flexible and efficient manner. As a number of key optical component technologies approach maturity, photonics in switching is becoming an increasingly attractive and practical solution for the next-generation of optical networks. The scope of this special issue is focused on the technology and architecture of optical switching nodes, including the architectural and algorithmic aspects of high-speed optical networks. Scope of Submission The scope of the papers includes, but is not limited to, the following topics: WDM node architectures Novel device technologies enabling photonics in switching, such as optical switch fabrics, optical memory, and wavelength conversion Routing protocols WDM switching and routing Quality of service Performance measurement and evaluation Next-generation optical networks: architecture, signaling, and control Traffic measurement and field trials Optical burst and packet switching OBS/OPS node architectures Burst/Packet scheduling and routing algorithms Contention resolution/avoidance strategies Services and applications for OBS/OPS (e.g., grid networks, storage-area networks, etc.) Burst assembly and ingress traffic shaping Hybrid OBS/TDM or OBS/wavelength routing Manuscript Submission To submit to this special issue, follow the normal procedure for submission to JON and select ``Photonics in Switching' in the features indicator of the online

  14. Geneva calling: WHO resolution on mental disorders

    Directory of Open Access Journals (Sweden)

    Barbui Corrado

    2012-06-01

    Full Text Available Abstract Background A new resolution on mental, neurological and substance use disorders was adopted in January 2012 by the World Health Organization (WHO Executive Board. The resolution urges WHO and Member States to collaborate in the development of a comprehensive mental health action plan, to be submitted for discussion and approval to the WHO World Health Assembly. This commentary aims at rising awareness on the risk that this resolution may not fulfil its potential. Discussion Lack of political awareness and visibility of the resolution is a first major issue. Theoretically, Member States should be aware of the resolution and support its implementation at their respective national level, but in practice political commitment may not be high enough, and technical and financial resources made available may be limited. A second challenge is that the resolution suggests to work with Member States and technical agencies to promote academic exchange through which to contribute to policy-making in mental health. It is not straightforward, however, how such a statement may be effectively translated into action. A third key methodological aspect is how scientific evidence and factors other than scientific evidence will be handled. This seems particularly relevant in the field of mental health, where value-based decisions together with resource and feasibility considerations may be unavoidable. Summary We argue that WHO and Member States should work together to increase the visibility of the resolution, ensuring that Ministries of Health and other relevant components of the health systems are aware of the resolution and its implications. As the resolution urges for academic exchange, WHO should develop a plan for an explicit, inclusive and open call for support and collaboration, so that partners willing to contribute are not kept out from the process. The production of an action plan for mental disorders should be based on scientifically sound

  15. Sculpting light for contemporary biophotonics

    DEFF Research Database (Denmark)

    Glückstad, Jesper

    DTUs IPR portfolio on so-­‐called Generalized Phase Contrast (GPC) covers a family of powerful “light-­‐engine” approaches for generating speckle-­‐free contiguous optical distributions using advanced spatial phase modulation. GPC has been used in applications such as optical trapping and manipul......DTUs IPR portfolio on so-­‐called Generalized Phase Contrast (GPC) covers a family of powerful “light-­‐engine” approaches for generating speckle-­‐free contiguous optical distributions using advanced spatial phase modulation. GPC has been used in applications such as optical trapping...... and manipulation, active microscopy, structured illumination, optical security, parallel laser marking trials and recently in contemporary biophotonics applications such as for real-­‐time parallel two-­‐photon optogenetics and neurophotonics. Our most recent GPC light sculpting developments geared towards...... these applications will be presented. This includes both a static and a dynamic GPC Light Shaper implementation based on our latest theoretical derivations to demonstrate the benefits for typical applications where lasers have to be actively shaped into particular light patterns. We then show the potential of GPC...

  16. Green lights

    DEFF Research Database (Denmark)

    Fisker, Peter Kielberg

    This study investigates the effect of drought on economic activity globally using remote sensing data. In particular, predicted variation in greenness is correlated with changes in the density of artificial light observed at night on a grid of 0.25 degree latitude-longitude pixels. I define drought...... as greenness estimated by lagged variation in monthly rainfall and temperature. This definition of drought performs well in identifying self-reported drought events since 2000 compared with measures of drought that do not take greenness into account, and the subsequent analysis indicates that predicted...... variation in greenness is positively associated with year-on-year changes in luminosity: If a unit of observation experiences a predicted variation in greenness that lies 1 standard deviation below the global mean, on average 1.5 - 2.5 light pixels out of 900 are extinguished that year. Finally, an attempt...

  17. Calling under pressure: Short-finned pilot whales make social calls during deep foraging dives

    DEFF Research Database (Denmark)

    Jensen, Frants Havmand; Marrero Perez, Jacobo; Johnson, Mark

    2011-01-01

    Toothed whales rely on sound to echolocate prey and communicate with conspecifics, but little is known about how extreme pressure affects pneumatic sound production in deep-diving species with a limited air supply. The short-finned pilot whale (Globicephala macrorhynchus) is a highly social species...... among the deep-diving toothed whales, in which individuals socialize at the surface but leave their social group in pursuit of prey at depths of up to 1000 m. To investigate if these animals communicate acoustically at depth and test whether hydrostatic pressure affects communication signals, acoustic...... DTAGs logging sound, depth and orientation were attached to 12 pilot whales. Tagged whales produced tonal calls during deep foraging dives at depths of up to 800 m. Mean call output and duration decreased with depth despite the increased distance to conspecifics at the surface. This shows...

  18. What was Glaucoma Called Before the 20th Century?

    Science.gov (United States)

    Leffler, Christopher T.; Schwartz, Stephen G.; Giliberti, Francesca M.; Young, Matthew T.; Bermudez, Dennis

    2015-01-01

    Glaucoma involves a characteristic optic neuropathy, often with elevated intraocular pressure. Before 1850, poor vision with a normal eye appearance, as occurs in primary open-angle glaucoma, was termed amaurosis, gutta serena, or black cataract. Few observers noted palpable hardness of the eye in amaurosis. On the other hand, angle-closure glaucoma can produce a green or gray pupil, and therefore was called, variously, glaucoma (derived from the Greek for glaucous, a nonspecific term connoting blue, green, or light gray) and viriditate oculi. Angle closure, with palpable hardness of the eye, mydriasis, and anterior prominence of the lens, was described in greater detail in the 18th and 19th centuries. The introduction of the ophthalmoscope in 1850 permitted the visualization of the excavated optic neuropathy in eyes with a normal or with a dilated greenish-gray pupil. Physicians developed a better appreciation of the role of intraocular pressure in both conditions, which became subsumed under the rubric “glaucoma”. PMID:26483611

  19. Errors in dentistry: a call for apology.

    Science.gov (United States)

    Schwartz, Barry

    2005-01-01

    Bad outcomes occur in dentistry and sometimes these are the results of dental errors. In both cases, this essay will argue that apologies are very important in maintaining a relationship with the patient that is based on trust and mutual respect. Nevertheless, apologies are often not forthcoming in dentistry for a number of reasons that deserve careful examination. In particular, the dentist's fear that an apology will increase the risk of legal harm will be critiqued. Ethical and psychological reasons for making an apology will be discussed, and strategies to assist clinicians in making an apology will be offered.

  20. No Call for Action? Why There Is No Union (Yet in Philippine Call Centers

    Directory of Open Access Journals (Sweden)

    Niklas Reese

    2013-01-01

    Full Text Available This contribution presents findings from a qualitative study which focused on young urban professionals in the Philippines who work(ed in international call centers – workplaces usually characterized by job insecurity and other forms of precarity, factory-like working conditions, and disembeddedness. Nevertheless, trade unions in these centers have not come into existence. Why collective action is not chosen by call center agents as an option to tackle the above mentioned problems – this is what the research project this article is based on tried to understand. After outlining some workrelated problems identified by Filipino call center agents, the article will focus on the strategies the agents employ to counter these problems (mainly accommodation and everyday resistance. By highlighting five objective and five subjective reasons (or reasons by circumstances and reasons by framing, we conclude that it is not repressive regulation policies, but rather the formative power and the internalization of discourses of rule within individual life strategies that are preventing the establishment of unions and other collective action structures.

  1. Using Semantic Similarity In Automated Call Quality Evaluator For Call Centers

    Directory of Open Access Journals (Sweden)

    Ria A. Sagum

    2015-08-01

    Full Text Available Conversation between the agent and client are being evaluated manually by a quality assurance officer QA. This job is only one of the responsibilities being done by a QA and particularly eat ups a lot of time for them which lead to late evaluation results that may cause untimely response of the company to concerns raised by their clients. This research developed an application software that automates and evaluates the quality assurance in business process outsourcing companies or customer service management implementing sentence similarity. The developed system includes two modules speaker diarization which includes transcription and question and answer extraction and similarity checker which checks the similarity between the extracted answer and the answer of the call center agent to a question. The system was evaluated for Correctness of the extracted answers and accurateness of the evaluation for a particular call. Audio conversations were tested for the accuracy of the transcription module which has an accuracy of 27.96. The Precision Recall and F-measure of the extracted answer was tested as 78.03 96.26 and 86.19 respectively. The Accuracy of the system in evaluating a call is 70.

  2. Survival as medical registrar on call: remember the doughnut.

    Science.gov (United States)

    Blayney, Sarah; Crowe, Alexander; Bray, Dominic

    2014-10-01

    Life as a medical registrar presents many challenges and concern is growing that a downwards trend in recruitment to General Medicine is the direct result of a perception by junior doctors that the role of the medical registrar is excessively demanding and results in poor work-life balance. A solution-focused approach (SFA) can be used successfully to find a satisfying outcome for both registrar and patient in many of the situations encountered during an on-call, as well as carrying over benefits into life outside of work. We explore the origins of SFA and the ways in which it can be successfully applied to clinical medicine, providing case studies from the author's own experience to illustrate the principles of this way of thinking. © 2014 Royal College of Physicians.

  3. [A call for qualitative research in Orthodontics].

    Science.gov (United States)

    Yitschaky, O; Hofnung, T; Zini, A

    2015-01-01

    Qualitative research is an umbrella term for an array of attitudes and strategies for conducting inquiries that are aimed at discerning how human beings understand, experience, and interpret the social world. It is employed in many different academic disciplines most particularly in the social sciences and humanities, however recently more and more qualitative research is being conducted under the medical sciences including dentistry and orthodontics. This is due to its nature of in-depth investigation, which can provide answers to questions that cannot be satisfactorily answered using quantitative methods alone. The aims of this article are to discuss the characteristics of qualitative research, to review the orthodontic English literature, and to highlight the advantages of qualitative research in orthodontics. The literature review yielded several important conclusions regarding qualitative research in orthodontics: 1. most of the qualitative research done in orthodontics chose to use semi structured in-depth interviews for data collection; 2. qualitative research highlights aspects that are very important, and sometimes crucial to everyday practice and long term treatment; 3. there is a lack of qualitative studies in the field of orthodontics. Taking into account the nature of the orthodontic treatment, which is a prolonged one, demanding of a good orthodontist-patient rapport, and a wide perspective on behalf of the clinician, filling the gap in the discipline through conducting more qualitative studies aimed at understanding the point of view of the patient, as well as that of the clinician, may be beneficial for the improvement of the treatment.

