WorldWideScience

Sample records for pediatrics certifying examination

  1. Certified pediatric nurses' perceptions of job satisfaction.

    Science.gov (United States)

    Wyatt, Janet; Harrison, Margaret

    2010-01-01

    The Pediatric Nursing Certification Board surveyed a national sample of 1354 hospital-based certified pediatric nurses (CPNs) to determine their perceptions of certification on job satisfaction and other factors. There is a substantial body of literature that demonstrates job satisfaction among nurses positively increases retention and reduces absenteeism and burnout. CPNs seek certification for a personal sense of achievement, professional recognition, and validation of clinical competency. The certified nurse survey respondents had self-reported high levels of job satisfaction and indicated that relationships with colleagues and a supportive work environment were very important to their levels of job satisfaction. The results of this study highlight important factors for hospitals to consider as they plan strategies and cost-effective ways to positively affect patient care and retain qualified pediatric nurses at the bedside.

  2. Core Competencies of the Certified Pediatric Doctor of Chiropractic

    DEFF Research Database (Denmark)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-01-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical...... education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists...... had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering...

  3. The use of office-based sedation and general anesthesia by board certified pediatric dentists practicing in the United States.

    Science.gov (United States)

    Olabi, Nassim F; Jones, James E; Saxen, Mark A; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Schrader, Stuart M; Tomlin, Angela M

    2012-01-01

    The purpose of this study is to explore the use of office-based sedation by board-certified pediatric dentists practicing in the United States. Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based sedation is an emerging trend. This study examines and compares these two models of office-based sedations. A survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) based on gender, age, years in practice, practice types, regions, and years as a diplomate of the ABPD was completed by 494 active members. The results were summarized using frequencies and percentages. Relationships of dentist age, gender, and number of years in practice with the use of intravenous (IV) sedation was completed using two-way contingency tables and Mantel-Haenszel tests for ordered categorical data. Relationships of office-based sedation use and the type of one's practice were examined using Pearson chi-square tests. Of the 1917 surveys e-mailed, 494 completed the survey for a response rate of 26%. Over 70% of board-certified US pediatric dentists use some form of sedation in their offices. Less than 20% administer IV sedation, 20 to 40% use a dentist anesthesiologist, and 60 to 70% would use dentist anesthesiologists if one were available.

  4. 9 CFR 355.26 - Samples of certified products, ingredients, etc., to be taken for examination.

    Science.gov (United States)

    2010-01-01

    ... AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Samples of certified products, ingredients, etc., to be taken for examination. 355.26 Section 355.26 Animals and Animal Products FOOD SAFETY...

  5. The utility of mock oral examinations in preparation for the American Board of Surgery certifying examination.

    Science.gov (United States)

    Higgins, Rana M; Deal, Rebecca A; Rinewalt, Daniel; Hollinger, Edward F; Janssen, Imke; Poirier, Jennifer; Austin, Delores; Rendina, Megan; Francescatti, Amanda; Myers, Jonathan A; Millikan, Keith W; Luu, Minh B

    2016-02-01

    Determine the utility of mock oral examinations in preparation for the American Board of Surgery certifying examination (ABS CE). Between 2002 and 2012, blinded data were collected on 63 general surgery residents: 4th and 5th-year mock oral examination scores, first-time pass rates on ABS CE, and an online survey. Fifty-seven residents took the 4th-year mock oral examination: 30 (52.6%) passed and 27 (47.4%) failed, with first-time ABS CE pass rates 93.3% and 81.5% (P = .238). Fifty-nine residents took the 5th-year mock oral examination: 28 (47.5%) passed and 31 (52.5%) failed, with first-time ABS CE pass rates 82.1% and 93.5% (P = .240). Thirty-eight responded to the online survey, 77.1% ranked mock oral examinations as very or extremely helpful with ABS CE preparation. Although mock oral examinations and ABS CE passing rates do not directly correlate, residents perceive the mock oral examinations to be helpful. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The in-training examination: an analysis of its predictive value on performance on the general pediatrics certification examination.

    Science.gov (United States)

    Althouse, Linda A; McGuinness, Gail A

    2008-09-01

    This study investigates the predictive validity of the In-Training Examination (ITE). Although studies have confirmed the predictive validity of ITEs in other medical specialties, no study has been done for general pediatrics. Each year, residents in accredited pediatric training programs take the ITE as a self-assessment instrument. The ITE is similar to the American Board of Pediatrics General Pediatrics Certifying Examination. First-time takers of the certifying examination over a 5-year period who took at least 1 ITE examination were included in the sample. Regression models analyzed the predictive value of the ITE. The predictive power of the ITE in the first training year is minimal. However, the predictive power of the ITE increases each year, providing the greatest power in the third year of training. Even though ITE scores provide information regarding the likelihood of passing the certification examination, the data should be used with caution, particularly in the first training year. Other factors also must be considered when predicting performance on the certification examination. This study continues to support the ITE as an assessment tool for program directors, as well as a means of providing residents with feedback regarding their acquisition of pediatric knowledge.

  7. Residency program characteristics that are associated with pass rate of the American Board of Pediatrics certifying exam.

    Science.gov (United States)

    Atsawarungruangkit, Amporn

    2015-01-01

    The US is home to almost 200 pediatrics residency programs; despite this, there is little information about the relationship between program characteristics and performance in the American Board of Pediatrics (ABP) certifying exam. To evaluate the relationship between pass rate of the ABP certifying exam with the characteristics of categorical pediatrics residency programs. This retrospective, cross-sectional study used publicly available data from the ABP website and the Fellowship and Residency Electronic Interactive Database. All programs that reported pass rates were included. The analysis, comprising univariate and multivariate linear regression, involved determining how 69 factors (eg, general information, number of faculty and trainees, work schedule, educational environment) related to the pass rate. Of 199 programs, 194 reported pass rates. The univariate analysis revealed 20 program characteristics with P-values program characteristics: ratio of full-time equivalent paid faculty to positions, percentage of US medical graduates, and average hours per week of regularly scheduled lectures or conferences. Unlike in previous studies, location and program size were not significantly associated with the pass rate in this multivariate analysis. The finding regarding the ratio of full-time equivalent paid faculty to positions highlighted the benefits of a well-supervised training environment, while that regarding the percentage of US medical graduates indicated the necessity of high competition in residency programs. Finally, longer hours per week of regularly scheduled lectures or conferences were associated with better academic outcomes, both statistically and intuitively.

  8. [Performance on the Board of Pediatrics certification examination by the Sociedad Argentina de Pediatría, 2001-2010].

    Science.gov (United States)

    Ferrero, Fernando; Yulitta, Horacio; Molina, María Paz; Valli, Raúl

    2011-08-01

    Professional certification guarantees professional's performance, but the examination tool must be periodically evaluated. To describe the result of the pediatric certifying examination (PCE) of the Sociedad Argentina de Pediatría (SAP), between 2001-2010 analyzing the impact of the age and the elapsed time since the graduation and to describe the performance of training institutions in this period. Cross-section study. Data were obtained from the records of Board of Pediatrics of the SAP. The results of the PCE, were analyzed assessing examination pass rate and training institutions (2001-2010), and age and elapsed time since graduation of the examined professionals (2001-2005). Of 2527 professionals from 138 institutions, 69.6% passed. Those that passed were younger (31.7 ± 4.1 vs. 35.6 ± 6.2 years; p <0.0001) and had less years since graduation (6.3 ± 4.0 vs. 9.0 ± 5.9; p <0.0001) than those who did not pass. The examination pass rate was higher in institutions accredited by SAP (78.4% vs. 48.8%; OR= 3,8 IC95%= 3,1-4,7; p <0.001). The pass rate was significantly higher in institutions with accredited programs for 5 years than those not accredited (78.4% vs. 48.8%, OR= 3.8 95% CI= 3.1 to 4.7, p <0.001). The pass rate at accredited institutions for 3 years (53.7%) and 1 year (48.7%) showed no statistically significant differences with non-accredited institutions. The certifying examination pass rate was 68.5%. Younger professionals with fewer years since graduation, and trained in SAP 5 years accredited programs were significantly more likely to pass the examination.

  9. Residency factors that influence pediatric in-training examination score improvement.

    Science.gov (United States)

    Chase, Lindsay H; Highbaugh-Battle, Angela P; Buchter, Susie

    2012-10-01

    The goal of this study was to determine which measurable factors of resident training experience contribute to improvement of in-training examination (ITE) and certifying examination (CE) scores. This is a descriptive retrospective study analyzing data from July 2003 through June 2006 at a large academic pediatric training program. Pediatric categorical residents beginning residency in July 2003 were included. Regression analyses were used to determine if the number of admissions performed, core lectures attended, acute care topics heard, grand rounds attended, continuity clinic patients encountered, or procedures performed correlated with improvement of ITE scores. These factors were then analyzed in relation to CE scores. Seventeen residents were included in this study. The number of general pediatric admissions was the only factor found to correlate with an increase in ITE score (P = .04). Scores for the ITE at pediatric levels 1 and 3 were predictive of CE scores. No other factors measured were found to influence CE scores. Although all experiences of pediatric residents likely contribute to professional competence, some experiences may have more effect on ITE and CE scores. In this study, only general pediatric admissions correlated significantly with an improvement in ITE scores from year 1 to year 3. Further study is needed to identify which elements of the residency experience contribute most to CE success. This would be helpful in optimizing residency program structure and curriculum within the limitations of duty hour regulations.

  10. Analysis of First-Time Unsuccessful Attempts on the Certified Nurse Educator Examination.

    Science.gov (United States)

    Lundeen, John D

    This retrospective analysis examined first-time unsuccessful attempts on the Certified Nurse Educator (CNE) examination from September 2005 through September 2011 (n = 390). There are few studies examining certification within the academic nurse educator role. There is also a lack of evidence to assist nurse educators in understanding those factors that best support success on the CNE exam. Nonexperimental, descriptive, retrospective correlational design using chi-square test of independence and factorial analyses of variance. A statistically significant relationship was found between first-time failure and highest degree obtained and institutional affiliation on the CNE exam. There was no statistically significant effect on mean scores in any of the six content areas measured by the CNE exam as related to highest degree or institutional affiliation. The findings from this study support a previous recommendation for faculty development, experience in the role, and doctoral preparation prior to seeking certification.

  11. Predictive value of the korean academy of family medicine in-training examination for certifying examination.

    Science.gov (United States)

    Cho, Jung-Jin; Kim, Ji-Yong

    2011-09-01

    In-training examination (ITE) is a cognitive examination similar to the written test, but it is different from the Clinical Practice Examination of the Korean Academy of Family Medicine (KAFM) Certification Examination (CE). The objective of this is to estimate the positive predictive value of the KAFM-ITE for identifying residents at risk for poor performance on the three types of KAFM-CE. 372 residents who completed the KAFM-CE in 2011 were included. We compared the mean KAFM-CE scores with ITE experience. We evaluated the correlation and the positive predictive value (PPV) of ITE for the multiple choice question (MCQ) scores of 1st written test & 2nd slide examination, the total clinical practice examination scores, and the total sum of 2nd test. 275 out of 372 residents completed ITE. Those who completed ITE had significantly higher MCQ scores of 1st written test than those who did not. The correlation of ITE scores with 1st written MCQ (0.627) was found to be the highest among the other kinds of CE. The PPV of the ITE score for 1st written MCQ scores was 0.672. The PPV of the ITE score ranged from 0.376 to 0.502. The score of the KAFM ITE has acceptable positive predictive value that could be used as a part of comprehensive evaluation system for residents in cognitive field.

  12. Examination of factors which may contribute to the underrepresentation of African American teachers certified in science

    Science.gov (United States)

    Davis, Rita C. F.

    Throughout this country the student population is becoming increasingly diverse, yet the teacher population does not reflect this diversity. This lack of diversity in the teacher population deprives students of color from having role models of the same race/ethnicity who look like them and who might have experiences which are similar to theirs (Epstein, 2005; Nettles & Perna, 1997). Having role models from their own race in the classroom could have a positive impact on students' attitudes about science (Perine, 2003), and facilitate their learning of the subject matter, and give students an incentive to do well in school (Vegas, Murnane, & Willett, 2001). In 2000, a national survey study of math and science teachers was conducted (Horizon Research, 2001). The majority of biology (90%), chemistry (93%), and physics (94%) teachers who participated in the study were White. Findings of the study revealed that only 55% to 60% of these teachers considered themselves well prepared to effectively teach a culturally diverse student population (Banilower, 2002; Smith, 2002; Wood, 2002). The majority of the teacher pool, which is White, prefer not to teach in urban communities as they have a preference for teaching jobs in the nonurban communities that are similar to those in which they were raised (Boyd, Lankford, Loeb, & Wyckoff, 2005; Epstein, 2005). The purpose of this quantitative study was to examine factors that may contribute to the underrepresentation of African American teachers certified in science. More specifically, it was decided to examine the high school experiences of in-service teachers. Study participants were teachers and other certificated faculty in two school districts located in the southern portion of the United States. Findings of the study revealed a statistically significant relationship between a teacher's decision to become certified in science and the following high school experiences: teachers and guidance counselors encouraging students to

  13. Examining the therapeutic relationship and confronting resistances in psychodynamic psychotherapy: a certified public accountant case.

    Science.gov (United States)

    Manetta, Christopher T; Gentile, Julie P; Gillig, Paulette Marie

    2011-05-01

    Psychodynamic psychotherapy is effective for a variety of mental health symptoms. This form of psychotherapy uses patient self reflection and self examination, as well as the therapeutic relationship between the patient and psychiatrist, to explore maladaptive coping strategies and relationship patterns of the patient. A thorough understanding of resistance and the core conflictual relationship theme afford the psychiatrist the ability to facilitate this work. In this article, the composite case illustrates some of the psychodynamic psychotherapy techniques that can be employed in a psychotherapy case. In this example, the case is about a certified public accountant that came to treatment because of an acute stressor that put her career goals at risk. An acute episode or event can bring to light chronic and ongoing symptoms, which have had a remitting and relapsing course, and leave the patient unable to compensate on his or her own.

  14. Attributes of Candidates Passing the ABS Certifying Examination on the First Attempt-Program Directors׳ Perspective.

    Science.gov (United States)

    Sheikh, Mohd Raashid; Hulme, Michael

    2016-01-01

    The American Board of Surgery Certifying Examination (CE) is a pivotal event in a surgeon's career development, as it is the last challenge before achieving Board certification. First-time pass rate on the CE is one of the key metrics of surgery residency programs. The overall pass rate on the CE has declined significantly in recent years. The goal of this study was the identification of attributes of general surgery residents that are associated with passing the CE at the first attempt. The modified Delphi process was used to survey general surgery program directors. The study was conducted in 2 rounds in the interest of time available for surgical education research fellowship project. All 259 program directors were contacted in each round of surveys. In all, 49 (19%) responded to the first round and 54 (21%) responded to the second round of survey. The characteristics of a successful resident on CE include confidence, self-motivation, sound knowledge base, strong performance on the Board's training examination (American Board of Surgery In-Training Examination), and mock orals, and good communication skills. Postgraduate years 4 and 5 are the most likely resident levels at which failure could be predicted. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Relationship Between Physician Assistant Program Length and Physician Assistant National Certifying Examination Pass Rates.

    Science.gov (United States)

    Colletti, Thomas P; Salisbury, Helen; Hertelendy, Attila J; Tseng, Tina

    2016-03-01

    This study was conducted to examine the relationship between physician assistant (PA) educational program length and PA programs' 5-year average Physician Assistant National Certifying Examination (PANCE) first-time pass rates. This was a retrospective correlational study that analyzed previously collected data from a nonprobability purposive sample of accredited PA program Web sites. Master's level PA programs (n = 108) in the United States with published average PANCE scores for 5 consecutive classes were included. Provisional and probationary programs were excluded (n = 4). Study data were not normally distributed per the Kolmogorov-Smirnov test, P = .00. There was no relationship between program length and PANCE pass rates, ρ (108) = -0.04, P = .68. Further analyses examining a possible relationship between program phase length (didactic and clinical) and PANCE pass rates also demonstrated no differences (ρ [107] = -0.05, P = .60 and ρ [107] = 0.02, P = .80, respectively). The results of this study suggest that shorter length PA programs perform similarly to longer programs in preparing students to pass the PANCE. In light of rapid expansion of PA educational programs, educators may want to consider these findings when planning the length of study for new and established programs.

  16. An examination of stress and burnout in certified athletic trainers at division I-a universities.

    Science.gov (United States)

    Hendrix, A E; Acevedo, E O; Hebert, E

    2000-04-01

    A growing body of knowledge indicates that too much stress can negatively influence psychological and physical health. A model proposed by Smith to explore personal and situational variables, stress appraisal, and burnout has led to significant understanding of burnout of individuals working in service professions. We examined the relationship of hardiness, social support, and work-related issues relevant to athletic trainers to perceived stress and the relationship of perceived stress to burnout. Correlational analyses were performed to examine the relationships predicted by Smith's model. In addition, we conducted stepwise multiple regression analyses to assess the relative contributions of the personal and situational variables to perceived stress and to examine the relative impact of perceived stress on 3 burnout factors (emotional exhaustion, personal accomplishment, and depersonalization). One hundred eighteen certified athletic trainers working in National Collegiate Athletic Association Division I-A intercollegiate settings that maintain a football program. We assessed personal and situational variables using the Hardiness Test, the Social Support Questionnaire, and the Athletic Training Issues Survey, adapted for this study. The Perceived Stress Scale was used to assess stress appraisal, and the Maslach Burnout Inventory was used to assess 3 dimensions of burnout. Our results were in support of Smith's theoretical model of stress and burnout. Athletic trainers who scored lower on hardiness and social support and higher on athletic training issues tended to have higher levels of perceived stress. Furthermore, higher perceived stress scores were related to higher emotional exhaustion and depersonalization and lower levels of personal accomplishment. Our findings examining burnout in Division I athletic trainers were similar to those of other studies investigating coaches and coach-teachers and in support of Smith's theoretical model of stress and burnout.

  17. Advancing the Certified in Public Health Examination: A Job Task Analysis.

    Science.gov (United States)

    Kurz, Richard S; Yager, Christopher; Yager, James D; Foster, Allison; Breidenbach, Daniel H; Irwin, Zachary

    In 2014, the National Board of Public Health Examiners performed a job task analysis (JTA) to revise the Certified in Public Health (CPH) examination. The objectives of this study were to describe the development, administration, and results of the JTA survey; to present an analysis of the survey results; and to review the implications of this first-ever public health JTA. An advisory committee of public health professionals developed a list of 200 public health job tasks categorized into 10 work domains. The list of tasks was incorporated into a web-based survey, and a snowball sample of public health professionals provided 4850 usable responses. Respondents rated job tasks as essential (4), very important (3), important (2), not very important (1), and never performed (0). The mean task importance ratings ranged from 2.61 to 3.01 (important to very important). The highest mean ratings were for tasks in the ethics domain (mean rating, 3.01). Respondents ranked 10 of the 200 tasks as the most important, with mean task rankings ranging from 2.98 to 3.39. We found subtle differences between male and female respondents and between master of public health and doctor of public health respondents in their rankings. The JTA established a set of job tasks in 10 public health work domains, and the results provided a foundation for refining the CPH examination. Additional steps are needed to further modify the content outline of the examination. An empirical assessment of public health job tasks, using methods such as principal components analysis, may provide additional insight.

  18. United States Medical Licensing Examination and American Board of Pediatrics Certification Examination Results: Does the Residency Program Contribute to Trainee Achievement.

    Science.gov (United States)

    Welch, Thomas R; Olson, Brad G; Nelsen, Elizabeth; Beck Dallaghan, Gary L; Kennedy, Gloria A; Botash, Ann

    2017-09-01

    To determine whether training site or prior examinee performance on the US Medical Licensing Examination (USMLE) step 1 and step 2 might predict pass rates on the American Board of Pediatrics (ABP) certifying examination. Data from graduates of pediatric residency programs completing the ABP certifying examination between 2009 and 2013 were obtained. For each, results of the initial ABP certifying examination were obtained, as well as results on National Board of Medical Examiners (NBME) step 1 and step 2 examinations. Hierarchical linear modeling was used to nest first-time ABP results within training programs to isolate program contribution to ABP results while controlling for USMLE step 1 and step 2 scores. Stepwise linear regression was then used to determine which of these examinations was a better predictor of ABP results. A total of 1110 graduates of 15 programs had complete testing results and were subject to analysis. Mean ABP scores for these programs ranged from 186.13 to 214.32. The hierarchical linear model suggested that the interaction of step 1 and 2 scores predicted ABP performance (F[1,1007.70] = 6.44, P = .011). By conducting a multilevel model by training program, both USMLE step examinations predicted first-time ABP results (b = .002, t = 2.54, P = .011). Linear regression analyses indicated that step 2 results were a better predictor of ABP performance than step 1 or a combination of the two USMLE scores. Performance on the USMLE examinations, especially step 2, predicts performance on the ABP certifying examination. The contribution of training site to ABP performance was statistically significant, though contributed modestly to the effect compared with prior USMLE scores. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The Effectiveness of Public Simulated Oral Examinations in Preparation for the American Board of Surgery Certifying Examination: A Systematic Review.

    Science.gov (United States)

    Pennell, Christopher; McCulloch, Peter

    2015-01-01

    The purpose of this study was to determine whether American Board of Surgery Certifying Examination (CE) performance is improved among residents who prepare using simulated oral examinations (SOEs). EMBASE and MEDLINE were searched using predefined search terms. No language restrictions were imposed and the latest search date was in November 2014. Included studies must have reported on residents training in a general surgery residency in the United States who used SOEs to prepare for the CE and have measured their performance against those without exposure to SOEs. Studies meeting inclusion criteria were qualitatively and quantitatively analyzed and a fixed effects meta-analysis was performed to determine the net effect of SOEs on CE performance. Overall, 4 of 25 abstracts reviewed met inclusion criteria and are included in this review. The most common simulation format included public examinations in front of resident peers during scheduled education sessions. All 4 included studies trended toward improved performance with SOEs and in 2 of these studies the improvement was statistically significant. Overall, 3 studies were of adequate quality to perform a meta-analysis and demonstrated a relative risk for first-attempt CE success of 1.22 (95% CI: 1.07-1.39, p = 0.003) for residents preparing with SOEs compared to those without SOEs. The published literature evaluating SOEs is limited and generally of fair quality. A modest improvement in CE performance was identified when public SOEs were used as an educational tool aimed to improve professionalism and communication skills, encourage reading at home, and provide a regular review of clinically relevant topics. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. Entrance surface dose measurements in pediatric radiological examinations

    International Nuclear Information System (INIS)

    Ribeiro, L.A.; Yoshimura, E.M.

    2008-01-01

    A survey of pediatric radiological examinations was carried out in a reference pediatric hospital of the city of Sao Paulo, in order to investigate the doses to children undergoing conventional X-ray examinations. The results showed that the majority of pediatric patients are below 4 years, and that about 80% of the examinations correspond to chest projections. Doses to typical radiological examinations were measured in vivo with thermoluminescent dosimeters (LiF: Mg, Ti and LiF: Mg, Cu, P) attached to the skin of the children to determine entrance surface dose (ESD). Also homogeneous phantoms were used to obtain ESD to younger children, because the technique uses a so small kVp that the dosimeters would produce an artifact image in the patient radiograph. Four kinds of pediatric examinations were investigated: three conventional examinations (chest, skull and abdomen) and a fluoroscopic procedure (barium swallow). Relevant information about kVp and mAs values used in the examinations was collected, and we discuss how these parameters can affect the ESD. The ESD values measured in this work are compared to reference levels published by the European Commission for pediatric patients. The results obtained (third-quartile of the ESD distribution) for chest AP examinations in three age groups were: 0.056 mGy (2-4 years old); 0.068 mGy (5-9 years old); 0.069 mGy (10-15 years old). All of them are below the European reference level (0.100 mGy). ESD values measured to the older age group in skull and abdomen AP radiographs (mean values 3.44 and 1.20 mGy, respectively) are above the European reference levels (1.5 mGy to skull and 1.0 mGy to abdomen). ESD values measured in the barium swallow examination reached 10 mGy in skin regions corresponding to thyroid and esophagus. It was noticed during this survey that some technicians use, improperly, X-ray fluoroscopy in conventional examinations to help them in positioning the patient. The results presented here are a

  1. Pediatric ophthalmic indications for examination under anesthesia in ...

    African Journals Online (AJOL)

    Objective: To determine the ophthalmic indications and challenges for pediatric ocular examination under anesthesia (EUA). Methods: The surgical register and patients' records of children who underwent EUA between 1990 and 2007 were examined to document patients' bio data, diagnoses and details of procedures and ...

  2. Pediatric radiation exposure from diagnostic nuclear medicine examinations in Tehran

    International Nuclear Information System (INIS)

    Neshandar Asli, I.; Tabeie, F.

    2005-01-01

    As a part of a nationwide survey to estimate population exposure to radiation from diagnostic nuclear medicine in Iran, this paper presents the pediatric population radiation exposure due to nuclear medicine examinations in Tehran. Patients and methods: the effective dose equivalent, H E , was used to calculate the collective effective dose in pediatric patients undergoing nuclear medicine procedures, and the corresponding data were obtained from thirty out of thirty seven active nuclear medicine departments in Tehran. Results: annually about 5.26% of nuclear medicine examinations were performed on patients under 15 years of age in Tehran. The most frequent was renal examinations (38.2%), followed y thyroid (27.4%) and bone (26.7%). The annual collective H E for patients under 15 was 19.03 human-Sv, which contributed 3.96% to the collective H E for all patients. The contribution of renal, bone and thyroid examinations to the pediatric collective H E were 24.6% 48.8% and 13.5% respectively. The mean effective dose equivalent per pediatric patient was 3.75 mSv.Conclusion: Among the three most frequent examinations, the bone with a relative frequency of 27.4% constituted 48.8% of the collective H E , which was the highest absorbed dose per examination. The mean effective dose per examination for patients younger than 15 years was 67.9% of the adults

  3. EnCE EnCase computer forensics : the official EnCase certified examiner : study guide

    CERN Document Server

    Bunting, Steve

    2012-01-01

    The official, Guidance Software-approved book on the newest EnCE exam! The EnCE exam tests that computer forensic analysts and examiners have thoroughly mastered computer investigation methodologies, as well as the use of Guidance Software's EnCase Forensic 7. The only official Guidance-endorsed study guide on the topic, this book prepares you for the exam with extensive coverage of all exam topics, real-world scenarios, hands-on exercises, up-to-date legal information, and sample evidence files, flashcards, and more. Guides readers through preparation for the newest EnCase Certified Examiner

  4. Doses from pediatric CT examinations in Norway: are pediatric scan protocols developed and in daily use?

    International Nuclear Information System (INIS)

    Friberg, Eva G.

    2008-01-01

    Doses to pediatric patients from CT examinations are known to be unnecessarily high if scan protocols developed for adult patients are adopted. This overexposure is most often not recognized by the operating radiographer, due to the digital behavior of the imaging system. Use of optimized size-specific pediatric scan protocols is therefore essential to keep the doses at an appropriate level. The aim of this study was to investigate the doses to pediatric patients from CT examinations and to evaluate the level of optimization of the scan protocols. Patient data, applied scan parameters together with the dose parameters volume computed tomography dose index (CTD vol ) and dose length product (DLP) for examinations of the head, chest and abdomen were collected by means of a questionnaire from five university hospitals. The effective dose was estimated from the total DLP by use of region-specific conversion coefficients (E DLP ). Totally 136, 108 and 82 questionnaires were received for examinations of the head, chest and abdomen, respectively. Large variations in patient doses between the hospitals were observed, addressing the need for optimization of the scan protocols in general. Most of the hospitals applied successive lower mAs with decreasing patient age for all scan areas, while the use of lower tube voltage for small patients and a higher tube voltage for large patients were more rarely. This indicates the presence, to a certain level, of size specific scan protocols at some Norwegian hospitals. Focus on developing size-specific scan protocols for pediatric patients are important to reduce the doses and risks associated with pediatric CT examinations. (author)

  5. The relationship between internal medicine residency graduate performance on the ABIM certifying examination, yearly in-service training examinations, and the USMLE Step 1 examination.

    Science.gov (United States)

    Kay, Cynthia; Jackson, Jeffrey L; Frank, Michael

    2015-01-01

    To explore the relationship between United States Medical Licensing Examination (USMLE) Step 1 scores, yearly in-service training exam (ITE) scores, and passing the American Board of Internal Medicine certifying examination (ABIM-CE). The authors conducted a retrospective database review of internal medicine residents from the Medical College of Wisconsin from 2004 through 2012. Residents' USMLE Step 1, ITE, and ABIM-CE scores were extracted. Pearson rho, chi-square, and logistic regression were used to determine whether relationships existed between the scores and if Step 1 and ITE scores correlate with passing the ABIM-CE. There were 241 residents, who participated in 728 annual ITEs. There were Step 1 scores for 195 (81%) residents and ABIM-CE scores for 183 (76%). Step 1 and ABIM-CE scores had a modest correlation (rho: 0.59), as did ITE and ABIM-CE scores (rho: 0.48-0.67). Failing Step 1 or being in the bottom ITE quartile during any year of testing markedly increased likelihood of failing the boards (Step 1: relative risk [RR]: 2.4; 95% CI: 1.0-5.9; first-year residents' RR: 1.3; 95% CI: 1.0-1.6; second-year residents' RR: 1.3; 95% CI: 1.1-1.5; third-year residents' RR: 1.3; 95% CI: 1.1-1.5). USMLE Step 1 and ITE scores have a modest correlation with board scores. Failing Step 1 or scoring in the bottom quartile of the ITE increased the risk of failing the boards. What effective intervention, if any, program directors may use with at-risk residents is a question deserving further research.

  6. Implementing Assessment Engineering in the Uniform Certified Public Accountant (CPA) Examination

    Science.gov (United States)

    Burke, Matthew; Devore, Richard; Stopek, Josh

    2013-01-01

    This paper describes efforts to bring principled assessment design to a large-scale, high-stakes licensure examination by employing the frameworks of Assessment Engineering (AE), the Revised Bloom's Taxonomy (RBT), and Cognitive Task Analysis (CTA). The Uniform CPA Examination is practice-oriented and focuses on the skills of accounting. In…

  7. Optimization of pediatric examinations in a multislice helical CT

    International Nuclear Information System (INIS)

    Ombada, T. H. A.

    2010-12-01

    Radiological protection of pediatric patients undergoing medical imaging procedures involving ionizing radiation has always received special attention. This is due to the fact that children have higher radiation sensitivity and increased likelihood for radiation-induced cancer manifesting in many more years of their life than adults. In computed tomography (CT), such attention is more important because of the potential of relatively higher radiation doses during these procedures. Such high doses are possible with technological developments where volume scanning using faster multi-slice CT systems is now preferred to conventional CT equipment. The task of this study is to assess the optimization of paediatric doses in multi-slice CT examinations. It was carried out in Alrebat University Hospital for 31 pediatric patients, 43 examinations (27 head examination and 16 body (chest, abdomen and pelvis) examinations). Data were collected for scan parameters (kV, m As, pitch, scan length, number of slices and slice thickness) and doses displayed in monitor (CTDI v ol and DLP) for head examinations and body (chest, abdomen and pelvis) examinations. For head CT, displayed CTDI v ol ranged from 1.56 to 69.12 mGy, calculated value from 2.10 to 70.93 mGy. Displayed DLP ranged from 53 to 1817 mGy.cm, calculated from 95.30 to 1532.16 mGy. cm. For body examination, the range of displayed CTDI from 1.63 to 3.92 mGy, calculated value from 2.22 to 5.34 mGy. Displayed DLP ranged from 34 to 194 mGy.cm, for calculated from 45.89 to 161.98 mGy. cm. The calculated values are in agreement with reference study dose values although there are some high values in this study for some examinations, this variation or difference may attribute to variation in pediatric ages (9 days- 15 years), scan length and m As values. There is variation between calculated and displayed values. more optimization for CT doses is needed. (Author)

  8. Optimization of pediatric examinations in a multislice helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Ombada, T H. A. [Atomic Energy Council, Sudan Academy of Sciences (SAS), Khartoum (Sudan)

    2010-12-15

    Radiological protection of pediatric patients undergoing medical imaging procedures involving ionizing radiation has always received special attention. This is due to the fact that children have higher radiation sensitivity and increased likelihood for radiation-induced cancer manifesting in many more years of their life than adults. In computed tomography (CT), such attention is more important because of the potential of relatively higher radiation doses during these procedures. Such high doses are possible with technological developments where volume scanning using faster multi-slice CT systems is now preferred to conventional CT equipment. The task of this study is to assess the optimization of paediatric doses in multi-slice CT examinations. It was carried out in Alrebat University Hospital for 31 pediatric patients, 43 examinations (27 head examination and 16 body (chest, abdomen and pelvis) examinations). Data were collected for scan parameters (kV, m As, pitch, scan length, number of slices and slice thickness) and doses displayed in monitor (CTDI{sub v}ol and DLP) for head examinations and body (chest, abdomen and pelvis) examinations. For head CT, displayed CTDI{sub v}ol ranged from 1.56 to 69.12 mGy, calculated value from 2.10 to 70.93 mGy. Displayed DLP ranged from 53 to 1817 mGy.cm, calculated from 95.30 to 1532.16 mGy. cm. For body examination, the range of displayed CTDI from 1.63 to 3.92 mGy, calculated value from 2.22 to 5.34 mGy. Displayed DLP ranged from 34 to 194 mGy.cm, for calculated from 45.89 to 161.98 mGy. cm. The calculated values are in agreement with reference study dose values although there are some high values in this study for some examinations, this variation or difference may attribute to variation in pediatric ages (9 days- 15 years), scan length and m As values. There is variation between calculated and displayed values. more optimization for CT doses is needed. (Author)

  9. Reference to the Safety Engineering Undergraduate Courses to Improve the Subjects and Contents of the Certified Safety Engineer Qualification and Examination System of China

    OpenAIRE

    Haibin Qiu; Shanghong Shi; Tingdi Zhao; Yiwei Qiao; Jiangshi Zhang

    2013-01-01

    The aim of this paper is to recommend that the subjects and contents of certified safety engineers use safety engineering undergraduate curriculum system for reference. Human resources play an important role in accident prevention and loss control. Education on safety engineering develops quickly in China. Moreover, the State Administration of Work Safety and the National Human Resources and Social Security Ministry have implemented a certified safety engineer qualification and examination sy...

  10. Measuring the differences in work ratios between pediatric and adult ophthalmologic examinations.

    Science.gov (United States)

    Hyun, Joo; Chang, Jee Ho; Kim, Seung Hoon; Park, Song Hee; Kim, Sunghoon

    2017-06-01

    To assess the differences in work needed for pediatric and adult ophthalmologic examinations. Seven ophthalmology residents conducted slit-lamp and refraction examinations on children 3-7 years of age and adults 20-69 years of age. The examiners reported the magnitude estimate (ME) of their work in relation to two references (cross-reference ME): average adult examination and average pediatric examination. The examination time was also measured. For the slit-lamp examination, 50 children and 58 adults were recruited. The ME was 1.45 (95% CI, 1.30-1.62) times higher for the pediatric examinations than for the adult examinations when the reference was an average adult case. With respect to time, the pediatric examinations took 1.22 (95% CI, 1.06-1.41) times longer than the adult examinations. For the refraction examinations, 58 children and 96 adults were recruited. The ME was 1.35 (95% CI, 1.21-1.52) times higher for the pediatric examinations. The pediatric examination took 1.32 (95% CI, 1.16-1.50) times longer than the adult examination. The cross-reference ME ratios measuring the pediatric over adult examinations against both the pediatric and adult reference cases were equivalent in both the slit-lamp and the refraction examinations; however, the ME and time ratios of the pediatric over the adult examinations were not equivalent for the slit-lamp or for the refraction examinations. The cross-reference ME showed that pediatric ophthalmologic examinations require more work than the adult examination with validity and reliability. The time estimate was insufficient as a single indicator for work estimation. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  11. Sedation for pediatric neuroradiological examinations. Retrospective study of 160 cases

    International Nuclear Information System (INIS)

    Shose, Yoshiteru; Oi, Shizuo

    1995-01-01

    A retrospective study of 160 pediatric neuroradiological examinations was conducted to determine the efficacy and safety of two sedation regimens (figs. 1, 2). For CT purposes, 150 patients (fig. 3) were orally given monosodium trichlorethyl phosphate syrup (100 mg/kg, with repeat 50 mg/kg if necessary), and for cerebral angiography, 15 patients (fig. 4) were intramuscularly administered a modified D.P.T. cocktail (pentazocine, chlorpromadine, promethazine). Failure rate in the oral syrup group was 6%, and in the D.P.T. group 6.7%. Diagnostic-quality images were obtained in 99.3% and 100%, respectively, of the two groups. There were neither mortality nor significant complications (table 3). It was concluded that each method had proved acceptably safe and effective, and that measures can be taken to further decrease complications and sedation failures. (author)

  12. Evaluation of Romblon State University’s Adopt-a-Reviewee Project for Certified Public Accountant Licensure Examination

    Directory of Open Access Journals (Sweden)

    Sherryll M. Fetalvero

    2018-02-01

    Full Text Available This study is part of a bigger evaluation research about the Adopt-a-Reviewee Project for Certified Public Accountant Licensure Examination (ADOPT of the College of Business and Accountancy of Romblon State University. The project was assessed using Stufflebeam’s Context, Input, Process and Product (CIPP evaluation model. This paper however, focuses only on CIPP’s product evaluation component which is essential in making decisions as to the continuation or abortion of the project. A mixed method research was employed in gathering information from 16 beneficiaries and their respective families using two parallel forms of validated evaluation questionnaire complemented with interviews. These data were triangulated in a focus group composed of beneficiaries, benefactors, administrative officials, college dean and accounting teachers. To determine the effect of ADOPT on RSU’s passing performance in the CPA Licensure Examination (CPALE, a series of comparative tests was done. Results reveal that ADOPT is an effective intervention in improving RSU’s performance in CPALE as well as the socio- economic condition and well-being of the beneficiaries and their families. Workable measures are advanced in order to sustain the project despite challenges in fund sourcing and generation.

  13. Certified Schools

    Data.gov (United States)

    Department of Homeland Security — Certified schools must provide specific information regarding the school, the nature and requirements of the educational program, location and contact information,...

  14. An algorithm to biological tissues evaluation in pediatric examinations

    International Nuclear Information System (INIS)

    Souza, R.T.F.; Miranda, J.R.A.; Alvarez, M.; Velo, A.F.; Pina, D.R.