  4. Recognising out-of-hospital cardiac arrest during emergency calls increases bystander cardiopulmonary resuscitation and survival

    DEFF Research Database (Denmark)

    Viereck, Søren; Møller, Thea Palsgaard; Ersbøll, Annette Kjær

    2017-01-01

    BACKGROUND: Initiation of early bystander cardiopulmonary resuscitation (CPR) depends on bystanders' or medical dispatchers' recognition of out-of-hospital cardiac arrest (OHCA). The primary aim of our study was to investigate if OHCA recognition during the emergency call was associated...... with bystander CPR, return of spontaneous circulation (ROSC), and 30-day survival. Our secondary aim was to identify patient-, setting-, and dispatcher-related predictors of OHCA recognition. METHODS: We performed an observational study of all OHCA patients' emergency calls in the Capital Region of Denmark from...... the association between OHCA recognition and bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of OHCA recognition. RESULTS: We included 779 emergency calls in the analyses. During the emergency calls, 70.1% (n=534) of OHCAs were recognised...

  5. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre

    DEFF Research Database (Denmark)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte

    2018-01-01

    with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. DISCUSSION: We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered......BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We...... records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. RESULTS: Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15...

  6. New degradation call admission control for increasing WCDMA system capacity

    Institute of Scientific and Technical Information of China (English)

    Liu Ningqing; Lu Zhi; Gu Xuemai

    2006-01-01

    Propose a new degradation call admission control(DCAC)scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call's access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls' blocking probability and increase the total number of the on-line users.

  7. Sleep and recovery in physicians on night call: a longitudinal field study

    Directory of Open Access Journals (Sweden)

    Malmberg Birgitta

    2010-08-01

    Full Text Available Abstract Background It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call. Methods Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons. Results Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p Conclusions Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers.

  8. Distinct neural and neuromuscular strategies underlie independent evolution of simplified advertisement calls.

    Science.gov (United States)

    Leininger, Elizabeth C; Kelley, Darcy B

    2013-04-07

    Independent or convergent evolution can underlie phenotypic similarity of derived behavioural characters. Determining the underlying neural and neuromuscular mechanisms sheds light on how these characters arose. One example of evolutionarily derived characters is a temporally simple advertisement call of male African clawed frogs (Xenopus) that arose at least twice independently from a more complex ancestral pattern. How did simplification occur in the vocal circuit? To distinguish shared from divergent mechanisms, we examined activity from the calling brain and vocal organ (larynx) in two species that independently evolved simplified calls. We find that each species uses distinct neural and neuromuscular strategies to produce the simplified calls. Isolated Xenopus borealis brains produce fictive vocal patterns that match temporal patterns of actual male calls; the larynx converts nerve activity faithfully into muscle contractions and single clicks. In contrast, fictive patterns from isolated Xenopus boumbaensis brains are short bursts of nerve activity; the isolated larynx requires stimulus bursts to produce a single click of sound. Thus, unlike X. borealis, the output of the X. boumbaensis hindbrain vocal pattern generator is an ancestral burst-type pattern, transformed by the larynx into single clicks. Temporally simple advertisement calls in genetically distant species of Xenopus have thus arisen independently via reconfigurations of central and peripheral vocal neuroeffectors.

  9. Two-state Markov-chain Poisson nature of individual cellphone call statistics

    Science.gov (United States)

    Jiang, Zhi-Qiang; Xie, Wen-Jie; Li, Ming-Xia; Zhou, Wei-Xing; Sornette, Didier

    2016-07-01

    Unfolding the burst patterns in human activities and social interactions is a very important issue especially for understanding the spreading of disease and information and the formation of groups and organizations. Here, we conduct an in-depth study of the temporal patterns of cellphone conversation activities of 73 339 anonymous cellphone users, whose inter-call durations are Weibull distributed. We find that the individual call events exhibit a pattern of bursts, that high activity periods are alternated with low activity periods. In both periods, the number of calls are exponentially distributed for individuals, but power-law distributed for the population. Together with the exponential distributions of inter-call durations within bursts and of the intervals between consecutive bursts, we demonstrate that the individual call activities are driven by two independent Poisson processes, which can be combined within a minimal model in terms of a two-state first-order Markov chain, giving significant fits for nearly half of the individuals. By measuring directly the distributions of call rates across the population, which exhibit power-law tails, we purport the existence of power-law distributions, via the ‘superposition of distributions’ mechanism. Our findings shed light on the origins of bursty patterns in other human activities.

  10. Photosynthetic efficiency of Chlamydomonas reinhardtii in attenuated, flashing light

    NARCIS (Netherlands)

    Vejrazka, C.; Janssen, M.G.J.; Streefland, M.; Wijffels, R.H.

    2012-01-01

    As a result of mixing and light attenuation, algae in a photobioreactor (PBR) alternate between light and dark zones and, therefore, experience variations in photon flux density (PFD). These variations in PFD are called light/dark (L/D) cycles. The objective of this study was to determine how these

  11. A Call for Saving Interdisciplinary Pain Management.

    Science.gov (United States)

    Ruan, Xiulu; Kaye, Alan David

    2016-12-01

    Chronic pain is pervasive and costly. In 2011, the Institute of Medicine (IOM) released a landmark report on chronic pain, which estimated that more than 100 million Americans suffer from chronic pain, making pain a major and significant public health problem. The benefits of interdisciplinary pain management programs are undeniable and have been demonstrated for over a half century. Until health care leaders and other stakeholders such as insurers work together to ensure best practices in pain management, we will certainly end up in a lose-lose situation for both the health care teams and patients. In order to impact health care policy more effectively, we need to better understand the politics of health policy decision making. J Orthop Sports Phys Ther 2016;46(12):1021-1023. doi:10.2519/jospt.2016.0611.

  12. Effectiveness of the Call in Beach Volleyball Attacking Play

    Directory of Open Access Journals (Sweden)

    Künzell Stefan

    2014-12-01

    Full Text Available In beach volleyball the setter has the opportunity to give her or his hitter a “call”. The call intends that the setter suggests to her or his partner where to place the attack in the opponent’s court. The effectiveness of a call is still unknown. We investigated the women’s and men’s Swiss National Beach Volleyball Championships in 2011 and analyzed 2185 attacks. We found large differences between female and male players. While men called in only 38.4% of attacks, women used calls in 85.5% of attacks. If the male players followed a given call, 63% of the attacks were successful. The success rate of attacks without any call was 55.8% and 47.6% when the call was ignored. These differences were not significant (χ2(2 = 4.55, p = 0.103. In women’s beach volleyball, the rate of successful attacks was 61.5% when a call was followed, 35% for attacks without a call, and 42.6% when a call was ignored. The differences were highly significant (χ2(2 = 23.42, p < 0.0005. Taking into account the findings of the present study, we suggested that the call was effective in women’s beach volleyball, while its effect in men’s game was unclear. Considering the quality of calls we indicate that there is a significant potential to increase the effectiveness of a call.

  13. Cell Phone Calls in the Operating Theater and Staff Distractions: An Observational Study.

    Science.gov (United States)

    Avidan, Alexander; Yacobi, Galel; Weissman, Charles; Levin, Phillip D

    2017-01-09

    Cell phones are the primary communication tool in our institution. There are no restrictions on their use in the operating rooms. The goal of this study was to evaluate the extent of cell phone use in the operating rooms during elective surgery and to evaluate whether they cause staff distractions. The following data on cell phone use were recorded anonymously: number of incoming and outgoing cell phone calls, duration of cell phone calls and their content (patient related, work related, private), who was distracted by the cell phone calls, and duration of distractions. We made observations during 52 surgeries. There were 205 cell phone calls, 197 (96.1%; median, 3 per surgery; interquartile range, 2-5) incoming and 8 (3.9%) outgoing. Incoming calls were answered on 110 (55.8%) of 197 (median, 2; interquartile range, 1-3) occasions. The mean duration of incoming calls (64 ± 40 seconds) was shorter than those of the outgoing calls (137 ± 242 seconds, P cell phone calls in the operating rooms during elective surgery was lower than expected and caused short-lived distractions mainly to the operating surgeons. We recommend that operating surgeons turn off their cell phones before surgery.

  14. Incidence and outcome of patients starting renal replacement therapy for end-stage renal disease due to multiple myeloma or light-chain deposit disease: an ERA-EDTA Registry study

    DEFF Research Database (Denmark)

    Tsakiris, D.J.; Stel, V.S.; Finne, P.

    2010-01-01

    Background. Information on demographics and survival of patients starting renal replacement therapy (RRT) for end-stage renal disease (ESRD) due to multiple myeloma (MM) or light-chain deposit disease (LCDD) is scarce. The aim of this study was to describe the incidence, characteristics, causes...... causes (non-MM) was observed overtime. Patient survival on RRT was examined, unadjusted and adjusted for age and gender. Results. Of the 159 637 patients on RRT, 2453 (1.54%) had MM or LCDD. The incidence of RRT for ESRD due to MM or LCDD, adjusted for age and gender, increased from 0.70 pmp in 1986...

  15. Handbook of industrial lighting

    CERN Document Server

    Lyons, Stanley L

    2013-01-01

    Handbook of Industrial Lighting is a practical guide on the specification, design, installation, operation, and maintenance of lighting in industrial premises. Coverage of the book includes the importance of good localized lighting; the different lighting schemes; lighting for difficult visual tasks; lighting in consideration to safety; and emergency lighting. The book also includes the practical, thermal, ventilation, and energy considerations; lighting in different environments; maintenance of lighting installations; and the cost benefits of efficient lighting. Appendices include useful info

  16. Call for concept notes: Research on Myanmar's decentralization and ...

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

    ... are launching this research call under a new initiative called Knowledge for ... Over the decades of military rule, information sharing, research, and freedom of ... Research outputs would take the form of working papers for peer-review and ...

  17. TPMG Northern California appointments and advice call center.

    Science.gov (United States)

    Conolly, Patricia; Levine, Leslie; Amaral, Debra J; Fireman, Bruce H; Driscoll, Tom

    2005-08-01

    Kaiser Permanente (KP) has been developing its use of call centers as a way to provide an expansive set of healthcare services to KP members efficiently and cost effectively. Since 1995, when The Permanente Medical Group (TPMG) began to consolidate primary care phone services into three physical call centers, the TPMG Appointments and Advice Call Center (AACC) has become the "front office" for primary care services across approximately 89% of Northern California. The AACC provides primary care phone service for approximately 3 million Kaiser Foundation Health Plan members in Northern California and responds to approximately 1 million calls per month across the three AACC sites. A database records each caller's identity as well as the day, time, and duration of each call; reason for calling; services provided to callers as a result of calls; and clinical outcomes of calls. We here summarize this information for the period 2000 through 2003.