    2011-01-01

    A prerequisite for the construction of phantoms is the quantification of the average thickness of biological tissues and the equivalence of these simulators in simulator material thicknesses. This study aim to develop an algorithm to classify and quantify tissues, based on normal distribution of CT numbers of anatomical structures found in the mean free path of the X-rays beam, using the examination histogram to carry out this evaluation. We have considered an algorithm for the determination of the equivalent biological tissues thickness from histograms. This algorithm classifies different biological tissues from tomographic exams in DICOM format and calculates the average thickness of these tissues. The founded results had revealed coherent with literature, presenting discrepancies of up to 21,6%, relative to bone tissue, analyzed for anthropomorphic phantom (RANDO). These results allow using this methodology in livings tissues, for the construction of thorax homogeneous phantoms, of just born and suckling patients, who will be used later in the optimization process of pediatrics radiographic images. (author)

  15. Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

    Science.gov (United States)

    Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

    2015-03-01

    A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P ITE total and percentile rank scores (P ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

  16. Sequential Participation in a Multi-Institutional Mock Oral Examination Is Associated With Improved American Board of Surgery Certifying Examination First-Time Pass Rate.

    Science.gov (United States)

    Fingeret, Abbey L; Arnell, Tracey; McNelis, John; Statter, Mindy; Dresner, Lisa; Widmann, Warren

    We sought to determine whether sequential participation in a multi-institutional mock oral examination affected the likelihood of passing the American Board of Surgery Certifying Examination (ABSCE) in first attempt. Residents from 3 academic medical centers were able to participate in a regional mock oral examination in the fall and spring of their fourth and fifth postgraduate year from 2011 to 2014. Candidate׳s highest composite score of all mock orals attempts was classified as risk for failure, intermediate, or likely to pass. Factors including United States Medical Licensing Examination steps 1, 2, and 3, number of cases logged, American Board of Surgery In-Training Examination performance, American Board of Surgery Qualifying Examination (ABSQE) performance, number of attempts, and performance in the mock orals were assessed to determine factors predictive of passing the ABSCE. A total of 128 mock oral examinations were administered to 88 (71%) of 124 eligible residents. The overall first-time pass rate for the ABSCE was 82%. There was no difference in pass rates between participants and nonparticipants. Of them, 16 (18%) residents were classified as at risk, 47 (53%) as intermediate, and 25 (29%) as likely to pass. ABSCE pass rate for each group was as follows: 36% for at risk, 84% for intermediate, and 96% for likely pass. The following 4 factors were associated with first-time passing of ABSCE on bivariate analysis: mock orals participation in postgraduate year 4 (p = 0.05), sequential participation in mock orals (p = 0.03), ABSQE performance (p = 0.01), and best performance on mock orals (p = 0.001). In multivariable logistic regression, the following 3 factors remained associated with ABSCE passing: ABSQE performance, odds ratio (OR) = 2.9 (95% CI: 1.3-6.1); mock orals best performance, OR = 1.7 (1.2-2.4); and participation in multiple mock oral examinations, OR = 1.4 (1.1-2.7). Performance on a multi-institutional mock oral examination can identify

  17. Establishment of radiation doses for pediatric X-ray examinations in a large pediatric hospital in Turkey

    International Nuclear Information System (INIS)

    Olgar, T.; Sahmaran, T.

    2017-01-01

    Pediatric patients are more sensitive to ionizing radiation when compared with adults. The aim of this study was to evaluate the radiation doses for some common pediatric x-ray examinations performed with various digital radiography systems. Quality control tests of the digital radiography systems were carried out according to international published protocols before the pediatric dose measurements. Radiation dose measurement was performed by using the x-ray tube outputs and thermoluminescent dosimeter dose measurement methods. In the present study, radiation doses were assessed for 247 chest, 230 pelvis, 194 skull and 73 abdomen x-ray examinations and in total 744 pediatric patients doses were measured. Pediatric patients were classified into four age groups 0-1, 1-5, 5-10 and 10-15 years as given by European Commission guidance. Effective doses were determined for each examination using a PCXMC 2.0 Monte Carlo program. The mean measured entrance skin doses for the age interval 1-5 years and AP projection by using tube output measurement methods were 149 μGy for chest, 304 μGy for pelvis, 387 μGy for skull and 199 μGy for abdomen examinations. The radiation dose results obtained in this study were in the range of the published results in the literature. (authors)

  18. Could Bad Certifiers Certify Best?

    DEFF Research Database (Denmark)

    Bizotto, Jacopo; Rudiger, Jesper; Vigier, Adrien

    2017-01-01

    We study product certification in settings where the certifier maximizes social welfare and bases his decisions on a mixture of information, some of which is voluntarily disclosed by the sellers, and some of which he acquires first hand by testing products. We show that unless the certifier is able...... to pre-commit to a testing strategy, then having better access to information may lead to worse certification quality, by crowding out information disclosed by the sellers. Policy implications are discussed....

  19. Radiation Measurement And Risk Estimation For Pediatric Patients During Routine Diagnostic Examination

    International Nuclear Information System (INIS)

    Bushra, E.; Sulieman, A.; Osman, H.

    2011-01-01

    The aim of the present work was to evaluate Entrance Surface Dose (ESD) to the patient using Thermo luminescence dosimeters (TLD) during some common routine pediatrics X-ray examinations in main pediatrics hospitals in Sudan. ESD and Effective Dose (E) for pediatrics have been carried out for 250 patients undergoing five different examinations. The mean ESD ranged for neonates ranged between 0.17 mGy-0.30 mGy per radiograph with scattered thyroid dose 0.01 to 0.19 mGy. The risk of radiation induced cancer of was 0.13 x 10-6.

  20. An Examination of a Yoga Intervention With Pediatric Burn Survivors.

    Science.gov (United States)

    Conn, Amy S; Hall, Morgan S; Quinn, Kristen; Wiggins, Bradley; Memmott, Carolyn; Brusseau, Timothy A

    Burn injuries have a major influence on the survivors' physical and psychological functioning. In pediatric burns, the consequences persist long after the injury. The objective of this study is to evaluate an existing yoga kids program to gain better understanding of the physical and psychosocial effects of a yoga practice among children with burn injuries. Thirty campers participated in a series of four (1 hour) yoga sessions during the summer of 2014. Nationally trained Instructors had taught children's yoga in the Southwestern United States for at least 10 years. A Yoga Evaluation Questionnaire, designed for children, was used to evaluate perceptions of somatic and cognitive anxiety before and after each Yoga session. Camper's age ranged from 6 to 12 years old with burn severities ranging from 5 to 75%. A dependent samples t-test was used to test for differences between composite pre- and postintervention scores for both somatic and cognitive anxiety. Significant effects emerged for somatic anxiety t(29) = -4.24, P Yoga program may lower perceptions of cognitive and somatic anxiety in pediatric burn survivors. Further, Yoga is one technique that may compliment the short- and long-term treatment of burn injuries.

  1. Adaptive statistical iterative reconstruction: reducing dose while preserving image quality in the pediatric head CT examination.

    Science.gov (United States)

    McKnight, Colin D; Watcharotone, Kuanwong; Ibrahim, Mohannad; Christodoulou, Emmanuel; Baer, Aaron H; Parmar, Hemant A

    2014-08-01

    Over the last decade there has been escalating concern regarding the increasing radiation exposure stemming from CT exams, particularly in children. Adaptive statistical iterative reconstruction (ASIR) is a relatively new and promising tool to reduce radiation dose while preserving image quality. While encouraging results have been found in adult head and chest and body imaging, validation of this technique in pediatric population is limited. The objective of our study was to retrospectively compare the image quality and radiation dose of pediatric head CT examinations obtained with ASIR compared to pediatric head CT examinations without ASIR in a large patient population. Retrospective analysis was performed on 82 pediatric head CT examinations. This group included 33 pediatric head CT examinations obtained with ASIR and 49 pediatric head CT examinations without ASIR. Computed tomography dose index (CTDIvol) was recorded on all examinations. Quantitative analysis consisted of standardized measurement of attenuation and the standard deviation at the bilateral centrum semiovale and cerebellar white matter to evaluate objective noise. Qualitative analysis consisted of independent assessment by two radiologists in a blinded manner of gray-white differentiation, sharpness and overall diagnostic quality. The average CTDIvol value of the ASIR group was 21.8 mGy (SD = 4.0) while the average CTDIvol for the non-ASIR group was 29.7 mGy (SD = 13.8), reflecting a statistically significant reduction in CTDIvol in the ASIR group (P ASIR group as compared to the 3- to 12-year-old non-ASIR group (21.5 mGy vs. 30.0 mGy; P = 0.004) as well as statistically significant reductions in CTDI for the >12-year-old ASIR group as compared to the >12-year-old non-ASIR group (29.7 mGy vs. 49.9 mGy; P = 0.0002). Quantitative analysis revealed no significant difference in the homogeneity of variance in the ASIR group compared to the non-ASIR group. Radiologist assessment of

  2. Adaptive statistical iterative reconstruction: reducing dose while preserving image quality in the pediatric head CT examination

    Energy Technology Data Exchange (ETDEWEB)

    McKnight, Colin D.; Watcharotone, Kuanwong; Ibrahim, Mohannad; Christodoulou, Emmanuel; Baer, Aaron H.; Parmar, Hemant A. [University of Michigan, Department of Radiology, Ann Arbor, MI (United States)

    2014-08-15

    Over the last decade there has been escalating concern regarding the increasing radiation exposure stemming from CT exams, particularly in children. Adaptive statistical iterative reconstruction (ASIR) is a relatively new and promising tool to reduce radiation dose while preserving image quality. While encouraging results have been found in adult head and chest and body imaging, validation of this technique in pediatric population is limited. The objective of our study was to retrospectively compare the image quality and radiation dose of pediatric head CT examinations obtained with ASIR compared to pediatric head CT examinations without ASIR in a large patient population. Retrospective analysis was performed on 82 pediatric head CT examinations. This group included 33 pediatric head CT examinations obtained with ASIR and 49 pediatric head CT examinations without ASIR. Computed tomography dose index (CTDI{sub vol}) was recorded on all examinations. Quantitative analysis consisted of standardized measurement of attenuation and the standard deviation at the bilateral centrum semiovale and cerebellar white matter to evaluate objective noise. Qualitative analysis consisted of independent assessment by two radiologists in a blinded manner of gray-white differentiation, sharpness and overall diagnostic quality. The average CTDI{sub vol} value of the ASIR group was 21.8 mGy (SD = 4.0) while the average CTDI{sub vol} for the non-ASIR group was 29.7 mGy (SD = 13.8), reflecting a statistically significant reduction in CTDI{sub vol} in the ASIR group (P < 0.01). There were statistically significant reductions in CTDI for the 3- to 12-year-old ASIR group as compared to the 3- to 12-year-old non-ASIR group (21.5 mGy vs. 30.0 mGy; P = 0.004) as well as statistically significant reductions in CTDI for the >12-year-old ASIR group as compared to the >12-year-old non-ASIR group (29.7 mGy vs. 49.9 mGy; P = 0.0002). Quantitative analysis revealed no significant difference in the

  3. Adaptive statistical iterative reconstruction: reducing dose while preserving image quality in the pediatric head CT examination

    International Nuclear Information System (INIS)

    McKnight, Colin D.; Watcharotone, Kuanwong; Ibrahim, Mohannad; Christodoulou, Emmanuel; Baer, Aaron H.; Parmar, Hemant A.

    2014-01-01

    Over the last decade there has been escalating concern regarding the increasing radiation exposure stemming from CT exams, particularly in children. Adaptive statistical iterative reconstruction (ASIR) is a relatively new and promising tool to reduce radiation dose while preserving image quality. While encouraging results have been found in adult head and chest and body imaging, validation of this technique in pediatric population is limited. The objective of our study was to retrospectively compare the image quality and radiation dose of pediatric head CT examinations obtained with ASIR compared to pediatric head CT examinations without ASIR in a large patient population. Retrospective analysis was performed on 82 pediatric head CT examinations. This group included 33 pediatric head CT examinations obtained with ASIR and 49 pediatric head CT examinations without ASIR. Computed tomography dose index (CTDI vol ) was recorded on all examinations. Quantitative analysis consisted of standardized measurement of attenuation and the standard deviation at the bilateral centrum semiovale and cerebellar white matter to evaluate objective noise. Qualitative analysis consisted of independent assessment by two radiologists in a blinded manner of gray-white differentiation, sharpness and overall diagnostic quality. The average CTDI vol value of the ASIR group was 21.8 mGy (SD = 4.0) while the average CTDI vol for the non-ASIR group was 29.7 mGy (SD = 13.8), reflecting a statistically significant reduction in CTDI vol in the ASIR group (P 12-year-old ASIR group as compared to the >12-year-old non-ASIR group (29.7 mGy vs. 49.9 mGy; P = 0.0002). Quantitative analysis revealed no significant difference in the homogeneity of variance in the ASIR group compared to the non-ASIR group. Radiologist assessment of gray-white differentiation, sharpness and overall diagnostic quality in ASIR examinations was not substantially different compared to non-ASIR examinations. The use of ASIR in

  4. Analysis of an In-Service Examination for Core Pediatric Craniofacial Surgery Knowledge.

    Science.gov (United States)

    Silvestre, Jason; Chang, Benjamin; Taylor, Jesse A

    2016-01-01

    Little is known about designing an effective residency curriculum for pediatric craniofacial surgery. This study elucidates the pediatric craniofacial curriculum of the Plastic Surgery In-Service Training Examination (PSITE) to facilitate knowledge acquisition during residency. Approximately, 6 consecutive PSITEs were reviewed for pediatric craniofacial questions (2010-2015). Subjects were categorized according to topics on the American Board of Plastic Surgery written board examination. Questions were categorized using an educational taxonomy model. Answer references were categorized by source and publication lag. Of 1174 PSITE questions, 147 tested pediatric craniofacial topics (12.5%). Questions appeared predominately in the Craniomaxillofacial section (83.0%, p < 0.001). The annual representation was stable more than 6 years (range: 10.2%-14.4%, p = 0.842). Question taxonomy favored interpretation (45.6%) and decision-making (40.8%) over recall (13.6%, p < 0.001) skills, and 41 questions had an associated image (27.9%) and most were photographic (76.7%, p < 0.001). The most frequently tested categories on the American Board of Plastic Surgery written examination content outline were craniofacial anomalies (23.5%), benign and malignant tumors (17.6%), and cleft lip and palate (12.5%). Overall, 80 unique journals were cited 304 times with a mean publication lag of 9.4 ± 10.9 years. Plastic and Reconstructive Surgery (34.5%) was the most cited journal (p < 0.001). These data may assist in designating core knowledge competency in pediatric craniofacial surgery for plastic surgery residents. A further understanding of PSITE utility for core knowledge competency in pediatric craniofacial surgery would be the focus of future work. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. An Uncontrolled Examination of a 5-Day Intensive Treatment for Pediatric OCD

    Science.gov (United States)

    Whiteside, Stephen P.; Jacobsen, Amy Brown

    2010-01-01

    This study examined the feasibility of a 5-day intensive treatment for pediatric obsessive-compulsive disorder (OCD). Fifteen children with OCD received a week-long treatment based on exposure and response prevention (ERP). The intervention also emphasized teaching children and parents how to conduct ERP independently at home. All families…

  6. Evaluation of Pediatric Questions on the Orthopaedic In-Training Examination-An Update.

    Science.gov (United States)

    Murphy, Robert F; Nunez, Leah; Barfield, William R; Mooney, James F

    2017-09-01

    Pediatric orthopaedics is tested frequently on the Orthopaedic In-Training Examination (OITE). The most recent data on the pediatrics section of the OITE were generated from content 10 years old. The purpose of this study is to assess the pediatric orthopaedic questions on the 2011 to 2014 OITE, and to compare question categories and cognitive taxonomy with previous data. Four years (2011 to 2014) of OITE questions, answers, and references were reviewed. The number of pediatric questions per year was recorded, as well as presence of a clinical photo or imaging modality. Each question was categorized and assigned a cognitive taxonomy level. Categories included: knowledge; knowledge-treatment modalities; diagnosis; diagnosis/recognition of associated conditions; diagnosis/further studies; and diagnosis/treatment. Cognitive taxonomy levels included: simple recall, interpretation of data, and advanced problem-solving. The 3 most commonly covered topics were upper extremity trauma (17.4%), scoliosis (10.1%), and developmental dysplasia of the hip (5.7%). Compared with previous data, the percentage of pediatric questions was constant (13% vs. 14%). Categorically, the more recent OITE examinations contained significantly fewer questions testing simple knowledge (19% vs. 39%, P=0.0047), and significantly more questions testing knowledge of treatment modalities (17% vs. 9%, P=0.016) and diagnosis with associated conditions (19% vs. 9%, P=0.0034). Regarding cognitive taxonomy, there was a significant increase in the average number of questions that required advanced problem-solving (57% vs. 46%, P=0.048). Significantly more questions utilized clinical photographs and imaging studies (62% vs. 48%, P=0.012). The most common reference materials provided to support correct responses included Lovell and Winter's Pediatric Orthopaedics (25.7%) and the Journal of Pediatric Orthopaedics (23.4%). Although the percentage of pediatric questions on the OITE has remained essentially

  7. Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations

    Energy Technology Data Exchange (ETDEWEB)

    Creeden, Sean G.; Rao, Anil G.; Eklund, Meryle J.; Hill, Jeanne G.; Thacker, Paul G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2017-03-15

    Although practice patterns vary, scout radiographs are often routinely performed with pediatric fluoroscopic studies. However few studies have evaluated their utility in routine pediatric fluoroscopy. To evaluate the value of scout abdomen radiographs in routine barium or water-soluble enema, upper gastrointestinal (GI) series, and voiding cystourethrogram pediatric fluoroscopic procedures. We retrospectively evaluated 723 barium or water-soluble enema, upper GI series, and voiding cystourethrogram fluoroscopic procedures performed at our institution. We assessed patient history and demographics, clinical indication for the examination, prior imaging findings and impressions, scout radiograph findings, additional findings provided by the scout radiograph that were previously unknown, and whether the scout radiograph contributed any findings that significantly changed management. We retrospectively evaluated 723 fluoroscopic studies (368 males and 355 females) in pediatric patients. Of these, 700 (96.8%) had a preliminary scout radiograph. Twenty-three (3.2%) had a same-day radiograph substituted as a scout radiograph. Preliminary scout abdomen radiographs/same-day radiographs showed no new significant findings in 719 (99.4%) studies. New but clinically insignificant findings were seen in 4 (0.6%) studies and included umbilical hernia, inguinal hernia and hip dysplasia. No findings were found on the scout radiographs that would either alter the examination performed or change management with regard to the exam. Pre-procedural scout abdomen radiographs are unnecessary in routine barium and water-soluble enema, upper GI series, and voiding cystourethrogram pediatric fluoroscopic procedures and can be substituted with a spot fluoroscopic last-image hold. (orig.)

  8. Eating disorder examination: Factor structure and norms in a clinical female pediatric eating disorder sample.

    Science.gov (United States)

    O'Brien, Amy; Watson, Hunna J; Hoiles, Kimberley J; Egan, Sarah J; Anderson, Rebecca A; Hamilton, Matthew J; Shu, Chloe; McCormack, Julie

    2016-01-01

    The factor structure of the eating disorder examination (EDE) has never been tested in a clinical pediatric sample, and no normative data exist. The factor structure of an adapted EDE was examined in a clinical sample of 665 females aged 9-17 years with anorexia nervosa spectrum (70%), bulimia nervosa spectrum (12%), purging disorder (3%), and unspecified feeding and eating disorders (15%). The original four-factor model was a good fit in a confirmatory factor analysis as well a higher order model with three dimensions of restraint, eating concern, and combined weight concern/shape concern. Normative data are reported for clinicians to identify the percentiles in which their patients' score. The findings support dimensions of restraint, eating concern, weight concern, and shape concern in a clinical pediatric sample. This supports the factorial validity of the EDE, and the norms may assist clinicians to evaluate symptoms in females under 18 years. © 2015 Wiley Periodicals, Inc.

  9. The usefulness of physical examination and laboratory data in pediatric patients with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Muramori, Katsumi; Kondo, Tsuyoshi; Zaizen, Yoshio; Tsuno, Shinsuke

    2007-01-01

    To evaluate the usefulness of clinical and laboratory data in pediatric patients with abdominal blunt trauma, the case records of 43 pediatric cases with blunt trauma who were admitted to our hospital were reviewed retrospectively. Among these patients, 23 were determined to have intraabdominal injury. Abdominal physical examination was not statistically identified to be a predictor of intraabdominal injury, however, the hematocrit and serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were significantly aberrant in these cases. Furthermore, the mean AST and ALT values in the non-hepatic injury cases were also apt to be higher than those in the no-injury group. These findings suggested that the serum AST and ALT may be possible predictors of intraabdominal injury, not only that restricted to the liver. Additionally, in our cases, abdominal CT examination was more diagnostic than ultrasound examination. Accordingly, in cases of pediatric abdominal blunt trauma with aberrant serum values of the liver transaminases, CT san should be performed electively. (author)

  10. Results of a second questionnaire on pediatric X-ray examinations

    International Nuclear Information System (INIS)

    Ishikawa, Mitsuo; Kubota, Katsumi

    1999-01-01

    Radiographic conditions (x-ray tube voltage, irradiation time, etc.) differ among medical facilities. A second questionnaires was sent out to determine the current state of pediatric radiography and eventually provide reference materials for the standardization of radiographic parameters used in pediatric x-ray examinations. The questionnaire, which was sent in 1996, targeted 161 facilities that belong to the Society for Pediatric Radiological Technology. The objects of examination were the chest, upper airway, abdomen, hip joint, skull, and knee joint. The questionnaire investigated age (children of six months, three years, and seven years), type of x-ray generator, radiographic conditions, etc. Moreover, this time the items head x-ray computed tomography (X-CT) and abdominal X-CT were added. Completed questionnaires were received from 79 facilities, for a recovery of 49.1%. Compared with the previous investigation, inverter-type high-voltage assemblies increased, whereas twelve-peak high-voltage assemblies decreased. The focal spot of the x-ray tube assembly was smaller, and maximum anode heat content had increased. CR systems and green luminescence-orthochromatic systems were increasingly being used as image receptors. Advances in x-ray generators and the image receptor systems created reductions in the time required for radiography, which was possible at as short a time as 1 msec. Moreover, image quality was also improved by these advances. However, no major changes were observed in the conditions of radiography. (author)

  11. Pediatric sexual assault nurse examiner care: trace forensic evidence, ano-genital injury, and judicial outcomes.

    Science.gov (United States)

    Hornor, Gail; Thackeray, Jonathan; Scribano, Philip; Curran, Sherry; Benzinger, Elizabeth

    2012-09-01

    Although pediatric sexual assault nurse examiners (P-SANEs) have been providing care for over two decades there remain major gaps in the literature describing the quality of P-SANE care and legal outcomes associated with their cases. The purpose of this study was to compare quality indicators of care in a pediatric emergency department (PED) before and after the implementation of a P-SANE program described in terms of trace forensic evidence yield, identification of perpetrator DNA, and judicial outcomes in pediatric acute sexual assault. A retrospective review of medical and legal records of all patients presenting to the PED at Nationwide Children's Hospital with concerns of acute sexual abuse/assault requiring forensic evidence collection from 1/1/04 to 12/31/07 was conducted. Detection and documentation of ano-genital injury, evaluation and documentation of pregnancy status, and testing for N. gonorrhea and C. trachomatis was significantly improved since implementation of the P-SANE Program compared to the historical control. The addition of a P-SANE to the emergency department (ED) provider team improved the quality of care to child/adolescent victims of acute sexual abuse/assault. © 2012 International Association of Forensic Nurses.

  12. Pediatrics

    Science.gov (United States)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  13. Pediatrics

    NARCIS (Netherlands)

    Rasheed, Shabana; Teo, Harvey James Eu Leong; Littooij, Annemieke Simone

    2015-01-01

    Imaging of pediatric patients involves many diverse modalities, including radiography, ultrasound imaging, computed tomography, magnetic resonance imaging, and scintigraphic and angiographic studies. It is therefore important to be aware of potential pitfalls that may be related to these modalities

  14. Survey of image quality and radiographic technique of pediatric chest examinations performed in Latin America

    International Nuclear Information System (INIS)

    Khoury, H.; Mora, P.; Defaz, M.Y.; Blanco, S.; Leyton, F.; Benavente, T.; Ortiz Lopez, P.; Ramirez, R.

    2008-01-01

    This work presents the results of a survey of entrance surface air kerma values (K e ), image quality and radiographic exposure parameters used in pediatric chest examinations performed in Latin America. This study is part of the activities of the IAEA Regional Project RLA/9/057 whose objective is to optimize the radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. The survey was performed in nine hospitals in Argentina (1), Brazil (4), Chile (1), Costa Rica (1), Peru (1) and Ecuador (1). The study group consisted of 462 pediatric patients (Group I- from two days to one year, Group II- from four to six years of age) undergoing chest PA/AP examinations. At the time of the examination the exposure parameters (kVp, mAs, focal-spot-to-film distance, etc.) and patient information (gender, height, weight and age) were recorded. The radiographic image quality was evaluated by the local radiologist based on the European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Pediatrics. The results showed that the exposure parameters used on newborn patients were in the majority outside the 60-65kV range recommended by the European Guidelines for a good radiographic practice. In the case of examinations of patients with age between 4 to 6 years, 80% were performed with a peak tube voltage within the 60-80 kV range, as recommended by the European Guidelines. It was found that none of countries fully comply with the European Guidelines on Quality Criteria and those criteria No. 2 and No. 3 (reproduction of the chest without rotation) received the lowest scores. Probably this occurs because there are no proper patient immobilization devices. The Ke values, for both patient groups, showed a wide dispersion, ranged from 10 μGy to 160μGy for the newborn patients and from 20μGy to 240μGy for infant patients. It is possible to conclude that, in the participating Latin American countries on this project

  15. Development of a method to estimate organ doses for pediatric CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Papadakis, Antonios E., E-mail: apapadak@pagni.gr; Perisinakis, Kostas; Damilakis, John [Department of Medical Physics, University Hospital of Heraklion, Faculty of Medicine, University of Crete, P.O. Box 1352, Iraklion, Crete 71110 (Greece)

    2016-05-15

    Purpose: To develop a method for estimating doses to primarily exposed organs in pediatric CT by taking into account patient size and automatic tube current modulation (ATCM). Methods: A Monte Carlo CT dosimetry software package, which creates patient-specific voxelized phantoms, accurately simulates CT exposures, and generates dose images depicting the energy imparted on the exposed volume, was used. Routine head, thorax, and abdomen/pelvis CT examinations in 92 pediatric patients, ranging from 1-month to 14-yr-old (49 boys and 43 girls), were simulated on a 64-slice CT scanner. Two sets of simulations were performed in each patient using (i) a fixed tube current (FTC) value over the entire examination length and (ii) the ATCM profile extracted from the DICOM header of the reconstructed images. Normalized to CTDI{sub vol} organ dose was derived for all primary irradiated radiosensitive organs. Normalized dose data were correlated to patient’s water equivalent diameter using log-transformed linear regression analysis. Results: The maximum percent difference in normalized organ dose between FTC and ATCM acquisitions was 10% for eyes in head, 26% for thymus in thorax, and 76% for kidneys in abdomen/pelvis. In most of the organs, the correlation between dose and water equivalent diameter was significantly improved in ATCM compared to FTC acquisitions (P < 0.001). Conclusions: The proposed method employs size specific CTDI{sub vol}-normalized organ dose coefficients for ATCM-activated and FTC acquisitions in pediatric CT. These coefficients are substantially different between ATCM and FTC modes of operation and enable a more accurate assessment of patient-specific organ dose in the clinical setting.

  16. Study of dosimetric quantities and image quality in pediatric examinations of chest and abdomen computed tomography

    International Nuclear Information System (INIS)

    Jornada, Tiago da Silva

    2013-01-01

    This work had the objective to achieve the knowledge of the dosimetric quantities related to chest and abdomen computed tomography (CT) examinations of pediatric patients, in Belo Horizonte city. The reason of this work is based on the fact that the probability of health detriment in children, which it may be caused by radiation, is higher than in adults. Besides, although in many countries the knowledge and control of patient doses is a normal procedure, this safety culture does not exist in Brazil. Another objective of this work was to compare the dosimetric quantity values with the Diagnostic Reference Levels (DRLs); when it was needed, an optimization process was applied and the quality of the diagnostic image obtained with the optimized technical parameters was analyzed. This study was carried out in five hospitals, where the weighted air kerma index (Cw), the volumetric air kerma index (Cvol), the air kerma - length product (PKL,CT), the Effective Dose (E) and the Normalized Effective Dose (En) were determined; three methods were adopted for measurements: the ionization chamber inside a chest pediatric phantom, radiochromic films and the CT-EXPO software. The optimization process was applied to a single hospital through variations in the current (mA) and voltage (kV) of the x-ray tube for the protocols used for abdomen CT examinations. The analysis of the quality of the diagnostic image was done by Normal Distribution and ROC analysis; spatial resolution analysis was used through MTF determination and the noise level was judged in terms quantitative and qualitative. Results of the dosimetric quantities showed that they significantly differed between single-slice and multi-slice tomography units, but their values were always below the recommended DRLs. The optimized values of the dosimetric quantities obtained after the optimization process showed that it was possible to reduce the radiation exposure of pediatric patient without losing the image quality

  17. Examining Profiles of Family Functioning in Pediatric Asthma: Longitudinal Associations With Child Adjustment and Asthma Severity.

    Science.gov (United States)

    Al G Hriwati, Nour; Winter, Marcia A; Everhart, Robin S

    2017-05-01

    Identify profiles of functioning in families of children with asthma and examine whether profile membership predicts subsequent child mental and physical well-being. Primary caregivers and children ( N  = 1,030) from the Childhood Asthma Management Program completed questionnaires assessing family functioning and child adaptation at five time points. Asthma severity was also assessed via spirometry. Latent profile analyses identified a four-profile solution as best fitting the data: cohesive, permissive, controlling/disengaged, and controlling/enmeshed families. Distal outcome analyses using Bolck-Croon-Hagenaars techniques suggested that children from families that were more cohesive had fewer internalizing and externalizing symptoms. These associations remained stable across time. Family profiles did not differ with regards to child asthma severity. Results highlight the importance of looking beyond the effects of distinct components of family functioning and instead using pattern-based approaches. Recommendations for incorporating screenings and services for families in pediatric care settings are provided. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  18. Estimation of effective doses in pediatric X-ray computed tomography examination.

    Science.gov (United States)

    Obara, Hideki; Takahashi, Midori; Kudou, Kazuya; Mariya, Yasushi; Takai, Yoshihiro; Kashiwakura, Ikuo

    2017-11-01

    X-ray computed tomography (CT) images are used for diagnostic and therapeutic purposes in various medical disciplines. In Japan, the number of facilities that own diagnostic CT equipment, the number of CT examinations and the number of CT scanners increased by ~1.4-fold between 2005 and 2011. CT operators (medical radiological technologists, medical physicists and physicians) must understand the effective doses for examinations at their own institutions and carefully approach each examination. In addition, the patients undergoing the examination (as well as his/her family) must understand the effective dose of each examination in the context of the cumulative dose. In the present study, the numbers of pediatric patients (aged 0-5 years) and total patients who underwent CT at Hirosaki University Hospital (Hirosaki, Japan) between January 2011 and December 2013 were surveyed, and effective doses administered to children aged 0, 1 and 5 years were evaluated. Age- and region-specific conversion factors and dose-length products obtained from the CT scanner were used to estimate the effective doses. The numbers of CT examinations performed in 2011, 2012 and 2013 were 16,662, 17,491 and 17,649, respectively, of which 613 (1.2%) of the overall total involved children aged 0-5 years. The estimated effective doses per examination to children aged 0, 1 and 5 years were 6.3±4.8, 4.9±3.8 and 2.7±3.0 mSv, respectively. This large variation was attributed to several factors associated with scan methods and ranges in actual setting. In conclusion, the requirement for individual patient prospective exposure management systems and estimations of low-dose radiation exposure should be considered in light of the harmful effects of exposure.

  19. Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

    Science.gov (United States)

    Franklin, Corinna C; Bosch, Patrick P; Grudziak, Jan S; Dede, Ozgur; Ramirez, Rey N; Mendelson, Steven A; Ward, W Timothy; Brooks, Maria; Kenkre, Tanya; Lubahn, John D; Deeney, Vincent F; Roach, James W

    2017-03-01

    Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (Pdidactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores. Level III-retrospective case-control study.

  20. Scatter and transmission doses from several pediatric X-ray examinations in a nursery

    International Nuclear Information System (INIS)

    Burrage, John W.; Rampant, Peter L.; Beeson, Brendan P.

    2003-01-01

    While several studies have investigated the dose from scattered radiation from X-ray procedures in a pediatric nursery, they examined scatter from chest procedures only, or the types of examination were not specified. The aim of this study was to collect scatter and transmission data from several types of X-ray examinations. Using a ''newborn'' anthropomorphic phantom and an ion chamber, a series of scatter and transmission dose measurements were performed using typical exposure factors for chest, chest and abdomen, skull, skeletal long bone and spine procedures. The phantom was inside a crib for all exposures. The maximum scatter dose measured at 1 m from the field center was about 0.05 μGy per exposure for lateral skulls. Transmission doses for lateral exams were around 0.1 μGy per exposure at 1 m from the isocenter. The study demonstrated that scatter dose to other patients in a neonatal unit is not significant, assuming the distance between adjacent cribs is in the order of 1 m. Transmission doses are also low provided the beam is fully intercepted by the cassette. For an average workload the dose received by imaging technologists would be small. (orig.)

  1. Evaluation of radiation dose in pediatric head CT examination: a phantom study

    Science.gov (United States)

    Norhasrina Nik Din, Nik; Zainon, Rafidah; Rahman, Ahmad Taufek Abdul

    2018-01-01

    The aim of this study was to evaluate the radiation dose in pediatric head Computed Tomography examination. It was reported that decreasing tube voltage in CT examination can reduce the dose to patients significantly. A head phantom was scanned with dual-energy CT at 80 kV and 120 kV. The tube current was set using automatic exposure control mode and manual setting. The pitch was adjusted to 1.4, 1.45 and 1.5 while the slice thickness was set at 5 mm. The dose was measured based on CT Dose Index (CTDI). Results from this study have shown that the image noise increases substantially with low tube voltage. The average dose was 2.60 mGy at CT imaging parameters of 80 kV and 10 - 30 mAs. The dose increases up to 17.19 mGy when the CT tube voltage increases to 120 kV. With the reduction of tube voltage from 120 kV to 80 kV, the radiation dose can be reduced by 12.1% to 15.1% without degradation of contrast-to-noise ratio.

  2. Then and Now: Examining Memories of Pediatric Experiences and Their Influence on Opinions about Healthcare as an Adult

    Directory of Open Access Journals (Sweden)

    Sherwood Burns-Nader

    2017-03-01

    Full Text Available Children use their memories of healthcare experiences to navigate subsequent visits. The purpose of this exploratory study was to examine young adults’ (N =343 memories of childhood medical experiences, how support from parents and the medical team influenced these memories, and how memories of pediatric experiences influence opinions about healthcare as an adult. The participants remembered having mild anxiety about childhood medical visits, feeling parents and the medical team were helpful with coping, and thinking the medical staff were supportive/friendly. Participants remembered having a relationship with their healthcare providers and the healthcare providers communicating with them as a child. The adults reported their current opinion and healthcare use was influenced by childhood healthcare experiences. These findings highlight the importance of parents and the medical team during pediatric healthcare visits. Also, visits during childhood were found to influence use of healthcare as an adult, highlighting the need for positive pediatric experiences, both at the doctor and dentist.

  3. Physician Religion and End-of-Life Pediatric Care: A Qualitative Examination of Physicians' Perspectives.

    Science.gov (United States)

    Bateman, Lori Brand; Clair, Jeffrey Michael

    2015-01-01

    Physician religion/spirituality has the potential to influence the communication between physicians and parents of children at the end of life. In order to explore this relationship, the authors conducted two rounds of narrative interviews to examine pediatric physicians' perspectives (N=17) of how their religious/spiritual beliefs affect end-of-life communication and care. Grounded theory informed the design and analysis of the study. As a proxy for religiosity/spirituality, physicians were classified into the following groups based on the extent to which religious/spiritual language was infused into their responses: Religiously Rich Responders (RRR), Moderately Religious Responders (MRR), and Low Religious Responders (LRR). Twelve of the 17 participants (71%) were classified into the RRR or MRR groups. The majority of participants suggested that religion/spirituality played a role in their practice of medicine and communication with parents in a myriad of ways and to varying degrees. Participants used their religious/spiritual beliefs to support families' spirituality, uphold hope, participate in prayer, and alleviate their own emotional distress emerging from their patients' deaths.

  4. Pediatrics chest x-ray examination in general hospitals in Khartoum State

    International Nuclear Information System (INIS)

    Elawad, S. O. A.

    2011-01-01

    Study was performed to evaluate radiation dose for pediatric patients undergoing chest x-ray examination in selected general radiography hospitals in Khartoum State in seven x-ray machines. x-ray tube output measurements were made in the range of typical exposure parameters using calibrated dose rate meter. To estimate entrance surface air kerma (ESA K), the radiographer in charge of the facility was asked to provide typical exposure parameters (kV, m As and FSD) for each age category (newborn (1-30 days), 1,5.10 and years). ESA K was estimated using the x-ray tube output measurements and the recorded exposure parameters. The obtained mean ESA K range from /27/ to 57/ μGy, /25 -103/ μGy, /45-128/ μGy, /47-139/ μGy and from /68-299/ μGy for newborn, 1,5,10, and 15 years patients, respectively. The estimated ESA K were within the established international reference dose values and also the values obtained in previous studies. However, variations were observed in ESA K values among hospitals under study which could be due to the differences in exposure parameters used. Also tube output has some difference on the obtained ESA K. (Author)

  5. A Qualitative Examination of Physician Gender and Parental Status in Pediatric End-of-Life Communication.

    Science.gov (United States)

    Bateman, Lori Brand; White, Marjorie Lee; Tofil, Nancy M; Clair, Jeffrey Michael; Needham, Belinda L

    2017-07-01

    In this study we utilized the framework of patient-centered communication to explore the influence of physician gender and physician parental status on (1) physician-parent communication and (2) care of pediatric patients at the end of life (EOL). The findings presented here emerged from a larger qualitative study that explored physician narratives surrounding pediatric EOL communication. The current study includes 17 pediatric critical care and pediatric emergency medicine physician participants who completed narrative interviews between March and October 2012 to discuss how their backgrounds influenced their approaches to pediatric EOL communication. Between April and June of 2013, participants completed a second round of narrative interviews to discuss topics generated out of the first round of interviews. We used grounded theory to inform the design and analysis of the study. Findings indicated that physician gender is related to pediatric EOL communication and care in two primary ways: (1) the level of physician emotional distress and (2) the way physicians perceive the influence of gender on communication. Additionally, parental status emerged as an important theme as it related to EOL decision-making and communication, emotional distress, and empathy. Although physicians reported experiencing more emotional distress related to interacting with patients at the EOL after they became parents, they also felt that they were better able to show empathy to parents of their patients.

  6. ENERGY STAR Certified Displays

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 7.0 ENERGY STAR Program Requirements for Displays that are effective as of July 1, 2016....

  7. ENERGY STAR Certified Boilers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Boilers that are effective as of October 1,...

  8. ENERGY STAR Certified Televisions

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 7.0 ENERGY STAR Program Requirements for Televisions that are effective as of October 30,...

  9. ENERGY STAR Certified Dehumidifiers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Dehumidifiers that are effective as of October...

  10. ENERGY STAR Certified Telephones

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Telephony (cordless telephones and VoIP...

  11. Certified Electronics Recyclers

    Science.gov (United States)

    Learn how EPA encourages all electronics recyclers become certified by demonstrating to an accredited, independent third-party auditor and that they meet specific standards to safely recycle and manage electronics.

  12. Doses in pediatric patients undergoing chest and abdomen CT examinations. Preliminary results

    International Nuclear Information System (INIS)

    Jornada, Tiago S.; Silva, Teogenes A. da

    2011-01-01

    Computed tomography (CT) is a non-invasive method of image production that imparts significant doses to a patient, it is expected that pediatric CT examinations will increase the risk of induced cancer in children. In this study the effective doses in a five year-old child submitted to chest or abdomen CT scans were assessed for comparison purposes. The CTEXPO computed program was used with data from routine protocols of a 0 to 13 year-old children in two public hospitals in Belo Horizonte. Hospital A used a Siemens Dual-Slice unit with 80 kV, 41 mA and pitch 2 for chest or abdomen; hospital B used a Multislice GE unit with 120 kV, 45 mA and pitch 1 for chest and 120 kV, 55 mA. and pitch 1 for abdomen. Results of effective doses in a five year-old child were 1.7 and 1.0 mSv in hospital A and 9.1 and 7.2 mSv in hospital B, for chest and abdomen, respectively. Results were compared to the reference effective doses of 7.2 and 5.0 mSv for chest and abdomen respectively that were derived from the air kerma length product values given in ICRP publication 87. Results of hospital A showed that low dose exposures also can be achieved in CT scans of children. Results showed that even a hospital with a modern facility (hospital B) can provided doses higher than reference values if protocols are not adjusted for children. Preliminary results suggested that there is a room for optimizing children exposure submitted to CT scans. (author)

  13. Radiation dose and cancer risk from pediatric CT examinations on 64-slice CT: A phantom study

    International Nuclear Information System (INIS)

    Feng Shiting; Law, Martin Wai-Ming; Huang Bingsheng; Ng, Sherry; Li Ziping; Meng Quanfei; Khong, Pek-Lan

    2010-01-01

    Objective: To measure the radiation dose from CT scans in an anthropomorphic phantom using a 64-slice MDCT, and to estimate the associated cancer risk. Materials and methods: Organ doses were measured with a 5-year-old phantom and thermoluminescent dosimeters. Four protocols; head CT, thorax CT, abdomen CT and pelvis CT were studied. Cancer risks, in the form of lifetime attributable risk (LAR) of cancer incidence, were estimated by linear extrapolation using the organ radiation doses and the LAR data. Results: The effective doses for head, thorax, abdomen and pelvis CT, were 0.7 mSv, 3.5 mSv, 3.0 mSv, 1.3 mSv respectively. The organs with the highest dose were; for head CT, salivary gland (22.33 mGy); for thorax CT, breast (7.89 mGy); for abdomen CT, colon (6.62 mGy); for pelvis CT, bladder (4.28 mGy). The corresponding LARs for boys and girls were 0.015-0.053% and 0.034-0.155% respectively. The organs with highest LARs were; for head CT, thyroid gland (0.003% for boys, 0.015% for girls); for thorax CT, lung for boys (0.014%) and breast for girls (0.069%); for abdomen CT, colon for boys (0.017%) and lung for girls (0.016%); for pelvis CT, bladder for both boys and girls (0.008%). Conclusion: The effective doses from these common pediatric CT examinations ranged from 0.7 mSv to 3.5 mSv and the associated lifetime cancer risks were found to be up to 0.16%, with some organs of higher radiosensitivity including breast, thyroid gland, colon and lungs.

  14. Examining Pediatric Cases From the Clinical Research Office of the Endourological Society Ureteroscopy Global Study.

    Science.gov (United States)

    Guven, Selcuk; Basiri, Abbas; Varshney, Anil Kumar; Aridogan, Ibrahim Atilla; Miura, Hiroyasu; White, Mark; Kilinc, Mehmet; de la Rosette, Jean

    2017-03-01

    To evaluate the characteristics and outcomes of ureteroscopy (URS) in children treated in several hospitals participating in the Clinical Research Office of the Endourological Society (CROES) Study, and to present the overall results of pediatric URS compared with adults. The CROES Study collected data on consecutive patients treated with URS for urolithiasis at each participating center over a 1-year period. The collected prospective global database includes data for 11,885 patients who received URS at 114 centers in 32 countries. Of these URS-treated patients, 192 were ≤18 years old. Of the 114 centers participating in the study, 42% had conducted pediatric URS. Among the pediatric cases, 7 were infants, 53 were small children, 59 were school-aged children, and 73 were adolescents. A considerable number (37%) of the pediatric cases had previously undergone URS treatment. No differences in the surgical outcomes of the adults and children were reported. The URS-treated children had a greater number of positive preoperative urine cultures when compared with adult cases treated. A semirigid scope was used in the vast majority of pediatric cases (85%). According to the present data, within the group of URS-treated children, the younger the child, the more readmissions occurred. URS is as efficient and safe in children as it is in adults. The data suggest that readmissions among URS-treated children are associated with age, with the likelihood of readmissions greater among younger age groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

    Science.gov (United States)

    Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

    2016-01-01

    To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

  16. Radiation measurement and risk estimation for pediatrics during routine diagnostic examination in some hospitals of Khartoum state

    International Nuclear Information System (INIS)

    Saeed, E. B. Y.

    2010-01-01

    Patient dose monitoring was formalized in the national protocol for patient dose measurement in Diagnostic Radiology. Entrance Skin Dose (ESD) and Effective Dose have been measured for pediatric patient under going some routine pediatric x-ray examination in five Hospitals in Sudan namely (Ahmed Gasim for Paediatric Hospital, Khartoum state for main paediatric Hospital (Omdurman, Khartoum , Ah Gassim, Ab naof) Paediatric Hospitals. Two examination projection have been investigated, namely anterior posterior (AP) and posterior Anterior ( PA). Patient were classed into three different age groups 0-2 year, 2-5 year, 5-15 year. The result have been obtained with the use of the TLD as first time in Sudan. The mean of ESD and thyroid dose are represented and comparisons were made between these dose and international standard dose, local study also between doses and those from other counters. The mean of ESD and ED in Ah Gasim and Khartoum Hospital are higher than reference dose and low than other counters. The reason for the higher dose have been discussed and suggestions are given to reduced dosed to pediatric patient during x-ray examination especially in developing countries. (Author)

  17. Estimation of radiation dose for adult and pediatric patients during X-ray examinations in Khartoum State

    International Nuclear Information System (INIS)

    Altahir, Ataalmanan Yosif Ataalmanan

    2018-01-01

    The aim of this study to evaluate the patient doses in X-ray examinations for skull and in three main hospitals in Khartoum State. The examination parameters took from 125 radiographs for both male and female were the females was 58 and the male 67 patients undergoing skull (AP), were the age of pediatric patients 1-18 years and adults 19-79 years. The result shows that the calculation of ESAK for according to gender for male skull 0.206 mGy, and ESAK according to gender for male skull 0.0719 mGy, for female skull 0.0942 mGy, for male chest 0.082 mGy and female for female chest 0.098 mGy. The calculation of ESAK according to patients age, adults and pediatric, the ESAK estimation for adults 0.122 mGy for skull, 0.1306 mGy for chest, and for pediatric 0.0432 mGy for skull, 0.055 mGy for chest. This data will be useful for the formulation of national reference levels as recommended by the International Atomic Energy Agency (IAEA). (Author)

  18. Attainment of dosimetric pediatrics grandeur to computed tomography examinations of the abdomen

    International Nuclear Information System (INIS)

    Jormada, Tiago S.

    2013-01-01

    Currently, 10% of all computerized tomography exams (CT) are made in pediatric patients. In developed countries, the practice of obtaining the dosimetric quantities (weighted index dose C w , index air kerma volumetric C vol product kerma-length P KL , CT ) and effective dose (E) in pediatric CT scans is common. In Brazil, data like these are practically nonexistent. The goal of this work is to obtain the dosimetric quantities and the dose effective in pediatric CT scans, and study its application in the optimization process. The study took place in a thermographs' Toshiba Asteion Single-Slice and a GE Brightsped's multi-slice where measurements were made with type pencil ionization chamber and a trunk's phantom of PMMA with diameter of 16 cm. In single-slice CT scanner, the results obtained for the C vol , P KL , CT and E were 18.73 mGy, 15.61 mGy and 6.87 mSv mGy.cm 343.51, respectively, whereas in multi-slice CT scanner the results were 18.81 mGy, 20.07 mGy, 441.64 mGy.cm and 8,83 mSv. There was no significant difference between the values of C w obtained already in the values of the Cvol, P KL , CT and E dose the differences between the results were quite significant. Comparing the C w and P KL , CT and with the values recommended by UCRP 87 (25 mGy for C vol and 360 mGy.cm for P KL , CT in pediatric CT scans of the abdomen), the two scanners were below reference levels for C w and not require an start on process of optimization. (author)

  19. Evaluation of X ray radiation doses in pediatric examinations of cranial computerized tomography based on optimization studies

    International Nuclear Information System (INIS)

    Daros, Kellen Adriana Curci

    2005-01-01

    This paper identifies the technical conditions for CT examination which offers lowest absorbed dose and to attend the manufacturer recommendations as far the spatial resolution is concerned. The paper evaluates the absorbed dose during cranial CT in up to 6 years children satisfying the technical condition recommended by the manufacturer and routine clinical conditions. The paper also established a quantitative relationship among the absorbed dose and its distribution in the cranial regions of pediatric patients up to 6 years old in a way to estimate the doses subject to optimized conditions

  20. Radioactive certified reference materials

    International Nuclear Information System (INIS)

    Watanabe, Kazuo

    2010-01-01

    Outline of radioactive certified reference materials (CRM) for the analysis of nuclear materials and radioactive nuclides were described. The nuclear fuel CRMs are supplied by the three institutes: NBL in the US, CETAMA in France and IRMM in Belgium. For the RI CRMs, the Japan Radioisotope Association is engaged in activities concerning supply. The natural-matrix CRMs for the analysis of trace levels of radio-nuclides are prepared and supplied by NIST in the US and the IAEA. (author)

  1. Size-specific dose estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Bria M.; Brady, Samuel L., E-mail: samuel.brady@stjude.org; Kaufman, Robert A. [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee 38105 (United States); Mirro, Amy E. [Department of Biomedical Engineering, Washington University, St Louis, Missouri 63130 (United States)

    2014-07-15

    Purpose: To investigate the correlation of size-specific dose estimate (SSDE) with absorbed organ dose, and to develop a simple methodology for estimating patient organ dose in a pediatric population (5–55 kg). Methods: Four physical anthropomorphic phantoms representing a range of pediatric body habitus were scanned with metal oxide semiconductor field effect transistor (MOSFET) dosimeters placed at 23 organ locations to determine absolute organ dose. Phantom absolute organ dose was divided by phantom SSDE to determine correlation between organ dose and SSDE. Organ dose correlation factors (CF{sub SSDE}{sup organ}) were then multiplied by patient-specific SSDE to estimate patient organ dose. The CF{sub SSDE}{sup organ} were used to retrospectively estimate individual organ doses from 352 chest and 241 abdominopelvic pediatric CT examinations, where mean patient weight was 22 kg ± 15 (range 5–55 kg), and mean patient age was 6 yrs ± 5 (range 4 months to 23 yrs). Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm; thus, showing appropriate scalability of the phantoms across the entire pediatric population in this study. IndividualCF{sub SSDE}{sup organ} were determined for a total of 23 organs in the chest and abdominopelvic region across nine weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7–1.4) and abdominopelvic region (average 0.9; range 0.7–1.3) was near unity. For organ/tissue that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1–0.4) for both the chest and abdominopelvic regions, respectively. A means to estimate patient organ dose was demonstrated. Calculated patient organ dose, using patient SSDE and CF{sub SSDE}{sup organ}, was compared to

  2. Difficulties of Alternatively Certified Teachers

    Science.gov (United States)

    Schonfeld, Irvin Sam; Feinman, Samantha J.

    2012-01-01

    This daily diary study followed, over a 2-week period, 252 beginning New York City public school teachers. Seventy percent were alternatively certified (New York City Teaching Fellows) and the rest, traditionally certified teachers. Alternatively certified teachers were more likely to experience stressors such as violent incidents and classroom…

  3. Kerma in the air at entry surface in thorax pediatric examinations at public hospital in Parana, Brazil

    International Nuclear Information System (INIS)

    Santos, Amanda; Porto, Lorena; Bunick, Ana; Paschuk, Sergei; Denyak, Valeriy; Schelin, Hugo; Tilly, Joao; Khoury, Helen

    2011-01-01

    This work consisted in the evaluation of the entrance skin air kerma (ESAK) in pediatric chest x-ray examinations. A study of 186 exams in anterior-posterior, posterior-anterior and lateral projections was carried out for patients with ages ranging from 0 to 15 years. The ESAK was measured with the DoseCal software and Li-Fl thermoluminescent dosimeters. The results were compared with measurements done recently at the same place and with the reference dose values established by the European Community. It was observed that the optimization of the technique and the routine changes suggested in the previous study were not maintained. The charge (mAs) and the ESAK values found in the present study were much higher than the previous one, and the voltage (kVp) values found was lower. The results suggest that the implementation of the Quality Assurance Program could adequate these parameters to the established levels and keep the pediatric examinations more uniform. (author)

  4. Pediatric Food Allergies and Psychosocial Functioning: Examining the Potential Moderating Roles of Maternal Distress and Overprotection.

    Science.gov (United States)

    Chow, Candice; Pincus, Donna B; Comer, Jonathan S

    2015-01-01

    Identify factors associated with maternal perceptions of health-related quality of life (QoL) among youth with food allergies (FA), and identify maternal factors that may moderate relationships between FA-related challenges and child QoL. In all, 533 mothers of children with FA completed measures assessing characteristics of their child's FA, maternal perceptions of child QoL, maternal psychological distress, and maternal overprotection. FA severity, maternal psychological distress, and overprotection were significantly associated with maternal reports of poorer child functioning and/or poorer QoL among youth with FA. Hierarchical linear regression analyses showed an FA severity by maternal distress interaction in the prediction of child FA-related anxiety; children of higher stress mothers showed a stronger link between auto-injector use and anxiety than children of lower stress mothers. When identifying youth with FA who are at risk for low QoL, it is important to assess history of FA-related challenges, parental psychological distress, and overprotection. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen

    2015-01-01

    for sustainability and wants a certification. This research investigates the decision‐making and design process (DMaDP) behind four DGNB certified Healthcare Centres (HCC) in Northern Jutland in Denmark. In general, knowledge about the DMaDP is important. However it is important to know what part DGNB plays...... a dialog about DGNB and energy concept is important even before anyone start sketching. Experiences with the different approaches will be further outlined in the paper.Future research has the intention to collect further knowledge about DGNB and DMaDP in practise. This project was limited to Healthcare...

  6. An examination of product packaging marketing strategies used to promote pediatric multivitamins.

    Science.gov (United States)

    Ethan, Danna; Basch, Corey H; Samuel, Lalitha; Quinn, Christine; Dunne, Stephanie

    2015-06-01

    The purpose of this study was to describe the nature of marketing strategies for multivitamin and multimineral (MVM) supplement packaging and to assess the extent to which these supplements are marketed as food products. A cross-sectional study of children's supplement packaging was conducted. Descriptive statistics identified common marketing practices. Websites of the three largest retail chain pharmacies in the United States and MVM manufacturers were accessed. The study's sample consisted of packaging for 52 children's MVM supplements. Child-targeted marketing included reference to trademarked characters on 42.3% of MVM packaging (n = 22). More than 80% of the sample (n = 42) listed fruity flavors and almost all packaging included descriptive words related to the MVMs' shape and/or flavor (88.5%, n = 46). Nearly one-fifth of the packaging (n = 10) pictured a food item. With respect to parent-targeted promotional language, almost 83% of the supplement packages (n = 43) included text on the support of bodily structure/function. More than half of the sample (53.8%, n = 28) had promotional language related to dietary practice (e.g. organic, gluten-free). Pediatricians can play a role in ensuring that parents are aware of (1) possible risks associated with MVM overconsumption, and (2) the importance of deriving vitamins and minerals from a balanced diet. Given the high number of exposures to pediatric MVMs among youth and established influence of food marketing on shaping children's perceptions and behaviors, further research is necessary to determine the extent to which children's MVMs are marketed as a food product and perceived as such by children.

  7. Synthesizing Certified Code

    Science.gov (United States)

    Whalen, Michael; Schumann, Johann; Fischer, Bernd

    2002-01-01

    Code certification is a lightweight approach to demonstrate software quality on a formal level. Its basic idea is to require producers to provide formal proofs that their code satisfies certain quality properties. These proofs serve as certificates which can be checked independently. Since code certification uses the same underlying technology as program verification, it also requires many detailed annotations (e.g., loop invariants) to make the proofs possible. However, manually adding theses annotations to the code is time-consuming and error-prone. We address this problem by combining code certification with automatic program synthesis. We propose an approach to generate simultaneously, from a high-level specification, code and all annotations required to certify generated code. Here, we describe a certification extension of AUTOBAYES, a synthesis tool which automatically generates complex data analysis programs from compact specifications. AUTOBAYES contains sufficient high-level domain knowledge to generate detailed annotations. This allows us to use a general-purpose verification condition generator to produce a set of proof obligations in first-order logic. The obligations are then discharged using the automated theorem E-SETHEO. We demonstrate our approach by certifying operator safety for a generated iterative data classification program without manual annotation of the code.

  8. Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting

    DEFF Research Database (Denmark)

    Johansen, Anders; Holm, Jens-Christian; Pearson, Seija

    2015-01-01

    as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI......Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children...... and adolescents a chronic illness, which is in line with the American Medical Society. We summarize the evidence for the efficacy of a combination of diet, physical activity and behavior-focused interventions in a family-based setting. The present guidelines propose a multidisciplinary service implemented...

  9. Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting

    DEFF Research Database (Denmark)

    2015-01-01

    Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children...... circumference, growth, pubertal stage, blood pressure, neurology and skin and provide comprehensive paraclinical investigations for obesity and obesity related conditions. Treatment of obesity in children and adolescents is fully dependent on the combined effort of the entire family. This cannot...... as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI...

  10. Shielding during x-ray examination of pediatric female patients with developmental dysplasia of the hip

    International Nuclear Information System (INIS)

    Tsai, Yi-Shan; Liu, Yi-Sheng; Chuang, Ming-Tsung; Wang, Chien-Kuo; Lai, Cheng-Shih; Tsai, Hong-Ming; Lu, Chia-Hsing; Lin, Chii-Jeng

    2014-01-01

    Patients with developmental dysplasia of the hip (DDH) generally undergo multiple x-ray examinations of both hip joints. During these examinations, the gonads are completely exposed to radiation, unless shielded. Although many types and sizes of gonad shields exist, they often do not provide adequate protection because of size and placement issues; additionally, these shields are frequently omitted for female patients. Our aim was to assess gonad protection during x-ray examination that is provided by gonad shields designed for individual female patients with DDH. We retrospectively retrieved data from the Picture Archiving and Communication System database; pelvic plain x-ray films from 766 females, 18 years old or younger, were included in our analysis. Based on x-ray measurements of the anterior superior iliac spine, we developed a system of gonad shield design that depended on the distance between anterior superior iliac spine markers. We custom-made shields and then examined shielding rates and shielding accuracy before and after these new shields became available. Standard (general-purpose) shields were used before our custom design project was implemented. The shielding rate and shielding accuracy were, respectively, 14.5% and 8.4% before the project was implemented and 72.7% and 32.2% after it was implemented. A shield that is more anatomically correct and available in several different sizes may increase the likelihood of gonad protection during pelvic x-ray examinations. (paper)

  11. Shielding during x-ray examination of pediatric female patients with developmental dysplasia of the hip.

    Science.gov (United States)

    Tsai, Yi-Shan; Liu, Yi-Sheng; Chuang, Ming-Tsung; Wang, Chien-Kuo; Lai, Cheng-Shih; Tsai, Hong-Ming; Lin, Chii-Jeng; Lu, Chia-Hsing

    2014-12-01

    Patients with developmental dysplasia of the hip (DDH) generally undergo multiple x-ray examinations of both hip joints. During these examinations, the gonads are completely exposed to radiation, unless shielded. Although many types and sizes of gonad shields exist, they often do not provide adequate protection because of size and placement issues; additionally, these shields are frequently omitted for female patients. Our aim was to assess gonad protection during x-ray examination that is provided by gonad shields designed for individual female patients with DDH.We retrospectively retrieved data from the Picture Archiving and Communication System database; pelvic plain x-ray films from 766 females, 18 years old or younger, were included in our analysis. Based on x-ray measurements of the anterior superior iliac spine, we developed a system of gonad shield design that depended on the distance between anterior superior iliac spine markers. We custom-made shields and then examined shielding rates and shielding accuracy before and after these new shields became available. Standard (general-purpose) shields were used before our custom design project was implemented. The shielding rate and shielding accuracy were, respectively, 14.5% and 8.4% before the project was implemented and 72.7% and 32.2% after it was implemented. A shield that is more anatomically correct and available in several different sizes may increase the likelihood of gonad protection during pelvic x-ray examinations.

  12. Estimating pediatric entrance skin dose from digital radiography examination using DICOM metadata: A quality assurance tool

    Energy Technology Data Exchange (ETDEWEB)

    Brady, S. L., E-mail: samuel.brady@stjude.org; Kaufman, R. A., E-mail: robert.kaufman@stjude.org [Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, Tennessee 38105 (United States)

    2015-05-15

    Purpose: To develop an automated methodology to estimate patient examination dose in digital radiography (DR) imaging using DICOM metadata as a quality assurance (QA) tool. Methods: Patient examination and demographical information were gathered from metadata analysis of DICOM header data. The x-ray system radiation output (i.e., air KERMA) was characterized for all filter combinations used for patient examinations. Average patient thicknesses were measured for head, chest, abdomen, knees, and hands using volumetric images from CT. Backscatter factors (BSFs) were calculated from examination kVp. Patient entrance skin air KERMA (ESAK) was calculated by (1) looking up examination technique factors taken from DICOM header metadata (i.e., kVp and mA s) to derive an air KERMA (k{sub air}) value based on an x-ray characteristic radiation output curve; (2) scaling k{sub air} with a BSF value; and (3) correcting k{sub air} for patient thickness. Finally, patient entrance skin dose (ESD) was calculated by multiplying a mass–energy attenuation coefficient ratio by ESAK. Patient ESD calculations were computed for common DR examinations at our institution: dual view chest, anteroposterior (AP) abdomen, lateral (LAT) skull, dual view knee, and bone age (left hand only) examinations. Results: ESD was calculated for a total of 3794 patients; mean age was 11 ± 8 yr (range: 2 months to 55 yr). The mean ESD range was 0.19–0.42 mGy for dual view chest, 0.28–1.2 mGy for AP abdomen, 0.18–0.65 mGy for LAT view skull, 0.15–0.63 mGy for dual view knee, and 0.10–0.12 mGy for bone age (left hand) examinations. Conclusions: A methodology combining DICOM header metadata and basic x-ray tube characterization curves was demonstrated. In a regulatory era where patient dose reporting has become increasingly in demand, this methodology will allow a knowledgeable user the means to establish an automatable dose reporting program for DR and perform patient dose related QA testing for

  13. Consideration of the usefulness of a size-specific dose estimate in pediatric CT examination.

    Science.gov (United States)

    Tsujiguchi, Takakiyo; Obara, Hideki; Ono, Shuichi; Saito, Yoko; Kashiwakura, Ikuo

    2018-04-05

    Computed tomography (CT) has recently been utilized in various medical settings, and technological advances have resulted in its widespread use. However, medical radiation exposure associated with CT scans accounts for the largest share of examinations using radiation; thus, it is important to understand the organ dose and effective dose in detail. The CT dose index and dose-length product are used to evaluate the organ dose. However, evaluations using these indicators fail to consider the age and body type of patients. In this study, we evaluated the effective dose based on the CT examination data of 753 patients examined at our hospital using the size-specific dose estimate (SSDE) method, which can calculate the exposure dose with consideration of the physique of a patient. The results showed a large correlation between the SSDE conversion factor and physique, with a larger exposure dose in patients with a small physique when a single scan is considered. Especially for children, the SSDE conversion factor was found to be 2 or more. In addition, the patient exposed to the largest dose in this study was a 10-year-old, who received 40.4 mSv (five series/examination). In the future, for estimating exposure using the SSDE method and in cohort studies, the diagnostic reference level of SSDE should be determined and a low-exposure imaging protocol should be developed to predict the risk of CT exposure and to maintain the quality of diagnosis with better radiation protection of patients.

  14. Diagnosis of Pediatric Foreign Body Ingestion: Clinical Presentation, Physical Examination, and Radiologic Findings.

    Science.gov (United States)

    Sink, Jacquelyn R; Kitsko, Dennis J; Mehta, Deepak K; Georg, Matthew W; Simons, Jeffrey P

    2016-04-01

    (1) To describe clinical and radiologic findings in patients with esophageal foreign bodies. (2) To examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion. A retrospective cohort study was performed evaluating all children who underwent esophagoscopy for suspected foreign body ingestion at our institution from 2006 to 2013. Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively. Most patients with esophageal foreign bodies are symptomatic. Although many patients will have a normal physical examination, an abnormal exam should increase suspicion for a foreign body. Most esophageal foreign bodies are radiopaque, but a normal chest radiograph cannot rule out a foreign body. © The Author(s) 2015.

  15. Age-specific effective doses for pediatric MSCT examinations at a large children's hospital using DLP conversion coefficients: a simple estimation method

    International Nuclear Information System (INIS)

    Thomas, Karen E.; Wang, Bo

    2008-01-01

    There is a need for an easily accessible method for effective dose estimation in pediatric CT. To estimate effective doses for a variety of pediatric neurological and body CT examinations in five age groups using recently published age- and region-specific dose length product (DLP) to effective dose conversion coefficients. A retrospective review was performed of 1,431 consecutive CT scans over a 12-week period using age- and weight-adjusted CT protocols. Age- and region-specific DLP to effective dose conversion coefficients were applied to console-displayed DLP data. Effective dose estimates for single-phase head CT scans in neonatal, and 1-, 5-, 10- and 15-year-old age groups were 4.2, 3.6, 2.4, 2.0 and 1.4 mSv, respectively. For abdomen/pelvis CT scans the corresponding effective doses were 13.1, 11.1, 8.4, 8.9 and 5.9 mSv. The range of pediatric CT effective doses is wide, from ultralow dose protocols (<1 mSv) to extended-coverage body examinations (10-15 mSv). Age- and region-specific pediatric DLP to effective dose conversion coefficients provide an accessible and user-friendly method for estimating pediatric CT effective doses that is available to radiologists working without medical physics support. (orig.)

  16. Evaluation of entrance skin air kerma in digital and conventional pediatric chest examinations performed in Parana-Brazil

    International Nuclear Information System (INIS)

    Oliveira, Ana L.R.; Schelin, Hugo R.; Lunelli, Neuri; Paschuk, Sergei; Tilly Jr, Joao G.; Rogacheski, Enio; Khoury, Helen J.; Ferreira, Jose R.L.

    2008-01-01

    Full text: In pediatric radiology it is important to evaluate patient exposure due to the high sensitivity of his/her tissue and his/her relatively longer life expectancy, which may increase the chance of radiogenic cancer development. Special attention is necessary when digital systems are used since a high dosage level for the patient may go unnoticed because the resulting image is not overexposed. The purpose of this work is to evaluate the Entrance Skin Air Kerma (ESAK) in pediatric patients submitted to digital and conventional chest examinations performed in the State of Parana, located in the Southern region of Brazil. The survey was performed in two hospitals, one located in Curitiba, the Capital of the State (A) and the other in the city of Cascavel (B). Hospital A uses a conventional image system and Hospital B uses a CR digital system. The study group consisted of 50 patients (from 2 days to six years of age) undergoing chest PA/AP examinations. At the time of the examination, the exposure parameters (kV, mAs, focal-film distance, etc) and the gender, height, weight and age of the patient were recorded. To evaluate the Entrance Skin Air Kerma (ESAK), two TLD-100 dosimeters were packaged in a polyethylene case, heat sealed and placed on the surface of each patient. The TLDs were calibrated the Metrology Laboratory of Ionizing Radiation of the Federal University of Pernambuco. The TLDs were processed on a Victoreen readout system model 2800M. The results showed that the kilovoltage values used in Hospital A are in the range of 46 to 65 kV with the average value of 51,7 kV, while the ones in Hospital B are in the range of 65 to 80 kV. On the other hand, even though hospital B uses the CR system, the mAs used for the chest exams are 4 times higher than the ones used in Hospital A. For Hospital A, the mean ESAK value was 0.044 mGy (min: 0.08 and max 0.146 mGy), and for Hospital B the mean ESAK value was 0.368 mGy (min: 0.021 and max 1.21mGy). The results made

  17. Pediatric MS

    Science.gov (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  18. Comparability of the Patient-Reported Outcomes Measurement Information System Pediatric short form symptom measures across culture: examination between Chinese and American children with cancer.

    Science.gov (United States)

    Liu, Yanyan; Yuan, Changrong; Wang, Jichuan; Brown, Jeanne Geiger; Zhou, Fen; Zhao, Xiufang; Shen, Min; Hinds, Pamela S

    2016-10-01

    Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric forms measure symptoms and function of pediatric patients experiencing chronic disease by using the same measures. Comparability is one of the most important purposes of the PROMIS initiative. This study aimed to test the factorial structures of four symptom measures (i.e., Anxiety, Depression, Fatigue, and Pain Interference) in the original English and the Chinese versions and examine the measurement invariance of the measures across two cultures. Four PROMIS Pediatric measures were used to assess symptoms, respectively, in Chinese (n = 232) and American (n = 200) children and adolescents (8-17 years old) in treatment for cancer or in survivorship. The categorical confirmatory factor analysis (CCFA) model was used to examine factorial structures, and multigroup CCFA was applied to test measurement invariance of these measures between the Chinese and American samples. The CCFA models of the four PROMIS Pediatric symptom measures fit the data well for both the Chinese and American children and adolescents. Minor partial measurement invariance was identified. Factor means and factor variances of the four PROMIS measures were not significantly different between the two populations. Our results provide evidence that the four PROMIS Pediatric symptom measures have valid factorial structures and a statistical property of measurement invariance across American and Chinese children and adolescents with cancer. This means that the items of these measures were interpreted in a conceptually similar manner by two groups. They could be readily used for meaningful cross-cultural comparisons involving pediatric oncology patients in these two countries.

  19. Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting.

    Science.gov (United States)

    Johansen, Anders; Holm, Jens-Christian; Pearson, Seija; Kjærsgaard, Mimi; Larsen, Lone Marie; Højgaard, Birgitte; Cortes, Dina

    2015-05-01

    Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children and adolescents a chronic illness, which is in line with the American Medical Society. We summarize the evidence for the efficacy of a combination of diet, physical activity and behavior-focused interventions in a family-based setting. The present guidelines propose a multidisciplinary service implemented as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI corresponds to an isoBMI of minimum 30 or BMI corresponds to an isoBMI of 25 and complex obesity is suspected. Obtaining a thorough medical history is pivotal. We propose a structured interview to ensure collection of all relevant information. We recommend physical examination focused on BMI, waist circumference, growth, pubertal stage, blood pressure, neurology and skin and provide comprehensive paraclinical investigations for obesity and obesity related conditions. Treatment of obesity in children and adolescents is fully dependent on the combined effort of the entire family. This cannot be overemphasized! The main principle of the treatment is developing an individual detailed plan for every patient to reduce caloric intake whilst increasing physical activity, leaving no ambiguity with the recommendations.

  20. Assessment of the Mexican Board of Pediatric Surgery Certification System.

    Science.gov (United States)

    Porras-Hernandez, Juan D; Mora-Fol, Jose R; Lezama-Del Valle, Pablo; Yanowsky-Reyes, Guillermo; Perez-Lorenzana, Hector; Ortega-Salgado, Arturo; Aguirre-Jauregui, Oscar; Bracho-Blanchet, Eduardo; Sanchez-Mendiola, Melchor

    2015-01-01

    To evaluate the quality of the Mexican Board of Pediatric Surgery (MBPS) certifying system, using contemporary international guidelines. Retrospective assessment of evidence collected during the design and implementation processes of 2 consecutive applications of the MBPS certifying examination, using Cizek's checklist for evaluating credential-testing programs. It includes the relevant guidelines from the American Education Research Association, the American Psychological Association, the National Council on Measurement in Education, and the National Commission for Certifying Agencies. Four independent and previously trained raters used the checklist. They underwent a 2-week training using frame-of-reference and performance dimensions methodologies. Certification examinations of MBPS. The 2013 and 2014 MBPS certification examinations, with 111 evidence items of the processes, followed for the assessment of 86 examinees. The checklist internal consistency was 0.89. Absolute interrater agreement was 0.34 for the 2013 and 0.66 for the 2014 editions of the examination. The 2013 examination complied with 55 (64%) of the checklist 86 items, in 2014 with 72 (84%). In 2014, the certifying system reached a quality of 84%. For optimal fulfillment of its social responsibility, the MBPS is required to maintain its level of quality and attempt to improve its performance. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. ENERGY STAR Certified Commercial Dishwashers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Commercial Dishwashers that are effective as of...

  2. ENERGY STAR Certified Commercial Ovens

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.2 ENERGY STAR Program Requirements for Commercial Ovens that are effective as of...

  3. ENERGY STAR Certified Commercial Boilers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Commercial Boilers that are effective as of...

  4. ENERGY STAR Certified Commercial Griddles

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.2 ENERGY STAR Program Requirements for Commercial Griddles that are effective as of May...

  5. ENERGY STAR Certified Smart Thermostats

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Connected Thermostats that are effective as of...

  6. ENERGY STAR Certified Residential Dishwashers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 6.0 ENERGY STAR Program Requirements for Residential Dishwashers that are effective as of...

  7. ENERGY STAR Certified Roof Products

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Roof Products that are effective as of July 1,...

  8. ENERGY STAR Certified Pool Pumps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.1 ENERGY STAR Program Requirements for Pool Pumps that are effective as of February 15,...

  9. ENERGY STAR Certified Imaging Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Imaging Equipment that are effective as of...

  10. ENERGY STAR Certified Vending Machines

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.1 ENERGY STAR Program Requirements for Refrigerated Beverage Vending Machines that are...

  11. Find a NCCAOM Certified Practitioner

    Science.gov (United States)

    ... in finding a NCCAOM Certified Diplomate. The NCCAOM Find a Practitioner Directory is a voluntary directory designed ... by the NCCAOM. If you are unable to find an individual in our registry and would like ...

  12. ENERGY STAR Certified Water Coolers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Water Coolers that are effective as of February...

  13. ENERGY STAR Certified Audio Video

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Audio Video Equipment that are effective as of...

  14. ENERGY STAR Certified Ceiling Fans

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.1 ENERGY STAR Program Requirements for Ceiling Fans that are effective as of April 1,...

  15. ENERGY STAR Certified Ventilating Fans

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Ventilating Fans that are effective as of...

  16. ENERGY STAR Certified Commercial Fryers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Commercial Fryers that are effective as of...

  17. ENERGY STAR Certified Products - Lighting

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data set contains a simplified list of all currently certified ENERGY STAR Lighting models with basic model information collected across all product categories...

  18. ENERGY STAR Certified Residential Freezers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 5.0 ENERGY STAR Program Requirements for Residential Refrigerators and Freezers that are...

  19. ENERGY STAR Certified Residential Refrigerators

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 5.0 ENERGY STAR Program Requirements for Residential Refrigerators and Freezers that are...

  20. MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

    International Nuclear Information System (INIS)

    Moore, B; Brady, S; Kaufman, R; Mirro, A

    2014-01-01

    Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE

  1. MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

    Energy Technology Data Exchange (ETDEWEB)

    Moore, B; Brady, S; Kaufman, R [St Jude Children' s Research Hospital, Memphis, TN (United States); Mirro, A [Washington University, St. Louis, MO (United States)

    2014-06-15

    Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE.

  2. Effective dose estimation for pediatric upper gastrointestinal examinations using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology.

    Science.gov (United States)

    Emigh, Brent; Gordon, Christopher L; Connolly, Bairbre L; Falkiner, Michelle; Thomas, Karen E

    2013-09-01

    There is a need for updated radiation dose estimates in pediatric fluoroscopy given the routine use of new dose-saving technologies and increased radiation safety awareness in pediatric imaging. To estimate effective doses for standardized pediatric upper gastrointestinal (UGI) examinations at our institute using direct dose measurement, as well as provide dose-area product (DAP) to effective dose conversion factors to be used for the estimation of UGI effective doses for boys and girls up to 10 years of age at other centers. Metal oxide semiconductor field-effect transistor (MOSFET) dosimeters were placed within four anthropomorphic phantoms representing children ≤10 years of age and exposed to mock UGI examinations using exposures much greater than used clinically to minimize measurement error. Measured effective dose was calculated using ICRP 103 weights and scaled to our institution's standardized clinical UGI (3.6-min fluoroscopy, four spot exposures and four examination beam projections) as determined from patient logs. Results were compared to Monte Carlo simulations and related to fluoroscope-displayed DAP. Measured effective doses for standardized pediatric UGI examinations in our institute ranged from 0.35 to 0.79 mSv in girls and were 3-8% lower for boys. Simulation-derived and measured effective doses were in agreement (percentage differences  0.18). DAP-to-effective dose conversion factors ranged from 6.5 ×10(-4) mSv per Gy-cm(2) to 4.3 × 10(-3) mSv per Gy-cm(2) for girls and were similarly lower for boys. Using modern fluoroscopy equipment, the effective dose associated with the UGI examination in children ≤10 years at our institute is MOSFETs, which were shown to agree with Monte Carlo simulated doses.