  18. ASR performance analysis of an experimental call routing system

    CSIR Research Space (South Africa)

    Modipa, T

    2009-11-01

    Full Text Available Call routing is an important application of Automatic Speech Recognition (ASR) technology. In this paper the authors discuss the main issues affecting the performance of a call routing system and describe the ASR component of the "Auto...

  19. Advertisement call and tadpole morphology of the clutch-guarding ...

    African Journals Online (AJOL)

    Advertisement call and tadpole morphology of the clutch-guarding frog Mantidactylus argenteus from eastern ... We provide the first descriptions of the tadpole and advertisement call of Mantidactylus argenteus. ... AJOL African Journals Online.

  20. Purpose, Mission, and Context: The Call for Educating Future Leaders

    Science.gov (United States)

    Chunoo, Vivechkanand; Osteen, Laura

    2016-01-01

    This chapter calls on higher education to reclaim its role in leadership education. Specifically it examines higher education's purpose, context, and mission as clarion calls to embed leadership education throughout higher education institutions and focuses on why this is important.

  1. Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival-An evaluation of 548 emergency calls.

    Science.gov (United States)

    Viereck, Søren; Palsgaard Møller, Thea; Kjær Ersbøll, Annette; Folke, Fredrik; Lippert, Freddy

    2017-02-01

    This study aimed at evaluating if time for initiation of bystander cardiopulmonary resuscitation (CPR) - prior to the emergency call (CPR prior ) versus during the emergency call following dispatcher-assisted CPR (CPR during ) - was associated with return of spontaneous circulation (ROSC) and 30-day survival. The secondary aim was to identify predictors of CPR prior . This observational study evaluated out-of-hospital cardiac arrests (OHCA) occurring in the Capital Region of Denmark from 01.01.2013 to 31.12.2013. OHCAs were linked to emergency medical dispatch centre records and corresponding emergency calls were evaluated. Multivariable logistic regression analyses were applied to evaluate the association between time for initiation of bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of CPR prior . The study included 548 emergency calls for OHCA patients receiving bystander CPR, 34.9% (n=191) in the CPR prior group and 65.1% (n=357) in the CPR during group. Multivariable analyses showed no difference in ROSC (OR=0.88, 95% CI: 0.56-1.38) or 30-day survival (OR=1.14, 95% CI: 0.68-1.92) between CPR prior and CPR during . Predictors positively associated with CPR prior included witnessed OHCA and healthcare professional bystanders. Predictors negatively associated with CPR prior included residential location, solitary bystanders, and bystanders related to the patient. The majority of bystander CPR (65%) was initiated during the emergency call, following dispatcher-assisted CPR instructions. Whether bystander CPR was initiated prior to emergency call versus during the emergency call following dispatcher-assisted CPR was not associated with ROSC or 30-day survival. Dispatcher-assisted CPR was especially beneficial for the initiation of bystander CPR in residential areas. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  2. Shaping light

    CSIR Research Space (South Africa)

    Forbes, A

    2010-01-01

    Full Text Available Laser, a high- power laser to shoot down missiles, fills an entire Boeing 747! By customising the laser resonator it is possible to design light to order. Laser technology has been around for 50 years, yet new research and ideas are ensuring... that it will remain an active area of investigation for years to come. ? Professor Andrew Forbes is Chief Researcher and Research Group Leader at the CSIR National Laser Centre, and holds honorary positions in the Schools of Physics at both the University...

  3. Global action against dementia call for innovations

    Institute of Scientific and Technical Information of China (English)

    Dajue Wang

    2016-01-01

    With the fast-growing aging population, dementia has become a health priority. However, in the past, medicine was largely dealing with physical disorders, and not enough knowledge and experience have been accumulated for mental health. The main and first symptom of this disorder is the loss of memory; hence, understanding the hippocampal formation is the key to tackling dementia. In 2007, a milestone book titled"Hippocampus Book"was published. One of the authors/editors is the 2014 Nobel Laureate in Physiology and Medicine, Professor John O'Keefe. It is a MUST-READ encyclopedia about the hippocampal formation, for those who wish to commit them-selves to helping the patients with dementia. The formation consists of the hippocampus, entorhinal cortex, subiculum, presubiculum, parasubiculum, and dentate gyrus. The hippocampus is further divided into CA1, CA2, and CA3. The entorhinal cortex is the gateway of receiving all sensory information from the neocortex, while the subiculum is the exit for the efferent projections to the neocortex. Memory is divided into short-term and long-term memory. The former does not require protein synthesis while the latter does. The electrophysiological activities of creating these memories are short-term potentiation and long-term potentiation respectively. In most cases, the entorhinal cortex is the first structure to be damaged, and even short-term memory cannot be created. However, all except spatial memory are stored in the neocortex. Damage to the hippocampal formation would not affect the storage and retrieval of memories. Hence, past memories may remain intact in the early phases of the disorder. This devastating progressive disease has no cure. However, the highly plastic hippocampal formation may offer us some hope. It is the responsibility of the pharmaceutical industries to develop new drugs. Clinicians should add their efforts to the endeavor. The author would suggest that they explore insulin-like growth factors, brain

  4. Global action against dementia call for innovations

    Institute of Scientific and Technical Information of China (English)

    Dajue Wang

    2016-01-01

    With the fast-growing aging population, dementia has become a health priority.However, in the past, medicine was largely dealing with physical disorders, and not enough knowledge and experience have been accumulated for mental health. The main and first symptom of this disorder is the loss of memory; hence, understanding the hippocampal formation is the key to tackling dementia. In 2007, a milestone book titled 'Hippocampus Book' was published. One of the authors/editors is the 2014 Nobel Laureate in Physiology and Medicine, Professor John O’Keefe. It is a MUST-READ encyclopedia about the hippocampal formation, for those who wish to commit themselves to helping the patients with dementia. The formation consists of the hippocampus,entorhinal cortex, subiculum, presubiculum, parasubiculum, and dentate gyrus. The hippocampus is further divided into CA1, CA2, and CA3. The entorhinal cortex is the gateway of receiving all sensory information from the neocortex, while the subiculum is the exit for the efferent projections to the neocortex. Memory is divided into short-term and long-term memory. The former does not require protein synthesis while the latter does. The electrophysiological activities of creating these memories are short-term potentiation and long-term potentiation respectively. In most cases, the entorhinal cortex is the first structure to be damaged, and even short-term memory cannot be created. However, all except spatial memory are stored in the neocortex. Damage to the hippocampal formation would not affect the storage and retrieval of memories. Hence, past memories may remain intact in the early phases of the disorder. This devastating progressive disease has no cure. However, the highly plastic hippocampal formation may offer us some hope. It is the responsibility of the pharmaceutical industries to develop new drugs. Clinicians should add their efforts to the endeavor. The author would suggest that they explore insulin-like growth factors

  5. Electoronic Performance Monitoring in Call Centers: An Ethical Decision Model

    OpenAIRE

    Perkins, David

    2013-01-01

    Ever since it emerged on a widespread basis in the 1990s, electronic performance monitoring of employees has received significant scrutiny in the literature. Call centers have been the focus of many of these studies. This particular study addresses the issue of electronic performance monitoring in call centers from an ethical perspective. The following ethical dilemma is offered: "Is it ethical for a call center manager to evaluate the performance of a call center employee using electronic pe...

  6. Smart Grid Technology and Consumer Call Center Readiness

    OpenAIRE

    Schamber, Kelsey L.

    2010-01-01

    The following reasearch project deals with utility call center readiness to address customer concerns and questions about the Smart Grid and smart meter technology. Since consumer engagement is important for the benefits of the Smart Grid to be realized, the readiness and ability of utilities to answer consumer questions is an important issue. Assessing the readiness of utility call centers to address pertinant customer concerns was accomplished by calling utility call centers with Smart Grid...

  7. Call for a radiation health commission

    International Nuclear Information System (INIS)

    MacLeod, G.K.

    1986-01-01

    Public health and safety during nuclear accidents can best be safeguarded by physician participation in decision-making before, during, and after radiation emergencies. They are clearly best prepared to deal with the physical and emotional effects of such emergencies. Despite the continuing perception of safety by many experts, nuclear regulatory agencies are not able to relieve public anxiety about the health effects from nuclear power plants during radiation emergencies. Informed physician participation in patient care at the time of radiation emergencies in nuclear power plants could alleviate some of this anxiety. Since the medical profession has to be involved in postaccident medical care from radiation accidents, physicians must increase and update their understanding of the public health and clinical consequences of all kinds of radiation emergencies. They must be kept well informed about the dangers of radiation exposure in and around the worksite, in clinical settings, and in the community. If the public is to benefit from such medical expertise, there must be continuing medical involvement in dealing with radiation emergencies at the highest policy levels

  8. Calling vs Receiving Party Pays: Market Penetration and the Importance of the Call Externality

    OpenAIRE

    Tommaso Majer; Michele Pistollato

    2010-01-01

    In this paper we study how the access price affects the choice of the tariff regime taken by the network operators. We show that for high values of the access price, that is taken as a parameter by the firms, networks decide to charge only the callers. Otherwise, for low values of the access charge, networks charge also the receivers. Moreover, we compare market penetration and total welfare between the two price regimes. Our model suggests that, for high values of call externality, market pe...

  9. Calling vs receiving party pays : market penetration and the importance of the call externality

    OpenAIRE

    Majer, Tommaso

    2011-01-01

    In this paper we study how the access price affects the choice of the tariff regime taken by the network operators. We show that for high values of the access price, that is taken as a parameter by the firms, networks decide to charge only the callers. Otherwise, for low values of the access charge, networks charge also the receivers. Moreover, we compare market penetration and total welfare between the two price regimes. Our model suggests that, for high values of call externality, market pe...

  10. The prognostic value of T1 mapping and late gadolinium enhancement cardiovascular magnetic resonance imaging in patients with light chain amyloidosis.