  3. Examination of the Safety of Pediatric Vaccine Schedules in a Non-Human Primate Model: Assessments of Neurodevelopment, Learning, and Social Behavior

    Science.gov (United States)

    Curtis, Britni; Liberato, Noelle; Rulien, Megan; Morrisroe, Kelly; Kenney, Caroline; Yutuc, Vernon; Ferrier, Clayton; Marti, C. Nathan; Mandell, Dorothy; Burbacher, Thomas M.; Sackett, Gene P.

    2015-01-01

    Background In the 1990s, the mercury-based preservative thimerosal was used in most pediatric vaccines. Although there are currently only two thimerosal-containing vaccines (TCVs) recommended for pediatric use, parental perceptions that vaccines pose safety concerns are affecting vaccination rates, particularly in light of the much expanded and more complex schedule in place today. Objectives The objective of this study was to examine the safety of pediatric vaccine schedules in a non-human primate model. Methods We administered vaccines to six groups of infant male rhesus macaques (n = 12–16/group) using a standardized thimerosal dose where appropriate. Study groups included the recommended 1990s Pediatric vaccine schedule, an accelerated 1990s Primate schedule with or without the measles–mumps–rubella (MMR) vaccine, the MMR vaccine only, and the expanded 2008 schedule. We administered saline injections to age-matched control animals (n = 16). Infant development was assessed from birth to 12 months of age by examining the acquisition of neonatal reflexes, the development of object concept permanence (OCP), computerized tests of discrimination learning, and infant social behavior. Data were analyzed using analysis of variance, multilevel modeling, and survival analyses, where appropriate. Results We observed no group differences in the acquisition of OCP. During discrimination learning, animals receiving TCVs had improved performance on reversal testing, although some of these same animals showed poorer performance in subsequent learning-set testing. Analysis of social and nonsocial behaviors identified few instances of negative behaviors across the entire infancy period. Although some group differences in specific behaviors were reported at 2 months of age, by 12 months all infants, irrespective of vaccination status, had developed the typical repertoire of macaque behaviors. Conclusions This comprehensive 5-year case–control study, which closely examined

  4. Effective dose estimation for pediatric upper gastrointestinal examinations using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology

    International Nuclear Information System (INIS)

    Emigh, Brent; Gordon, Christopher L.; Falkiner, Michelle; Thomas, Karen E.; Connolly, Bairbre L.

    2013-01-01

    There is a need for updated radiation dose estimates in pediatric fluoroscopy given the routine use of new dose-saving technologies and increased radiation safety awareness in pediatric imaging. To estimate effective doses for standardized pediatric upper gastrointestinal (UGI) examinations at our institute using direct dose measurement, as well as provide dose-area product (DAP) to effective dose conversion factors to be used for the estimation of UGI effective doses for boys and girls up to 10 years of age at other centers. Metal oxide semiconductor field-effect transistor (MOSFET) dosimeters were placed within four anthropomorphic phantoms representing children ≤10 years of age and exposed to mock UGI examinations using exposures much greater than used clinically to minimize measurement error. Measured effective dose was calculated using ICRP 103 weights and scaled to our institution's standardized clinical UGI (3.6-min fluoroscopy, four spot exposures and four examination beam projections) as determined from patient logs. Results were compared to Monte Carlo simulations and related to fluoroscope-displayed DAP. Measured effective doses for standardized pediatric UGI examinations in our institute ranged from 0.35 to 0.79 mSv in girls and were 3-8% lower for boys. Simulation-derived and measured effective doses were in agreement (percentage differences 0.18). DAP-to-effective dose conversion factors ranged from 6.5 x 10 -4 mSv per Gy-cm 2 to 4.3 x 10 -3 mSv per Gy-cm 2 for girls and were similarly lower for boys. Using modern fluoroscopy equipment, the effective dose associated with the UGI examination in children ≤10 years at our institute is < 1 mSv. Estimations of effective dose associated with pediatric UGI examinations can be made for children up to the age of 10 using the DAP-normalized conversion factors provided in this study. These estimates can be further refined to reflect individual hospital examination protocols through the use of direct organ

  5. Pediatric Voiding Cystourethrogram

    Science.gov (United States)

    Scan for mobile link. Children's (Pediatric) Voiding Cystourethrogram A children’s (pediatric) voiding cystourethrogram uses fluoroscopy – a form of real-time x-ray – to examine a child’s bladder ...

  6. A preliminary examination of child well-being of physically abused and neglected children compared to a normative pediatric population.

    Science.gov (United States)

    Lanier, Paul; Kohl, Patricia L; Raghavan, Ramesh; Auslander, Wendy

    2015-02-01

    Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment. © The Author(s) 2014.

  7. Pediatric providers and radiology examinations. Knowledge and comfort levels regarding ionizing radiation and potential complications of imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wildman-Tobriner, Benjamin; Maxfield, Charles M. [Duke University Hospital, Department of Radiology, Durham, NC (United States); Parente, Victoria M. [Duke University Hospital, Department of Pediatrics, Durham, NC (United States)

    2017-12-15

    Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers' level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers. To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging. A 6-question survey was sent via email to 390 pediatric providers (faculty, trainees and midlevel providers) from a single academic institution. A knowledge-based question asked providers to identify which radiology modalities use ionizing radiation. Subjective questions asked providers about discussions with parents, consultations with radiologists, and complications of imaging studies. One hundred sixty-nine pediatric providers (43.3% response rate) completed the survey. Greater than 90% of responding providers correctly identified computed tomography (CT), fluoroscopy and radiography as modalities that use ionizing radiation, and ultrasound and magnetic resonance imaging (MRI) as modalities that do not. Fewer (66.9% correct, P<0.001) knew that nuclear medicine utilizes ionizing radiation. A majority of providers (82.2%) believed that discussions with radiologists regarding ionizing radiation were helpful, but 39.6% said they rarely had time to do so. Providers were more concerned with complications of sedation and cost than they were with radiation-induced cancer, renal failure or anaphylaxis. Providers at our academic referral center have a high level of basic knowledge regarding modalities that use ionizing radiation, but they are less aware of ionizing radiation use in nuclear medicine studies. They find discussions with radiologists helpful and are concerned about complications of sedation and cost. (orig.)

  8. Pediatric providers and radiology examinations: knowledge and comfort levels regarding ionizing radiation and potential complications of imaging.

    Science.gov (United States)

    Wildman-Tobriner, Benjamin; Parente, Victoria M; Maxfield, Charles M

    2017-12-01

    Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers' level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers. To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging. A 6-question survey was sent via email to 390 pediatric providers (faculty, trainees and midlevel providers) from a single academic institution. A knowledge-based question asked providers to identify which radiology modalities use ionizing radiation. Subjective questions asked providers about discussions with parents, consultations with radiologists, and complications of imaging studies. One hundred sixty-nine pediatric providers (43.3% response rate) completed the survey. Greater than 90% of responding providers correctly identified computed tomography (CT), fluoroscopy and radiography as modalities that use ionizing radiation, and ultrasound and magnetic resonance imaging (MRI) as modalities that do not. Fewer (66.9% correct, Pionizing radiation. A majority of providers (82.2%) believed that discussions with radiologists regarding ionizing radiation were helpful, but 39.6% said they rarely had time to do so. Providers were more concerned with complications of sedation and cost than they were with radiation-induced cancer, renal failure or anaphylaxis. Providers at our academic referral center have a high level of basic knowledge regarding modalities that use ionizing radiation, but they are less aware of ionizing radiation use in nuclear medicine studies. They find discussions with radiologists helpful and are concerned about complications of sedation and cost.

  9. Job satisfaction among multiple sclerosis certified nurses.

    Science.gov (United States)

    Gulick, Elsie E; Halper, June; Costello, Kathleen

    2007-08-01

    Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide.

  10. Survey of doses and frequency of X-ray examinations on children at the intensive care unit of a large reference pediatric hospital

    International Nuclear Information System (INIS)

    Pedrosa de Azevedo, Ana Cecilia; Osibote, Adelaja Otolorin; Bastos Boechat, Marcia Cristina

    2006-01-01

    Objective: This work aims to evaluate the entrance surface dose (ESD), the body organ dose (BOD) and the effective dose (E) resulting from pediatric radiological procedures with the use of portable X-ray equipments. Materials and methods: The software DoseCal was used to evaluate the doses imparted to patients. The children were classified according to their weight and age groups, and the study included three sectors of the intensive care unit of a large reference pediatric hospital in Rio de Janeiro. Results: A total of 518 radiographs have been performed (424 for chest and 94 for abdomen). The statistical data were compared with previously published results. The BOD is presented for the most exposed organs. Conclusion: The mean value of ESD and E varied widely among neonates. The highest number of radiographs per infant peaked 33 for chest examination in the age group 0-1 year

  11. ENERGY STAR Certified Vending Machines

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Refrigerated Beverage Vending Machines that are effective as of March 1, 2013. A detailed listing of key efficiency criteria are available at

  12. ENERGY STAR Certified Ceiling Fans

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Ceiling Fans that are effective as of April 1, 2012. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=ceiling_fans.pr_crit_ceiling_fans

  13. ENERGY STAR Certified Ventilating Fans

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Ventilating Fans that are effective as of October 1, 2015. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=vent_fans.pr_crit_vent_fans

  14. Variation in Part-Time Work among Pediatric Subspecialties.

    Science.gov (United States)

    Freed, Gary L; Boyer, Debra M; Van, Kenton D; Macy, Michelle L; McCormick, Julie; Leslie, Laurel K

    2018-04-01

    To assess the part-time workforce and average hours worked per week among pediatric subspecialists in the 15 medical subspecialties certified by the American Board of Pediatrics. We examined data from pediatric subspecialists who enrolled in Maintenance of Certification with the American Board of Pediatrics from 2009 to 2015. Data were collected via an online survey. Providers indicated whether they worked full time or part time and estimated the average number of hours worked per week in clinical, research, education, and administrative tasks, excluding time on call. We calculated and compared the range of hours worked by those in full- and part-time positions overall, by demographic characteristics, and by subspecialty. Overall, 9.6% of subspecialists worked part time. There was significant variation in part-time employment rates between subspecialties, ranging from 3.8% among critical care pediatricians to 22.9% among developmental-behavioral pediatricians. Women, American medical graduates, and physicians older than 70 years of age reported higher rates of part-time employment than men, international medical graduates, and younger physicians. There was marked variation in the number of hours worked across subspecialties. Most, but not all, full-time subspecialists reported working at least 40 hours per week. More than one-half of physicians working part time in hematology and oncology, pulmonology, and transplant hepatology reported working at least 40 hours per week. There are unique patterns of part-time employment and hours worked per week among pediatric medical subspecialists that make simple head counts inadequate to determine the effective workforce. Our findings are limited to the 15 American Board of Pediatrics-certified medical subspecialties. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Pediatric novice nurses: examining compassion fatigue as a mediator between stress exposure and compassion satisfaction, burnout, and job satisfaction.

    Science.gov (United States)

    Meyer, Rika M L; Li, Angela; Klaristenfeld, Jessica; Gold, Jeffrey I

    2015-01-01

    We investigated whether compassion fatigue mediated associations between nurse stress exposure and job satisfaction, compassion satisfaction, and burnout, controlling for pre-existing stress. The Life Events Checklist was administered to 251 novice pediatric nurses at the start of the nurse residency program (baseline) and 3 months after to assess pre-existing and current stress exposure. Compassion satisfaction, compassion fatigue, and burnout were assessed 3 months after baseline and job satisfaction 6 months after. Stress exposure significantly predicted lower compassion satisfaction and more burnout. Compassion fatigue partially mediated these associations. Results demonstrate a need for hospitals to prevent compassion fatigue in healthcare providers. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 7 CFR 983.7 - Certified pistachios.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Certified pistachios. 983.7 Section 983.7 Agriculture... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE PISTACHIOS GROWN IN CALIFORNIA, ARIZONA, AND NEW MEXICO Definitions § 983.7 Certified pistachios. Certified pistachios are those that meet...

  17. 7 CFR 1221.4 - Certified organization.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Certified organization. 1221.4 Section 1221.4 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... organization. Certified organization means any organization that has been certified by the Secretary pursuant...

  18. 7 CFR 1280.103 - Certified organization.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Certified organization. 1280.103 Section 1280.103 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... organization. Certified organization means any organization which has been certified by the Secretary pursuant...

  19. Dose levels from thoracic and pelvic examinations in two pediatric radiological departments in Norway - a comparison study of dose-area product and radiographic technique

    International Nuclear Information System (INIS)

    Kjernlie Saether, Hilde; Traegde Martinsen, Anne Catrine; Lagesen, Bente; Platou Holsen, Eva; Oevreboe, Kirsti Marie

    2010-01-01

    Background: Pediatric doses expressed in dose-area product (DAP) can be retrieved from only a few publications; most of which correlate DAP to patient size or large age spans. In clinical practice age is often the only available parameter describing the patient, and thus, evaluation of dose levels in pediatric radiology on the basis of DAP related to age alone would be useful in optimization work. Purpose: To provide comparable data on age-related DAP from thoracic and pelvic radiological examinations of children, and evaluate the usefulness of comparing age-related DAP and radiographic technique between systems to identify areas with potential for optimization. Material and Methods: DAP, age, and radiographic technique were registered for 575 thoracic examinations and 371 pelvic examinations of children from newborn up to 14 years of age in groups with an age span of 1 year, performed with two digital flat-panel systems and one computed radiography system. Results: DAP varies from 2.2 to 54.0 mGycm2 for thoracic examinations, and from 4.6 to 532.5 mGycm2 for pelvic examinations. There are significant differences in DAP between systems and departments due to differences in technique, equipment, and staff. Conclusion: This study provides comparable data on age-related DAP from thoracic and pelvic radiological examinations of children, which could be used as an input to estimate diagnostic reference levels. The comparison between systems of DAP and radiographic technique has proven useful in identifying areas where there may be a potential for optimization.

  20. Pediatric Specialists

    Science.gov (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  1. Skill qualifications in pediatric minimally invasive surgery.

    Science.gov (United States)

    Iwanaka, Tadashi; Morikawa, Yasuhide; Yamataka, Atsuyuki; Nio, Masaki; Segawa, Osamu; Kawashima, Hiroshi; Sato, Masahito; Terakura, Hirotsugu; Take, Hiroshi; Hirose, Ryuichiro; Yagi, Makoto

    2011-07-01

    In 2006, The Japanese Society of Pediatric Endoscopic Surgeons devised a plan to develop a pediatric endoscopic surgical skill qualification (ESSQ) system. This system is controlled by The Japan Society for Endoscopic Surgery. The standard requirement for skills qualification is the ability of each applicant to complete common types of laparoscopic surgery. The main goal of the system is to decrease complications of laparoscopic surgery by evaluating the surgical skills of each applicant and subsequently certify surgeons with adequate skills to perform laparoscopic operations safely. A committee of pediatric ESSQ created a checklist to assess the applicant's laparoscopic surgical skills. Skills are assessed in a double-blinded fashion by evaluating an unedited video recording of a fundoplication for pediatric gastroesophageal reflux disease. The initial pediatric ESSQ system was started in 2008. In 2008 and 2009, respectively, 9 out of 17 (53%) and 6 out of 12 (50%) applicants were certified as expert pediatric laparoscopic surgeons. Our ultimate goal is to provide safe and appropriate pediatric minimally invasive procedures and to avoid severe complications. To prove the predictive validity of this system, a survey of the outcomes of operations performed by certified pediatric surgeons is required.

  2. Examining the Psychometric Properties of the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire in Two Samples of Youth with OCD.

    Science.gov (United States)

    Wellen, B; Skriner, L C; Freeman, J; Stewart, E; Garcia, A; Sapyta, J; Franklin, M

    2017-02-01

    Researchers have demonstrated that quality of life (QOL) is an important construct to measure in individuals with mental health disorders, yet only a small amount of research has been dedicated to examining QOL and its response to treatment in children and adolescents with obsessive-compulsive disorder (OCD). The current study explored the psychometric properties of a measure of QOL, the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q), by examining the reliability, validity, and treatment sensitivity of this measure delivered in two separate RCTs for OCD (total N = 251 across both studies). Our results provide evidence for the reliability and validity of the PQ-LES-Q in adolescents with OCD (all Cronbach's alphas >.89, convergent validity correlations significant at the p < .05 level), but that an adaptation of the measure many be necessary for valid use in younger children with OCD.

  3. Certifiable Java for Embedded Systems

    DEFF Research Database (Denmark)

    Schoeberl, Martin; Dalsgaard, Andreas Engelbredt; Hansen, Rene Rydhof

    2014-01-01

    The Certifiable Java for Embedded Systems (CJ4ES) project aimed to develop a prototype development environment and platform for safety-critical software for embedded applications. There are three core constituents: A profile of the Java programming language that is tailored for safety......-critical applications, a predictable Java processor built with FPGA technology, and an Eclipse based application development environment that binds the profile and the platform together and provides analyses that help to provide evidence that can be used as part of a safety case. This paper summarizes key contributions...

  4. Certified randomness in quantum physics.

    Science.gov (United States)

    Acín, Antonio; Masanes, Lluis

    2016-12-07

    The concept of randomness plays an important part in many disciplines. On the one hand, the question of whether random processes exist is fundamental for our understanding of nature. On the other, randomness is a resource for cryptography, algorithms and simulations. Standard methods for generating randomness rely on assumptions about the devices that are often not valid in practice. However, quantum technologies enable new methods for generating certified randomness, based on the violation of Bell inequalities. These methods are referred to as device-independent because they do not rely on any modelling of the devices. Here we review efforts to design device-independent randomness generators and the associated challenges.

  5. Automatic exposure control in pediatric and adult multidetector CT examinations: A phantom study on dose reduction and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Papadakis, Antonios E.; Perisinakis, Kostas; Damilakis, John [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 1352, Iraklion 71110, Crete (Greece)

    2008-10-15

    The aim of this study was to assess the potential of a modern x,y,z modulation-based automatic exposure control system (AEC) for dose reduction in pediatric and adult multidetector CT (MDCT) imaging and evaluate the quality of the images obtained. Five physical anthropomorphic phantoms that simulate the average individual as neonate, 1-, 5-, 10-year old child, and adult were scanned with a MDCT scanner, equipped with a modern AEC system. Dose reduction (%DR) was calculated as the percentage difference of the mean modulated and the preset tube current-time product that is prescribed for standard head and body scan protocols. The effect of the tube potential and the orientation of the topogram acquisition on dose reduction were assessed. Image quality was evaluated on the basis of image noise and signal to noise ratio (SNR). The dose reduction values achieved in pediatric phantoms were remarkably lower than those achieved for the adult. The efficiency of the AEC is decreased at 80 kVp compared to higher tube potentials and for helical scans following an anterior posterior (AP-AEC) compared to a lateral (LAT-AEC) topogram acquisition. In AP-AEC scans, the dose reduction ranged between 4.7 and 34.7% for neonate, 15.4 and 30.9% for 1 year old, 3.1 and 26.7% for 5 years old, 1.2 and 58.7% for 10 years old, and 15.5 and 57.4% for adult. In LAT-AEC scans, the corresponding dose reduction ranged between 11.0 and 36.5%, 27.2 and 35.7%, 11.3 and 35.6%, 0.3 and 67.0%, and 15.0 and 61.7%, respectively. AP-AEC scans resulted in a 17.1% and 19.7% dose increase in the thorax of neonate and the pelvis of the 10-year old phantom, respectively. The variation in the measured noise among images obtained along the scanning z axis was lower in AEC activated compared to fixed milliamperes scans. However, image noise was significantly increased (P<.001) and SNR significantly decreased (P<.001) in most AEC activated compared to fixed milliamperes scans. In conclusion, AEC resulted in a (i

  6. The Meaning of Reflective Teaching to National Board Certified Teachers

    Science.gov (United States)

    Carey, Sharlotte F.

    2017-01-01

    This qualitative study examined how National Board certified teachers (NBCTs) perceive the meaning of reflective teaching and how their perceptions compare to the literature on reflective thinking and teaching. The study included five participants who had completed the National Board certification process. Data collection included three…

  7. A Study of How Certified and Noncertified Automotive Curriculum Impact Student Achievement

    Science.gov (United States)

    VanDalsem, B.

    2010-01-01

    The purpose of this case study was to examine whether written curriculum for Automotive Service Excellence (ASE) certified and non-certified training programs better prepares students for entry-level positions. The theoretical framework based on research by Frase described methodologies for comparing curricula at the system, school, and classroom…

  8. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of ... 30 minutes. top of page What will my child experience during and after the procedure? Ultrasound examinations ...

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... interventions. Children's (pediatric) nuclear medicine refers to imaging examinations done in babies, young children and teenagers. Nuclear ... nuclear medicine procedure work? With ordinary x-ray examinations, an image is made by passing x-rays ...

  10. ENERGY STAR Certified Data Center Storage

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Data Center Storage that are effective as of December 2, 2013. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/certified-products/detail/data_center_storage

  11. Supply and demand of board-certified emergency physicians by U.S. state, 2005.

    Science.gov (United States)

    Sullivan, Ashley F; Ginde, Adit A; Espinola, Janice A; Camargo, Carlos A

    2009-10-01

    The objective was to estimate the emergency medicine (EM) board-certified emergency physician (EP) workforce supply and demand by U.S. state. The 2005 National Emergency Department Inventories-USA provided annual visit volumes for U.S. emergency departments (EDs). We estimated full-time equivalent (FTE) EP demand at each ED by dividing the actual number of visits by the estimated average EP visit volume (3,548 visits/year) and then summing FTEs by state. Our model assumed that at least one EP should be present 24/7 in each ED. The number of EM board-certified EPs per state was provided by the American Board of Medical Specialties (American Board of Emergency Medicine, American Board of Pediatrics) and the American Osteopathic Board of Emergency Medicine. We used U.S. Census Bureau civilian population estimates to calculate EP population density by state. The supply of EM board-certified EPs was 58% of required FTEs to staff all EDs nationally and ranged from 10% in South Dakota to 104% in Hawai'i (i.e., there were more EPs than the estimated need). Texas and Florida had the largest absolute shortages of EM board-certified EPs (2,069 and 1,146, respectively). The number of EM board-certified EPs per 100,000 U.S. civilian population ranged from 3.6 in South Dakota to 13.8 in Washington, DC. States with a higher population density of EM board-certified EPs had higher percent high school graduates and a lower percent rural population and whites. The supply and demand of EM board-certified EPs varies by state. Only one state had an adequate supply of EM board-certified EPs to fully staff its EDs.

  12. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites

    International Nuclear Information System (INIS)

    Bisset, George S.; Crowe, James

    2014-01-01

    Extremity pain represents one of the most common reasons for obtaining conventional radiographs in childhood. Despite the frequency of these examinations little is known about the incidence of diagnostic errors by interpreting pediatric radiologists. The purpose of this study was to develop a standard error rate of pediatric radiologists by double-reading of extremity radiographs (elbow, wrists, knees and ankles) in children presenting with a history of trauma or pain. During a 6-month period all major extremity radiographs (excluding digits) obtained at a large pediatric referral hospital for evaluation of pain or trauma were reviewed by two senior pediatric radiologists and compared to the official interpretation. All radiographs were interpreted initially by a board-certified pediatric radiologist with a Certificate of Added Qualification (CAQ). We reviewed 3,865 radiographic series in children and young adults 2-20 years of age. We tabulated misses and overcalls. We did not assess the clinical significance of the errors. There were 61 miss errors and 44 overcalls in 1,235 abnormal cases and 2,630 normal cases, for a 1.6% miss rate and a 1.1% overcall rate. Misses and overcalls were most common in the ankle. Interpretive errors by pediatric radiologists reviewing certain musculoskeletal radiographs are relatively infrequent. Diagnostic errors in the form of a miss or overcall occurred in 2.7% of the radiographs. (orig.)

  13. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  14. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  15. Radiological examination in diagnosis of dolicho-sigmoid taking into consideration the colon and sigmoid length ratio in pediatric patients

    International Nuclear Information System (INIS)

    Bober, S.T.

    1993-01-01

    The aim of the study was usefulness evaluation of radiological examination in the diagnosis of dolicho sigmoid, especially establishing diagnosis criteria of pictures on contrast enema films which may be pathognomonic for dolicho sigmoid in children. An attempt has been made to establish objectively the length of sigmoid and colon to calculated the radio of their sizes in children with dolicho sigmoid syndrome and in control group. Contrast enemas were performed in 176 children. Among the examined children, in 26 cases dolicho sigmoid syndrome was found, including two cases of dolicho colon. Children with dolicho sigmoid syndrome showed various anomalies in elongated sigmoid location at its different levels. Generally, it was situated at the level of between L 1 and L 5 . The sigmoid formed often two or more abnormal loops with various bending and twisting or irregular protrusions. The coefficient or our invention concerned the ratio of colon length to the length of elongated sigmoid and on the basis of calculations made on children suffering from dolicho sigmoid syndrome the numerical values ranged from 0.7 to 1.5. The same calculations performed on the control for the proposed coefficient ranged from 2.2 to 4.2. (author). 65 refs, 15 figs, 11 tabs

  16. Implementation plans for the Korean certified tumor registrar qualification system.

    Science.gov (United States)

    Boo, Yoo-Kyung; Lim, Hyun-Sook; Won, Young-Joo

    2014-01-01

    Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.

  17. Organisational learning and continuous improvement of health and safety in certified manufacturers

    DEFF Research Database (Denmark)

    Granerud, Lise; Rocha, Robson Sø

    2011-01-01

    and raise goals within health and safety on a continuous basis. The article examines how certified occupational and health management systems influence this process to evaluate how far they hinder or support learning. It presents a model with which it is possible to identify and analyse improvement......Certified management systems have increasingly been applied by firms in recent decades and now cover the management of health and safety, principally through the OHSAS 18001 standard. In order to become certified, firms must not only observe the relevant legislation, but also improve performance...... processes. The model is applied to five cases from a qualitative study of Danish manufacturers with certified health and safety management systems. The cases illustrate the wide variation in health and safety management among certified firms. Certification is found to support lower levels of continuous...

  18. Evaluation of pediatrics entrance surface air kerma during chest X-ray examinations in some Khartoum hospitals

    International Nuclear Information System (INIS)

    Mohamed, Hassan Ishag Yahya

    2015-10-01

    The aim of this study was to determine the amount of entrance surface air kerma dose in air that can reflect the amount of the risk that the children, are subjected to. The parameters that are involved in this project are x-ray tube current (mA), exposure time (sec.), and focal skin distance (FSD) in cm. ESAK is calculated using the equation: ESAK=(Output (mGy/mAs) x (100/FSD) 2 X mAs) for different examination of different patients. 65 cases were involved in this study, the results show that the ESAK mean value (0.18±0.07) mGy, (0.06±0.07) mGy, (0.045±0.017) mGy and (0.049±0.013) mGy at the hospitals (IBNIOF Omdurman, police, clinic doctor) respectively. IBNIOF presented the highest ESAK (0.18±0.07) mGy, while it was lowest in police (0.045±0.017) mGy. The estimated ESAK value were within the established international reference dose values and also the values obtained in pervious studies however, variations were observed in ESAK values among hospitals under study which could be due to the differences in exposure parameters used. Also tube output has some effect on obtained ESAK. (author)

  19. ENERGY STAR Certified Commercial Ice Machines

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Automatic Commercial Ice Makers that are...

  20. ENERGY STAR Certified Commercial Refrigerators and Freezers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Commercial Refrigerators and Freezers that are...

  1. ENERGY STAR Certified Geothermal Heat Pumps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.1 ENERGY STAR Program Requirements for Geothermal Heat Pumps that are effective as of...

  2. 12 CFR 327.2 - Certified statements.

    Science.gov (United States)

    2010-01-01

    ... the FDIC's e-business Web site FDICconnect a quarterly certified statement invoice each assessment... of the Assessments Section. (4) Each assessment period, the FDIC will provide courtesy e-mail...

  3. ENERGY STAR Certified Residential Clothes Washers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 8.0 ENERGY STAR Program Requirements for Clothes Washers that are effective as of...

  4. ENERGY STAR Certified Residential Clothes Dryers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.1 ENERGY STAR Program Requirements for Clothes Dryers that are effective as of January...

  5. ENERGY STAR Certified Commercial Clothes Washers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 8.0 ENERGY STAR Program Requirements for Clothes Washers that are effective as of...

  6. ENERGY STAR Certified Electric Vehicle Supply Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Electric Vehicle Supply Equipment that are...

  7. ENERGY STAR Certified Light Commercial HVAC

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.1 ENERGY STAR Program Requirements for Light Commercial HVAC that are effective as of...

  8. ENERGY STAR Certified Room Air Conditioners

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Room Air Conditioners that are effective as of...

  9. ENERGY STAR Certified Commercial Steam Cookers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.2 ENERGY STAR Program Requirements for Commercial Steam Cookers that are effective as...

  10. ENERGY STAR Certified Small Network Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Small Networking Equipment that are effective as...

  11. ENERGY STAR Certified Room Air Cleaners

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.2 ENERGY STAR Program Requirements for Room Air Cleaners that are effective as of July...

  12. Get Your Automotive Program Nationally Certified!

    Science.gov (United States)

    Lundquist, Patricia A.

    2000-01-01

    Automotive programs that nationally certified enhance student recruitment and give students better employment opportunities. Technicians who earn the Automotive Service Excellence credential have joined the ranks of professionals in the automotive service industry. (Author/JOW)

  13. ENERGY STAR Certified Uninterruptible Power Supplies

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Uninterruptible Power Supplies that are...

  14. 77 FR 24103 - National Registry of Certified Medical Examiners

    Science.gov (United States)

    2012-04-20

    ... competence through periodic training and testing. Following establishment of the National Registry and a... they can determine effectively whether a CMV driver's medical fitness for duty meets FMCSA's standards... understanding of those standards, and maintain and demonstrate competence through periodic training and testing...

  15. The importance of using certified seed

    OpenAIRE

    Bogdanović Sandra; Mladenov Velimir; Balešević-Tubić Svetlana

    2015-01-01

    Certified seed is produced from the seed of known genetic origin and genetic purity with controlled and tested production, processed and declared in accordance with the Law on Seeds. Production of certified seed is carried out under the supervision of the Ministry of Agriculture and Environmental Protection, by seed producers formally listed in the Seed Register. Seed is processed in registered seed processing centres and quality is tested in laboratories accredited for seed testing. The orga...

  16. Characterizations of a quality certified athletic trainer.

    Science.gov (United States)

    Raab, Scot; Wolfe, Brent D; Gould, Trenton E; Piland, Scott G

    2011-01-01

    Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Delphi study. Interviews in conference rooms or business offices and by telephone. Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers? Association (2, 3, 4, 9). Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.

  17. Pediatric radiology

    International Nuclear Information System (INIS)

    Silverman, F.N.

    1982-01-01

    A literature review with 186 references of diagnostic pediatric radiology, a speciality restricted to an age group rather than to an organ system or technique of examination, is presented. In the present chapter topics follow the basic organ system divisions with discussions of special techniques within these divisions. The diagnosis of congenital malformations, infectious diseases and neoplasms are a few of the topics discussed for the head and neck region, the vertebrae, the cardiovascular system, the respiratory system, the gastrointestinal tract, the urinary tract, and the skeleton

  18. 7 CFR 945.7 - Certified seed potatoes.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Certified seed potatoes. 945.7 Section 945.7... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE IRISH POTATOES GROWN IN CERTAIN... Certified seed potatoes. Certified seed potatoes means and includes all potatoes officially certified and...

  19. A Comparison of Retention Rates of Alternatively Certified and Traditional Certified Teachers.

    Science.gov (United States)

    Dial, Micah

    1992-01-01

    A survey of 2,500 teachers entering a large urban school district over the last 7 years showed that alternatively certified teachers were as likely as traditional, university-certified teachers to remain in the profession and pay back the school district's initial investment in teacher training. Many become committed to teaching as a meaningful…

  20. An investigation of safety climate in OHSAS 18001-certified and non-certified organizations.

    Science.gov (United States)

    Ghahramani, Abolfazl

    2016-09-01

    Many organizations worldwide have implemented Occupational Health and Safety Assessment Series (OHSAS) 18001 in their premises because of the assumed positive effects of this standard on safety. Few studies have analyzed the effect of the safety climate in OHSAS 18001-certified organizations. This case-control study used a new safety climate questionnaire to evaluate three OHSAS 18001-certified and three non-certified manufacturing companies in Iran. Hierarchical regression indicated that the safety climate was influenced by OHSAS implementation and by safety training. Employees who received safety training had better perceptions of the safety climate and its dimensions than other respondents within the certified companies. This study found that the implementation of OHSAS 18001 does not guarantee improvement of the safety climate. This study also emphasizes the need for high-quality safety training for employees of the certified companies to improve the safety climate.

  1. Pediatric Stroke

    Science.gov (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  2. Myocarditis - pediatric

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007307.htm Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  3. A Comparison between Students' Performance in Multiple Choice and Modified Essay Questions in the MBBS Pediatrics Examination at the College of Medicine, King Khalid University, KSA

    Science.gov (United States)

    Salih, Karimeldin M. A.; Alshehri, Mohamed Abdullah Al-Gosadi; Elfaki, Omer Abdelgadir

    2016-01-01

    Objectives: To investigate the relation between the students' scores in MCQs and MEQs of the summative assessment in pediatrics at the College of medicine KKU. Introduction: Student assessment is the most difficult task in medicine since it is ultimately related to human life and safety. Assessment can take different types of formats with…

  4. Evaluation of Business Excellence among Halal Certified Food Manufacturers in Malaysia

    Directory of Open Access Journals (Sweden)

    Masrom Nor Ratna binti

    2017-01-01

    Full Text Available Business excellence is a key tool to improve the efficiency of the company. Through the business excellence model, the organization can execute their strategies to determine, forecast and survive in highly competitive market. This paper presents on identifying those elements in business excellence model (leadership, strategy and planning, customer focus, measurement, analysis, and knowledge management, operation focus this paper provides empirical support for halal food certified companies reviewing and improvement. Survey has been done and analyzed among halal food certified manufacturers in Malaysia. Thus, seven categories with 35 key elements regarding American MBNQA and eight equations are examined. The main conclusions are that, strategy and measurement, analysis and knowledge management are the main weakness of the halal food certified manufacturers in Malaysia. Overall, halal food certified manufacturers in Malaysia is at the silver level of excellence based on the calculation.

  5. Chronicle of pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Richter, Ernst

    2012-01-01

    The chronicle of pediatric radiology covers the following issues: Development of pediatric radiology in Germany (BRD, DDR, pediatric radiological accommodations); development of pediatric radiology in the Netherlands (chronology and pediatric radiological accommodations); development of pediatric radiology in Austria (chronology and pediatric radiological accommodations); development of pediatric radiology in Switzerland (chronology and pediatric radiological accommodations).

  6. ENERGY STAR Certified Geothermal Heat Pumps

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Geothermal Heat Pumps that are effective as of January 1, 2012. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=geo_heat.pr_crit_geo_heat_pumps

  7. Certified reference materials for organic analysis

    International Nuclear Information System (INIS)

    QianChuanfan

    2002-01-01

    This presentation discusses the requirements for certified reference materials (CRMs) to be used in measurements of residues of pesticides in food and environmental samples. It deals with the types of CRMs, matrix selection, sample preparation and representativeness. It also discusses CRM validity period and gives some examples of CRM preparation

  8. 31 CFR 306.45 - Certifying individuals.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying individuals. 306.45 Section 306.45 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... employees of depository institutions, corporate central credit unions, and institutions that are members of...

  9. 31 CFR 357.31 - Certifying individuals.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying individuals. 357.31 Section 357.31 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... institutions, corporate central credit unions, and institutions that are members of Treasury-recognized...

  10. 31 CFR 346.14 - Certifying officers.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying officers. 346.14 Section 346.14 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... imprint of the corporate seal, or, where the institution is an authorized issuing agent for United States...

  11. 31 CFR 341.14 - Certifying officers.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying officers. 341.14 Section 341.14 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... imprint of the corporate seal, or, where the institution is an authorized issuing agent for United States...

  12. 28 CFR 33.32 - Certified programs.

    Science.gov (United States)

    2010-07-01

    ... Statistics, and the Office of Juvenile Justice and Delinquency Prevention, certifies that the following... the National Institute of Justice, Director of the Bureau of Justice Statistics, and Administrator of the Office of Juvenile Justice and Delinquency Prevention, as having proved successful. (15)(i...

  13. Leakage from medically-certified to self-certified workplace absence among norwegian employees

    OpenAIRE

    Karlsen, Geir Runar; Ytterstad, Elinor

    2017-01-01

    Source at https://dx.doi.org/10.1080/20021518.2017.1411119 There are two different kinds of sickness absence in Norway: self-certified absence (SCA), and medically-certified absence (MCA). In this study of 6437 Norwegian employees, we applied logistic regression models for a dichotomous SCA variable on initially 38 independent vari- ables including age and gender. Our findings showed that employees reporting long-term health issues but no record of MCA in the past 12 months (...

  14. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan

    2017-01-01

    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  15. Study of the Impact of Certified Staff Perception of Digital Citizenship upon Teacher Professional Development

    Science.gov (United States)

    Ashmeade, Lisa Ann

    2016-01-01

    This record of study examines the relationship between certified staff personnel perception of digital citizenship and the impact upon professional development. Quantitative and qualitative data was used to examine responses to teacher familiarity with the concept of digital citizenship and status of teaching digital citizenship culminating with…

  16. Certifying the absence of quantum nonlocality

    OpenAIRE

    Miller, Carl A.; Shi, Yaoyun

    2016-01-01

    Quantum nonlocality is an inherently non-classical feature of quantum mechanics and manifests itself through violation of Bell inequalities for nonlocal games. We show that in a fairly general setting, a simple extension of a nonlocal game can certify instead the absence of quantum nonlocality. Through contraposition, our result implies that a super-classical performance for such a game ensures that a player's output is unpredictable to the other player. Previously such output unpredictabilit...

  17. Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

    International Nuclear Information System (INIS)

    Takei, Yasutaka; Miyazaki, Osamu; Matsubara, Kosuke; Koshida, Kichiro; Shimada, Yoshiya; Akahane, Keiichi; Muramatsu, Yoshihisa; Fujii, Keisuke; Suzuki, Shoichi

    2016-01-01

    Diagnostic reference levels (DRLs) have not been established in Japan. To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups. We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years. For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDI vol 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose-length products (DLP 16 [mGy·cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively. The majority of CTDI vol 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan. (orig.)

  18. Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

    Energy Technology Data Exchange (ETDEWEB)

    Takei, Yasutaka [Kanazawa University, Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Science, Kanazawa, Ishikawa (Japan); Miyazaki, Osamu [National Center for Child Health and Development, Department of Radiology, Tokyo (Japan); Matsubara, Kosuke; Koshida, Kichiro [Kanazawa University, Department of Quantum Medical Technology, Faculty of Health Sciences, Ishikawa (Japan); Shimada, Yoshiya; Akahane, Keiichi [National Institute of Radiological Sciences, Medical Exposure Research Project, Chiba (Japan); Muramatsu, Yoshihisa [National Cancer Center Hospital East, Department of Radiology, Chiba (Japan); Fujii, Keisuke [Nagoya University, Radiological Technology, Graduate School of Medicine, Aichi (Japan); Suzuki, Shoichi [Fujita Health University, Faculty of Radiological Technology, School of Health Sciences, Aichi (Japan)

    2016-02-15

    Diagnostic reference levels (DRLs) have not been established in Japan. To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups. We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years. For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDI{sub vol} 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose-length products (DLP 16 [mGy·cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively. The majority of CTDI{sub vol} 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan. (orig.)

  19. Development of solid water-equivalent radioactive certified reference materials

    International Nuclear Information System (INIS)

    Finke, E.; Greupner, H.; Groche, K.; Rittwag, R.; Geske, G.

    1991-01-01

    This paper presents a brief description of the development of solid water-equivalent beta volume radioactive certified reference materials. These certified reference materials were prepared for the beta fission nuclides 90 Sr/ 90 Y, 137 Cs, 147 Pm and 204 Tl. Comparative measurements of liquid and solid water-equivalent beta volume radioactive certified reference materials are discussed. (author)

  20. 76 FR 19310 - Information Collection; Certified State Mediation Program

    Science.gov (United States)

    2011-04-07

    ... DEPARTMENT OF AGRICULTURE Farm Service Agency Information Collection; Certified State Mediation... supports the Certified State Mediation Program. The information collection is necessary to ensure the grant... submit comments by any of the following methods: Mail: Carol Wagner, Certified State Mediation Program...

  1. 30 CFR 90.203 - Certified person; maintenance and calibration.

    Science.gov (United States)

    2010-07-01

    ... COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.203 Certified person; maintenance and calibration. (a) Approved sampling devices shall be maintained and calibrated by a certified person. (b) To be certified, a...

  2. 30 CFR 71.202 - Certified person; sampling.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Certified person; sampling. 71.202 Section 71... Sampling Procedures § 71.202 Certified person; sampling. (a) The respirable dust sampling required by this... on sampling of respirable coal mine dust. (c) A person may be temporarily certified by MSHA to take...

  3. 30 CFR 70.202 - Certified person; sampling.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Certified person; sampling. 70.202 Section 70... HEALTH MANDATORY HEALTH STANDARDS-UNDERGROUND COAL MINES Sampling Procedures § 70.202 Certified person; sampling. (a) The respirable dust sampling required by this part shall be done by a certified person. (b...

  4. Evaluation of X ray radiation doses in pediatric examinations of cranial computerized tomography based on optimization studies; Avaliacao das doses de radiacao X em exames pediatricos de tomografia computadorizada de cranio com base em estudos de otimizacao

    Energy Technology Data Exchange (ETDEWEB)

    Daros, Kellen Adriana Curci

    2005-07-01

    This paper identifies the technical conditions for CT examination which offers lowest absorbed dose and to attend the manufacturer recommendations as far the spatial resolution is concerned. The paper evaluates the absorbed dose during cranial CT in up to 6 years children satisfying the technical condition recommended by the manufacturer and routine clinical conditions. The paper also established a quantitative relationship among the absorbed dose and its distribution in the cranial regions of pediatric patients up to 6 years old in a way to estimate the doses subject to optimized conditions

  5. Norwegian farmers ceasing certified organic production: characteristics and reasons.

    Science.gov (United States)

    Flaten, Ola; Lien, Gudbrand; Koesling, Matthias; Løes, Anne-Kristin

    2010-12-01

    This article examines the characteristics of and reasons for Norwegian farmers' ceasing or planning to cease certified organic production. We gathered cross-sectional survey data in late 2007 from organic farmers deregistering between January 2004 and September 2007 (n=220), and similar data from a random sample of farmers with certified organic management in 2006 (n=407). Of the respondents deregistering by November 2007, 17% had quit farming altogether, 61% now farmed conventionally, and 21% were still farming by organic principles, but without certification. Nearly one in four organic farmers in 2007 indicated that they planned to cease certification within the next 5-10 years. From the two survey samples, we categorised farmers who expect to be deregistered in 5-10 years into three groups: conventional practices (n=139), continuing to farm using organic principles (uncertified organic deregistrants, n=105), and stopped farming (n=33). Of the numerous differences among these groups, two were most striking: the superior sales of uncertified organic deregistrants through consumer-direct marketing and the lowest shares of organic land among conventional deregistrants. We summarised a large number of reasons for deregistering into five factors through factor analysis: economics, regulations, knowledge-exchange, production, and market access. Items relating to economics and regulations were the primary reasons offered for opting out. The regression analysis showed that the various factors were associated with several explanatory variables. Regulations, for example, figured more highly among livestock farmers than crop farmers. The economic factor strongly reflected just a few years of organic management. Policy recommendations for reducing the number of dropouts are to focus on economics, environmental attitudes, and the regulatory issues surrounding certified organic production. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Causes of fatal accidents for instrument-certified and non-certified private pilots.

    Science.gov (United States)

    Shao, Bob Siyuan; Guindani, Michele; Boyd, Douglas D

    2014-11-01

    Instrument certification (IFR) enhances a pilot's skills in precisely controlling the aircraft and requires a higher level of standards in maintaining heading and altitude compared with the less stringent private pilot certificate. However, there have been no prior studies to compare fatal accident causes for airmen with, and without, this rating, The NTSB accident database was queried for general aviation fatal accidents for private pilots with, and without IFR certification. Exact Poisson tests were used to calculate whether two rate parameters were equal (ratio of 1), normalized to the number of IFR-rated pilots and flight hours in the given time period. Proportion tests were used to determine whether there were significant differences in fatal accident causes between IFR-certified and non-certified pilots. A logistic regression for log-odds success was used in determining the trend and effect of age on fatal accident rates. IFR certification was associated with a reduced risk of accidents due to failure to maintain obstacle/terrain clearance and spatial disorientation for day and night operations respectively. In contrast, the likelihood of fatal accident due to equipment malfunction during day operations was higher for IFR-certified pilots. The fatal accident rate decreased over the last decade for IFR-certified but not for non-IFR-certified private pilots. However, the overall accident rate for IFR-certified private pilots was more than double that of the cohort lacking this certification. Finally, we found a trend for an increased fatality rate with advancing age for both group of pilots. Our findings informs on where training and/or technology should be focused. Both training for aerodynamic stalls, which causes over a quarter of all fatal accidents, should be intensified for both IFR-certified and non-certified private pilots. Similarly, adherence to minimum safe altitudes for both groups of pilots should be encouraged toward reducing the fatal accidents

  7. Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

    Science.gov (United States)

    Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

    2015-01-01

    Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

  8. Understanding the pediatric dermatology workforce shortage: mentoring matters.

    Science.gov (United States)

    Admani, Shehla; Caufield, Maura; Kim, Silvia S; Siegfried, Elaine C; Friedlander, Sheila Fallon

    2014-02-01

    To target pediatric dermatologists directly in order to evaluate their current demographics and the most important motivating factors that influenced their career choice. Pediatric dermatology is one of the pediatric subspecialties with an inadequate supply to meet current patient needs. A survey was designed to evaluate the training pathway, employment status, participation in teaching, and clinical practice characteristics of pediatric dermatologists. The survey was administered to attendants of the 2010 Society for Pediatric Dermatology annual meeting. Any remaining board certified pediatric dermatologists who had not previously responded were queried via Survey Monkey. There was a 71% response rate. The majority chose a career in pediatric dermatology early, often prior to starting a dermatology residency. The vast majority of respondents noted mentorship as the most important influence on their decision to pursue a career in pediatric dermatology. The most common obstacles cited by respondents were financial hardship and resistance of some dermatology programs to accept applicants previously trained in pediatrics. Our survey provides evidence to support the importance of early exposure to the field and, most importantly, to committed pediatric dermatologists who can serve as mentors. This information may be helpful in approaching solutions to the workforce shortage in the field of pediatric dermatology. Copyright © 2014 Mosby, Inc. All rights reserved.

  9. Kerma in the air at entry surface in thorax pediatric examinations at public hospital in Parana, Brazil; Kerma no ar na superficie de entrada em exames pediatricos de torax em hospital publico no Parana, Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Amanda; Porto, Lorena; Bunick, Ana; Paschuk, Sergei; Denyak, Valeriy, E-mail: schelin@utfpr.edu.b [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Schelin, Hugo; Tilly, Joao, E-mail: joao.tilly@derax.com.b [DERAX Desenvolvimento Radiologico, Curitiba, PR (Brazil); Khoury, Helen, E-mail: hjkhoury@gmail.co [Universidade Federal de Pernambuco (DOIN/UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear. Grupo de Dosimetria e Instrumentacao Nuclear; Ferreira, Jose [Universidade Estadual do Oeste do Parana (UNIOESTE), Cascavel, PR (Brazil)

    2011-07-01

    This work consisted in the evaluation of the entrance skin air kerma (ESAK) in pediatric chest x-ray examinations. A study of 186 exams in anterior-posterior, posterior-anterior and lateral projections was carried out for patients with ages ranging from 0 to 15 years. The ESAK was measured with the DoseCal software and Li-Fl thermoluminescent dosimeters. The results were compared with measurements done recently at the same place and with the reference dose values established by the European Community. It was observed that the optimization of the technique and the routine changes suggested in the previous study were not maintained. The charge (mAs) and the ESAK values found in the present study were much higher than the previous one, and the voltage (kVp) values found was lower. The results suggest that the implementation of the Quality Assurance Program could adequate these parameters to the established levels and keep the pediatric examinations more uniform. (author)

  10. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  11. International directory of certified radioactive sources

    International Nuclear Information System (INIS)

    Grosse, G.; Bambynek, W.

    1983-01-01

    This directory lists the products of 16 suppliers of certified reference materials (CRM) of radioactivity as given in their catalogues. Included are only products for which certificates are delivered and whose uncertainties are given according to the rules defined in ICRU Report No. 12, ''Certification of Standardized Radioactive Sources'' (International Commission on Radiation and Measurements, Washington, 1968). Only those products are included of which the standard uncertainties according to the above rules are less than 10%. Prices of the products are not mentioned since they frequently change. The products are divided into four groups: Radioactive Solutions, Radioactive Gases, Solid Sources and Sources for Liquid Scintillation Counting). (orig./WL)

  12. International directory of certified radioactive sources

    Energy Technology Data Exchange (ETDEWEB)

    Grosse, G; Bambynek, W

    1983-01-01

    This directory lists the products of 16 suppliers of certified reference materials (CRM) of radioactivity as given in their catalogues. Included are only products for which certificates are delivered and whose uncertainties are given according to the rules defined in ICRU Report No. 12, ''Certification of Standardized Radioactive Sources'' (International Commission on Radiation and Measurements, Washington, 1968). Only those products are included of which the standard uncertainties according to the above rules are less than 10%. Prices of the products are not mentioned since they frequently change. The products are divided into four groups: Radioactive Solutions, Radioactive Gases, Solid Sources and Sources for Liquid Scintillation Counting).

  13. Going the distance for certified cancer registrars.

    Science.gov (United States)

    Backus, Amanda; Kolender, Ellen R

    2009-01-01

    Cancer registry departments are using electronic technology to solve the local and national Certified Tumor Registrar (CTR) shortages. As demand for CTRs continues to increase without an accompanied increase in the supply of qualified personnel, cancer registry departments are looking for new solutions to this growing local and national trend. In order to solve this problem, some cancer registries have started using telecommunication to fill the empty positions within their departments. This is the case at Roper St. Francis Healthcare (RSFH) in Charleston, SC, where Cancer Registry Manager, Ellen Kolender, RHIA, CTR, used telecommuting to fill one full-time and one part-time CTR position.

  14. CEH Certified Ethical Hacker Study Guide

    CERN Document Server

    Graves, Kimberly

    2010-01-01

    Prepare for the new version of CEH certification with this advanced guide. Once you learn the thought processes of unethical hackers, you can figure out how to secure your computer systems to defend against them. That's the philosophy behind ethical hacking, and it's a growing field. Prepare for certification in this important area with this advanced study guide that covers all exam objectives for the challenging CEH Certified Ethical Hackers exam. The book provides full coverage of exam topics, real-world examples, and a CD with additional materials for extra review and practice.:; Covers eth

  15. CISA Certified Information Systems Auditor : study guide

    CERN Document Server

    Cannon, David L

    2011-01-01

    The industry-leading study guide for the CISA exam, fully updated. More than 27,000 IT professionals take the Certified Information Systems Auditor exam each year. SC Magazine lists the CISA as the top certification for security professionals. Compliances, regulations, and best practices for IS auditing are updated twice a year, and this is the most up-to-date book available to prepare aspiring CISAs for the next exam.: CISAs are among the five highest-paid IT security professionals; more than 27,000 take the exam each year and the numbers are growing; Standards are updated twice a year, and t

  16. Pediatric allergy and immunology in Spain.

    Science.gov (United States)

    Nieto, Antonio; Mazon, Angel; Martin-Mateos, Maria Anunciacion; Plaza, Ana-Maria; Garde, Jesus; Alonso, Elena; Martorell, Antonio; Boquete, Manuel; Lorente, Felix; Ibero, Marcel; Bone, Javier; Pamies, Rafael; Garcia, Juan Miguel; Echeverria, Luis; Nevot, Santiago; Martinez-Cañavate, Ana; Fernandez-Benitez, Margarita; Garcia-Marcos, Luis

    2011-11-01

    The data of the ISAAC project in Spain show a prevalence of childhood asthma ranging from 7.1% to 15.3%, with regional differences; a higher prevalence, 22.6% to 35.8%, is described for rhinitis, and atopic dermatitis is found in 4.1% to 7.6% of children. The prevalence of food allergy is 3%. All children in Spain have the right to be visited in the National Health System. The medical care at the primary level is provided by pediatricians, who have obtained their titles through a 4-yr medical residency training program. The education on pediatric allergy during that period is not compulsory and thus very variable. There are currently 112 certified European pediatric allergists in Spain, who have obtained the accreditation of the European Union of Medical Specialist for proven skills and experience in pediatric allergy. Future specialists in pediatric allergy should obtain their titles through a specific education program to be developed in one of the four accredited training units on pediatric allergy, after obtaining the title on pediatrics. The Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) gathers over 350 pediatric allergists and pediatricians working in this field. SEICAP has a growing activity including yearly congresses, continued education courses, elaboration of technical clinical documents and protocols, education of patients, and collaboration with other scientific societies and associations of patients. The official journal of SEICAP is Allergologia et Immunophatologia, published every 2 months since 1972. The web site of SEICAP, http://www.seicap.es, open since 2004, offers information for professionals and extensive information on pediatric allergic and immunologic disorders for the lay public; the web site is receiving 750 daily visits during 2011. The pediatric allergy units are very active in clinical work, procedures as immunotherapy or induction of oral tolerance in food allergy, contribution to scientific literature, and

  17. Pediatric dermatology workforce shortage: perspectives from academia.

    Science.gov (United States)

    Craiglow, Brittany G; Resneck, Jack S; Lucky, Anne W; Sidbury, Robert; Yan, Albert C; Resnick, Steven D; Antaya, Richard J

    2008-12-01

    The pediatric dermatology workforce has not been systematically evaluated since recent changes in board certification requirements. To quantify and characterize the workforce of academic pediatric dermatologists and examine issues related to training, hiring, and retention. Dermatology chairpersons and residency directors in the United States and Canada completed a 30-question survey. Eighty of 132 programs (61%) responded to the survey. More than two thirds of programs (56/80) employed a pediatric dermatologist, and 34 programs were recruiting a pediatric dermatologist. The number of residents that pursue careers in pediatric dermatology is significantly associated with the number of pediatric dermatologists on faculty at their institution. Self-reported data, which may have been reflected by recall bias, and 61% response rate. At a majority of academic centers, the current pool of pediatric dermatology faculty is neither adequate to meet academic nor clinical demands. Methods to increase exposure to pediatric dermatology among medical students and residents must be sought.

  18. Reflections on International Certified Nursing Assistants.

    Science.gov (United States)

    Shaw, Penelope Ann

    2017-01-01

    The author, a former university faculty member who taught English to speakers of other languages and now a nursing home resident, shares her observations about how English language proficiency, culture, and religious differences affect her care. She provides examples of communication challenges that can be annoying or cause harm, her coping strategies, and reasons many certified nursing assistants might never be fully fluent in English. She explains how international certified nursing assistants can benefit residents because of skills developed by family-centered care in their countries of origin. She also discusses related issues-the importance of being culturally competent about U.S. culture. She points out how religiousness not only affects residents but is a buffer for staff against the stress of physically and emotionally demanding low-wage work. Overall, the author likes receiving care from individuals from other countries, finding reward in comparing how her personal struggle with illness and paralysis resonates with the trauma of migration and how learning firsthand about varying beliefs and attitudes clarifies her identity and place in world history.

  19. 77 FR 5415 - National Organic Program: Notice of Draft Guidance for Accredited Certifying Agents, Certified...

    Science.gov (United States)

    2012-02-03

    ... in order to be excluded from the organic certification requirements of Part 205. The NOSB recommended... handling operations that are or are not excluded from organic certification. The draft guidance proposes... excluded from certification and, therefore, must be certified organic operations. \\1\\ NOSB Recommendation...

  20. Training and Certification Program for Certified Energy Auditors (CEA) and Certified Building Commissioning Professionals (CBCP)

    Energy Technology Data Exchange (ETDEWEB)

    Kent, Bill

    2012-08-24

    The Association of Energy Engineers (AEE) has offered energy efficiency training and certification programs for over 30 years. During that time AEE has certified more than 22,000 professionals. All of our certification programs are the result of extensive industry research and program development and oversight by certification boards. For this project award, AEE proposed to work with the Department of Energy to utilize and extend existing industry recognized Certified Energy Auditor (CEA) and Certified Building Commissioning Professional (CBCP) programs under this Training Program Development Announcement. These expanded training programs will have significant impact in training professionals for building commissioning and energy auditing to achieve the goal of bringing existing buildings up to their optimal energy performance potential and ensuring that new buildings maintain their expected optimal level of performance. The goals and objectives of the training development project were achieved with the development of new training programs that are now being offered as self-sustaining commercial training and certification programs. These new programs are training and certifying professionals who are accomplishing the goal of increasing building energy performance in both existing and new buildings.

  1. Beliefs of Certified Public Accountants toward Distance Education: A Statewide Georgia Survey.

    Science.gov (United States)

    Perdue, Kathy J.; Valentine, Thomas

    1998-01-01

    Examines the beliefs of certified public accountants (CPAs) in the state of Georgia concerning the effectiveness of distance education in providing continuing professional education (CPE). Findings indicate that the CPAs believe distance education to be an effective mode of learning, and that necessary technological capabilities are available to…

  2. Understanding the Intentions of Accounting Students in China to Pursue Certified Public Accountant Designation

    Science.gov (United States)

    Wen, Lei; Hao, Qian; Bu, Danlu

    2015-01-01

    Based on the theory of planned behavior [Ajzen, I. (1991). "The theory of planned behavior." "Organizational Behavior and Human Decision Processes," 50(2), 179-211], we examine the factors influencing the decisions of accounting students in China concerning the certified public accountant (CPA) designation. Surveying 288…

  3. An Analysis of the Future Need for Certified Animal Health Technicians and Instructional Program Content.

    Science.gov (United States)

    Nevada State Council on Occupational Education, Carson City.

    A study examined the future need for certified animal health technicians (CAHT) in Nevada and the skills/knowledge that future CAHTs will need. Questionnaires were mailed to all of Nevada's 306 licensed veterinarians; 100 (32.68%) responded. The estimated numbers of CAHTs needed by the state's veterinarians in 1, 3, and 5 years were 62, 142, and…

  4. Organic Coasts? Regulatory Challenges of Certifying Integrated Shrimp-Mangrove Production Systems in Vietnam

    Science.gov (United States)

    Ha, Tran Thi Thu; Bush, Simon R.; Mol, Arthur P. J.; van Dijk, Han

    2012-01-01

    The Vietnamese government aims to expand the scale of Naturland certified organic production in integrated shrimp-mangrove farming systems across the coast of Ca Mau province by 2015. In doing so the division between public and private regulation has become blurred. We analyze the government's goal by examining the regulatory challenges of using…

  5. Do pediatric gastroenterology doctors address pediatric obesity?

    OpenAIRE

    Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra

    2017-01-01

    Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

  6. Pediatric Terminology

    Science.gov (United States)

    The National Institute of Child Health and Human Development (NICHD) works with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other research activities.

  7. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  8. [The state of pediatric anesthesia in Japan: an analysis of the Japanese society of anesthesiologists survey of critical incidents in the operating room].

    Science.gov (United States)

    Irita, Kazuo; Tsuzaki, Koichi; Sawa, Tomohiro; Sanuki, Michiyoshi; Nakatsuka, Hideki; Makita, Koshi; Morita, Kiyoshi

    2007-01-01

    The Japanese Society of Anesthesiologists (JSA) survey of critical incidents in the operating room and other reports have shown that pediatric patients undergoing anesthesia are at an increased risk. Purpose was to examine the state of pediatric anesthesia in Japan. This might clarify the role of children's hospitals for pediatric anesthesia, and the relationship between critical incidents and volume of pediatric anesthetic procedures. The JSA has conducted annual surveys of critical incidents in the operating room by sending to and collecting confidential questionnaires from all JSA Certified Training Hospitals. From 1999 to 2003, 342,840 pediatric (0-5 yr) anesthetic procedures were registered. During this period, only 15 cardiac arrests and 3 deaths within 7 postoperative days totally attributable to anesthetic management were reported. Therefore, we analyzed cardiac arrests and deaths due to all etiologies. The hospitals were classified as children's hospitals, university hospitals, and other hospitals, and the incidence of cardiac arrest, the recovery rate from cardiac arrest without any sequelae, and the mortality rate were compared according to types of the hospitals. The relationship between death due to intraoperative critical incidents and the volume of pediatric anesthetic procedures was examined using data from the 2003 survey, the recovery rate of which was 85.7%. In 2003, 739 JSA Certified Training Hospitals responded to the survey: 7 children's hospitals, 109 university hospitals, and 623 other hospitals. Among these hospitals, 707 and 270 hospitals conducted pediatric and newborn (anesthesia, respectively. In 2003, 4,630 newborn, 17,890 infant (risks among the hospital groups, and the 95% confidential interval (CI) was shown. The Chi square test was used to compare the background of patients with cardiac arrest. P values less than 0.05 were considered significant. In 2003, 95.7% and 36.5% of JSA Certified Training Hospitals which responded to the

  9. Development of solid water-equivalent radioactive certified reference materials

    Energy Technology Data Exchange (ETDEWEB)

    Finke, E.; Greupner, H.; Groche, K.; Rittwag, R. (Office for Standardization, Metrology and Quality Control (ASMW), Berlin (Germany, F.R.)); Geske, G. (Jena Univ. (Germany, F.R.))

    1991-01-01

    This paper presents a brief description of the development of solid water-equivalent beta volume radioactive certified reference materials. These certified reference materials were prepared for the beta fission nuclides {sup 90}Sr/{sup 90}Y, {sup 137}Cs, {sup 147}Pm and {sup 204}Tl. Comparative measurements of liquid and solid water-equivalent beta volume radioactive certified reference materials are discussed. (author).

  10. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  11. Fertilizers applied to certified organic tomato culture

    International Nuclear Information System (INIS)

    Martins, T.C.G.; De Nadai Fernandes, E.A.; Ferrari, A.A.; Bacchi, M.A.; Tagliaferro, F.S.

    2010-01-01

    The tomato culture demands large quantities of mineral nutrients, which are supplied by synthetic fertilizers in the conventional cultivation system. In the organic cultivation system only alternative fertilizers are allowed by the certifiers and accepted as safe for humans and environment. The chemical composition of rice bran, oyster flour, cattle manure and ground charcoal, as well as soils and tomato fruits were evaluated by instrumental neutron activation analysis (INAA). The potential contribution of organic fertilizers to the enrichment of chemical elements in soil and their transfer to fruits was investigated using concentration ratios for fertilizer and soil samples, and also for soil and tomato. Results evidenced that these alternative fertilizers could be taken as important sources of Br, Ca, Ce, K, Na and Zn for the organic tomato culture. (author)

  12. Development studies of captopril certified reference material

    Directory of Open Access Journals (Sweden)

    Raquel Nogueira

    2011-06-01

    Full Text Available This paper describes the studies performed with the candidate Certified Reference Material (CRM of captopril, the first CRM of an active pharmaceutical ingredient (API in Brazil, including determination of impurities (organic, inorganic and volatiles, homogeneity testing, short- and long-term stability studies, calculation of captopril content using the mass balance approach, and estimation of the associated measurement uncertainty.Este artigo descreve os estudos realizados com o candidato a Material de Referência Certificado (MRC de captopril, primeiro MRC de fármacos no Brasil, incluindo a determinação de impurezas (orgânicas, inorgânicas e voláteis, testes de homogeneidade, testes de estabilidade de curta e longa duração, cálculo do teor de captopril por balanço de massa e estimativa da incerteza de medição associada ao valor certificado.

  13. Examination of the torque required to passively palmar abduct the thumb CMC joint in a pediatric population with hemiplegia and stroke.

    Science.gov (United States)

    Stirling, Leia; Ahmad, Mona Qureshi; Kelty-Stephen, Damian; Correia, Annette

    2015-12-16

    Many activities of daily living involve precision grasping and bimanual manipulation, such as putting toothpaste on a toothbrush or feeding oneself. However, children afflicted by stroke, cerebral palsy, or traumatic brain injury may have lost or never had the ability to actively and accurately control the thumb. To translate insights from adult rehabilitation robotics to innovative therapies for hand rehabilitation in pediatric care, specifically for thumb deformities, an understanding of the torque needed to abduct the thumb to assist grasping tasks is required. Participants (n=16, 10 female, 13.2±3.1 years) had an upper extremity evaluation and measures were made of their passive range of motion, anthropometrics, and torques to abduct the thumb for both their affected and non-affected sides. Torque measures were made using a custom wrist orthosis that was adjusted for each participant. The torque to achieve maximum abduction was 1.47±0.61inlb for the non-affected side and 1.51±0.68inlb for the affected side, with a maximum recorded value of 4.87inlb. The overall maximum applied torque was observed during adduction and was 5.10inlb. We saw variation in the applied torque, which could have been due to the applied torques by the Occupational Therapist or the participant actively assisting or resisting the motion rather than remaining passive. We expect similar muscle and participant variation to exist with an assistive device. Thus, the data presented here can be used to inform the specifications for the development of an assistive thumb orthosis for children with "thumb-in-palm" deformity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. The business case for pediatric asthma quality improvement in low-income populations: examining a provider-based pay-for-reporting intervention.

    Science.gov (United States)

    Reiter, Kristin L; Lemos, Kristin Andrews; Williams, Charlotte E; Esposito, Dominick; Greene, Sandra B

    2015-06-01

    To measure the return on investment (ROI) for a pediatric asthma pay-for-reporting intervention initiated by a Medicaid managed care plan in New York State. Practice-level, randomized prospective evaluation. Twenty-five primary care practices providing care to children enrolled in the Monroe Plan for Medical Care (the Monroe Plan). Practices were randomized to either treatment (13 practices, 11 participated) or control (12 practices). For each of its eligible members assigned to a treatment group practice, the Monroe plan paid a low monthly incentive fee to the practice. To receive the incentive, treatment group practices were required to conduct, and report to the Monroe Plan, the results of chart audits on eligible members. Chart audits were conducted by practices every 6 months. After each chart audit, the Monroe Plan provided performance feedback to each practice comparing its adherence to asthma care guidelines with averages from all other treatment group practices. Control practices continued with usual care. Intervention implementation and operating costs and per member, per month claims costs. ROI was measured by net present value (discounted cash flow analysis). The ROI to the Monroe Plan was negative, primarily due to high intervention costs and lack of reductions in spending on emergency department and hospital utilization for children in treatment relative to control practices. A pay-for-reporting, chart audit intervention is unlikely to achieve the meaningful reductions in utilization of high-cost services that would be necessary to produce a financial ROI in 2.5 years. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  15. Feasibility of using the computed tomography dose indices to estimate radiation dose to partially and fully irradiated brains in pediatric neuroradiology examinations

    International Nuclear Information System (INIS)

    Januzis, Natalie; Nguyen, Giao; Yoshizumi, Terry T; Frush, Donald P; Hoang, Jenny K; Lowry, Carolyn

    2015-01-01

    The purpose of this study was two-fold: (a) to measure the dose to the brain using clinical protocols at our institution, and (b) to develop a scanner-independent dosimetry method to estimate brain dose. Radiation dose was measured with a pediatric anthropomorphic phantom and MOSFET detectors. Six current neuroradiology protocols were used: brain, sinuses, facial bones, orbits, temporal bones, and craniofacial areas. Two different CT vendor scanners (scanner A and B) were used. Partial volume correction factors (PVCFs) were determined for the brain to account for differences between point doses measured by the MOSFETs and average organ dose. The CTDI vol and DLP for each protocol were recorded. The dose to the brain (mGy) for scanners A and B was 10.7 and 10.0 for the brain protocol, 7.8 and 3.2 for the sinus, 10.2 and 8.6 for the facial bones, 7.4 and 4.7 for the orbits and 1.6 and 1.9 for the temporal bones, respectively. On scanner A, the craniofacial protocol included a standard and high dose option; the dose measured for these exams was 3.9 and 16.9 mGy, respectively. There was only one craniofacial protocol on scanner B; the brain dose measured on this exam was 4.8 mGy. A linear correlation was found between DLP and brain dose with the conversion factors: 0.049 (R 2 = 0.87), 0.046 (R 2 = 0.89) for scanner A and B, and 0.048 (R 2 = 0.89) for both scanners. The range of dose observed was between 1.8 and 16.9 mGy per scan. This suggests that brain dose estimates may be made from DLP. (paper)

  16. The Current Landscape of US Pediatric Anesthesiologists: Demographic Characteristics and Geographic Distribution.

    Science.gov (United States)

    Muffly, Matthew K; Muffly, Tyler M; Weterings, Robbie; Singleton, Mark; Honkanen, Anita

    2016-07-01

    There is no comprehensive database of pediatric anesthesiologists, their demographic characteristics, or geographic location in the United States. We endeavored to create a comprehensive database of pediatric anesthesiologists by merging individuals identified as US pediatric anesthesiologists by the American Board of Anesthesiology, National Provider Identifier registry, Healthgrades.com database, and the Society for Pediatric Anesthesia membership list as of November 5, 2015. Professorial rank was accessed via the Association of American Medical Colleges and other online sources. Descriptive statistics characterized pediatric anesthesiologists' demographics. Pediatric anesthesiologists' locations at the city and state level were geocoded and mapped with the use of ArcGIS Desktop 10.1 mapping software (Redlands, CA). We identified 4048 pediatric anesthesiologists in the United States, which is approximately 8.8% of the physician anesthesiology workforce (n = 46,000). The median age of pediatric anesthesiologists was 49 years (interquartile range, 40-57 years), and the majority (56.4%) were men. Approximately two-thirds of identified pediatric anesthesiologists were subspecialty board certified in pediatric anesthesiology, and 33% of pediatric anesthesiologists had an identified academic affiliation. There is substantial heterogeneity in the geographic distribution of pediatric anesthesiologists by state and US Census Division with urban clustering. This description of pediatric anesthesiologists' demographic characteristics and geographic distribution fills an important gap in our understanding of pediatric anesthesia systems of care.

  17. Sharing the Wealth:National Board Certified Teachers and the Students Who Need Them Most

    Directory of Open Access Journals (Sweden)

    Daniel C. Humphrey

    2005-03-01

    Full Text Available It is a commonly understood problem in education that many highly qualified teachers tend to gravitate toward higher performing schools, including schools with lower minority enrollments and lower incidence of poverty. This article explores the distribution of a subset of teachers, namely, those who are National Board Certified. To what extent do these teachers' assignment choices mirror the pattern of their non-Board Certified colleagues and to what extent are they different? Part of a larger study of Board Certified Teachers in lower performing schools, the article examines the distribution of NBCTs in the six states with the largest number of them'California, Florida, Mississippi, North Carolina, Ohio, and South Carolina. The research finds that, with the exception of California, Board Certified Teachers are not equitably distributed across schools that serve different populations of students. In five of the six states examined, poor, minority, and lower performing students are far less likely to benefit from the teaching of an NBCT than are their more affluent, majority, higher performing peers. The article explores some possible explanations for the California distribution pattern as well as the kinds of incentives provided across the states for teachers to seek Board Certification and for those who earn it. The authors conclude with a rationale and a set of policy suggestions for realigning the distribution of NBCTs.

  18. Diagnostic Accuracy of History, Physical Examination, Laboratory Tests, and Point-of-care Ultrasound for Pediatric Acute Appendicitis in the Emergency Department: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Benabbas, Roshanak; Hanna, Mark; Shah, Jay; Sinert, Richard

    2017-05-01

    Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. The aim of this study was to determine the utility of history, physical examination, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients. We performed a systematic review and meta-analysis and used a test-treatment threshold model to identify diagnostic findings that could rule in/out AA and obviate the need for further imaging studies, specifically computed tomography (CT) scan, magnetic resonance imaging (MRI), and radiology department ultrasound (RUS). We searched PubMed, EMBASE, and SCOPUS up to October 2016 for studies on ED pediatric patients with abdominal pain. Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality and applicability of included studies. Positive and negative likelihood ratios (LR+ and LR-) for diagnostic modalities were calculated and when appropriate data was pooled using Meta-DiSc. Based on the available literature on the test characteristics of different imaging modalities and applying the Pauker-Kassirer method we developed a test-treatment threshold model. Twenty-one studies were included encompassing 8,605 patients with weighted AA prevalence of 39.2%. Studies had variable quality using the QUADAS-2 tool with most studies at high risk of partial verification bias. We divided studies based on their inclusion criteria into two groups of "undifferentiated abdominal pain" and abdominal pain "suspected of AA." In patients with undifferentiated abdominal pain, history of "pain migration to right lower quadrant (RLQ)" (LR+ = 4.81, 95% confidence interval [CI] = 3.59-6.44) and presence of "cough/hop pain" in the physical

  19. The Impact of Mentoring on Alternatively Certified Teachers

    Science.gov (United States)

    Kesler, Becky

    2013-01-01

    The purpose of this study was to explore the perceived effectiveness of mentoring for teachers certified through non-traditional avenues. This quantitative study investigated the type and amount of support teachers certified through the Arkansas Non-traditional Licensure Program (NTLP) and the Master of Arts in Teaching Program (MATP) received…

  20. 19 CFR 159.36 - Multiple certified rates.

    Science.gov (United States)

    2010-04-01

    ... multiple rates have been certified for a foreign currency, the rate to be used for Customs purposes shall... TREASURY (CONTINUED) LIQUIDATION OF DUTIES Conversion of Foreign Currency § 159.36 Multiple certified rates... rates of exchange (e.g., official and free) for a foreign currency: (a) Rates to be published. When the...

  1. 19 CFR 159.35 - Certified daily rate.

    Science.gov (United States)

    2010-04-01

    ... TREASURY (CONTINUED) LIQUIDATION OF DUTIES Conversion of Foreign Currency § 159.35 Certified daily rate. The daily buying rate of foreign currency which is determined by the Federal Reserve Bank of New York and certified to the Secretary of the Treasury in accordance with 31 U.S.C. 5151(e) shall be used for...

  2. 19 CFR 115.9 - Certifying Authorities responsibilities-containers.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Certifying Authorities responsibilities-containers...; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Administration § 115.9 Certifying Authorities responsibilities—containers. (a) General. Containers...

  3. 76 FR 80741 - TRICARE: Certified Mental Health Counselors

    Science.gov (United States)

    2011-12-27

    ...] TRICARE: Certified Mental Health Counselors AGENCY: Office of the Secretary, Department of Defense. ACTION... would allow licensed or certified mental health counselors to be able to independently provide care to... mental health counselors (CMHCs), who will be authorized to practice independently under TRICARE. During...

  4. 30 CFR 90.202 - Certified person; sampling.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Certified person; sampling. 90.202 Section 90... HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.202 Certified person; sampling. (a) The respirable dust sampling required by this...

  5. Pediatric AIDS

    International Nuclear Information System (INIS)

    Price, D.B.; Haller, J.O.; Kramer, J.; Hotson, G.C.; Loh, J.P.; Schlusselberg, D.; Inglese, C.M.; Jacobs, J.; Rose, A.L.; Menez-Bautista, R.; Fikrig, S.

    1988-01-01

    A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that that contrast enhancing inflammatory mass lesions are uncommon. (orig.)