    Science.gov (United States)

    Lin, Lu; Li, Xiao; Feng, Jun; Shen, Kai-Ni; Tian, Zhuang; Sun, Jian; Mao, Yue-Ying; Cao, Jian; Jin, Zheng-Yu; Li, Jian; Selvanayagam, Joseph B; Wang, Yi-Ning

    2018-01-03

    Cardiac impairment is associated with high morbidity and mortality in immunoglobulin light chain (AL) type amyloidosis, for which early identification and risk stratification is vital. For myocardial tissue characterization, late gadolinium enhancement (LGE) is a classic and most commonly performed cardiovascular magnetic resonance (CMR) parameter. T1 mapping with native T1 and extracellular volume (ECV) are recently developed quantitative parameters. We aimed to investigate the prognostic value of native T1, ECV and LGE in patients with AL amyloidosis. Eighty-two patients (55.5 ± 8.5 years; 52 M) and 20 healthy subjects (53.2 ± 11.7 years; 10 M) were prospectively recruited. All subjects underwent CMR with LGE imaging and T1 mapping using a Modified Look-Locker Inversion-recovery (MOLLI) sequence on a 3 T scanner. Native T1 and ECV were measured semi-automatically using a dedicated CMR software. The left ventricular (LV) LGE pattern was classified as none, patchy, and global groups. Global LGE was considered when there was diffuse, transmural LGE in more than half of the short axis images. Follow-up was performed for all-cause mortality using Cox proportional hazards regression analysis and Kaplan-Meier survival curves. The patients demonstrated an increase in native T1 (1438 ± 120 ms vs. 1283 ± 46 ms, P = 0.001) and ECV (43.9 ± 10.9% vs. 27.0 ± 1.7%, P = 0.001) compared to healthy controls. Native T1, ECV and LGE showed significant correlation with Mayo Stage, and ECV and LGE showed significant correlation with echocardiographic E/E' and LV ejection fraction. During the follow-up for a median time of 8 months, 21 deaths occurred. ECV ≥ 44.0% (hazard ratio [HR] 7.249, 95% confidence interval (CI) 1.751-13.179, P = 0.002) and global LGE (HR 4.804, 95% CI 1.971-12.926, P = 0.001) were independently prognostic for mortality over other clinical and imaging parameters. In subgroups with the same LGE pattern

  11. Examining calling as a double-edged sword for employability

    NARCIS (Netherlands)

    Lysova, Evgenia I.; Jansen, Paul G.W.; Khapova, Svetlana N.; Plomp, Judith; Tims, Maria

    2018-01-01

    Using a two-study design (total N = 1232), this paper examines the relationship between calling and employability. We suggest that, on the one hand, calling can positively relate to employability due to individuals’ engagement in proactive professional development (PPD). On the other hand, calling

  12. 29 CFR 785.17 - On-call time.

    Science.gov (United States)

    2010-07-01

    ... On-call time. An employee who is required to remain on call on the employer's premises or so close... employee who is not required to remain on the employer's premises but is merely required to leave word at his home or with company officials where he may be reached is not working while on call. (Armour & Co...

  13. Evolution of advertisement calls in African clawed frogs

    Science.gov (United States)

    Tobias, Martha L.; Evans, Ben J.; Kelley, Darcy B.

    2014-01-01

    Summary For most frogs, advertisement calls are essential for reproductive success, conveying information on species identity, male quality, sexual state and location. While the evolutionary divergence of call characters has been examined in a number of species, the relative impacts of genetic drift or natural and sexual selection remain unclear. Insights into the evolutionary trajectory of vocal signals can be gained by examining how advertisement calls vary in a phylogenetic context. Evolution by genetic drift would be supported if more closely related species express more similar songs. Conversely, a poor correlation between evolutionary history and song expression would suggest evolution shaped by natural or sexual selection. Here, we measure seven song characters in 20 described and two undescribed species of African clawed frogs (genera Xenopus and Silurana) and four populations of X. laevis. We identify three call types — click, burst and trill — that can be distinguished by click number, call rate and intensity modulation. A fourth type is biphasic, consisting of two of the above. Call types vary in complexity from the simplest, a click, to the most complex, a biphasic call. Maximum parsimony analysis of variation in call type suggests that the ancestral type was of intermediate complexity. Each call type evolved independently more than once and call type is typically not shared by closely related species. These results indicate that call type is homoplasious and has low phylogenetic signal. We conclude that the evolution of call type is not due to genetic drift, but is under selective pressure. PMID:24723737

  14. The Role of Analyst Conference Calls in Capital Markets

    NARCIS (Netherlands)

    E.M. Roelofsen (Erik)

    2010-01-01

    textabstractMany firms conduct a conference call with analysts shortly after the quarterly earnings announcement. In these calls, management discusses the completed quarter, and analysts can ask questions. Due to SEC requirements, conference calls in the United States are virtually always live

  15. Bats aloft: Variation in echolocation call structure at high altitudes

    Science.gov (United States)

    Bats alter their echolocation calls in response to changes in ecological and behavioral conditions, but little is known about how they adjust their call structure in response to changes in altitude. This study examines altitudinal variation in the echolocation calls of Brazilian free-tailed bats, T...

  16. Calling and Career Preparation: Investigating Developmental Patterns and Temporal Precedence

    Science.gov (United States)

    Hirschi, Andreas; Herrmann, Anne

    2013-01-01

    The presence of a calling and career development are assumed to be closely related. However, the nature of and reason for this relationship have not been thoroughly investigated. We hypothesized the existence of reciprocal effects between calling and three dimensions of career preparation and assessed the change of the presence of a calling,…

  17. Correlates of Gay-Related Name-Calling in Schools

    Science.gov (United States)

    Slaatten, Hilde; Hetland, Jørn; Anderssen, Norman

    2015-01-01

    The aim of this study was to examine whether attitudes about gay-related name-calling, social norms concerning gay-related name-calling among co-students, teacher intervention, and school-related support would predict whether secondary school pupils had called another pupil a gay-related name during the last month. A total of 921 ninth-grade…

  18. 47 CFR 90.241 - Radio call box operations.

    Science.gov (United States)

    2010-10-01

    ... remains on for a period in excess of three minutes. The automatic cutoff system must be designed so the... Public Safety Pool for highway call box systems subject to the following requirements: (1) Call box... effective radiated power (ERP). (3) The height of a call box antenna may not exceed 6.1 meters (20 feet...

  19. LinkLights

    DEFF Research Database (Denmark)

    Grönvall, Erik; Kramp, Gunnar

    2011-01-01

    The project described in this paper aims to provide assistive tools to support elderly people affected by vestibular dysfunction (i.e. a form of balance disorder leading to dizziness and nausea) in their home-based rehabilitation activities. Challenges emerge as the rehabilitation moves from...... a supervised hospital setting to private homes. Our studies have shown that the elderly people are less motivated to perform the training at home. This paper presents a tangible, portable, two dimensional modular platform called LinkLights that has been developed to sustain the home-based rehabilitation......, giving clear guidelines what to do, adding motivational cues and elements of variation and surprise in the activity. Furthermore, a set of challenges for successful translocation of the therapeutic regimen from a supervised, hospital setting to an unsupervised home-based setting together with some early...

  20. An explorative study of non-invasive ultra-weak photon emission and the anti-oxidative influence of oral zinc sulphate in light-sensitive patients with erythropoietic protoporphyria

    DEFF Research Database (Denmark)

    Petersen, Anita Birgit; Philipsen, Peter Alshede; Wulf, Hans Christian

    2011-01-01

    BACKGROUND: Erythropoietic protoporphyria (EPP) is a rare, inherited disorder of haem biosynthesis owing to deficient ferrochelatase (FECH) and accumulation of protoporphyrin IX (PPIX). This results in acute cutaneous photosensitivity upon light exposure with production of reactive oxygen species...... correlation was found between plasma zinc concentration and the initial burst. CONCLUSION: Measurements of UPE can be used for monitoring UVA-induced oxidative processes in vivo in the skin of EPP patients....... (ROS) and ultra-weak photon emission (UPE) as a by-product. We investigated if UPE evaluated the light sensitivity in EPP patients and influence of zinc treatment. METHODS: Fourteen EPP patients took zinc sulphate (3 × 200 mg/day) during spring and summer. Using a photomultiplier (PM), UPE was measured...... from the buttock skin and dorsal hand before and after solar-simulated light (SUN) exposure. Blood samples were analysed routinely for plasma zinc, iron, ferritin, transferrin, haemoglobin, erythrocyte PPIX and Zn-PPIX. RESULTS: UPE in EPP patients resembled that seen in healthy individuals. Without...

  1. Indoor Lighting Facilities

    Science.gov (United States)

    Matsushima, Koji; Saito, Yoshinori; Ichikawa, Shigenori; Kawauchi, Takao; Tanaka, Tsuneo; Hirano, Rika; Tazuke, Fuyuki

    According to the statistics on building construction floor area from the Ministry of Land, Infrastructure, Transport and Tourism, the total floor area of building construction started in Japan in 2007 was 160,991 thousand square meters, or 14.8% less than the area of the previous year, and the reduction was the first reduction in the past five years. The office markets in Tokyo and Nagoya were active, as represented by the supplies of skyscrapers, and energy saving measures, such as the adoption of high efficiency lighting equipment, the control for initial stage illuminance, daylight harvesting, and the use of occupancy sensors, were well established. In the field of public construction, including museums, multi-purpose halls, and religious buildings, the total area of the new construction was 10.8% less than the total for the previous year, and this reduction was a continuation of an eleven-year trend. In spaces with high ceiling, the innovation for easy replacement of light sources used with reflection mirror systems and optical fibers was noted. Hospitals adapted to the expectation for improved services in their selection of lighting facilities to improve the residential environment for patients while taking into consideration the needs of the aging population, by their use of devices in corridors to help maintain a continuity of light. In libraries, a pendant system was developed to illuminate both ceilings and book shelves. In the field of theaters and halls, the time limit for repairing existing systems had come for the large facilities that were opened during the theater and hall construction boom of the 1960s through 1980s, and around 26 renovations were done. Almost all the renovations were conversions to intelligent dimming systems and lighting control desks. In the field of stores and commercial facilities, the atmosphere and glitter of the selling floor was produced by new light sources, such as ceramic metal halide lamps and LEDs, which have high

  2. Transforming trauma healthcare delivery in rural areas by use of an integrated call center

    Directory of Open Access Journals (Sweden)

    Deepak Agrawal

    2012-01-01

    Full Text Available Introduction: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. Aims and Objectives: The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital′s electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. Results: The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000, with a recurring cost of Rs 80,000 (US$ 2000 per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305 were from rural areas. Patients′ overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. Conclusions: As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to

  3. Transforming trauma healthcare delivery in rural areas by use of an integrated call center

    Science.gov (United States)

    Agrawal, Deepak

    2012-01-01

    Introduction: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. Aims and Objectives: The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital's electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. Results: The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000), with a recurring cost of Rs 80,000 (US$ 2000) per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305) were from rural areas. Patients’ overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. Conclusions: As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to rural areas in an

  4. Physician alert: the legal risks associated with 'on-call' duties in the USA.

    Science.gov (United States)

    Paterick, Zachary R; Patel, Nachiket J; Paterick, Timothy Edward

    2018-06-13

    On-call physicians encounter a diverse aggregate of interfaces with sundry persons concerning patient care that may surface potential legal peril. The duties and obligations of an on-call physician, who must act as a fiduciary to all patients, create a myriad of circumstances where there is a risk of falling prey to legal ambiguities. The understanding of the doctor-patient relationship, the obligations of physicians under the Emergency Medical Treatment and Labor Act, the meaning of medical informed consent and the elements of negligence will help physicians avoid the legal risk associated with the various encounters of being on call. After introducing the legal concepts, we will explore the interactions that may put physicians at legal risk and outline how to mitigate that risk. Being on call is time consuming and arduous. While on call, physicians have a duty to act morally and ethically in the best interest of the patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. The Barbados Emergency Ambulance Service: High Frequency of Nontransported Calls

    Directory of Open Access Journals (Sweden)

    Sherwin E. Phillips

    2012-01-01

    Full Text Available Objectives. There are no published studies on the Barbados Emergency Ambulance Service and no assessment of the calls that end in nontransported individuals. We describe reasons for the nontransport of potential clients. Methods. We used the Emergency Medical Dispatch (Medical Priority Dispatch System instrument, augmented with five local call types, to collect information on types of calls. The calls were categorised under 7 headings. Correlations between call types and response time were calculated. Results. Most calls were from the category medical (54%. Nineteen (19% percent of calls were in the non-transported category. Calls from call type Cancelled accounted for most of these and this was related to response time, while Refused service was inversely related (. Conclusions. The Barbados Ambulance Service is mostly used by people with a known illness and for trauma cases. One-fifth of calls fall into a category where the ambulance is not used often due to cancellation which is related to response time. Other factors such as the use of alternative transport are also important. Further study to identify factors that contribute to the non-transported category of calls is necessary if improvements in service quality are to be made.

  6. Post discharge issues identified by a call-back program: identifying improvement opportunities.

    Science.gov (United States)

    Ojeda, Patricia I; Kara, Areeba

    2017-12-01

    The period following discharge from the hospital is one of heightened vulnerability. Discharge instructions serve as a guide during this transition. Yet, clinicians receive little feedback on the quality of this document that ties into the patients' experience. We reviewed the issues voiced by discharged patients via a call-back program and compared them to the discharge instructions they had received. At our institution, patients receive an automated call forty-eight hours following discharge inquiring about progress. If indicated by the response to the call, they are directed to a nurse who assists with problem solving. We reviewed the nursing documentation of these encounters for a period of nine months. The issues voiced were grouped into five categories: communication, medications, durable medical equipment/therapies, follow up and new or ongoing symptoms. The discharge instructions given to each patient were reviewed. We retrieved data on the number of discharges from each specialty from the hospital over the same period. A total of 592 patients voiced 685 issues. The numbers of patients discharged from medical or surgical services identified as having issues via the call-back line paralleled the proportions discharged from medical and surgical services from the hospital during the same period. Nearly a quarter of the issues discussed had been addressed in the discharge instructions. The most common category of issues was related to communication deficits including missing or incomplete information which made it difficult for the patient to enact or understand the plan of care. Medication prescription related issues were the next most common. Resource barriers and questions surrounding medications were often unaddressed. Post discharge issues affect patients discharged from all services equally. Data from call back programs may provide actionable targets for improvement, identify the inpatient team's 'blind spots' and be used to provide feedback to clinicians.

  7. Journal of Proton Therapy: Call for Papers

    Directory of Open Access Journals (Sweden)

    Journal of Proton Therapy

    2015-03-01

    - Patient Care, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Alexei V. Trofimov, PhD Dr. Trofimov is a Radiation Physicist at the Department of Radiation Oncology, Massachusetts General Hospital (MGH as well as Assistant Professor of Radiation Oncology at Harvard Medical School, Boston, Massachusetts, USA.Minesh Mehta, MD Dr. Mehta is the Medical Director at the Maryland Proton Treatment Center as well as Professor at the Department of Radiation Oncology, University of Maryland, Baltimore, Maryland, USA.Terence Sio, MD, MS Dr. Sio is a Resident Physician at the Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.Bijan Arjomandy, PhD Dr. Arjomandy is a Lead Senior Proton Medical Physicist at the McLaren Proton Therapy Center, Flint, Michigan, USA.Gino Lim, PhD Dr. Lim is the Department Chair and Associate Professor at the Department of Industrial Engineering, University of Houston, Houston, Texas, USA.Wayne D. Newhauser, PhD Dr. Newhauser is the Professor and Director of Medical Physics and Health Physics at Louisiana State University, Baton Rouge, Louisiana, USA.Shikui Tang, PhD Dr. Tang is a Medical Physicist at ProCure Proton Therapy Center, Somerset, New Jersey, USA.David Mansur, MD Dr. Mansur is a Division Chief at Radiation Oncology, Case Western Reserve University School of Medicine, University Hospitals Seidman Cancer Center, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA.Barbara Rombi, MD Dr. Rombi is an Attending Physician at Proton Therapy Center, S. Chiara Hospital, Trento, Italy.Cole Kreofsky, MD Dr. Kreofsky is a Resident Physician at the Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.Lane Rosen, MDDr. Rosen is a Radiation Oncologist at the Department of Radiation Oncology, Willis-Knighton Cancer Center, Shreveport, Louisiana, USA.Charles Bloch, PhDDr. Bloch is an Associate Professor at the Department of Radiation Oncology, University of

  8. Synchrotron light sources in developing countries

    Science.gov (United States)

    Mtingwa, Sekazi K.; Winick, Herman

    2018-03-01

    We discuss the role that synchrotron light sources, such as SESAME, could play in improving the socioeconomic conditions in developing countries. After providing a brief description of a synchrotron light source, we discuss the important role that they played in the development of several economically emerging countries. Then we describe the state of synchrotron science in South Africa and that country’s leadership role in founding the African Light Source initiative. Next, we highlight a new initiative called Lightsources for Africa, the Americas & Middle East Project, which is a global initiative led by the International Union of Pure and Applied Physics and the International Union of Crystallography, with initial funding provided by the International Council for Science. Finally, we comment on a new technology called the multibend achromat that has launched a new paradigm for the design of synchrotron light sources that should be attractive for construction in developing countries.

  9. Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival

    DEFF Research Database (Denmark)

    Viereck, Søren; Palsgaard Møller, Thea; Kjær Ersbøll, Annette

    2017-01-01

    BACKGROUND: This study aimed at evaluating if time for initiation of bystander cardiopulmonary resuscitation (CPR) - prior to the emergency call (CPRprior) versus during the emergency call following dispatcher-assisted CPR (CPRduring) - was associated with return of spontaneous circulation (ROSC...... and corresponding emergency calls were evaluated. Multivariable logistic regression analyses were applied to evaluate the association between time for initiation of bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of CPRprior. RESULTS: The study...... included 548 emergency calls for OHCA patients receiving bystander CPR, 34.9% (n=191) in the CPRpriorgroup and 65.1% (n=357) in the CPRduringgroup. Multivariable analyses showed no difference in ROSC (OR=0.88, 95% CI: 0.56-1.38) or 30-day survival (OR=1.14, 95% CI: 0.68-1.92) between CPRpriorand CPRduring...

  10. Barriers to recognition of out-of-hospital cardiac arrest during emergency medical calls

    DEFF Research Database (Denmark)

    Alfsen, David; Møller, Thea Palsgaard; Egerod, Ingrid

    2015-01-01

    the dispatchers' recognition of OHCA, focusing on the communication during the emergency call. The purpose of this study is to identify factors affecting medical dispatchers' recognition of OHCA during emergency calls in a qualitative analysis of calls. METHODS: An investigator triangulated inductive thematic...... to an automated external defibrillator should be initiated. Previous studies have investigated barriers to recognition of OHCA, and found the caller's description of sign of life, the type of caller, caller's emotional state, an inadequate dialogue during the emergency call, and patient's agonal breathing...... as influential factors. Though many of these factors are included in the algorithms used by medical dispatchers, many OHCA still remain not recognised. Qualitative studies investigating the communication between the caller and dispatcher are very scarce. There is a lack of knowledge about what influences...

  11. Sleep Quality of Call Handlers Employed in International Call Centers in National Capital Region of Delhi, India.

    Science.gov (United States)

    Raja, J D; Bhasin, S K

    2016-10-01

    Call center sector in India is a relatively new and fast growing industry driving employment and growth in modern India today. Most international call centers in National Capital Region (NCR) of Delhi operate at odd work hours corresponding to a time suitable fortheir international customers. The sleep quality of call handlers employed in these call centers is in jeopardy owing to their altered sleep schedule. To assess the sleep quality and determine its independent predictors among call handlers employed in international call centers in NCR of Delhi. A cross-sectional questionnaire-based study was conducted on 375 call handlers aged 18-39 years employed in international call centers in NCR of Delhi. Sleep quality was assessed using Athens Insomnia scale along with a pre-tested, structured questionnaire. The mean age of respondents was 24.6 (SD 2.4) years. 78% of participants were male. 83.5% of respondents were unmarried. 44.3% of call handlers were cigarette smokers. Physical ailments were reported by 37% call handlers. 77.6% of call handlers had somesuspicion of insomnia or suspected insomnia; the rest had no sleep problem. Smoking, poor social support, heavy workload, lack of relaxation facility at office, and prolonged travel time to office were independent predictors of sleep quality (pSafeguarding their health becomes an occupational health challenge to public health specialists.

  12. Heart rate variability changes in physicians working on night call.

    Science.gov (United States)

    Malmberg, Birgitta; Persson, Roger; Flisberg, Per; Ørbaek, Palle

    2011-03-01

    Adverse effects by night-call duty have become an important occupational health issue. The aim of this study was to investigate whether the heart rate variability (HRV) differed during recovery from day work and night-call duty between distinct physician specialities. We studied the impact of a 16-h night-call duty on autonomic balance, measured by HRV, among two physician groups differing with respect to having to deal with life-threatening conditions while on call. Nineteen anaesthesiologists (ANEST) and 16 paediatricians and ear, nose and throat surgeons (PENT) were monitored by ambulatory digital Holter electrocardiogram (ECG). Heart rate variability was analysed between 21:00 and 22:00 after an ordinary workday, on night call and in the evening post-call. Absolute and normalized high-frequency power (HF, HFnu) were the main outcome variables, expressing parasympathetic influence on the heart. ANEST had lower HF power than PENT while on night call and post-daytime work (p work compared with post-night-call duty (p balance and did not differ between specialities. However, the less dynamic HRV after daytime work and during night-call duty in the ANEST group may indicate a higher physiological stress level. These results may contribute to the improvement of night-call schedules within the health care sector.