  6. Certified metamodels for sensitivity indices estimation

    Directory of Open Access Journals (Sweden)

    Prieur Clémentine

    2012-04-01

    Full Text Available Global sensitivity analysis of a numerical code, more specifically estimation of Sobol indices associated with input variables, generally requires a large number of model runs. When those demand too much computation time, it is necessary to use a reduced model (metamodel to perform sensitivity analysis, whose outputs are numerically close to the ones of the original model, while being much faster to run. In this case, estimated indices are subject to two kinds of errors: sampling error, caused by the computation of the integrals appearing in the definition of the Sobol indices by a Monte-Carlo method, and metamodel error, caused by the replacement of the original model by the metamodel. In cases where we have certified bounds for the metamodel error, we propose a method to quantify both types of error, and we compute confidence intervals for first-order Sobol indices. L’analyse de sensibilité globale d’un modèle numérique, plus précisément l’estimation des indices de Sobol associés aux variables d’entrée, nécessite généralement un nombre important d’exécutions du modèle à analyser. Lorsque celles-ci requièrent un temps de calcul important, il est judicieux d’effectuer l’analyse de sensibilité sur un modèle réduit (ou métamodèle, fournissant des sorties numériquement proches du modèle original mais pour un coût nettement inférieur. Les indices estimés sont alors entâchés de deux sortes d’erreur : l’erreur d’échantillonnage, causée par l’estimation des intégrales définissant les indices de Sobol par une méthode de Monte-Carlo, et l’erreur de métamodèle, liée au remplacement du modèle original par le métamodèle. Lorsque nous disposons de bornes d’erreurs certifiées pour le métamodèle, nous proposons une méthode pour quantifier les deux types d’erreurs et fournir des intervalles de confiance pour les indices de Sobol du premier ordre.

  7. Pediatric vasculitis.

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur

    2016-01-01

    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  8. Teacher quality: a comparison of National Board-certified and non-Board-certified teachers of deaf students.

    Science.gov (United States)

    Scheetz, Nanci A; Martin, David S

    2006-01-01

    THE STUDY was designed to identify specific components of teacher excellence, focusing initially on the characteristics of the small number of teachers of the deaf who are certified by the National Board for Professional Teaching Standards (NBPTS), then comparing those with the characteristics of other teachers identified as master teachers by university faculty in teacher preparation in deafness. Classroom observation, written lesson plans, teacher questionnaires on beliefs, and content analysis of interactive electronic focus groups were used to compare the two groups of teachers. Results indicated similarities between Board-certified and non-Board-certified master teachers in regard to teacher behaviors and commitment to well-founded pedagogical principles. Differences were found in classroom priorities and in the greater level of interconnectivity expressed by Board-certified teachers as the result of becoming Board certified. Recommendations are made for preparing teachers of deaf students.

  9. Pediatric acquired brain injury.

    Science.gov (United States)

    Bodack, Marie I

    2010-10-01

    Although pediatric patients are sometimes included in studies about visual problems in patients with acquired brain injury (ABI), few studies deal solely with children. Unlike studies dealing with adult patients, in which mechanisms of brain injury are divided into cerebral vascular accident (CVA) and traumatic brain injury (TBI), studies on pediatric patients deal almost exclusively with traumatic brain injury, specifically caused by accidents. Here we report on the vision problems of 4 pediatric patients, ages 3 to 18 years, who were examined in the ophthalmology/optometry clinic at a children's hospital. All patients had an internally caused brain injury and after the initial insult manifested problems in at least one of the following areas: acuity, binocularity, motility (tracking or saccades), accommodation, visual fields, and visual perceptual skills. Pediatric patients can suffer from a variety of oculo-visual problems after the onset of head injury. These patients may or may not be symptomatic and can benefit from optometric intervention. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  10. 48 CFR 52.215-20 - Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data.

    Science.gov (United States)

    2010-10-01

    ... Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data. 52.215-20 Section 52.215-20... Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data. As prescribed in 15.408(l), insert the following provision: Requirements for Certified Cost or Pricing Data and Data Other Than...

  11. 48 CFR 52.215-21 - Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing...

    Science.gov (United States)

    2010-10-01

    ... Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data-Modifications. 52.215-21... Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data... Pricing Data and Data Other Than Certified Cost or Pricing Data—Modifications (OCT 2010) (a) Exceptions...

  12. Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

    Science.gov (United States)

    Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

    2014-01-01

    Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

  13. Nationwide survey on pediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects

    International Nuclear Information System (INIS)

    Ono, K.; Ban, N.; Ojima, M.; Yoshinaga, S.; Akahane, K.; Fujii, K.; Toyota, M.; Hamada, F.; Kouriyama, C.; Akiba, S.; Kunugita, N.; Shimada, Y.; Kai, M.

    2011-01-01

    A nationwide survey was conducted in Japan on paediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects. A survey questionnaire was sent out to 3173 public primary and junior high schools and 317 public health centres during October to December in 2009. According to the collected responses, 410 (16.2 %) children received the CT scans and the total number of CT scans was 585. Most of respondents expressed a high interest in radiation health effects and an intent to participate in the epidemiological study that will follow-up the health conditions of children. This study provides information to discuss the feasibility of the epidemiological study on health effects in children who received CT scans. (authors)

  14. Radiation exposure of children in pediatric radiology, Pt. 8. Radiation doses during thoracoabdominal babygram and abdominal X-ray examination of the newborn and young infants

    International Nuclear Information System (INIS)

    Schneider, Karl; Seidenbusch, M.C.

    2010-01-01

    Purpose: Reconstruction of radiation doses for the thoracoabdominal babygram and the abdomen X-ray from radiographic settings and exposure data acquired at Dr. von Hauner's Kinderspital (children's hospital of the University of Munich, DvHK) between 1976 and 2007; comparison of these dose values with values reported in the literature; recommendation of a reference dose value for the thoracoabdominal babygram. Materials and Methods: The data from all X-ray examinations performed since 1976 at DvHK were stored electronically in a database. After 30 years of data collection, the database now includes 305 107 radiological examinations (radiographs and fluoroscopies), especially 1493 thoracoabdominal babygrams and 3632 abdomen X-rays of newborns and young infants. With the computer program PAeDOS, a specific dose reconstruction algorithm was developed. Results: the entrance dose values of thoracoabdominal babygrams and abdomen X-rays in DvHK could be reduced in the last 30 years by a factor of 5 to 8. They are far below the entrance dose values reported by other radiology departments in Europe. Nevertheless, a slight increase in the entrance doses that correlates with the introduction of a digital storage phosphor system could be observed in the last years. Conclusion: because nearly all radiosensitive body organs in early life are involved during a thoracoabdominal babygram and because of the high radiation sensitivity of newborns, thoracoabdominal babygrams should be performed in neonatology with caution. A dose value of 1.0 cGy cm 2 could serve as the actual reference dose value for the thoracoabdominal babygram of the newborn. (orig.)

  15. Nonparametric decision tree: The impact of ISO 9000 on certified and non certified companies Nonparametric decision tree: The impact of ISO 9000 on certified and non certified companies Nonparametric decision tree: The impact of ISO 9000 on certified and non certified companies

    Directory of Open Access Journals (Sweden)

    Joaquín Texeira Quirós

    2013-09-01

    Full Text Available Purpose: This empirical study analyzes a questionnaire answered by a sample of ISO 9000 certified companies and a control sample of companies which have not been certified, using a multivariate predictive model. With this approach, we assess which quality practices are associated to the likelihood of the firm being certified. Design/methodology/approach: We implemented nonparametric decision trees, in order to see which variables influence more the fact that the company be certified or not, i.e., the motivations that lead companies to make sure. Findings: The results show that only four questionnaire items are sufficient to predict if a firm is certified or not. It is shown that companies in which the respondent manifests greater concern with respect to customers relations; motivations of the employees and strategic planning have higher likelihood of being certified. Research implications: the reader should note that this study is based on data from a single country and, of course, these results capture many idiosyncrasies if its economic and corporate environment. It would be of interest to understand if this type of analysis reveals some regularities across different countries. Practical implications: companies should look for a set of practices congruent with total quality management and ISO 9000 certified. Originality/value: This study contributes to the literature on the internal motivation of companies to achieve certification under the ISO 9000 standard, by performing a comparative analysis of questionnaires answered by a sample of certified companies and a control sample of companies which have not been certified. In particular, we assess how the manager’s perception on the intensity in which quality practices are deployed in their firms is associated to the likelihood of the firm being certified.Purpose: This empirical study analyzes a questionnaire answered by a sample of ISO 9000 certified companies and a control sample of companies

  16. Pediatric tracheostomy.

    Science.gov (United States)

    Campisi, Paolo; Forte, Vito

    2016-06-01

    Tracheotomy refers to a surgical incision made into a trachea. Tracheostomy, on the other hand, refers to a surgical procedure whereby the tracheal lumen is positioned in close proximity to the skin surface. Tracheostomy is an uncommon procedure in the pediatric population. When required tracheostomy is typically performed as an open surgical procedure under general anesthesia with the patient intubated. However, it may need to be performed under local anesthesia or over a rigid bronchoscope in the patient with a precarious airway. Over the past half century, the primary indication for pediatric tracheostomy has shifted from acute infectious airway compromise to the need for prolonged ventilatory support in neurologically compromised children. The surgical technique, choice of tracheostomy tube, and post-operative care requires a nuanced approach in infants and young children. This article will review these topics in a comprehensive fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Pediatric biobanking

    DEFF Research Database (Denmark)

    Salvaterra, Elena; Giorda, Roberto; Bassi, Maria T

    2012-01-01

    Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking such as ......Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking...... such as decision making, privacy protection, minor recontact, and research withdrawal by focusing on theoretical or empirical perspectives. Our research attempted to analyze such issues in a comprehensive manner by exploring practices, rules, and researcher opinions regarding proxy consent, minor assent, specimens...

  18. Pediatric stroke

    International Nuclear Information System (INIS)

    Hoermann, M.

    2008-01-01

    Stroke in childhood has gained increasingly more attention and is accepted as an important disease in childhood. The reasons for this severe event and the consequences for the rest of the life are totally different than for adults. This is also true for the diagnosis and therapy. This paper gives a comprehensive overview on the characteristics of pediatric stroke to assist radiologists in making a rapid and safe diagnosis in order to identify the underlying disease. (orig.) [de

  19. The Pediatric Cataract Register (PECARE)

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Nyström, Alf; Rosensvärd, Annika

    2015-01-01

    examination with a pencil light at age 5 weeks, whereas newborn red reflex examination using a handheld ophthalmoscope is routine protocol in Swedish maternity wards. Data regarding age of referral were derived from the Pediatric Cataract Register (PECARE). All children operated on before 1 year of age...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  1. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  3. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  4. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  6. Pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, G.

    1997-01-01

    Pediatric radiology is an important subsection of diagnostic radiology involving specific difficulties, but unfortunately is quite too often neglected as a subject of further education and training. The book therefore is not intended for specialists in the field, but for radiologists wishing to plunge deeper into the matter of pediatric radiology and to acquire a sound, basic knowledge and information about well-proven modalities, the resulting diagnostic images, and interpretation of results. The book is a compact guide and a helpful source of reference and information required for every-day work, or in special cases. With patients who are babies or children, the challenges are different. The book offers all the information needed, including important experience from pediatric hospital units that may be helpful in diagnostic evaluation, information about specific dissimilarities in anatomy and physiology which affect the imaging results, hints for radiology planning and performance, as well as information about the various techniques and their indication and achievements. The book presents a wide spectrum of informative and annotated images. (orig./CB) [de

  7. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin

    2012-09-01

    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  8. [Are We Really as Happy as We Think We are? A Critical Examination of Work Satisfaction in a University Pediatric Hospital].

    Science.gov (United States)

    Hiemisch, Andreas; Stöbel-Richter, Yve; Grande, Gesine; Brähler, Elmar; Kiess, Wieland

    2017-12-15

    Goals Despite numerous reported deficits and an increasingly tense working environment in German hospitals, employees themselves often assess their job satisfaction as being high to very high. Hence, the board of directors does not have important arguments for sustainable improvement of working conditions. This discrepancy between working conditions and subjective satisfaction was the motivation for this work. Methods Data were acquired via an attitude survey at the University Hospital for Children and Adolescents Leipzig, with employees sub-divided into medical, nursing and administrative/technical staff. The subjective satisfaction was examined by means of classical global ratings almost exclusively used by companies vs. the much more modern cognitive-emotional concept of the 'Schweizer Modell' describing qualitative job satisfaction. In addition, working hours, work-related effects on mental health, willingness to quit the job and actual dropout rate were compared. Results A rather high level of job satisfaction was revealed while interpreting the classical global ratings. In contrast, the qualitative analysis showed that only 1 in 4 employees was really satisfied with his or her job, amongst doctors even only 1 in 10. Altogether there are four categories of satisfaction. Significant differences between occupational categories were seen when stratifying the data according to age profiles and the evaluation of the consequences of psychological job strain. These differences were not seen in willingness to quit the job. Discussion Reports of high job satisfaction in hospitals in numerous publications can be mostly explained by employees who are resignedly satisfied. This is the psychodynamic outcome of strain compensating. This is not measurable with the concept of classical global ratings. Furthermore, the constructively dissatisfied employees, who are an often-underestimated resource for companies, are neglected. The reduction of strain in these people then

  9. ENERGY STAR Certified Commercial Hot Food Holding Cabinet

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Commercial Hot Food Holding Cabinets that are...

  10. Certified reference materials of trace elements in water

    Indian Academy of Sciences (India)

    Many decisions regarding the suitability of material/products are based on the ... In the present scenario of globalization of economy, use of certified reference ... our national accreditation body, National Accreditation Board for Testing and ...

  11. 7 CFR 205.665 - Noncompliance procedure for certifying agents.

    Science.gov (United States)

    2010-01-01

    ... applicable State organic program's governing State official all records concerning its certification...) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Administrative Compliance § 205.665... agent. (f) Cessation of certification activities. A certifying agent whose accreditation is suspended or...

  12. Simulation-based medical education in pediatrics.

    Science.gov (United States)

    Lopreiato, Joseph O; Sawyer, Taylor

    2015-01-01

    The use of simulation-based medical education (SBME) in pediatrics has grown rapidly over the past 2 decades and is expected to continue to grow. Similar to other instructional formats used in medical education, SBME is an instructional methodology that facilitates learning. Successful use of SBME in pediatrics requires attention to basic educational principles, including the incorporation of clear learning objectives. To facilitate learning during simulation the psychological safety of the participants must be ensured, and when done correctly, SBME is a powerful tool to enhance patient safety in pediatrics. Here we provide an overview of SBME in pediatrics and review key topics in the field. We first review the tools of the trade and examine various types of simulators used in pediatric SBME, including human patient simulators, task trainers, standardized patients, and virtual reality simulation. Then we explore several uses of simulation that have been shown to lead to effective learning, including curriculum integration, feedback and debriefing, deliberate practice, mastery learning, and range of difficulty and clinical variation. Examples of how these practices have been successfully used in pediatrics are provided. Finally, we discuss the future of pediatric SBME. As a community, pediatric simulation educators and researchers have been a leading force in the advancement of simulation in medicine. As the use of SBME in pediatrics expands, we hope this perspective will serve as a guide for those interested in improving the state of pediatric SBME. Published by Elsevier Inc.

  13. Pediatric digital chest imaging.

    Science.gov (United States)

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  14. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

  15. Hippocrates on Pediatric Dermatology.

    Science.gov (United States)

    Sgantzos, Markos; Tsoucalas, Gregory; Karamanou, Marianna; Giatsiou, Styliani; Tsoukalas, Ioannis; Androutsos, George

    2015-01-01

    Hippocrates of Kos is well known in medicine, but his contributions to pediatric dermatology have not previously been examined. A systematic study of Corpus Hippocraticum was undertaken to document references of clinical and historical importance of pediatric dermatology. In Corpus Hippocraticum, a variety of skin diseases are described, along with proposed treatments. Hippocrates rejected the theory of the punishment of the Greek gods and supported the concept that dermatologic diseases resulted from a loss of balance in the body humors. Many of the terms that Hippocrates and his pupils used are still being used today. Moreover, he probably provided one of the first descriptions of skin findings in smallpox, Henoch-Schönlein purpura (also known as anaphylactoid purpura, purpura rheumatica, allergic purpura), and meningococcal septicemia. © 2015 Wiley Periodicals, Inc.

  16. Inventory of pediatric neurology "manpower" in Canada.

    Science.gov (United States)

    Keene, Daniel L; Humphreys, Peter

    2005-08-01

    To review the demographics and workload characteristics of pediatric neurology in Canada. A standardized survey questionnaire was mailed out to practicing pediatric neurologists in Canada in 2001. Variables examined were age, gender, hours on call, regular hours worked per week, type of practice and projected changes in practice over next five to ten years. Results were compared to the 1994 Pediatric Neurology Manpower Survey which had used the same survey instrument. Fifty-six (70%) pediatric neurologists practicing in Canada returned the survey. As was the case in 1994, no significant differences in workload were found based on age or gender. The average age of the practicing pediatric neurologist in 2001 was 51 years compared to 45 years in 1994. The proportion of physicians over 55 years in 2001 was 35% compared to 25% in 1994. Pediatric neurology in Canada is an aging specialty needing a significant recruitment of new members

  17. Dental traumatology: an orphan in pediatric dentistry?

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Daugaard-Jensen, Jette

    2009-01-01

    Traumatic dental injuries are very frequent during childhood and adolescence. In fact, 2 out of 3 children have suffered a traumatic dental injury before adulthood. This fact links dental traumatology to pediatric dentistry. Unfortunately, this is not reflected by active participation by pediatric...... dentists in acute treatment, follow-up, and research. To examine the status of pediatric dentistry in relation to dental trauma, a publication analysis was undertaken in 1980, 1990, 2000, and 2007 about trauma articles published in 4 pediatric journals: journal of Dentistry for Children, Pediatric...... Dentistry, The journal of Pedodontics, and the International journal of Pediatric Dentistry. This study shows an average publication rate of trauma articles of approximately 3 percent of all articles published and with no improvement in later decennia. If only clinical studies are considered (leaving out...

  18. Find a Pediatric Dentist

    Science.gov (United States)

    ... AAPD AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Oral ...

  19. Is OSCE successful in pediatrics?

    Directory of Open Access Journals (Sweden)

    M Imani

    2009-02-01

    Full Text Available Background: The Faculty of Medical Sciences, University of Zahedan implemented the Objective Structured Clinical Examination (OSCE in the final Examination during the 2003–2004 academic year. Simultaneously, the pediatric department initiated faculty and student training, and instituted the OSCE as an assessment instrument during the pediatric clerkship in year 5. The study set out to explore student acceptance of the OSCE as part of an evaluation of the Pediatric clerkship.Purpose: This study implemented to evaluate a new method of assessment in medical education in pediatrics.Methods: A self-administered questionnaire was completed by successive groups of students immediately after the OSCE at the end of each clerkship rotation. Main outcome measures were student perception of examination attributes, which included the quality of instructions and organization, the quality of performance, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared to other methods.Results: There was overwhelming acceptance of the OSCE in Pediatric with respect to the comprehensiveness (90%, transparency (87%, fairness (57% and authenticity of the required tasks (58–78%. However, students felt that it was a strong anxiety-producing experience. And concerns were expressed regarding the ambiguity of some questions and inadequacy of time for expected tasks.Conclusion: Student feedback was invaluable in influencing faculty teaching, curriculum direction and appreciation of student opinion. Further psychometric evaluation will strengthen the development of the OSCE.Key words: OSCE, COMPETENCE ASSESSMENT

  20. Perceived value of national certification for pediatric nurses.

    Science.gov (United States)

    Messmer, Patricia R; Hill-Rodriguez, Deborah; Williams, Arthur R; Ernst, Mary E; Tahmooressi, Jill

    2011-09-01

    This study evaluated whether pediatric nurses who were certified valued national certifications to a greater degree than those who were not certified. The Gaberson, Schroeter, Killen, and Valentine (2003) Perceived Value of Certification Tool (PVCT) was used to measure nurses' perceptions of certification. The PVCT includes 18 certification-related value statements, using a five-point Likert scale response ranging from strongly agree to strongly disagree. A principal factor analysis was performed to identify clusters of related variables. Certified pediatric nurses valued national certifications to a greater degree than those who were not certified. More favorable views of certification were moderately associated with favorable views of the effects of certification on salary. The PVCT was found to have one factor, not two, as previously reported in the literature. Lower perceived relationships were reported between certification and salary, clinical competence, and consumer confidence compared with feelings of professionalism and personal satisfaction. Efforts to improve the relationship between certification and its perceived value at one institution were addressed. More attention may be needed to strengthen relationships, perceived or otherwise, between certification and competency skills, public awareness, and compensation of nurses for holding national certification. Copyright 2011, SLACK Incorporated.

  1. A new career path in radiation protection training. Certified power plant shift supervisor. Radiation protection

    International Nuclear Information System (INIS)

    Terbeek, Christoph

    2011-01-01

    Apart from theoretical knowledge, effective day-to-day radiation protection operations also require a certain measure of practical experience. Therefore, the professional degree of 'Certified Radiation Worker', issued by the Chamber of Industry and Commerce (CIC) Aachen, Germany, established at an early stage. In order to provide experienced radiation protection specialists with an attractive career path, POWERTECH TRAINING CENTER e.V., in co-operation with VGB PowerTech. e.V., the Paul Scherrer Institute (Switzerland) and the Swiss Atomic Energy Agency (ENSI), has devised a new power plant shift supervisor training course specialising in radiation protection. The vocational training degree called 'Certified Power Plant Shift Supervisor - Radiation Protection' is awarded after successful completion of the advanced training examination conducted by the CIC in Essen, Germany. (orig.)

  2. Pediatric fibromyalgia.

    Science.gov (United States)

    Buskila, Dan

    2009-05-01

    Fibromyalgia is an idiopathic chronic pain syndrome defined by widespread nonarticular musculoskeletal pain and generalized tender points. The syndrome is associated with a constellation of symptoms, including fatigue, nonrefreshing sleep, irritable bowel, and more. Central nervous system sensitization is a major pathophysiologic aspect of fibromyalgia; in addition, various external stimuli such as trauma and stress may contribute to development of the syndrome. Fibromyalgia is most common in midlife, but may be seen at any age. This article reviews the epidemiology, clinical characteristics, etiology, management, and outcome of pediatric fibromyalgia.

  3. Pediatric neuroimaging

    International Nuclear Information System (INIS)

    Tidwell, A.S.; Solano, M.; Schelling, S.H.

    1994-01-01

    In this article, some of the common and not-so-common neuropediatric disorders were discussed. As in the full-grown animal, abnormalities of the CNS in the pediatric animal patient may be classified according to the type of insult present (eg, malformation, injury, neoplasia, inflammation, or degeneration). To recognize the imaging manifestations of such disorders, an appreciation of normal anatomy, the pathological response of nervous system tissue to insult, and the principles of image interpretation is required. These fundamentals may then be applied to any CNS disease, regardless of frequency and to any animal patient, regardless of age

  4. Pediatric nurse practitioners: influences on career choice.

    Science.gov (United States)

    Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura

    2014-01-01

    The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  5. Pediatric radiology

    International Nuclear Information System (INIS)

    Kirkpatrick, J.A. Jr.

    1985-01-01

    Computed tomography has made possible the excellent and basic work having to do with the characteristics of the trachea, its caliber, shape, and length in children. Another group of articles has to do with interventional pediatric radiology. This year there were a number of articles of which only a sample is included, dealing with therapeutic procedures involving drainage of abscesses, angioplasty, nephrostomy, therapeutic embolization, and the removal of esophageal foreign bodies. Obviously, there is no reason to think that techniques developed for the adult may not be applicable to the infant or child; also, there is no reason to believe that processes peculiar to the child should not be amenable to intervention, for instance, use of embolization of hepatic hemangioma and transluminal balloon valvuloplasty for pulmonary valvular stenosis. Among the reports and reviews, the author would add that sonography remains a basic imaging technique in pediatric radiology and each year its application broadens. For example, there is an excellent article having to do with sonography of the neonatal and infant hip and evaluation of the inferior vena cava and the gallbladder. Nuclear medicine continues to play a significant role in diagnosis, which is featured in two articles concerned with problems of the hip

  6. The Perception of "Training Availability" among Certified Nurse Aides: Relationship to CNA Performance, Turnover, Attitudes, Burnout, and Empowerment

    Science.gov (United States)

    Yeatts, Dale E.; Cready, Cynthia; Swan, James; Shen, Yuying

    2010-01-01

    The purpose of this study was to examine the relationship between the certified nurse aides' (CNAs) perception that "training is always available when needed" and the CNAs' performance, turnover, attitudes, burnout, and empowerment. The data came from a larger study where a self-administered survey instrument was completed by 359 CNAs…

  7. The Study of Electronic Medical Record Adoption in a Medicare Certified Home Health Agency Using a Grounded Theory Approach

    Science.gov (United States)

    May, Joy L.

    2013-01-01

    The purpose of this qualitative grounded theory study was to examine the experiences of clinicians in the adoption of Electronic Medical Records in a Medicare certified Home Health Agency. An additional goal for this study was to triangulate qualitative research between describing, explaining, and exploring technology acceptance. The experiences…

  8. What Is the Value of Nurse Educator Certification? A Comparison Study of Certified and Noncertified Nurse Educators.

    Science.gov (United States)

    Barbé, Tammy; Kimble, Laura P

    The purpose of this study was to examine differences in how certified nurse educators and noncertified nurse educators valued nurse educator certification. No studies have investigated the differences in perceptions of certified and noncertified nurse educators. Understanding these differences may influence how the nursing profession recognizes and promotes excellence within the academic nursing specialty. Perceived Value of Certification Tool-Nurse Educator and demographic survey were administered via a web-based survey to a national sample of nursing faculty. Certified nurse educators valued certification with greater agreement than noncertified nurse educators. Personal accomplishment, personal satisfaction, and validation of knowledge were identified as the greatest rewards to certification. Nurse educators identified with intrinsic rewards of certification. Despite overall positive perceptions of nurse educator certification, strategies focused on extrinsic rewards may be necessary to increase certification rates. Such strategies may help overcome factors preventing educators from attaining certification.

  9. National Board Certified Teachers andTheir Students' Achievement

    Directory of Open Access Journals (Sweden)

    Leslie G. Vandevoort

    2004-09-01

    Full Text Available Contemporary research on teaching indicates that teachers are powerful contributors to students’ academic achievement, though the set and interrelationships of characteristics that make for high-quality and effective teaching have yet to be satisfactorily determined. Nevertheless, on the basis of the extant research and a vision of exemplary teaching, the National Board for Professional Teaching Standards stipulated a definition of a superior teacher. The Board did this without empirical evidence to support their claim that teachers’ who meet the standards set by the Board were superior in promoting academic achievement to those who did not meet those standards. In the 17 years since the founding of the National Board, only a few empirical studies have addressed this important issue. In this study we compare the academic performance of students in the elementary classrooms of 35 National Board Certified teachers and their non-certified peers, in 14 Arizona school districts. Board Certified teachers and their principals provide additional information about these teachers and their schools. Four years of results from the Stanford Achievement Tests in reading, mathematics and language arts, in grades three through six, were analyzed. In the 48 comparisons (four grades, four years of data, three measures of academic performance, using gain scores adjusted for students’ entering ability, the students in the classes of National Board Certified Teachers surpassed students in the classrooms of non-Board certified teachers in almost threequarters of the comparisons. Almost one-third of these differences were statistically significant. In the cases where the students of non-Board certified teachers gained more in an academic year, none of the differences found were statistically significant. Effect size, translated into grade equivalents, informs us that the gains made by students of Board Certified teachers were over one month greater than the

  10. Financing of certified centers: a willingness-to-pay analysis.

    Science.gov (United States)

    Thiel, Falk C; Scharl, Anton; Hildebrandt, Thomas; Kotziabassis, Efstratios; Schrauder, Michael G; Bani, Mayada R; Müller, Andreas; Hauzenberger, Tanja; Loehberg, Christian R; Jud, Sebastian M; Fasching, Peter A; Hartmann, Arndt; Schulz-Wendtland, Rüdiger; Strnad, Vratislav; Beckmann, Matthias W; Lux, Michael Patrick

    2013-03-01

    Although care in certified breast centers is now established throughout Germany, numerous services are still not being reimbursed. This also affects other centers involved in the specialty of gynecology such as gynecological cancer centers, perinatal centers, and endometriosis centers. Although a certified center is entitled to charge additional fees, these are in most cases not reimbursed. Calculation of additional costs is limited by the fact that data from the Institute for the Hospital Reimbursement System (Institut für das Entgeltsystem im Krankenhaus, InEK) do not reflect interdisciplinary services and procedures. For decision-makers, society's willingness to pay is an important factor in guiding decisions on the basis of social priorities. A hypothetical maximum willingness to pay can be calculated using a willingness-to-pay analysis, making it possible to identify deficiencies in the arbitrary setting of health budgets at the macro-level. In a multicenter study conducted between November 2009 and December 2010, 2,469 patients at a university hospital and at a non-university hospital were asked about the extent of their awareness of certified centers, the influence of centers on hospital presentation, and about personal attitudes toward quality-oriented reimbursement. A subjective assessment of possible additional charges was calculated using a willingness-to-pay analysis. In the overall group, 53.4 % of the patients were aware of what a certified center is and 27.4 % had specific information (obstetrics 40.0/32.3 %; mastology 66.8/23.2 %; gynecological oncology 54.7/27.3 %; P < 0.001). For 43.8 %, a certified center was one reason or the major reason for presentation (obstetrics 26.2 %; mastology 66.8 %; gynecological oncology 46.6 %; P < 0.001). A total of 72.6 % were in favor of quality-oriented reimbursement and 69.7 % were in favor of an additional charge for a certified center amounting to €538.56 (mastology €643.65, obstetrics €474

  11. The Effectiveness of "Teach for America" and Other Under-certified Teachers

    OpenAIRE

    Ildiko Laczko-Kerr; David C. Berliner

    2002-01-01

    The academic achievements of students taught by under-certified primary school teachers were compared to the academic achievements of students taught by regularly certified primary school teachers.  This sample of under-certified teachers included three types of under-qualified personnel: emergency, temporary and provisionally certified teachers.  One subset of these under-certified teachers was from the national program "Teach For America (TFA)."  Recent college graduates are placed by TF...

  12. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... work? Unlike conventional x-ray examinations and computed tomography (CT) scans, MRI does not utilize ionizing radiation. Instead, ... Angiography Magnetic Resonance, Functional (fMRI) - Brain Children's (Pediatric) CT (Computed Tomography) Magnetic Resonance Imaging (MRI) Safety Contrast Materials Children ...

  13. Pediatric Uveitis.

    Science.gov (United States)

    Chan, Nicole Shu-Wen; Choi, Jessy; Cheung, Chui Ming Gemmy

    2018-01-01

    Pediatric uveitis differs from adult-onset uveitis and is a topic of special interest because of its diagnostic and therapeutic challenges. Children with uveitis are often asymptomatic and the uveitis is often chronic, persistent, recurrent, and resistant to conventional treatment. Anterior uveitis is the most common type of uveitis in children; the prevalence of intermediate, posterior, and panuveitis varies geographically and among ethnic groups. Regarding etiology, most cases of pediatric uveitis are idiopathic but can be due to systemic inflammatory disorders, infections, or a manifestation of masquerade syndrome. Ocular complications include cataracts, hypotony or glaucoma, band keratopathy, synechiae formation, macular edema, optic disc edema, choroidal neovascular membranes, and retinal detachment. These complications are often severe, leading to irreversible structural damage and significant visual disability due to delayed presentation and diagnosis, persistent chronic inflammation from suboptimal treatment, topical and systemic corticosteroid dependence, and delayed initiation of systemic disease‒modifying agents. Treatment for noninfectious uveitis is a stepwise approach starting with corticosteroids. Immunomodulatory therapy should be initiated in cases where quiescence cannot be achieved without steroid dependence. Patients should be monitored regularly for complications of uveitis along with systemic and ocular adverse effects from treatments. The goals are to achieve steroid-free durable remission, to reduce the risk of sight-threatening complications from the uncontrolled ocular inflammation, and to avoid the impact of lifelong burden of visual loss on the child and their family. Multidisciplinary management will ensure holistic care of affected children and improve the support for their families. Copyright 2018 Asia-Pacific Academy of Ophthalmology.

  14. 78 FR 27343 - Medical Examiner's Certification Integration

    Science.gov (United States)

    2013-05-10

    ... efficiency; (2) reflect current medical terminology and examination components; and (3) be a self-contained... 391 [Docket No. FMCSA-2012-0178] RIN 2126-AB40 Medical Examiner's Certification Integration AGENCY...: FMCSA proposes to require certified medical examiners (MEs) performing physical examinations on drivers...

  15. NEW CZECH & CERTIFIED METHODOLOGY „TOOLS OF RESILIENCE“

    Directory of Open Access Journals (Sweden)

    Pavel DOBEŠ

    2017-12-01

    Full Text Available The article deals with possibilities of better governance regarding natural and anthropogenic risks and building of resilience of medium towns and cities against disasters. Such systematic approach could be applied for example using new Czech certified methodology “Tools Of Resilience”, which has been developed recently within the short project number no. VF20152016047 under the grant of Czech Ministry of the Interior in period 2015 - 2016 and afterwards certified in 2017 by Czech Ministry of the Environment. Basic starting points, used methods, steps of new methodology and its annexes, will be breafly described in the topic.

  16. Final Report - Certifying the Performance of Small Wind Turbines

    Energy Technology Data Exchange (ETDEWEB)

    Sherwood, Larry [Small Wind Certification Council, Clifton Park, NY (United States)

    2015-08-28

    The Small Wind Certification Council (SWCC) created a successful accredited certification program for small and medium wind turbines using the funding from this grant. SWCC certifies small turbines (200 square meters of swept area or less) to the American Wind Energy Association (AWEA) Small Wind Turbine Performance and Safety Standard (AWEA Standard 9.1 – 2009). SWCC also certifies medium wind turbines to the International Electrical Commission (IEC) Power Performance Standard (IEC 61400-12-1) and Acoustic Performance Standard (IEC 61400-11).

  17. CEH certified ethical hacker : version 8 : study guide

    CERN Document Server

    Oriyano, Sean-Philip

    2014-01-01

    Prepare for the new Certified Ethical Hacker version 8 exam with this Sybex guide Security professionals remain in high demand. The Certified Ethical Hacker is a one-of-a-kind certification designed to give the candidate a look inside the mind of a hacker. This study guide provides a concise, easy-to-follow approach that covers all of the exam objectives and includes numerous examples and hands-on exercises. Coverage includes cryptography, footprinting and reconnaissance, scanning networks, enumeration of services, gaining access to a system, Trojans, viruses, worms, covert channels, and muc

  18. The Future of Pediatric Obesity.

    Science.gov (United States)

    Hutchinson, Jeff; Emerick, Jill; Saxena, Harshita

    2016-03-01

    The National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention reports a steady increase in obesity over the last 30 years. The greatest increase was seen in 15 to 19 year olds, whose obesity prevalence almost doubled from 10.5% to 19.4%. The solution to pediatric obesity requires a multidisciplinary approach addressing cultural norms, technologic advances, and family engagement. Future treatment strategies to combat the obesity epidemic will have to extend beyond the health care provider's office. Behavior modification remains the key component to pediatric obesity prevention and treatment. Published by Elsevier Inc.

  19. Dexmedetomidine in the pediatric population

    DEFF Research Database (Denmark)

    Plambech, Morten; Afshari, A

    2015-01-01

    Dexmedetomidine, an alpha-2 agonist approved only for sedation in adult intensive care patients, is increasingly used off-label in- and outside Europe in the pediatric setting for various indications such as to prevent agitation, as premedication in the form of intranasal, buccal and oral solution...... of sedation of children. In this paper, we assess 51 minor trials in the form of 44 randomized controlled trials and 7 prospective observational studies in an attempt to update the available evidence on dexmedetomidine use in pediatrics. Furthermore, we discuss its potential indications, benefits and adverse....... Based on the best current evidence dexmedetomidine is found suitable and safe for various indications. However, in order to discover its full potential, indications, dosing and safety profile for various ages and procedures, it should urgently be examined by conducting good quality pediatric trials...

  20. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children

    Directory of Open Access Journals (Sweden)

    Jambert Elodie

    2010-10-01

    Full Text Available Abstract Background Important advances in the development and production of quality-certified pediatric antiretroviral (ARV formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. Methods We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Results Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs in solid and dispersible forms have been quality-certified since 2005. Most (67% of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Conclusion Pediatric ARV markets are more fragile than

  1. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children.

    Science.gov (United States)

    Waning, Brenda; Diedrichsen, Ellen; Jambert, Elodie; Bärnighausen, Till; Li, Yun; Pouw, Mieke; Moon, Suerie

    2010-10-17

    Important advances in the development and production of quality-certified pediatric antiretroviral (ARV) formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs) in solid and dispersible forms have been quality-certified since 2005. Most (67%) of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Pediatric ARV markets are more fragile than adult markets. Ensuring a long-term supply of quality, well

  2. What Is a Pediatric Rheumatologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Rheumatologist? Page Content Article Body If your child ... a pediatric rheumatologist. What Kind of Training Do Pediatric Rheumatologists Have? Pediatric rheumatologists are medical doctors who ...

  3. Musculoskeletal ultrasound in pediatric rheumatology

    Directory of Open Access Journals (Sweden)

    Özçakar Levent

    2011-09-01

    Full Text Available Abstract Although musculoskeletal ultrasound (MSUS has emerged as an indispensible tool among physicians involved in musculoskeletal medicine in the last two decades, only recently has it become more attractive to pediatric rheumatologists. Thereafter, the use of MSUS in pediatric rheumatology has started to increase. Yet, an ever-growing body of literature shows parity and even superiority of MSUS when compared to physical examination and other imaging modalities. MSUS is suitable for examination of children of all ages and it has certain advantages over other imaging modalities; as it is cheaper, mobile, instantly accessible bedside, easy to combine with clinical assessment (interactivity and non-invasive. It does not require sedation, which facilitates repetitive examinations. Assessment of multiple locations is possible during the same session. Agitation is rarely a problem and small children can be seated in their parents' lap or they can even play while being examined.

  4. Sedation in Pediatric Esophagogastroduodenoscopy

    Directory of Open Access Journals (Sweden)

    Seak Hee Oh

    2018-03-01

    Full Text Available Pediatric esophagogastroduodenoscopy (EGD has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

  5. 40 CFR 85.1505 - Final admission of certified vehicles.

    Science.gov (United States)

    2010-07-01

    ... PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Importation of Motor Vehicles and Motor... vehicle or engine from the previous test (e.g., adjusting the RPM, timing, air-to-fuel ratio, etc.) other... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Final admission of certified vehicles...

  6. 77 FR 43535 - Grantee Codes for Certified Radiofrequency Equipment

    Science.gov (United States)

    2012-07-25

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 2 [FCC 12-60] Grantee Codes for Certified Radiofrequency Equipment AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: This document... authorization program for radiofrequency (RF) devices under part 2 of its rules. This program is one of the...