  13. Physician Burnout and the Calling to Care for the Dying: A National Survey.

    Science.gov (United States)

    Yoon, John D; Hunt, Natalie B; Ravella, Krishna C; Jun, Christine S; Curlin, Farr A

    2017-12-01

    Physician burnout raises concerns over what sustains physicians' career motivations. We assess whether physicians in end-of-life specialties had higher rates of burnout and/or calling to care for the dying. We also examined whether the patient centeredness of the clinical environment was associated with burnout. In 2010 to 2011, we conducted a national survey of US physicians from multiple specialties. Primary outcomes were a validated single-item measure of burnout or sense of calling to end-of-life care. Primary predictors of burnout (or calling) included clinical specialty, frequency of encounters with dying patients, and patient centeredness of the clinical environments ("My clinical environment prioritizes the need of the patient over maximizing revenue"). Adjusted response rate among eligible respondents was 62% (1156 of 1878). Nearly a quarter of physicians (23%) experienced burnout, and rates were similar across all specialties. Half of the responding physicians (52%) agreed that they felt called to take care of patients who are dying. Burned-out physicians were more likely to report working in profit-centered clinical environments (multivariate odds ratio [OR] of 1.9; confidence interval [CI]: 1.3-2.8) or experiencing emotional exhaustion when caring for the dying (multivariate OR of 2.1; CI: 1.4-3.0). Physicians who identified their work as a calling were more likely to work in end-of-life specialties, to feel emotionally energized when caring for the dying, and to be religious. Physicians from end-of-life specialties not only did not have increased rates of burnout but they were also more likely to report a sense of calling in caring for the dying.

  14. Dynamic light scattering. Observation of polymer dynamics

    International Nuclear Information System (INIS)

    Hiroi, Takashi

    2015-01-01

    Dynamic light scattering is a technique to measure properties of polymer solutions such as size distribution. Principle of dynamic light scattering is briefly explained. Sometime dynamic light scattering is regarded as the observation of Doppler shift of scattered light. First, the difficulty for the direct observation of this Doppler shift is mentioned. Then the measurement by using a time correlation function is introduced. Measuring techniques for dynamic light scattering are also introduced. In addition to homodyne and heterodyne detection techniques, the technique called partial heterodyne method is also introduced. This technique is useful for the analysis of nonergodic medium such as polymer gels. Then the application of this technique to condensed suspension is briefly reviewed. As one of the examples, a dynamic light scattering microscope is introduced. By using this apparatus, we can measure the concentration dependence of the size distribution of polymer solutions. (author)

  15. BRDF invariant stereo using light transport constancy.

    Science.gov (United States)

    Wang, Liang; Yang, Ruigang; Davis, James E

    2007-09-01

    Nearly all existing methods for stereo reconstruction assume that scene reflectance is Lambertian and make use of brightness constancy as a matching invariant. We introduce a new invariant for stereo reconstruction called light transport constancy (LTC), which allows completely arbitrary scene reflectance (bidirectional reflectance distribution functions (BRDFs)). This invariant can be used to formulate a rank constraint on multiview stereo matching when the scene is observed by several lighting configurations in which only the lighting intensity varies. In addition, we show that this multiview constraint can be used with as few as two cameras and two lighting configurations. Unlike previous methods for BRDF invariant stereo, LTC does not require precisely configured or calibrated light sources or calibration objects in the scene. Importantly, the new constraint can be used to provide BRDF invariance to any existing stereo method whenever appropriate lighting variation is available.

  16. Uncertain call likelihood negatively affects sleep and next-day cognitive performance while on-call in a laboratory environment.

    Science.gov (United States)

    Sprajcer, Madeline; Jay, Sarah M; Vincent, Grace E; Vakulin, Andrew; Lack, Leon; Ferguson, Sally A

    2018-05-11

    On-call working arrangements are employed in a number of industries to manage unpredictable events, and often involve tasks that are safety- or time-critical. This study investigated the effects of call likelihood during an overnight on-call shift on self-reported pre-bed anxiety, sleep and next-day cognitive performance. A four-night laboratory-based protocol was employed, with an adaptation, a control and two counterbalanced on-call nights. On one on-call night, participants were instructed that they would definitely be called during the night, while on the other on-call night they were told they may be called. The State-Trait Anxiety Inventory form x-1 was used to investigate pre-bed anxiety, and sleep was assessed using polysomnography and power spectral analysis of the sleep electroencephalographic analysis. Cognitive performance was assessed four times daily using a 10-min psychomotor vigilance task. Participants felt more anxious before bed when they were definitely going to be called, compared with the control and maybe conditions. Conversely, participants experienced significantly less non-rapid eye movement and stage two sleep and poorer cognitive performance when told they may be called. Further, participants had significantly more rapid eye movement sleep in the maybe condition, which may be an adaptive response to the stress associated with this on-call condition. It appears that self-reported anxiety may not be linked with sleep outcomes while on-call. However, this research indicates that it is important to take call likelihood into consideration when constructing rosters and risk-management systems for on-call workers.

  17. Do attendees at sexual health and HIV clinics prefer to be called in by name or number?

    Science.gov (United States)

    Dabis, R; Nightingale, P; Kumar, V; Jaffer, K; Radcliffe, K

    2014-06-01

    Calling patients in from the waiting area is an important aspect of the initial medical encounter. According to national and international guidelines, clinics should decide on an appropriate way of calling patients in from the waiting room for consultations; however, no preference is actually recommended. A survey was carried out to see if patients were happy to be called in by number, first name, surname, full name, or title (Mr/Mrs/Miss/Ms) followed by surname. One hundred unselected patients were drawn from each clinic including; a genito-urinary medicine (GUM), a co-located GUM (cGUM) and co-located reproductive health (cRH), an HIV and a reproductive health (RH) clinic. Patients from the GUM, cGUM, cRH and RH clinics preferred to be called in by number rather than full name or title. Patients from the cRH clinic also preferred number to first name. In contrast, patients from the HIV clinics preferred to be called in by first name rather than number, surname, full name or title. Following this survey it would appear that number would be the most popular method of calling patients in sexual and reproductive health clinics and first name is the choice in HIV clinics. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Reducing juvenile delinquency with automated cell phone calls.

    Science.gov (United States)

    Burraston, Bert O; Bahr, Stephen J; Cherrington, David J

    2014-05-01

    Using a sample of 70 juvenile probationers (39 treatment and 31 controls), we evaluated the effectiveness of a rehabilitation program that combined cognitive-behavioral training and automated phone calls. The cognitive-behavioral training contained six 90-min sessions, one per week, and the phone calls occurred twice per day for the year following treatment. Recidivism was measured by whether they were rearrested and the total number of rearrests during the 1st year. To test the impact of the phone calls, those who received phone calls were divided into high and low groups depending on whether they answered more or less than half of their phone calls. Those who completed the class and answered at least half of their phone calls were less likely to have been arrested and had fewer total arrests.

  19. An empirical analysis of the corporate call decision

    International Nuclear Information System (INIS)

    Carlson, M.D.

    1998-01-01

    An economic study of the the behaviour of financial managers of utility companies was presented. The study examined whether or not an option pricing based model of the call decision does a better job of explaining callable preferred share prices and call decisions compared to other models. In this study, the Rust (1987) empirical technique was extended to include the use of information from preferred share prices in addition to the call decisions. Reasonable estimates were obtained from data of shares of the Pacific Gas and Electric Company (PGE) for the transaction costs associated with a call. It was concluded that the managers of the PGE clearly take into account the value of the option to delay the call when making their call decisions

  20. Elevated Concentrations of Serum Immunoglobulin Free Light Chains in Systemic Lupus Erythematosus Patients in Relation to Disease Activity, Inflammatory Status, B Cell Activity and Epstein-Barr Virus Antibodies

    DEFF Research Database (Denmark)

    Draborg, Anette H; Lydolph, Magnus; Westergaard, Marie

    2015-01-01

    , FLCs' association with Epstein-Barr virus (EBV) antibodies was examined. METHODS: Using a nephelometric assay, κFLC and λFLC concentrations were quantified in sera from 45 SLE patients and 40 healthy controls. SLE patients with renal insufficiency were excluded in order to preclude high concentrations......OBJECTIVE: In this study, we examined the concentration of serum immunoglobulin free light chains (FLCs) in systemic lupus erythematosus (SLE) patients and investigated its association with various disease parameters in order to evaluate the role of FLCs as a potential biomarker in SLE. Furthermore...... of serum FLCs due to decreased clearance. RESULTS: Serum FLC concentrations were significantly elevated in SLE patients compared to healthy controls (pdisease activity (SLE disease activity...

  1. The oil market. Call on OPEC determines the oil price

    International Nuclear Information System (INIS)

    Kingma, D.; Mulder, M.

    2001-01-01

    Several scenarios are applied to determine the oil price for the medium-long term, based on the so-called 'call on OPEC'. The 'call on OPEC' is part of the demand for oil which has to supplied by OPEC. It is expected that the nominal oil price will be circa $24 per barrel in 2004, based on a global growth of 4%. 2 refs

  2. Light and inherited retinal degeneration

    OpenAIRE

    Paskowitz, D M; LaVail, M M; Duncan, J L

    2006-01-01

    Light deprivation has long been considered a potential treatment for patients with inherited retinal degenerative diseases, but no therapeutic benefit has been demonstrated to date. In the few clinical studies that have addressed this issue, the underlying mutations were unknown. Our rapidly expanding knowledge of the genes and mechanisms involved in retinal degeneration have made it possible to reconsider the potential value of light restriction in specific genetic contexts. This review summ...

  3. Leveraging management information in improving call centre productivity

    Directory of Open Access Journals (Sweden)

    Manthisana Mosese

    2016-04-01

    Objectives: This research explored the use of management information and its impact on two fundamental functions namely, improving productivity without compromising the quality of service, in the call centre of a well-known South African fashion retailer, Edcon. Following the implementation of the call centre technology project the research set out to determine how Edcon can transform their call centre to improve productivity and customer service through effective utilisation of their management information. Method: Internal documents and reports were analysed to provide the basis of evaluation between the measures of productivity prior to and post the implementation of a technology project at Edcon’s call centre. Semi-structured in-depth and group interviews were conducted to establish the importance and use of management information in improving productivity and customer service. Results: The results indicated that the availability of management information has indeed contributed to improved efficiency at the Edcon call centre. Although literature claims that there is a correlation between a call centre technology upgrade and improvement in performance, evident in the return on investment being realised within a year or two of implementation, it fell beyond the scope of this study to investigate the return on investment for Edcon’s call centre. Conclusion: Although Edcon has begun realising benefits in improved productivity in their call centre from their available management information, information will continue to play a crucial role in supporting management with informed decisions that will improve the call centre operations. [pdf to follow

  4. On-call work and health: a review

    Directory of Open Access Journals (Sweden)

    Botterill Jackie S

    2004-12-01

    Full Text Available Abstract Many professions in the fields of engineering, aviation and medicine employ this form of scheduling. However, on-call work has received significantly less research attention than other work patterns such as shift work and overtime hours. This paper reviews the current body of peer-reviewed, published research conducted on the health effects of on-call work The health effects studies done in the area of on-call work are limited to mental health, job stress, sleep disturbances and personal safety. The reviewed research suggests that on-call work scheduling can pose a risk to health, although there are critical gaps in the literature.