  7. 19 CFR 159.34 - Certified quarterly rate.

    Science.gov (United States)

    2010-04-01

    ..., Denmark, Finland, France, Germany, Hong Kong, India, Iran, Ireland, Italy, Japan, Malaysia, Mexico... Customs purposes in connection with merchandise exported on such date. (2) Certified daily rate. If the... merchandise exported on such day. [T.D. 73-175, 38 FR 17482, July 2, 1973, as amended by T.D. 81-117, 46 FR...

  8. A Comparison of Alienation among Alternatively and Traditionally Certified Teachers.

    Science.gov (United States)

    Shoho, Alan R.; Martin, Nancy K.

    The purpose of this study was to investigate the perceptions of alienation among alternatively and traditionally certified teachers. A total of 228 teachers in grades K-12 from a public university offering both traditional certification (TC) and cooperative alternative certification (AC) graduate programs were assessed using the School Alienation…

  9. Relevant or determinant: Importance in certified sustainable food consumption

    NARCIS (Netherlands)

    Dam, van Y.K.; Trijp, van J.C.M.

    2013-01-01

    Perceived relevance and determinance are two distinct constructs, underlying the overall concept of attribute importance. The present study proposes a survey based measure of attribute determinance. Based on construal level theory it is argued and empirically shown that actual choices of certified

  10. Software testing an ISTQB-BCS certified tester foundation guide

    CERN Document Server

    Hambling, Brian; Samaroo, Angelina; Thompson, Geoff; Williams, Peter; Hambling, Brian

    2015-01-01

    This practical guide provides insight into software testing, explaining the basics of the testing process and how to perform effective tests. It provides an overview of different techniques and how to apply them. It is the best-selling official textbook of the ISTQB-BCS Certified Tester Foundation Level.

  11. 31 CFR 360.55 - Individuals authorized to certify.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Individuals authorized to certify. 360.55 Section 360.55 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... imprint of either the corporate seal of the institution or of the issuing or paying agent's stamp. The...

  12. 31 CFR 315.55 - Individuals authorized to certify.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Individuals authorized to certify. 315.55 Section 315.55 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... authenticated by a legible imprint either of a corporate stamp of the institution or of the issuing or paying...

  13. 31 CFR 353.55 - Individuals authorized to certify.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Individuals authorized to certify. 353.55 Section 353.55 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... imprint of either the corporate seal of the institution or of the issuing or paying agent's stamp. The...

  14. 78 FR 79010 - Criteria to Certify Coal Mine Rescue Teams

    Science.gov (United States)

    2013-12-27

    ... coal requires more heat to combust; (3) anthracite dust does not propagate an explosion; and (4) there... to Certify Coal Mine Rescue Teams AGENCY: Mine Safety and Health Administration, Labor. ACTION... updated the coal mine rescue team certification criteria. The Mine Improvement and New Emergency Response...

  15. 19 CFR 115.7 - Designation of additional Certifying Authorities.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Designation of additional Certifying Authorities. 115.7 Section 115.7 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS...

  16. 19 CFR 115.12 - Records maintained by Certifying Authority.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Records maintained by Certifying Authority. 115.12 Section 115.12 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS...

  17. 44 CFR 204.53 - Certifying costs and payments.

    Science.gov (United States)

    2010-10-01

    ....21 and U. S. Treasury 31 CFR part 205, Cash Management Improvement Act. ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Certifying costs and payments. 204.53 Section 204.53 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY...

  18. 40 CFR 85.1407 - Notification of intent to certify.

    Science.gov (United States)

    2010-07-01

    ... handling costs and taxes; (ii) A detailed breakout of the total number of hours necessary to install the... documentation that demonstrate compliance with the life cycle cost requirements specified in § 85.1403(b)(1)(ii... by the equipment certifier as evidence of compliance with the emission requirements specified in § 85...

  19. A comparison of certified and noncertified pet foods.

    Science.gov (United States)

    Brown, R G

    1997-11-01

    The market presents the buyer with a wide array of pet food choices. Marketing pet foods has changed in the last decade and today foods may be bought at a variety of outlets. The present study compares nutrient composition, digestibility, and effect on urine pH (cat foods only) of selected certified and noncertified pet foods from different outlets. The selected foods were considered analogous in terms of declared ingredients and macronutrient profiles. The analytical methods used were those of the Association of Official Analytical Chemists as described in the Pet Food Certification Protocol of the Canadian Veterinary Medical Association. The test foods were sampled 4 times from August 1994 to July 1995. Both certified and noncertified products met the nutritional requirements on a consistent basis, although 1 of the noncertified dog foods consistently failed to meet the zinc requirements. This same product also failed to meet the Canadian Veterinary Medical Association's standards for concentrations of protein, calcium, and phosphorus. One of the noncertified cat foods failed to meet the recommended calcium level. With the exception of fat digestion in 1 noncertified food, there were no statistically significant differences in major nutrient digestibility between certified and noncertified pet foods. There were some statistically significant differences in digestibility within both the certified and noncertified groups of foods. The practical significance of any of the statistical differences in digestibility is uncertain. Urine pH observed in cats fed noncertified test diets was variable, with some values greater than 7.0 as a maximum or 6.5 as an average. The general conclusion of this study was that the commonly available certified products were the nutritional equal of those foods that position themselves as "premium."

  20. A quick guide to API 510 certified pressure vessel inspector syllabus example questions and worked answers

    CERN Document Server

    Matthews, Clifford

    2010-01-01

    The API Individual Certification Programs (ICPs) are well established worldwide in the oil, gas, and petroleum industries. This Quick Guide is unique in providing simple, accessible and well-structured guidance for anyone studying the API 510 Certified Pressure Vessel Inspector syllabus by summarizing and helping them through the syllabus and providing multiple example questions and worked answers.Technical standards are referenced from the API 'body of knowledge' for the examination, i.e. API 510 Pressure vessel inspection, alteration, rerating; API 572 Pressure vessel inspection; API

  1. Pediatric Celiac Disease

    Science.gov (United States)

    ... a protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, ... physician. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Celiac Disease Eosinophilic ...

  2. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  3. Pediatric MATCH Infographic

    Science.gov (United States)

    Infographic explaining NCI-COG Pediatric MATCH, a cancer treatment clinical trial for children and adolescents, from 1 to 21 years of age, that is testing the use of precision medicine for pediatric cancers.

  4. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... navigate their brain tumor diagnosis. WATCH AND SHARE Brain tumors and their treatment can be deadly so ... Pediatric Central Nervous System Cancers Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  5. Pediatric Thyroid Cancer

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  6. Pediatric Endocrinology Nurses Society

    Science.gov (United States)

    ... Join Now International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development ... nurses in the art and science of pediatric endocrinology nursing. Learn More Text1 2018 PENS Call for ...

  7. National Pediatric Program Update

    International Nuclear Information System (INIS)

    2008-01-01

    The book of the National Pediatric Program Update, issued by the Argentina Society of Pediatrics, describes important issues, including: effective treatment of addictions (drugs); defects of the neural tube; and the use of radiation imaging in diagnosis. [es

  8. 30 CFR 75.361 - Supplemental examination.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Supplemental examination. 75.361 Section 75.361... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.361 Supplemental examination. (a) Except for certified persons conducting examinations required by this subpart, within 3 hours before anyone...

  9. Pediatric portal hypertension

    Science.gov (United States)

    Vogel, Clarissa Barbon

    2017-01-01

    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  10. Nuclear imaging in pediatrics

    International Nuclear Information System (INIS)

    Siddiqui, A.R.

    1985-01-01

    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed

  11. Pediatric Cushing′s disease: Management Issues

    Directory of Open Access Journals (Sweden)

    Martin O Savage

    2012-01-01

    Full Text Available Cushing′s disease (CD, caused by an ACTH-secreting pituitary corticotroph adenoma, is the commonest cause of Cushing syndrome in children over 5 years of age. It is rare in the pediatric age range and presents difficult diagnostic and therapeutic challenges. Key presenting features include weight gain, growth failure and change in facial appearance. Most pediatric endocrinologists have limited experience managing children or adolescents with CD and thus benefit from close consultation with adult colleagues. We describe a diagnostic protocol which broadly follows the model for adult patients. Treatment strategies are examined and appraised. The management of pediatric CD patients after cure is also discussed.

  12. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  13. Pediatric neurocritical care.

    Science.gov (United States)

    Murphy, Sarah

    2012-01-01

    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  14. Radiodiagnosis in pediatrics today

    International Nuclear Information System (INIS)

    Baklanova, V.F.

    1982-01-01

    The fields of radiodiagnosis application in pediatrics are considered. The improvement of roentgenologic methods and application of various contrast proparations enable to study and precisely differentiate congenital and acquired diseases. The scope of roentgenology application in pediatrics extends due to differentiation of pediatric specialities. New methods of investigation with decreasing radiation exposure to minimal are realized [ru

  15. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  16. Elemental Quantification and Residues Characterization of Wet Digested Certified and Commercial Carbon Materials

    KAUST Repository

    Simoes, Filipa R. F.; Batra, Nitin M.; Warsama, Bashir H.; Canlas, Christian; Patole, Shashikant; Yapici, Tahir F.; Costa, Pedro M. F. J.

    2016-01-01

    .g., graphene and nanotubes) has suffered from the lack of efficient digestion steps and certified reference materials (CRM). Here, various commercial and certified graphitic carbon materials were subjected to a

  17. Beyond Survival - Cognition after Pediatric Brain Tumor

    OpenAIRE

    Tonning Olsson, Ingrid

    2015-01-01

    Background: Pediatric Brain Tumor (PBT) survivors suffer from cognitive sequelae, especially within the areas of cognitive tempo, attention, executive function and memory. The cognitive difficulties are often accentuated over the years, but knowledge about the long term trajectory is still scarce. Aim: The aim of this thesis was to examine cognitive sequelae after Pediatric Brain Tumor (PBT); risk factors, common difficulties, development and neuroimaging correlates. Methods: In study...

  18. Exponential gain of randomness certified by quantum contextuality

    Science.gov (United States)

    Um, Mark; Zhang, Junhua; Wang, Ye; Wang, Pengfei; Kim, Kihwan

    2017-04-01

    We demonstrate the protocol of exponential gain of randomness certified by quantum contextuality in a trapped ion system. The genuine randomness can be produced by quantum principle and certified by quantum inequalities. Recently, randomness expansion protocols based on inequality of Bell-text and Kochen-Specker (KS) theorem, have been demonstrated. These schemes have been theoretically innovated to exponentially expand the randomness and amplify the randomness from weak initial random seed. Here, we report the experimental evidence of such exponential expansion of randomness. In the experiment, we use three states of a 138Ba + ion between a ground state and two quadrupole states. In the 138Ba + ion system, we do not have detection loophole and we apply a methods to rule out certain hidden variable models that obey a kind of extended noncontextuality.

  19. Certified Basic Life Support Instructors Assess Cardiopulmonary Resuscitation Skills Poorly

    DEFF Research Database (Denmark)

    Hansen, Camilla; Rasmussen, Stinne E; Kristensen, Mette Amalie

    2016-01-01

    Introduction: High-quality cardiopulmonary resuscitation (CPR) improves survival from cardiac arrest. During basic life support (BLS) training, instructors assess CPR skills to enhance learning outcome. Emergency department staff and senior residents have been shown to assess chest compression...... quality poorly. Currently no studies have evaluated CPR assessment among certified BLS instructors. The aim of this study was to investigate certified BLS instructors’ assessment of chest compressions and rescue breathing.Methods: Data were collected at BLS courses for medical students at Aarhus...... of CPR skills may be beneficial to ensure high-quality learning outcome.Author Disclosures: C. Hansen: None. S.E. Rasmussen: None. M.A. Nebsbjerg: None. M. Stærk: None. B. Løfgren: None....

  20. Measuring Certified Registered Nurse Anesthetist Organizational Climate: Instrument Adaptation.

    Science.gov (United States)

    Boyd, Donald; Poghosyan, Lusine

    2017-08-01

    No tool exists measuring certified registered nurse anesthetist (CRNA) organizational climate. The study's purpose is to adapt a validated tool to measure CRNA organizational climate. Content validity of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ) was established. Pilot testing was conducted to determine internal reliability consistency of the subscales. Experts rated the tool as content valid. The subscales had high internal consistency reliability (with respective Cronbach's alphas): CRNA-Anesthesiologist Relations (.753), CRNA-Physician Relations (.833), CRNA-Administration Relations (.895), Independent Practice (.830), Support for CRNA Practice (.683), and Professional Visibility (.772). Further refinement of the CRNA-OCQ is necessary. Measurement and assessment of CRNA organizational climate may produce evidence needed to improve provider and patient outcomes.

  1. A new certified reference material for size analysis of nanoparticles

    International Nuclear Information System (INIS)

    Braun, Adelina; Kestens, Vikram; Franks, Katrin; Roebben, Gert; Lamberty, Andrée; Linsinger, Thomas P. J.

    2012-01-01

    A certified reference material, ERM-FD100, for quality assurance and validation of various nanoparticle sizing methods, was developed by the Institute for Reference Materials and Measurements. The material was prepared from an industrially sourced colloidal silica containing nanoparticles with a nominal equivalent spherical diameter of 20 nm. The homogeneity and stability of the candidate reference material was assessed by means of dynamic light scattering and centrifugal liquid sedimentation. Certification of the candidate reference material was based on a global interlaboratory comparison in which 34 laboratories participated with various analytical methods (DLS, CLS, EM, SAXS, ELS). After scrutinising the interlaboratory comparison data, 4 different certified particle size values, specific for the corresponding analytical method, could be assigned. The good comparability of results allowed the certification of the colloidal silica material for nanoparticle size analysis.

  2. Production of quality/certified seed of fodder-crops

    International Nuclear Information System (INIS)

    Bhutta, A.R.; Hussain, A.

    2006-01-01

    Although, Pakistan has well developed Seed-production and certification Programme for major crops, but seed programme for fodder-crops is still not well organized. Availability of local certified seed, remained 250-350 mt for Berseem, Sorghum, maize, barley and oat. About 5000 to 9000 mt of seed has being imported during 2003-04 to 2005-06. Fodder Research Institute and jullundhur Seed Corporation have demonstrated a model of public/private partnership for initiation of certified seed of a few fodder crops. To produce quality seeds of fodder crops, various steps, procedures and prescribed standards have been given, which will help in production of quality seed of fodder crops in Pakistan. (author)

  3. The Effects of the 150-Credit-Hour Requirement for the Certified Public Accountant (CPA) Exam On the Career Intentions of Women and Minorities

    Science.gov (United States)

    Bierstaker, James Lloyd; Howe, Martha A.; Seol, Inshik

    2005-01-01

    In most states, students who sit for the certified public accountant (CPA) examination are now required to have 150 credit hours of college education. In this article, the authors examined the effects of this requirement on the career intentions of women and minorities. The authors collected data from 600 accounting students and the results…

  4. Vehicle Authentication via Monolithically Certified Public Key and Attributes

    OpenAIRE

    Dolev, Shlomi; Krzywiecki, Łukasz; Panwar, Nisha; Segal, Michael

    2015-01-01

    Vehicular networks are used to coordinate actions among vehicles in traffic by the use of wireless transceivers (pairs of transmitters and receivers). Unfortunately, the wireless communication among vehicles is vulnerable to security threats that may lead to very serious safety hazards. In this work, we propose a viable solution for coping with Man-in-the-Middle attacks. Conventionally, Public Key Infrastructure (PKI) is utilized for a secure communication with the pre-certified public key. H...

  5. A proposed evolution for the Italian certified electronic mail system

    OpenAIRE

    Buzzi, Marina; Ferrucci, Luca; Francesco, Gennai; Petrucci, Claudio

    2016-01-01

    One the main objective of the European Commission is to innovate and bring ICT to its full potential in any sector, including eGovernment, eCommerce, and eHealth services. Certified Electronic Mail (CEM) systems of Member States are currently not interoperable, thus impacting on economic growth and competitiveness. The paper investigates the use of the DNSSec technology as a technological evolution of the Italian CEM System and the first step towards interoperability and adherence to internat...

  6. Certified Nursing Assistants’ Explanatory Models of Nursing Home Resident Depression

    OpenAIRE

    Piven, Mary Lynn; Anderson, Ruth A.; Colón-Emeric, Cathleen S.; Sandelowski, Margarete

    2008-01-01

    In this study, we explored how Certified Nursing Assistants (CNAs) understood resident depression. Interviews with 18 CNAs, working in two nursing homes were guided by Kleinman’s Explanatory Models of Illness framework. Interview data were content analyzed and CNAs’ descriptions of depression were compared to the MDS 2.0 Mood Screen and to DSM-IV-TR Depression Criteria. CNAs identified causes, signs, and symptoms of depression, but they were unsure about the duration and normalcy of depressio...

  7. Cost analysis of LEED certified United States navy buildings

    OpenAIRE

    Kirar, Carl V.

    2011-01-01

    CIVINS (Civilian Institutions) Thesis document A study was completed at UW-Madison in 2010 that reviewed the energy consumption of US Navy buildings which earned Leadership in Energy and Environmental Design (LEED) certification by the United States Green Building Council (USGBC). The research compared LEED certified buildings to a commercial counterpart within the US Navy inventory against Executive Order (EO) 13423. The EO mandated that all federal agencies meet a 30 percent reduction of...

  8. Climate change and WTO : boundary mediation on certified emission reductions

    International Nuclear Information System (INIS)

    Kim, Ho Cheol

    2011-07-01

    This book mentions climate change and WTO with is climate change true? International effort for reduce of greenhouse gas with UNFCCC, Kyoto protocol, Copenhagen Accord and Cancun Agreement, WTO norm, discussion on introduction of boundary mediation on certified emission reductions, analysis on regulation related WTO norm, violation of regulation on border measure of prohibition, violation of principle on GATT, justification, except through Article 20 of GATT, assessment of policy and supplementation on the law.

  9. A comparison of certified and noncertified pet foods.

    OpenAIRE

    Brown, R G

    1997-01-01

    The market presents the buyer with a wide array of pet food choices. Marketing pet foods has changed in the last decade and today foods may be bought at a variety of outlets. The present study compares nutrient composition, digestibility, and effect on urine pH (cat foods only) of selected certified and noncertified pet foods from different outlets. The selected foods were considered analogous in terms of declared ingredients and macronutrient profiles. The analytical methods used were those ...

  10. Perception of pediatric neurology among non-neurologists.

    Science.gov (United States)

    Jan, Mohammed M S

    2004-01-01

    Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.

  11. 7 CFR 785.4 - Grants to certified State mediation programs.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Grants to certified State mediation programs. 785.4..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS CERTIFIED STATE MEDIATION PROGRAM § 785.4 Grants to certified State mediation programs. (a) Eligibility. To be eligible to receive a grant, a State mediation program...

  12. 43 CFR 44.23 - How does the Department certify payment computations?

    Science.gov (United States)

    2010-10-01

    ... Certified Public Accountant, or an independent public accountant, that the statement has been audited in... guidelines that State auditors, independent Certified Public Accountants, or independent public accountants... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false How does the Department certify payment...

  13. 7 CFR 457.145 - Potato crop insurance-certified seed endorsement.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Potato crop insurance-certified seed endorsement. 457... INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.145 Potato crop insurance—certified seed endorsement. The Potato Crop Insurance Certified Seed Endorsement Provisions for...

  14. 7 CFR 201.73 - Processors and processing of all classes of certified seed.

    Science.gov (United States)

    2010-01-01

    ... (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.73 Processors and processing... of certified seed: (a) Facilities shall be available to perform processing without introducing... 7 Agriculture 3 2010-01-01 2010-01-01 false Processors and processing of all classes of certified...

  15. Pediatric allergy and immunology in Israel.

    Science.gov (United States)

    Geller-Bernstein, Carmi; Etzioni, Amos

    2013-03-01

    After the geographic and sociodemographic settings as well as the health care in Israel are briefly described, the scope of pediatric allergy and immunology in Israel is presented. This includes specific disorders commonly encountered, the environment that induces symptoms, the specialists who treat them, and the common challenges of patients, parents, doctors, and allied health personnel who collaborate to manage the maladies and patient care. Allergies usually affect some overall 15-20% of the pediatric population. The main allergens are inhaled, ingested, or injected (insects stings). Generally, the incidence of the various allergens affecting children in Israel, is similar to other parts of the Western world. Owing to the high consanguinity rate in the Israeli population, the prevalence of the various immunodeficiency conditions (in the adaptive as well as the innate system) is higher than that reported worldwide. Pediatric allergists/immunologists also treat autoimmune disorders affecting the pediatric group. Pediatric allergy and clinical immunology are not separate specialties. The 25 specialists who treat children with allergic/immunologic diseases have undergone a basic training in Pediatrics. They also received an additional 2-yr training in allergy and clinical immunology and then have to pass the board examinations. They work mainly in pediatric allergy units, in several hospitals that are affiliated to the five medical schools in the country. Aside from clinical work, most of the centers are also heavily involved in clinical and basic research in allergy and immunology. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  16. Pediatric Headache: An Overview.

    Science.gov (United States)

    Langdon, Raquel; DiSabella, Marc T

    2017-03-01

    Headache represents the most common neurologic disorder in the general population including children and is increasingly being recognized as a major source of morbidity in youth related to missed school days and activities. In this article, we take a holistic approach to the child presenting with headache with a focus on the detailed headache history, physical and neurologic examinations, and diagnostic evaluation of these patients. Clinical presentations and classification schema of multiple primary and secondary headache types in children are discussed using the International Headache Criteria (IHCD-3) as a guide, and a summary provided of the various treatment modalities employed for pediatric headache including lifestyle modifications, behavioral techniques, and abortive and preventive medications. Copyright © 2017 Mosby, Inc. All rights reserved.

  17. Pediatric thoracic CT angiography

    International Nuclear Information System (INIS)

    Frush, Donald P.; Herlong, J. Rene

    2005-01-01

    One of the principal benefits of contemporary multidetector row computed tomography (MDCT) has been the ability to obtain high-data sets for evaluation of the cardiovascular system. The benefits of the greater number of detector rows and submillimeter image thicknesses were quickly recognized and are especially advantageous in children. For example, since imaging is performed so quickly, issues with motion are minimized. This is a substantial benefit of CTA compared with MR imaging, the traditional noninvasive cross sectional modality for pediatric cardiovascular imaging. This, together with faster and more powerful computers, including improved transfer and storage capabilities, offers improved depiction of the heart, great vessels, other vasculature and adjacent intrathoracic structures in a fashion that is well accepted by clinical colleagues. In order to be successful, however, one must have an understanding of the technology and often unique technical considerations in infants and children. With this familiarity, excellent cardiovascular examinations can be performed even in the most challenging case. (orig.)

  18. Digital radiography: a survey of pediatric dentists.

    Science.gov (United States)

    Russo, Julie M; Russo, James A; Guelmann, Marcio

    2006-01-01

    The purpose of this study was to: (1) determine the popularity of digital radiography among members of the American Academy of Pediatric Dentistry (AAPD); and (2) report the most common systems in use. An AAPD-approved, voluntary, and anonymous electronic survey was developed and sent to 923 board certified pediatric dentists. Years in practice and in-office x-ray technology (digital or conventional) were inquired about initially. If negative for the use of digital radiography, future consideration for converting to digital radiography was ascertained. For positive responses, more in-depth information was requested. Information on type of system (sensor or phosphor plate), user friendliness, diagnostic ability, patient's comfort, general costs, durability, and parental and overall satisfaction was collected. For most of the questions, a 5-point assessment scale was used. Opportunity for additional comments was provided upon survey completion. Data was analyzed using descriptive statistics. A 32% (296/923) response rate was obtained. Twenty-six percent of practitioners (78/296) implemented digital radiography in their practices, whereas 71% considered future acquisition. Similar distribution for sensor and phosphor plate users was found. Sensor technology was reported to produce faster images, but was less tolerable by young children due to size and thickness. Phosphor plates were considered more children friendly, less expensive, and less durable. Parental satisfaction was very high with great marketing value. Picture quality was comparable to conventional film. Overall, digital radiography users would recommend it to other pediatric dentists. Digital radiography is not yet popular among pediatric dentists. Cost reduction and technology advancement may enhance utilization.

  19. Research by pediatric radiologists - past accomplishments and future opportunities

    International Nuclear Information System (INIS)

    Effmann, E.L.

    1987-01-01

    Pediatric radiologists have made numerous and important contributions to the body of medical knowledge. This essay reviews aspects of biomedical and radiological research, analyses the state of scholarship in pediatric radiology today, and examines future research opportunities. The author's research interest in cardiopulmonary malformations and in the use of murine models of human disease serve to illustrate of but one of many investigative areas open to academic pediatric radiologists. Finally, the application process for NIH funding is briefly discussed. (orig.)

  20. COMPARATIVE ANALYSIS OF INNOVATION PERFORMANCE IN CERTIFIED FIRMS IN MONTENEGRO AND REPUBLIC OF SRPSKA

    Directory of Open Access Journals (Sweden)

    Zdravko Krivokapic

    2014-03-01

    Full Text Available Research subjects of this study are certified companies and their commitment to innovation, as well as their own development and implementation of innovation. Certified companies are those companies that have set one or more standards: ISO 9001:2008, ISO 14001: 2004, HACCP, OHSAS 18001, ISO 17025:2006, ISO 27001. The research is based on 60 certified companies in Montenegro and 165 certified companies Republic of Srpska. The research was conducted at certified companies from all regions, for every activity and sizes. For this purpose it was used questionnaire with 91 questions and it was filled in like interview.

  1. Practical techniques for pediatric computed tomography

    International Nuclear Information System (INIS)

    Fitz, C.R.; Harwood-Nash, D.C.; Kirks, D.R.; Kaufman, R.A.; Berger, P.E.; Kuhn, J.P.; Siegel, M.J.

    1983-01-01

    Dr. Donald Kirks has assembled this section on Practical Techniques for Pediatric Computed Tomography. The material is based on a presentation in the Special Interest session at the 25th Annual Meeting of the Society for Pediatric Radiology in New Orleans, Louisiana, USA in 1982. Meticulous attention to detail and technique is required to ensure an optimal CT examination. CT techniques specifically applicable to infants and children have not been disseminated in the radiology literature and in this respect it may rightly be observed that ''the child is not a small adult''. What follows is a ''cookbook'' prepared by seven participants and it is printed in Pediatric Radiology, in outline form, as a statement of individual preferences for pediatric CT techniques. This outline gives concise explanation of techniques and permits prompt dissemination of information. (orig.)

  2. Pediatric Inpatient Nurses' Perceptions of Child Maltreatment.

    Science.gov (United States)

    Lavigne, Jenifer L; Portwood, Sharon G; Warren-Findlow, Jan; Brunner Huber, Larissa R

    The purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. A cross-sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. Many nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. Due to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. There is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Diagnosis of poor safety culture as a major shortcoming in OHSAS 18001-certified companies.

    Science.gov (United States)

    Ghahramani, Abolfazl

    2017-04-07

    The evaluation of safety performance in occupational health and safety assessment series (OHSAS) 18001-certified companies provides useful information about the quality of the management system. A certified organization should employ an adequate level of safety management and a positive safety culture to achieve a satisfactory safety performance. The present study conducted in six manufacturing companies: three OHSAS 18001-certified, and three non-certified to assess occupational health and safety (OHS) as well as OHSAS 18001 practices. The certified companies had a better OHS practices compared with the non-certified companies. The certified companies slightly differed in OHS and OHSAS 18001 practices and one of the certified companies had the highest activity rates for both practices. The results indicated that the implemented management systems have not developed and been maintained appropriately in the certified companies. The in-depth analysis of the collected evidence revealed shortcomings in safety culture improvement in the certified companies. This study highlights the importance of safety culture to continuously improve the quality of OHSAS 18001 and to properly perform OHS/OHSAS 18001 practices in the certified companies.

  4. Age Limit of Pediatrics.

    Science.gov (United States)

    Hardin, Amy Peykoff; Hackell, Jesse M

    2017-09-01

    Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs. Copyright © 2017 by the American Academy of Pediatrics.

  5. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  6. What Is a Pediatric Gastroenterologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Gastroenterologist? Page Content Article Body If your child ... children, and teens. What Kind of Training Do Pediatric Gastroenterologists Have? Pediatric gastroenterologists are medical doctors who ...

  7. What Is a Pediatric Endocrinologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Endocrinologist? Page Content Article Body If your child ... the teen years. What Kind of Training Do Pediatric Endocrinologists Have? Pediatric endocrinologists are medical doctors who ...

  8. What Is a Pediatric Geneticist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Geneticist? Page Content Article Body Fortunately, most children ... with similar problems. What Kind of Training Do Pediatric Geneticists Have? Pediatric geneticists are medical doctors who ...

  9. What is Pediatric Palliative Care?

    Science.gov (United States)

    ... FAQ Handout for Patients and Families What Is Pediatric Palliative Care? Pediatric Palliative care (pronounced pal-lee-uh-tiv) is ... life for both the child and the family. Pediatric palliative care is provided by a team of ...

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  11. What Is a Pediatric Urologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Urologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Urologists Have? Pediatric urologists are medical doctors who ...

  12. Children's (Pediatric) Abdominal Ultrasound Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  13. The Impact of Working in a Green Certified Building on Cognitive Function and Health.

    Science.gov (United States)

    MacNaughton, Piers; Satish, Usha; Laurent, Jose Guillermo Cedeno; Flanigan, Skye; Vallarino, Jose; Coull, Brent; Spengler, John D; Allen, Joseph G

    2017-03-01

    Thirty years of public health research have demonstrated that improved indoor environmental quality is associated with better health outcomes. Recent research has demonstrated an impact of the indoor environment on cognitive function. We recruited 109 participants from 10 high-performing buildings (i.e. buildings surpassing the ASHRAE Standard 62.1-2010 ventilation requirement and with low total volatile organic compound concentrations) in five U.S. cities. In each city, buildings were matched by week of assessment, tenant, type of worker and work functions. A key distinction between the matched buildings was whether they had achieved green certification. Workers were administered a cognitive function test of higher order decision-making performance twice during the same week while indoor environmental quality parameters were monitored. Workers in green certified buildings scored 26.4% (95% CI: [12.8%, 39.7%]) higher on cognitive function tests, controlling for annual earnings, job category and level of schooling, and had 30% fewer sick building symptoms than those in non-certified buildings. These outcomes may be partially explained by IEQ factors, including thermal conditions and lighting, but the findings suggest that the benefits of green certification standards go beyond measureable IEQ factors. We describe a holistic "buildingomics" approach for examining the complexity of factors in a building that influence human health.

  14. Certified causes of death in patients with mesothelioma in South East England

    Directory of Open Access Journals (Sweden)

    Peto Julian

    2009-01-01

    Full Text Available Abstract Background Mesothelioma is a highly fatal cancer that is caused by exposure to asbestos fibres. In many populations, the occurrence of mesothelioma is monitored with the use of mortality data from death certification. We examine certified causes of death of patients who have been diagnosed with mesothelioma, and assess the validity of death certification data as a proxy for mesothelioma incidence. Methods We extracted mesothelioma registrations in the South East of England area between 2000 and 2004 from the Thames Cancer Registry database. We retained for analysis 2200 patients who had died at the time of analysis, after having excluded seven dead cases where the causes of death were not known to the cancer registry. The 2200 deaths were classified hierarchically to identify (1 mesothelioma deaths, (2 deaths certified as lung cancer deaths or (3 deaths from unspecified cancer, and (4 deaths from other causes. Results 87% of the patients had mesothelioma mentioned on the death certificate. 6% had no mention of mesothelioma but included lung cancer as a cause of death. Another 6% had no mention of mesothelioma or lung cancer, but included an unspecified cancer as a cause of death. Lastly, 2% had other causes of death specified on the death certificate. Conclusion This analysis suggests that official mortality data may underestimate the true occurrence of mesothelioma by around 10%.

  15. Applications of nuclear magnetic resonance spectroscopy to certifiable food colors

    International Nuclear Information System (INIS)

    Marmion, D.M.

    Nuclear magnetic resonance spectroscopy was found suitable for the identification of individual colours, for distinguishing individual colours from colour mixtures, for the identification and semi-quantitative determination of the individual colours in mixtures and for proofs of the adulteration of certified colours adding noncertified colours. The method is well suited for observing the purity of colours and may also be used as the control method in the manufacture of colours and in assessing their stability and their resistance to increased temperature and light. (M.K.)

  16. Understanding academic clinicians' intent to treat pediatric obesity.

    Science.gov (United States)

    Frankfurter, Claudia; Cunningham, Charles; Morrison, Katherine M; Rimas, Heather; Bailey, Karen

    2017-02-08

    To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians' intent to treat pediatric obesity. A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data. A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity. A total of 198 physicians, surgeons, and allied health professionals across Canada (British Columbia, Alberta, Manitoba, Saskatchewan, Nova Scotia, Ontario and Quebec) completed the survey. On step 1, demographic factors accounted for 7.4% of the variance in intent scores. Together in step 2, demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity. Perceived behavioral control, that is, confidence in one's ability to manage pediatric obesity, and subjective norms, congruent with one's context of practice, were the most significant predictors of the intent to treat pediatric obesity. Attitudes and barriers did not predict the intent to treat pediatric obesity in this context. Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinician's intent to treat pediatric obesity.

  17. Medical students¿ assessment of pediatric patients - teaching and evaluation using video cases

    DEFF Research Database (Denmark)

    Malon, Michelle; Cortes, Dina; Greisen, Gorm

    2014-01-01

    and examination for pediatric medicine.MethodsMedical students on a pediatric clerkship at the University of Copenhagen assessed eight short pediatric video cases during autumn 2011 and spring 2012. Two independent observers evaluated a subset of records in a pilot study. A blind evaluation was made...

  18. On being a certifying abortion consultant: an ethical dilemma.

    Science.gov (United States)

    Clarkson, S E

    1980-05-14

    The medical profession was relieved when the Contraceptive, Sterilization and Abortion Act was passed in New Zealand in 1977, but it now appears that there are continuing problems with the implementation of the law. Most of the law's clauses are concerned with the practical aspects of the performance of abortions in New Zealand. Outlined in the law are requirements for licenses of hospitals, certifying consultants and operating surgeons, and the tasks of the supervising committee are specified. Thus, the medical profession accepted the impossible job of becoming the arbiter of morals of New Zealand society. There have been problems, since passage of the law, with inadequate numbers of certifying consultants being recruited, the resignation of the chair of the Abortion Supervisory Committee, a lack of resources to provide the required counseling services, and local variation in interpretations resulting in inconsistent treatment of abortion requests in different parts of the country. The basis of the problem is the fact that this law requires a moral rather than a medical decision to be made. Although at 1st glance the phrase serious risk to mental health would appear to be easily interpreted, this is not so. The morality of an act of abortion depends on the right afforded the fetus, and no society has as yet achieved a consensus on this. Thus, this must remain the conviction of each separate individual. Some guidance may come from medidal and legal advisers in this moral decision, but it is impossible to delegate personal moral decisions.

  19. Sustaining without Changing: The Metabolic Rift of Certified Organic Farming

    Directory of Open Access Journals (Sweden)

    Julius Alexander McGee

    2016-01-01

    Full Text Available Many proponents of organic farming claim that it is a sustainable alternative to conventional agriculture due to its reliance on natural agro-inputs, such as manure based fertilizers and organic pesticides. However, in this analysis we argue that although particular organic farming practices clearly benefit ecosystems and human consumers, the social context in which some organic farms develop, limit the potential environmental benefits of organic agriculture. Specifically, we argue that certified organic farming’s increased reliance on agro-inputs, such as organic fertilizers and pesticides, reduces its ability to decrease global water pollution. We review recent research that demonstrates the environmental consequences of specific organic practices, as well as literature showing that global organic farming is increasing its reliance on agro-inputs, and contend that organic farming has its own metabolic rift with natural water systems similar to conventional agriculture. We use a fixed-effects panel regression model to explore how recent rises in certified organic farmland correlate to water pollution (measured as biochemical oxygen demand. Our findings indicate that increases in the proportion of organic farmland over time increases water pollution. We conclude that this may be a result of organic farms increasing their reliance on non-farm agro-inputs, such as fertilizers.

  20. Pediatric radiology

    International Nuclear Information System (INIS)

    Kirkpatrick, J.A. Jr.

    1987-01-01

    Magnetic resonance imaging is proving to be a powerful diagnostic modality. Included in this year's abstracts and discussions are papers having to do with it application to neoplasia in general and a variety of specific disorders of the brain and spinal column. Magnetic resonance spectroscopy is reported; whether or not this becomes practical, it is an exciting prospect. Perhaps because interventional techniques are so readily applicable at this time, both in the infant and child as well as in the adult, little has been included. On the other hand, some disorders that were in the province of adult medicine are now becoming distressingly common in infants and children, i.e., the adult respiratory distress syndrome; the acquired immune deficiency syndrome and AIDS-related complex; and aluminum bone disease in children. Of those developments that are promising and related to the infant or child, one can count the articles having to do with extracorporeal membrane oxygenation and the treatment of the respiratory distress syndrome, hyaline membrane disease, with human surfactant. The latter raises expectations for the end of multiple examinations of the sick neonate necessary for the definition and follow-up of pulmonary interstitial emphysema and the other complications of air block phenomenon. The two contributions on the role of diagnostic imaging before and after transplantation of the liver serve as a reference

  1. Citation classics in pediatrics: a bibliometric analysis.

    Science.gov (United States)

    Chhapola, Viswas; Tiwari, Soumya; Deepthi, Bobbity; Kanwal, Sandeep Kumar

    2018-03-06

    Citation analysis provides insights into the history and developmental trajectory of scientific fields. Our objective was to perform an analysis of citation classics in the journals of pediatric specialty and to examine their characteristics. Initially, all the journals listed under the category of pediatrics (n = 120) were identified using Journal Citation Reports. Web of science database was then searched (1950-2016) to select the top-100 cited articles in the above identified pediatric journals. The top-100 cited article were categorized according the study design, sub-specialty, country, institutional affiliation, and language. The top-100 articles were published in 18 different journals, with Pediatrics having the highest numbers (n = 40), followed by The Journal of Pediatrics (n = 17). The majority (n = 62) of classics were published after 1990. The most cited article had citation count of 3516 and the least cited had a citation count of 593. The USA (n = 71) was the most commonly represented country, and 60 institutions contributed to 100 articles. Fifteen authors contributed to more than one classic as first or second author. Observational study (n = 55) was the commonest study design across all decades, followed by reviews (n = 12), scale development studies (n = 11), and guidelines (n = 11). Among the pediatric sub-specialties, growth and development articles were highly cited (n = 24), followed by pediatric psychiatry and behavior (n = 21), endocrinology (n = 15), and neonatology (n = 12). The top-100 cited articles in pediatrics identify the impactful authors, journals, institutes, and countries. Observational study design was predominant-implying that inclusion among citation classics is not related to soundness of study design.