  5. The Influence of Judgment Calls on Meta-Analytic Findings.

    Science.gov (United States)

    Tarrahi, Farid; Eisend, Martin

    2016-01-01

    Previous research has suggested that judgment calls (i.e., methodological choices made in the process of conducting a meta-analysis) have a strong influence on meta-analytic findings and question their robustness. However, prior research applies case study comparison or reanalysis of a few meta-analyses with a focus on a few selected judgment calls. These studies neglect the fact that different judgment calls are related to each other and simultaneously influence the outcomes of a meta-analysis, and that meta-analytic findings can vary due to non-judgment call differences between meta-analyses (e.g., variations of effects over time). The current study analyzes the influence of 13 judgment calls in 176 meta-analyses in marketing research by applying a multivariate, multilevel meta-meta-analysis. The analysis considers simultaneous influences from different judgment calls on meta-analytic effect sizes and controls for alternative explanations based on non-judgment call differences between meta-analyses. The findings suggest that judgment calls have only a minor influence on meta-analytic findings, whereas non-judgment call differences between meta-analyses are more likely to explain differences in meta-analytic findings. The findings support the robustness of meta-analytic results and conclusions.

  6. IMPORTANT REMINDER - In a Medical Emergency Call 74444

    CERN Multimedia

    2005-01-01

    What happened? A CERN employee, complaining of pains that might indicate a serious heart problem, went to building 57 for medical assistance1). He went to the first floor and found the reception desk temporarily unoccupied. He then went to the CERN Fire Station. The firemen and the CERN medical team took care of him and requested helicopter transport to the Geneva cantonal hospital, where he responded well to medical treatment. What do we learn from this event? Although in this case the patient is doing well, precious time was lost. In the event of serious and acute illness, you must call the CERN internal number 74444 and avoid going in person, even accompanied by someone else. This number is available for all types of emergency. The firemen can provide professional assistance at all times as required: first aid on the spot, ambulance transport and medical assistance as necessary. The CERN Fire Station is located in building 65, on ‘Route Einstein', the first road on your right when you enter CERN Ent...

  7. ASSESSMENT OF THE RESIDUAL TUMOR IN PATIENTS WITH MULTIPLE MYELOMA BASED ON THE ANALYSIS OF THE FREE LIGHT CHAINS OF IMMUNOGLOBULINS IN BLOOD SERUM

    Directory of Open Access Journals (Sweden)

    T. A. Мitina

    2013-01-01

    Full Text Available Efficiency of the multiple myeloma treatment with chemotherapy including bortezomib was assessed based on determination of the level of immunoglobulin free light chains in blood serum. The method enables estimation of changes in kinetic parameters of the residual tumor, detection of the disease course prognosis, and the choice of the optimal approach to the disease therapy.

  8. Persons with Alzheimer's Disease Make Phone Calls Independently Using a Computer-Aided Telephone System

    Science.gov (United States)

    Perilli, Viviana; Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Cassano, Germana; Cordiano, Noemi; Pinto, Katia; Minervini, Mauro G.; Oliva, Doretta

    2012-01-01

    This study assessed whether four patients with a diagnosis of Alzheimer's disease could make independent phone calls via a computer-aided telephone system. The study was carried out according to a non-concurrent multiple baseline design across participants. All participants started with baseline during which the telephone system was not available,…

  9. Uptake of 201Thallium in a so-called brown tumour of hyperparathyroidism

    International Nuclear Information System (INIS)

    Simons, M.; Verhaaren, H.; Schelstraete, K.; Schauteet, H.; Craen, M.

    1987-01-01

    When performing a 201 Tl-sup(99m)Tc subtraction scan of the parathyroids in a patient with secondary hyperparathyroidism, a marked accumulation of 201 Tl was observed in a so-called brown tumour of the mandible. The 201 Tl uptake can probably be explained by the rich vascularity and the high cellularity of the lesion. (Author)

  10. The 3D Elevation Program initiative: a call for action

    Science.gov (United States)

    Sugarbaker, Larry J.; Constance, Eric W.; Heidemann, Hans Karl; Jason, Allyson L.; Lukas, Vicki; Saghy, David L.; Stoker, Jason M.

    2014-01-01

    The 3D Elevation Program (3DEP) initiative is accelerating the rate of three-dimensional (3D) elevation data collection in response to a call for action to address a wide range of urgent needs nationwide. It began in 2012 with the recommendation to collect (1) high-quality light detection and ranging (lidar) data for the conterminous United States (CONUS), Hawaii, and the U.S. territories and (2) interferometric synthetic aperture radar (ifsar) data for Alaska. Specifications were created for collecting 3D elevation data, and the data management and delivery systems are being modernized. The National Elevation Dataset (NED) will be completely refreshed with new elevation data products and services. The call for action requires broad support from a large partnership community committed to the achievement of national 3D elevation data coverage. The initiative is being led by the U.S. Geological Survey (USGS) and includes many partners—Federal agencies and State, Tribal, and local governments—who will work together to build on existing programs to complete the national collection of 3D elevation data in 8 years. Private sector firms, under contract to the Government, will continue to collect the data and provide essential technology solutions for the Government to manage and deliver these data and services. The 3DEP governance structure includes (1) an executive forum established in May 2013 to have oversight functions and (2) a multiagency coordinating committee based upon the committee structure already in place under the National Digital Elevation Program (NDEP). The 3DEP initiative is based on the results of the National Enhanced Elevation Assessment (NEEA) that was funded by NDEP agencies and completed in 2011. The study, led by the USGS, identified more than 600 requirements for enhanced (3D) elevation data to address mission-critical information requirements of 34 Federal agencies, all 50 States, and a sample of private sector companies and Tribal and local

  11. Well Being and Job Satisfaction Among Call Centre Agents

    DEFF Research Database (Denmark)

    Wiegman, Inger Marie; Mathiesen, Karen; Møller, Niels

    2004-01-01

    A survey among 774 agents in four large Danish companies in house call centres shows that working in a call center is stressfull. Lack of control and autonomy, lack of potentiality and challenges, conflict between qualitative and quantitative demands and monitoring all have an adverse effect on job...

  12. Environmental constraints and call evolution in torrent-dwelling frogs.

    Science.gov (United States)

    Goutte, Sandra; Dubois, Alain; Howard, Samuel D; Marquez, Rafael; Rowley, Jodi J L; Dehling, J Maximilian; Grandcolas, Philippe; Rongchuan, Xiong; Legendre, Frédéric

    2016-04-01

    Although acoustic signals are important for communication in many taxa, signal propagation is affected by environmental properties. Strong environmental constraints should drive call evolution, favoring signals with greater transmission distance and content integrity in a given calling habitat. Yet, few empirical studies have verified this prediction, possibly due to a shortcoming in habitat characterization, which is often too broad. Here we assess the potential impact of environmental constraints on the evolution of advertisement call in four groups of torrent-dwelling frogs in the family Ranidae. We reconstruct the evolution of calling site preferences, both broadly categorized and at a finer scale, onto a phylogenetic tree for 148 species with five markers (∼3600 bp). We test models of evolution for six call traits for 79 species with regard to the reconstructed history of calling site preferences and estimate their ancestral states. We find that in spite of existing morphological constraints, vocalizations of torrent-dwelling species are most probably constrained by the acoustic specificities of torrent habitats and particularly their high level of ambient noise. We also show that a fine-scale characterization of calling sites allows a better perception of the impact of environmental constraints on call evolution. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

  13. Online scheduling policies for multiclass call centers with impatient customers

    NARCIS (Netherlands)

    Jouini, O.; Pot, S.A.; Koole, G.M.; Dallery, Y.

    2010-01-01

    We consider a call center with two classes of impatient customers: premium and regular classes. Modeling our call center as a multiclass GI / GI / s + M queue, we focus on developing scheduling policies that satisfy a target ratio constraint on the abandonment probabilities of premium customers to

  14. Analysis of jitter due to call-level fluctuations

    NARCIS (Netherlands)

    M.R.H. Mandjes (Michel)

    2005-01-01

    textabstractIn communication networks used by constant bit rate applications, call-level dynamics (i.e., entering and leaving calls) lead to fluctuations in the load, and therefore also fluctuations in the delay (jitter). By intentionally delaying the packets at the destination, one can transform

  15. The advertisement call, breeding biology, description of the tadpole ...

    African Journals Online (AJOL)

    Males of Bufo dombensis were observed calling late at night at Ongongo Waterfall in north-western Namibia. The analyzed advertisement calls differ distinctly from those of B. vertebralis, B. hoeschi and B. fenoulheti, indicating that all these taxa are separate valid species. Tadpoles raised from a breeding pair found at ...

  16. Jamaican Call-In Radio: A Uses and Gratification Analysis.

    Science.gov (United States)

    Surlin, Stuart H.

    Noting that radio call-in programs seem to contain the elements for active audience involvement and participation, a study was conducted to examine the hypothesis that information gain and surveillance are the primary gratifications sought through call-in radio programs, especially in a culture that has a strong oral tradition and relatively few…

  17. Sustainability in CALL Learning Environments: A Systemic Functional Grammar Approach

    Science.gov (United States)

    McDonald, Peter

    2014-01-01

    This research aims to define a sustainable resource in Computer-Assisted Language Learning (CALL). In order for a CALL resource to be sustainable it must work within existing educational curricula. This feature is a necessary prerequisite of sustainability because, despite the potential for educational change that digitalization has offered since…

  18. The Structure and Function of Male Thomas Langur Loud Calls

    NARCIS (Netherlands)

    Wich, Serge Alexander

    2002-01-01

    This study has addressed the acoustical structure of male loud calls and their function in Thomas langur social organisation. Thomas langurs are medium sized primate that lives in Sumatra, Indonesia. Ome of the characteristics of this species is the loud call of males. Several functions for loud

  19. In- and Out-of-the-Money Convertible Bond Calls

    DEFF Research Database (Denmark)

    Bechman, Ken; Lunde, Asger; Zebedee, Allan

    2014-01-01

    Convertible bond calls typically cause significant reactions in equity prices. The empirical research largely finds negative and positive announcement effects for the in-the-money and the out-of-the-money calls respectively. However, this research has difficulty distinguishing between the two mai...

  20. Consumer Experiences Calling Toll-Free Corporate Hotlines.

    Science.gov (United States)

    Martin, Charles L.; Smart, Denise T.

    1994-01-01

    Finds that dimensions that contribute to caller satisfaction (of toll-free corporate hotlines) included operator characteristics such as knowledge, courtesy, and interest; specific behaviors such as apologizing for a problem, thanking the consumer for calling, and encouraging them to call again; and reducing time placed on "hold." (SR)

  1. 39 CFR 6.4 - Attendance by conference telephone call.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Attendance by conference telephone call. 6.4 Section 6.4 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE MEETINGS (ARTICLE VI) § 6.4 Attendance by conference telephone call. For regularly scheduled meetings of...

  2. 47 CFR 64.1320 - Payphone call tracking system audits.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Payphone call tracking system audits. 64.1320... call tracking system audits. (a) Unless it has entered into an alternative compensation arrangement... Completing Carrier must undergo an audit of its § 64.1310(a)(1) tracking system by an independent third party...

  3. Called to do meaningful work : A blessing or a curse?

    NARCIS (Netherlands)

    van Vuuren, Hubrecht A.

    2017-01-01

    Two groups of people are particularly inclined to mention a calling when talking about their work motivation: those who are spiritual (because the concept of calling originated in the religious realm) and those in serving occupations (such as hospitals, schools, and nongovernmental organizations).

  4. Short communications: Calls of three species of arthroleptid frogs ...

    African Journals Online (AJOL)

    The calls of three anuran species in the family Arthroleptidae in the sub-family Astylosterminae from Equatorial Guinea are described including information on calling behaviour. For each species, we present a characteristic audiospectrogram and oscillogram. We also provide numerical information about the spectral and ...

  5. Advertisement calls of Bolivian species of Scinax (Amphibia, Anura, Hylidae)

    NARCIS (Netherlands)

    Riva, de la Ignacio; Márquez, Rafael; Bosch, Jaime

    1994-01-01

    The advertisement calls of eight Bolivian species of Scinax are described including information on the calling behaviour of each species. A characteristic audiospectrogram and oscillogram are presented for each species, as well as numerical information about the spectral and temporal features of the

  6. 47 CFR 64.1505 - Restrictions on collect telephone calls.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other Information Services § 64.1505 Restrictions on collect telephone calls. (a) No common carrier shall provide interstate transmission or billing and collection services to an entity offering any service within the scope...

  7. CALL in the Year 2000: A Look Back from 2016

    Science.gov (United States)

    Chapelle, Carol A.

    2016-01-01

    This commentary offers a brief reflection on the state of CALL in 1997, when "Language Learning & Technology" was launched with my paper entitled "CALL in the year 2000: Still in search of research paradigms?" The point of my 1997 paper was to suggest the potential value of research on second language learning for the study…

  8. Call Centres in Denmark 2004 - Strategy, HR Practices & Performance

    DEFF Research Database (Denmark)

    Sørensen, Ole H.; El-Salanti, Nadia

    This survey is the first scientifically based benchmarking study of the Danish call centre industry. The main results from the study are based on answers from 128 call centres, which correspond to a response rate of 65%. The Danish study is part of a global project coordinated by researchers at C...

  9. Impact of Using CALL on Iranian EFL Learners' Vocabulary Knowledge

    Science.gov (United States)

    Yunus, Melor Md; Salehi, Hadi; Amini, Mahdi

    2016-01-01

    Computer Assisted Language Learning (CALL) integration in EFL contexts has intensified noticeably in recent years. This integration might be in different ways and for different purposes such as vocabulary acquisition, grammar learning, phonology, writing skills, etc. More explicitly, this study is an attempt to explore the effect of using CALL on…

  10. 47 CFR 25.284 - Emergency Call Center Service.

    Science.gov (United States)

    2010-10-01

    ... mobile satellite service to end-user customers (part 25, subparts A-D) must provide Emergency Call Center... Center personnel must determine the emergency caller's phone number and location and then transfer or otherwise redirect the call to an appropriate public safety answering point. Providers of mobile satellite...

  11. Evaluation of Static JavaScript Call Graph Algorithms

    NARCIS (Netherlands)

    J.-J. Dijkstra (Jorryt-Jan)

    2014-01-01

    htmlabstractThis thesis consists of a replication study in which two algorithms to compute JavaScript call graphs have been implemented and evaluated. Existing IDE support for JavaScript is hampered due to the dynamic nature of the language. Previous studies partially solve call graph computation

  12. Steven MacCall: Winner of LJ's 2010 Teaching Award

    Science.gov (United States)

    Berry, John N., III

    2010-01-01

    This article profiles Steven L. MacCall, winner of "Library Journal's" 2010 Teaching Award. An associate professor at the School of Library and Information Studies (SLIS) at the University of Alabama, Tuscaloosa, MacCall was nominated by Kathie Popadin, known as "Kpop" to the members of her cohort in the online MLIS program at SLIS. Sixteen of…

  13. Calls to Teen Line: Representative Concerns of Adolescents.

    Science.gov (United States)

    Boehm, Kathryn E.; Schondel, Connie K.; Ivoska, William J.; Marlowe, Alison L.; Manke-Mitchell, Laurie

    1998-01-01

    Study examines whether the concerns of teenagers calling a peer listening service are representative of the concerns of teenagers in the area served. Results indicate that students' biggest concerns involve family problems, peer relationships, self-esteem, and school problems. Concludes that calls to the teen line are representative. (Author/GCP)

  14. A cross-site vascular radiology on-call service: the Manchester experience

    International Nuclear Information System (INIS)

    Ashleigh, R.J.; Butterfield, J.S.; Asquith, J.; Chalmers, N.; Murphy, G.

    2005-01-01

    AIM: A cross-site vascular radiology on-call service was established 5 years ago to cover two vascular centres in Manchester. We aimed to review the service. MATERIALS AND METHODS: A prospective audit of out-of hours referrals and procedures over a three month period (March-May 2003) was undertaken. RESULTS: There were 52 incidents in 49 patients (mean 4 calls per week). Nine involved telephone advice only, the remainder (82%) required a procedure. Angiography was performed on 88% of patients and therapeutic radiological intervention on 50%. 71% of calls occurred at a weekend. 50% of the calls were from vascular surgery and 50% from other sources. The consultant vascular radiologist was present for 93% of procedures. CONCLUSIONS: The workload suggests that a vascular radiology on call service is justified in Manchester. There have been no major problems with its implementation and operation. This is a consultant led service, with very few cases being devolved to a specialist registrar (SpR)

  15. Investigating CALL in the Classroom: Situational Variables to Consider

    Directory of Open Access Journals (Sweden)

    Darlene Liutkus

    2012-01-01

    Full Text Available A new paradigm in second language pedagogy has Computer Assisted Language Learning (CALL playing a significant role. Much of the literature to-date claims that CALL can have a positive impact on students’ second language acquisition (SLA. Mixed method of research produces data to investigate if CALL positively affects student language proficiency, motivation and autonomy. Classroom observation of participants in their natural environment is a qualitative technique used but has situational variables that could skew results if not structured. A questionnaire is a quantitative tool that can offer insight regarding participants’ perception of performance but can contradict what the researcher has observed. This paper will take an in-depth look at variables such as: instructor’s pedagogical application; blending CALL into the curriculum; types of CALL implemented; feedback received and their implications for design of the data collection tools

  16. Call Admission Scheme for Multidimensional Traffic Assuming Finite Handoff User

    Directory of Open Access Journals (Sweden)

    Md. Baitul Al Sadi

    2017-01-01

    Full Text Available Usually, the number of users within a cell in a mobile cellular network is considered infinite; hence, M/M/n/k model is appropriate for new originated traffic, but the number of ongoing calls around a cell is always finite. Hence, the traffic model of handoff call will be M/M/n/k/N. In this paper, a K-dimensional traffic model of a mobile cellular network is proposed using the combination of limited and unlimited users case. A new call admission scheme (CAS is proposed based on both thinning scheme and fading condition. The fading condition of the wireless channel access to a handoff call is prioritized compared to newly originated calls.

  17. Addressee Errors in ATC Communications: The Call Sign Problem

    Science.gov (United States)

    Monan, W. P.

    1983-01-01

    Communication errors involving aircraft call signs were portrayed in reports of 462 hazardous incidents voluntarily submitted to the ASRS during an approximate four-year period. These errors resulted in confusion, disorder, and uncoordinated traffic conditions and produced the following types of operational anomalies: altitude deviations, wrong-way headings, aborted takeoffs, go arounds, runway incursions, missed crossing altitude restrictions, descents toward high terrain, and traffic conflicts in flight and on the ground. Analysis of the report set resulted in identification of five categories of errors involving call signs: (1) faulty radio usage techniques, (2) call sign loss or smearing due to frequency congestion, (3) confusion resulting from similar sounding call signs, (4) airmen misses of call signs leading to failures to acknowledge or readback, and (5) controller failures regarding confirmation of acknowledgements or readbacks. These error categories are described in detail and several associated hazard mitigating measures that might be aken are considered.

  18. The renewal of hydroelectric concessions in competitive call

    International Nuclear Information System (INIS)

    2013-01-01

    This document discusses various issues associated with the planned competitive call on the French hydraulic power plants. The principles of this competitive call for hydroelectric concessions are first addressed: administrative regime of concessions, competitive call process, criteria of selection of the concession holder, case of 'concession of valleys', potential competitors. It outlines and discusses the difficulties of this competitive call: France is the single country to implement this procedure; it concerns a national asset; it questions the guarantee of a future use of equipment at best for the energy benefits of French consumers; the competitive call is a nice idea indeed but extremely complex. A note discusses the profitability aspects of Plants for Transfer of Energy by Pumping

  19. Evidence That Calls-Based and Mobility Networks Are Isomorphic.

    Directory of Open Access Journals (Sweden)

    Michele Coscia

    Full Text Available Social relations involve both face-to-face interaction as well as telecommunications. We can observe the geography of phone calls and of the mobility of cell phones in space. These two phenomena can be described as networks of connections between different points in space. We use a dataset that includes billions of phone calls made in Colombia during a six-month period. We draw the two networks and find that the call-based network resembles a higher order aggregation of the mobility network and that both are isomorphic except for a higher spatial decay coefficient of the mobility network relative to the call-based network: when we discount distance effects on the call connections with the same decay observed for mobility connections, the two networks are virtually indistinguishable.

  20. Shining light on radiation detection and energy transfer : Triazole ligands used for detection of radiation and lanthanide binding

    NARCIS (Netherlands)

    Dijkstra, Peter

    2016-01-01

    Some substances, fluorophores, absorb light and then emit that light again as fluorescence. Apart from absorption of light, some of these substances can also emit light after having absorbed energy from radiation. A substance which can absorb radiation and emit the energy as light is called a