  2. Advances in pediatric dentistry.

    Science.gov (United States)

    Yoon, Richard K; Best, Jed M

    2011-07-01

    This article addresses advances in 4 key areas related to pediatric dentistry: (1) caries detection tools, (2) early interventions to arrest disease progression, (3) caries-risk assessment tools, and (4) trends in pediatric procedures and dental materials. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Pediatric magnetic resonance imaging

    International Nuclear Information System (INIS)

    Cohen, M.D.

    1986-01-01

    This book defines the current clinical potential of magnetic resonance imaging and focuses on direct clinical work with pediatric patients. A section dealing with the physics of magnetic resonance imaging provides an introduction to enable clinicians to utilize the machine and interpret the images. Magnetic resonance imaging is presented as an appropriate imaging modality for pediatric patients utilizing no radiation

  4. Social Media in Pediatric Orthopaedics.

    Science.gov (United States)

    Lander, Sarah T; Sanders, James O; Cook, Peter C; O'Malley, Natasha T

    Internet searches and social media utilization in health care has exploded over the past 5 years, and patients utilize it to gain information on their health conditions and physicians. Social media has the potential to serve as a means for education, communication, and marketing in all health care specialties. Physicians are sometimes reluctant to engage because of concerns of privacy, litigation, and lack of experience with this modality. Many surgical subspecialties have capitalized on social media but no study to date has examined the specific footprint of pediatric orthopaedic surgeons in this realm. We aim to quantify the utilization of individual social media platforms by pediatric orthopaedic surgeons, and identify any differences between private and hospital-based physicians, but also regional differences. Using the Pediatric Orthopaedic Society of North America Member Directory, each active member's social media presence was reviewed through an Internet search. Members were stratified on the basis of practice model and geographic location. Individual Internet searches, social media sites, and number of publications were reviewed for social media presence. Of 987 Pediatric Orthopaedic Society of North America members, 95% had a professional webpage, 14.8% a professional Facebook page, 2.2% a professional Twitter page, 36.8% a LinkedIn profile, 25.8% a ResearchGate profile, 33% at least 1 YouTube. Hospital-based physicians had a lower mean level of utilization of social media compared with their private practice peers, and a higher incidence of Pubmed publications. Private practice physicians had double the social media utilization. Regional differences reveal that practicing Pediatric Orthopaedists in the Northeast had increased utilization of ResearchGate and LinkedIn and the West had the lowest mean social media utilization levels. The rapid expansion of social media usage by patients and their family members is an undeniable force affecting the health

  5. The Effectiveness of "Teach for America" and Other Under-certified Teachers

    Directory of Open Access Journals (Sweden)

    Ildiko Laczko-Kerr

    2002-09-01

    Full Text Available The academic achievements of students taught by under-certified primary school teachers were compared to the academic achievements of students taught by regularly certified primary school teachers.  This sample of under-certified teachers included three types of under-qualified personnel: emergency, temporary and provisionally certified teachers.  One subset of these under-certified teachers was from the national program "Teach For America (TFA."  Recent college graduates are placed by TFA where other under-qualified under-certified teachers are often called upon to work, namely, low-income urban and rural school districts. Certified teachers in this study were from accredited universities and all met state requirements for receiving the regular initial certificate to teach.  Recently hired under-certified and certified teachers (N=293 from five low-income school districts were matched on a number of variables, resulting in 109 pairs of teachers whose students all took the mandated state achievement test. Results indicate 1 that students of TFA teachers did not perform significantly different from students of other under-certified teachers, and 2 that students of certified teachers out-performed students of teachers who were under-certified.  This was true on all three subtests of the SAT 9—reading, mathematics and language arts.  Effect sizes favoring the students of certified teachers were substantial.  In reading, mathematics, and language, the students of certified teachers outperformed students of under-certified teachers, including the students of the TFA teachers, by about 2 months on a grade equivalent scale.  Students of under-certified teachers make about 20% less academic growth per year than do students of teachers with regular certification.  Traditional programs of teacher preparation apparently result in positive effects on the academic achievement of low-income primary school children.  Present

  6. Pediatric oncologic endosurgery.

    Science.gov (United States)

    Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J

    2017-08-01

    Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

  7. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

    Science.gov (United States)

    Perez, Jose A., Jr.; Greer, Sharon

    2009-01-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

  8. Remote nursing certified practice: viewing nursing and nurse practitioner practice through a social justice lens.

    Science.gov (United States)

    Tarlier, Denise S; Browne, Annette J

    2011-06-01

    Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.

  9. Nursing home practices following resident death: the experience of Certified Nursing Assistants.

    Science.gov (United States)

    Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R

    2015-01-01

    This study examined certified nursing assistants' (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities' practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants.

    Science.gov (United States)

    Rodwell, John; Demir, Defne; Gulyas, Andre

    2015-08-01

    Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers. © 2015 Wiley Publishing Asia Pty Ltd.

  11. 30-Day Mortality and Readmission after Hemorrhagic Stroke among Medicare Beneficiaries in Joint Commission Primary Stroke Center Certified and Non-Certified Hospitals

    Science.gov (United States)

    Lichtman, Judith H.; Jones, Sara B.; Leifheit-Limson, Erica C.; Wang, Yun; Goldstein, Larry B.

    2012-01-01

    Background and Purpose Ischemic stroke patients treated at Joint Commission Primary Stroke Center (JC-PSC) certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC certified versus non-certified hospitals. Methods The study included all fee-for-service Medicare beneficiaries ≥65 years old with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC certified hospital on 30-day mortality and readmission. Results There were 2,305 SAH and 8,708 ICH discharges from JC-PSC certified hospitals and 3,892 SAH and 22,564 ICH discharges from non-certified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% vs. 33.2%, pmortality (SAH: 35.1% vs. 44.0%, pmortality was 34% lower (OR 0.66, 95% CI 0.58–0.76) after SAH and 14% lower (OR 0.86, 95% CI 0.80–0.92) after ICH for patients discharged from JC-PSC certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. Conclusions Patients treated at JC-PSC certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with non-certified hospitals. PMID:22033986

  12. Pediatric allergy and immunology in Japan.

    Science.gov (United States)

    Ebisawa, Motohiro; Nishima, Sankei; Ohnishi, Hidenori; Kondo, Naomi

    2013-11-01

    The Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI) was started in 1966 and currently has 3613 members as of August 1, 2012. The number of pediatricians specializing in allergies who have been certified by the Japanese Society of Allergology is 817. Among these, there are 125 training directors and training facilities for allergy and clinical immunology. The JSPACI first published an asthma guideline specific for children in 2000, and this has been revised every 3 yrs, contributing to better control of pediatric asthma. Food allergy management guidelines were first developed in 2005, which have helped to improve the care of food allergy patients. Among 514 pediatric training programs by the Japanese Society of Pediatrics, there are 312 facilities routinely performing oral food challenges. Among these, there were already 53 facilities performing oral immunotherapy at the end of 2011, treating 1400 cases of food allergy. The prevalence of pediatric allergic diseases has increased in Japan over the past 50 yrs. A number of International Study of Asthma and Allergies in Childhood surveys have been conducted in the past at specific times. The prevalence of wheezing among children aged 13-14 yrs in 2002 was 13.0%. Multi-year surveys found a 1.5- to 2-fold increase every 10 yrs until 2002. However, according to the latest data in 2012, asthma prevalence seems to have slightly decreased in Japan. Food allergy mainly associated with infantile atopic eczema among infants younger than 1 yr of age is the most common form as with other developed countries. The estimated food allergy prevalence based on data from several surveys is 5-10% among infants (0-6 yrs) and 1-2% among schoolchildren (6-15 yrs). A variety of patients suffering from primary deficiency syndrome have been actively analyzed. Previously, antibody defects and well-defined syndromes with immunodeficiency were analyzed, but recent research is focusing on not only acquired immune

  13. The relationship between formative and summative examinations and PANCE scores; can the past predict the future?

    Science.gov (United States)

    Massey, Scott; Stallman, John; Lee, Louise; Klingaman, Kathy; Holmerud, David

    2011-01-01

    This paper describes how a systematic analysis of students at risk for failing the Physician Assistant National Certifying Examination (PANCE) may be used to identify which students may benefit from intervention prior to taking the PANCE and thus increase the likelihood of successful completion of the PANCE. The intervention developed and implemented uses various formative and summative examinations to predict students' PANCE scores with a high degree of accuracy. Eight end-of-rotation exams (EOREs) based upon discipline-specific diseases and averaging 100 questions each, a 360-question PANCE simulation (SUMM I), the PACKRAT, and a 700-question summative cognitive examination based upon the NCCPA blueprint (SUMM II) were administered to all students enrolled in the program during the clinical year starting in January 2010 and concluding in December 2010. When the PACKRAT, SUMM I, SUMM II, and the surgery, women's health, and pediatrics EOREs were combined in a regression model, an Rvalue of 0.87 and an R2 of 0.75 were obtained. A predicted score was generated for the class of 2009. The predicted PANCE score based upon this model had a final correlation of 0.790 with the actual PANCE score. This pilot study demonstrated that valid predicted scores could be generated from formative and summative examinations to provide valuable feedback and to identify students at risk of failing the PANCE.

  14. Social pediatrics: weaving horizontal and vertical threads through pediatric residency.

    Science.gov (United States)

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle

    2017-01-13

    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  15. Increasing nursing treatment for pediatric procedural pain.

    Science.gov (United States)

    Bice, April A; Gunther, Mary; Wyatt, Tami

    2014-03-01

    Procedural pain management is an underused practice in children. Despite the availability of efficacious treatments, many nurses do not provide adequate analgesia for painful interventions. Complementary therapies and nonpharmacologic interventions are additionally essential to managing pain. Owing to the increasing awareness of inadequate nursing utilization of pharmacologic measures for procedural pain, this paper focuses only on analgesic treatments. The aim of this review was to examine how varying degrees of quality improvement affect nursing utilization of treatments for routine pediatric procedural pain. A comprehensive search of databases including Cinahl, Medline/Pubmed, Web of Science, Google Scholar, Psycinfo, and Cochrane Library was performed. Sixty-two peer-reviewed research articles were examined. Ten articles focusing on quality improvement in pediatric pain management published in English from 2001 to 2011 were included. Three themes emerged: 1) increasing nursing knowledge; 2) nursing empowerment; and 3) protocol implementation. Research critique was completed with the use of guidelines and recommendations from Creswell (2009) and Garrard (2011). The literature reveals that nurses still think that pediatric pain management is essential. Quality improvement increases nursing utilization of procedural pain treatments. Although increasing nursing knowledge improves pediatric pain management, it appears that nursing empowerment and protocol implementation increase nursing compliance more than just education alone. Nurses providing pain management can enhance their individual practice with quality improvement measures that may increase nursing adherence to institutional and nationally recommended pediatric procedural pain management guidelines. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  16. AWS certified solutions architect official study guide associate exam

    CERN Document Server

    Baron, Joe; Bixler, Tim; Gaut, Biff; Kelly, Kevin E; Senior, Sean; Stamper, John

    2017-01-01

    This is your opportunity to take the next step in your career by expanding and validating your skills on the AWS cloud. AWS has been the frontrunner in cloud computing products and services, and the AWS Certified Solutions Architect Official Study Guide for the Associate exam will get you fully prepared through expert content, and real-world knowledge, key exam essentials, chapter review questions, access to Sybex's interactive online learning environment, and much more. This official study guide, written by AWS experts, covers exam concepts, and provides key review on exam topics, including: * Mapping Multi-Tier Architectures to AWS Services, such as web/app servers, firewalls, caches and load balancers * Understanding managed RDBMS through AWS RDS (MySQL, Oracle, SQL Server, Postgres, Aurora) * Understanding Loose Coupling and Stateless Systems * Comparing Different Consistency Models in AWS Services * Understanding how AWS CloudFront can make your application more cost efficient, faster and secure * Implem...

  17. Do personality traits predict work outcomes of certified nursing assistants?

    Science.gov (United States)

    Kovach, Christine R; Simpson, Michelle R; Reitmaier, Amy B; Johnson, Addie; Kelber, Sheryl T

    2010-10-01

    The purposes of this study were to describe personality traits of certified nursing assistants (CNAs) employed at nursing homes and explore relationships between personality traits, job satisfaction, and job performance. The sample included 177 CNAs providing direct care to residents in three nursing homes. CNAs with high and low job performance skills were distinguished by the cluster of traits associated with teamwork skills. Overall, 21.3% of the variance in job satisfaction was explained by the personality traits of Adjustment, Prudence, Likeability, Excitable, and Dutiful, F(8, 145) = 4.899, p personality, job satisfaction, and job performance provide important information about the personality traits of nursing staff who are most likely to enjoy and perform well in the nursing home setting. Knowledge of these links may be useful for hiring the appropriate person for direct care nursing home positions. Copyright 2010, SLACK Incorporated.

  18. Bias detection and certified reference materials for random measurands

    Science.gov (United States)

    Rukhin, Andrew L.

    2015-12-01

    A problem that frequently occurs in metrology is the bias checking of data obtained by a laboratory against the specified value and uncertainty estimate given in the certificate of analysis. The measurand—a property of a certified reference material (CRM)—is supposed to be random with a normal distribution whose parameters are given by the certificate specifications. The laboratory’s data from subsequent measurements of the CRM (a CRM experiment) are summarized by the sample mean value and its uncertainty which is commonly based on a repeatability standard deviation. New confidence intervals for the lab’s bias are derived. Although they may lack intuitive appeal, those obtained by using higher order asymptotic methods, compared and contrasted in this paper, are recommended.

  19. DH-1a: a certified uranium-thorium reference ore

    International Nuclear Information System (INIS)

    Steger, H.F.; Bowman, W.S.; Zechanowitsch, G.

    1981-09-01

    A 122-kg sample of uranium-thorium ore, DH-1a, from Elliot Lake, Ontario, was prepared as a compositional reference material to replace the similar certified ore, DH-1. DH-1a was ground to minus 74μm, blended in one lot, and bottled in 200 g units. The homogeneity of DH-1a with respect to uranium was confirmed using the volumetric umpire method. The recommended value for uranium is based on the data from the confirmation of homogeneity. For thorium, twelve laboratories provided results in a free choice analytical program. A statistical analysis of the data gave a recommended value of 0.263 percent for uranium and 0.091 percent for thorium

  20. Certifying the decommissioned Shippingport reactor vessel for transport

    International Nuclear Information System (INIS)

    Towell, R.H.

    1990-01-01

    The decommissioned Shippingport reactor pressure vessel with its concentric neutron shield tank was shipped to Hanford, WA as part of the effort to restore the Shippingport Station to its original condition. The metal walls of the reactor vessel had become radioactive from neutron bombardment while the reactor was operating so it had to be shipped under the regulations for transporting radioactive material. Because of the large amount of radioactivity in the walls, 16,467 Curies, and because the potentially dispersible corrosion layer on the inner walls of both tanks was also radioactive, the Shippingport reactor vessel was transported under the most stringent of the regulations, those for a type B package. Compliance with the packaging regulations was confirmed via independent analysis by the staff of the Department of Energy certifying official and the Shippingport reactor vessel was shipped under DOE Certificate of Compliance USA/9515/B(U)

  1. Compliance with Environmental and Social Legislation in Certified Forestry Companies

    Directory of Open Access Journals (Sweden)

    Marcos Vinicius Santana Leite

    2017-12-01

    Full Text Available ABSTRACT The objective of this study was to evaluate the contribution of the FSC forestry certification system to improve the forestry sector, in terms of compliance to environmental and social laws and improvements in working conditions resulting from the certification process. Thirty-seven auditing reports from five Brazilian forestry companies were evaluated, throughout the 2006-2013 period. Non-compliance and observations were analyzed and organized into categories, which identified the main performance issues found in certified forestry organizations. 301 instances of non-compliance and 138 observations of audit reports were verified, where 48 and 57% respectively, were linked to the two principles studied. For obtaining and/or maintaining the certificate it is necessary for all violations to be resolved. Therefore, it was concluded that forest certification contributes to the advancement of the forestry sector in Brazil, in relation to compliance with legal, social and labor issues.

  2. Results of the 2015 National Certified Pharmacy Technician Workforce Survey.

    Science.gov (United States)

    Desselle, Shane P; Holmes, Erin R

    2017-07-01

    The results of the 2015 National Certified Pharmacy Technician Workforce Survey are described. A survey was e-mailed to a randomized sample of 5,000 certified pharmacy technicians (CPhTs) throughout the United States, with response reminders employed. Survey items eliciting demographic and work characteristics and work life attitudes were generated from the literature and qualitative interviews. This study aimed to describe job satisfaction, sources of stress, profession and employer commitment, education and training, and reasons for entry into the profession among CPhTs and determine relationships between those variables and CPhTs' level of involvement in various work activities, with particular attention paid to differences in practice setting. Frequency statistics, correlation analysis, and means testing were used to meet study objectives and identify significant differences. A total of 516 CPhTs currently working as a pharmacy technician responded to the survey. The CPhTs reported high levels of involvement in more traditional activities but less involvement in those that involve greater cognitive load. Respondents reported moderate levels of job satisfaction and commitment and somewhat high levels of stress overall. Most CPhTs chose to be a pharmacy technician because they desired to enter a healthcare field and help people and were recruited. CPhTs derived benefit from all aspects of education and training evaluated and most from on-the-job training. Perceived value of education and training was associated with higher satisfaction and commitment and with lower stress. There were a number of differences in these work life attitudes across practice settings and by involvement in various job functions. The results of the survey indicated that job satisfaction and commitment were moderate and that stress levels were somewhat high among CPhTs. There were a number of differences in work life attitudes across practice settings and by involvement in various job

  3. Experimentally generated randomness certified by the impossibility of superluminal signals.

    Science.gov (United States)

    Bierhorst, Peter; Knill, Emanuel; Glancy, Scott; Zhang, Yanbao; Mink, Alan; Jordan, Stephen; Rommal, Andrea; Liu, Yi-Kai; Christensen, Bradley; Nam, Sae Woo; Stevens, Martin J; Shalm, Lynden K

    2018-04-01

    From dice to modern electronic circuits, there have been many attempts to build better devices to generate random numbers. Randomness is fundamental to security and cryptographic systems and to safeguarding privacy. A key challenge with random-number generators is that it is hard to ensure that their outputs are unpredictable 1-3 . For a random-number generator based on a physical process, such as a noisy classical system or an elementary quantum measurement, a detailed model that describes the underlying physics is necessary to assert unpredictability. Imperfections in the model compromise the integrity of the device. However, it is possible to exploit the phenomenon of quantum non-locality with a loophole-free Bell test to build a random-number generator that can produce output that is unpredictable to any adversary that is limited only by general physical principles, such as special relativity 1-11 . With recent technological developments, it is now possible to carry out such a loophole-free Bell test 12-14,22 . Here we present certified randomness obtained from a photonic Bell experiment and extract 1,024 random bits that are uniformly distributed to within 10 -12 . These random bits could not have been predicted according to any physical theory that prohibits faster-than-light (superluminal) signalling and that allows independent measurement choices. To certify and quantify the randomness, we describe a protocol that is optimized for devices that are characterized by a low per-trial violation of Bell inequalities. Future random-number generators based on loophole-free Bell tests may have a role in increasing the security and trust of our cryptographic systems and infrastructure.

  4. Pediatric maxillary fractures.

    Science.gov (United States)

    Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit

    2011-07-01

    Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

  5. Survey of the professors of child neurology: neurology versus pediatrics home for child neurology.

    Science.gov (United States)

    Pearl, Phillip L; McConnell, Emily R; Fernandez, Rosamary; Brooks-Kayal, Amy

    2014-09-01

    The optimal academic home for child neurology programs between adult neurology versus pediatric departments remains an open question. The Professors of Child Neurology, the national organization of child neurology department chairs, division chiefs, and training program directors, was surveyed to evaluate the placement of child neurology programs. Professors of Child Neurology members were surveyed regarding the placement of child neurology programs within adult neurology versus pediatric departments. Questions explored academic versus clinical lines of reporting and factors that may be advantages and disadvantages of these affiliations. Issues also addressed were the current status of board certification and number of clinics expected in academic child neurology departments. Of 120 surveys sent, 95 responses were received (79% response rate). The primary academic affiliation is in neurology in 54% of programs versus 46% in pediatrics, and the primary clinical affiliation is 45% neurology and 55% pediatrics. Advantages versus disadvantages of one's primary affiliation were similar whether the primary affiliation was in neurology or pediatrics. While 61% of respondents are presently board certified in pediatrics, only 2% of those with time-limited certification in general pediatrics plan to be recertified going forward. Typically six to eight half-day clinics per week are anticipated for child neurologists in academic departments without additional funding sources. Overall, leaders of child neurology departments and training programs would not change their affiliation if given the opportunity. Advantages and disadvantages associated with current affiliations did not change whether child neurology was located in neurology or pediatrics. Board certification by the American Board of Psychiatry and Neurology in child neurology is virtually universal, whereas pediatric board certification by the American Board of Pediatrics is being maintained by very few. Most academic

  6. [Robotics in pediatric surgery].

    Science.gov (United States)

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  7. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience.

    Science.gov (United States)

    Rosen, H David; Mervitz, Deborah; Cravero, Joseph P

    2016-02-01

    Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. A web-based survey was sent to pediatric anesthesiologists working at academic health science centers across Canada. The participants were selected based on being members of the Canadian Pediatric Anesthesia Society (CPAS), which represents the subspecialty in Canada. All members of CPAS who had e-mail contact information available in the membership database were invited to participate. A total of 209 members out of the total of 211 fulfilled these criteria and were included in the study population. The response rate was 51% (106/209). Of respondents, 42% felt that ED was a significant problem at their institutions, with 45% giving medication before or during anesthesia to prevent the development of ED. Propofol was the most common medication given to prevent ED (68%) and to treat ED (42%). Total intravenous anesthesia (TIVA) was considered by 38% of respondents as a technique used to prevent ED. Medications used for treatment included propofol (42%), midazolam (31%), fentanyl (10%), morphine (7%), and dexmedetomidine (5%), with 87% of respondents rating effectiveness of treatment as 'usually works quickly with one dose'. We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric

  8. Problems and preferences in pediatric imaging

    International Nuclear Information System (INIS)

    Thukral, Brij Bhushan

    2015-01-01

    Radiological imaging is extremely valuable as a diagnostic tool in the pediatric population, but it comes with a number of distinct challenges as compared to the imaging of adults. This is because of the following: It requires dedicated imaging protocols to acquire the images, there is need for sedation or general anesthesia for longer procedures such as MRI, specific training is required for the healthcare personnel involved, thorough knowledge and expertise should be applied for evaluating the images, and most importantly, it requires consideration for radiation exposure if ionizing radiation is being used. One of the challenges for clinical care personnel is to gain the child's trust and co-operation before and throughout the duration of an examination, which can prove to be difficult in children who may be ill and have pain. This is important to acquire quality images and prevent repeat examinations. Even with a quality examination, the accurate interpretation of images requires a thorough knowledge of the intricate and dynamic face of anatomy and specific pathological presentations in children. The increased radiation sensitivity of growing organs and children's longer expected life spans make them more susceptible to the harmful effects of radiation. Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. In order to prevent the harmful effects of ionizing radiation, As Low As Reasonably Achievable (ALARA) principle should be strictly followed. This article seeks to draw attention to various challenges of pediatric imaging and the ways to overcome them

  9. Pharmacological management of obesity in pediatric patients.

    Science.gov (United States)

    Boland, Cassie L; Harris, John Brock; Harris, Kira B

    2015-02-01

    To review current evidence of pharmacological options for managing pediatric obesity and provide potential areas for future research. A MEDLINE search (1966 to October 2014) was conducted using the following keywords: exenatide, liraglutide, lorcaserin, metformin, obesity, orlistat, pediatric, phentermine, pramlintide, topiramate, weight loss, and zonisamide. Identified articles were evaluated for inclusion, with priority given to randomized controlled trials with orlistat, metformin, glucagon-like peptide-1 agonists, topiramate, and zonisamide in human subjects and articles written in English. References were also reviewed for additional trials. Whereas lifestyle modification is considered first-line therapy for obese pediatric patients, severe obesity may benefit from pharmacotherapy. Orlistat is the only Food and Drug Administration (FDA)-approved medication for pediatric obesity and reduced body mass index (BMI) by 0.5 to 4 kg/m(2), but gastrointestinal (GI) adverse effects may limit use. Metformin has demonstrated BMI reductions of 0.17 to 1.8 kg/m(2), with mild GI adverse effects usually managed with dose titration. Exenatide reduced BMI by 1.1 to 1.7 kg/m(2) and was well-tolerated with mostly transient or mild GI adverse effects. Topiramate and zonisamide reduced weight when used in the treatment of epilepsy. Future studies should examine efficacy and safety of pharmacological agents in addition to lifestyle modifications for pediatric obesity. Lifestyle interventions remain the treatment of choice in pediatric obesity, but concomitant pharmacotherapy may be beneficial in some patients. Orlistat should be considered as second-line therapy for pediatric obesity. Evidence suggests that other diabetes and antiepileptic medications may also provide weight-loss benefits, but safety should be further evaluated. © The Author(s) 2014.

  10. Sonography of iatrogenic pneumothorax in pediatric patients

    Science.gov (United States)

    2013-01-01

    Pneumothorax is defined as the presence of air in the pleural cavity. The incidence of iatrogenic pneumothorax in the pediatric population is 0.3–0.48 in 1000 patients. A conventional chest X-ray, in some cases supplemented with chest computed tomography, is a typical imaging examination used to confirm the diagnosis of pneumothorax. Within the last years, the relevance of transthoracic lung ultrasound in the diagnostic process of this disease entity has greatly increased. This is confirmed by the opinion of a group of experts in ultrasound lung imaging in patients in a life-threatening condition, who strongly recommend a transthoracic ultrasound examination for the diagnosis of pneumothorax in such patients. These data constituted the basis for initiating the prospective studies on the application of this method in pneumothorax diagnosis in patients of pediatric hematology and oncology wards. Aim The aim of the study was to present the possibility of using the transthoracic lung ultrasound in the diagnostic process of pneumothorax in pediatric patients, with particular attention paid to its iatrogenic form. The article discusses sonographic criteria for pneumothorax diagnosis in pediatric patients, including the sensitivity and specificity of the method, in relation to conventional chest X-ray. Material and methods The prospective studies included a group of patients treated in the Clinic of Pediatrics, Pediatric Hematology, Oncology and Endocrinology of the Academic Clinical Centre (Medical University of Gdańsk, Poland) in whom a central venous catheter was placed in the subclavian veins. The studies lasted for one year – from 1 July 2011 to 30 June 2012. The examined group comprised 63 patients – 25 girls (39.7%) and 38 boys (60.3%) aged from 1 to 17. The analysis included the results of 115 ultrasound examinations conducted in this group. Results In t he examined group with suspected or diagnosed neoplasm, iatrogenic pneumothorax was identified in 4 out

  11. [Complications in pediatric anesthesia].

    Science.gov (United States)

    Becke, K

    2014-07-01

    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia.

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help diagnose childhood disorders that are congenital (present at birth) or that develop during childhood. Physicians use nuclear medicine imaging to ...

  13. Pediatric Urinary Tract Infection

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and Bowel Why is it important to begin urologic care in infancy and ...

  14. Pediatric Nephrolithiasis: A Review.

    Science.gov (United States)

    Miah, Tayaba; Kamat, Deepak

    2017-06-01

    The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. Computed tomography (CT) is the gold standard for diagnosis; however, because of radiation exposure associated with a CT scan, ultrasonography is also an accepted modality for the diagnosis. Extensive metabolic evaluation is important to rule out an underlying metabolic disorder. Urinary decompression, medical expulsion therapy, and surgical interventions such as ureteroscopy and extracorporeal shockwave lithotripsy are some of the options available for treating pediatric nephrolithiasis. [Pediatr Ann. 2017;46(6):e242-e244.]. Copyright 2017, SLACK Incorporated.

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts of radioactive materials called radiotracers, a special ... is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine ...

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... imaging techniques. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... To locate a medical imaging or radiation oncology provider in your community, you can search the ACR- ...

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ... at birth) or that develop during childhood. Physicians use nuclear medicine imaging to evaluate organ systems, including ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... child is taking as well as vitamins and herbal supplements and if he or she has any ... What are the limitations of Children's (Pediatric) Nuclear Medicine? Nuclear medicine procedures can be time consuming. It ...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Children's (Pediatric) Nuclear Medicine? What are some common uses of the procedure? How does the nuclear medicine procedure work? What does the equipment look like? How is ...

  1. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... to Children's (Pediatric) Nuclear Medicine Sponsored by Please note RadiologyInfo.org is not a medical facility. Please ... is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of ...

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  3. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ...

  4. Causes of Pediatric Cardiomyopathy

    Science.gov (United States)

    ... inherited metabolic or congenital muscle disorder such as Noonan syndrome, Pompe disease, fatty acid oxidation defect or Barth ... where a specific chromosome is deleted or duplicated. Noonan syndrome is the most common form associated with pediatric ...

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... The teddy bear denotes child-specific content. Related Articles and Media General Nuclear Medicine Children's (Pediatric) CT ( ... About Us | Contact Us | FAQ | Privacy | Terms of Use | Links | Site Map Copyright © 2018 Radiological Society of ...

  6. Online and Certifiable Spectroscopy Courses Using Information and Communication Tools. a Model for Classrooms and Beyond

    Science.gov (United States)

    Krishnan, Mangala Sunder

    2015-06-01

    ) strategy, but with proctored and certified examination processes for large numbers in some of the above courses. I would like to present a summary of developments in these areas to help focus classroom (online and offline) learning of Molecular spectroscopy.

  7. Impact of Music in Reducing Patient Anxiety During Pediatric Ultrasound

    OpenAIRE

    Kesselman, Andrew; Bergen, Michael; Stefanov, Dimitre; Goldfisher, Rachelle; Amodio, John

    2016-01-01

    The use of noninvasive ultrasound examinations can potentially result in significant anxiety in the pediatric population. The purpose of this study was to assess the influence of music during pediatric ultrasound examinations to reduce anxiety measured by heart rate. A total of 44 patients were recruited; 21 controls and 23 experimental. Each participant was randomized to either music or no music (control) after parental consent was obtained. Pulse oximeters were used to monitor heart rate at...

  8. The pediatric knee.

    Science.gov (United States)

    Orth, Robert C

    2013-03-01

    Knee pain is a common problem in children and adolescents, and MRI of the knee is the most commonly performed pediatric cross-sectional musculoskeletal imaging exam. The purpose of this pictorial review is to highlight differences between adult and pediatric knee imaging with an emphasis on normal developmental variants, injury and disease patterns unique to children and adolescents, and differences in response and presentation to conditions affecting both adults and children.

  9. 19 CFR 10.57 - Certified seed potatoes, and seed corn or maize.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Certified seed potatoes, and seed corn or maize... Provisions Potatoes, Corn, Or Maize § 10.57 Certified seed potatoes, and seed corn or maize. Claim for classification as seed potatoes under subheading 0701.10.00, as seed corn (maize) under subheading 1005.10...

  10. Recognising and Certifying Lifelong Skills: Impact on Labour Market Integration of the Unemployed

    Science.gov (United States)

    Fernandes, Pedro Afonso

    2009-01-01

    The process for recognising, validating and certifying (RVC) non-formally or informally acquired lifelong learning, launched in 2000, is now part of mainstream education and training policies in Portugal. This article aims to determine how much the labour-market behaviour of the RVC-certified unemployed differs from that of other unemployed…

  11. 13 CFR 124.1003 - How does a firm become certified as an SDB?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false How does a firm become certified... Protests Relating to Federal Small Disadvantaged Business Programs § 124.1003 How does a firm become certified as an SDB? (a) All firms that are current Participants in SBA's 8(a) BD program are automatically...

  12. 17 CFR 274.128 - Form N-CSR, certified shareholder report.

    Science.gov (United States)

    2010-04-01

    ... Form N-CSR, certified shareholder report. This form shall be used by registered management investment... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form N-CSR, certified... Form N-CSR, see the List of CFR Sections Affected, which appears in the Finding Aids section of the...

  13. 17 CFR 249.331 - Form N-CSR, certified shareholder report.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form N-CSR, certified... Required Under Sections 13 and 15(d) of the Securities Exchange Act of 1934 § 249.331 Form N-CSR, certified shareholder report. This form shall be used by registered management investment companies to file reports...

  14. Assessment of Readiness to Participate in Distance Learning of the Certified Florida Behavioral Workforce

    Science.gov (United States)

    Baston, George R.

    2011-01-01

    This research study explored perceptions of readiness to participate in distance learning among the certified behavioral workforce in Florida. The study sought to determine if there were significant differences in perception of readiness to participate in distance learning between certified behavioral health professionals at the administrator…

  15. 48 CFR 15.407-1 - Defective certified cost or pricing data.

    Science.gov (United States)

    2010-10-01

    ...—Modifications. The clauses give the Government the right to a price adjustment for defects in certified cost or... recognize that the Government's right to a price adjustment is not affected by any of the following... certified, cost or pricing data, the Government has the right, under the clauses at 52.215-10, Price...

  16. 48 CFR 52.215-12 - Subcontractor Certified Cost or Pricing Data.

    Science.gov (United States)

    2010-10-01

    ... Cost or Pricing Data. 52.215-12 Section 52.215-12 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-12 Subcontractor Certified Cost or Pricing Data. As prescribed in 15.408(d), insert the following clause: Subcontractor Certified Cost or Pricing Data (OCT 2010) (a) Before awarding...

  17. 48 CFR 52.215-10 - Price Reduction for Defective Certified Cost or Pricing Data.

    Science.gov (United States)

    2010-10-01

    ... Defective Certified Cost or Pricing Data. 52.215-10 Section 52.215-10 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.215-10 Price Reduction for Defective Certified Cost or Pricing Data... or Pricing Data (OCT 2010) (a) If any price, including profit or fee, negotiated in connection with...

  18. 48 CFR 15.403-3 - Requiring data other than certified cost or pricing data.

    Science.gov (United States)

    2010-10-01

    ... certified cost or pricing data. 15.403-3 Section 15.403-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-3 Requiring data other than certified cost or pricing data. (a)(1) In those acquisitions that do...

  19. 30 CFR 18.80 - Approval of machines assembled with certified or explosion-proof components.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Approval of machines assembled with certified... ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Machines Assembled With Certified or Explosion-Proof Components, Field...

  20. 19 CFR 115.16 - Notification of Certifying Authority by manufacturer.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Notification of Certifying Authority by manufacturer. 115.16 Section 115.16 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND... INTERNATIONAL CUSTOMS CONVENTIONS Administration § 115.16 Notification of Certifying Authority by manufacturer...

  1. 7 CFR 301.75-17 - Funds for the replacement of certified citrus nursery stock.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Funds for the replacement of certified citrus nursery... nursery stock. Subject to the availability of appropriated funds, a commercial citrus nursery may be eligible to receive funds to replace certified citrus nursery stock in accordance with the provisions of...

  2. 20 CFR 416.804 - Certified copy in lieu of original.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Certified copy in lieu of original. 416.804... AGED, BLIND, AND DISABLED Determination of Age § 416.804 Certified copy in lieu of original. In lieu of the original of any record, except a Bible or other family record, there may be submitted as evidence...

  3. Leadership trends in academic pediatric departments.

    Science.gov (United States)

    Stapleton, F Bruder; Jones, Douglas; Fiser, Debra H

    2005-08-01

    To examine recent turnover trends among chairs of academic pediatric departments. Membership data for the 150 institutions represented by the Association of Medical School Pediatric Department Chairs in the United States, Canada, and Puerto Rico were reviewed for the time period of 1993-2003. From 1993 to 2003, 278 individuals (250 men and 28 women) held the position of chair. The mean time of service was 5.58 +/- 3.2 years (median: 5 years). Twenty-nine individuals served continuously as chairs during the 11-year period. Seventy-two individuals served as interim chairs. Twenty-eight women were appointed either chairs or interim chairs during the 11 years. The number of female chairs decreased from 13 in 1993 to 11 in 2003. Female chairs were in office 3.42 +/- 2.72 years. A total of 123 departments had a change in leadership, with a mean annual turnover rate of 17% (range: 4.6-24%). Three departments had 5 different leaders as either interim chair or chair and 6 departments had 4 different leaders during this time period. Neonatology was the most common subspecialty represented by recent pediatric chairs, although nephrology was the subspecialty with the greatest proportional representation. Departments of pediatrics have high turnover of leadership. Women, in particular, serve for relatively short periods and appear to be under-represented within the leadership of pediatrics. Efforts should be made to ascertain personal qualities that allow sustained leadership and to attract more women into leadership positions.

  4. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.

    2006-01-01

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  5. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Gordon, I.

    1998-01-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics

  6. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  7. Aortic Involvement in Pediatric Marfan syndrome: A Review.

    Science.gov (United States)

    Ekhomu, Omonigho; Naheed, Zahra J

    2015-06-01

    Outlining specific protocols for the management of pediatric patients with Marfan syndrome has been challenging. This is mostly due to a dearth of clinical studies performed in pediatric patients. In Marfan syndrome, the major sources of morbidity and mortality relate to the cardiovascular system. In this review, we focus on aortic involvement seen in pediatric patients with Marfan syndrome, ranging from aortic dilatation to aortic rupture and heart failure. We discuss the histological, morphological, and pathogenetic basis of the cardiac manifestations seen in pediatric Marfan syndrome and use a specific case to depict our experienced range of cardiovascular manifestations. The survival for patients with Marfan syndrome may approach the expected survival for non-affected patients, with optimal management. With this potentiality in mind, we explore possible and actual management considerations for pediatric Marfan syndrome, examining both medical and surgical therapy modalities that can make the possibility of improved survival a reality.

  8. Farmers’ decision analysis to select certified palm oil seedlings in Lampung, Indonesia

    Science.gov (United States)

    Utoyo, Bambang; Yolandika, Clara

    2018-03-01

    This research aimed to analyse (1) decission making process of certified and uncertified palm oil seedlings and (2) factors that influence farmer decision to select certified and uncertified palm oil seedlings. This research was conducted in some districts in Lampung, such as Mesuji, Central Lampung, Tulang Bawang, North Lampung, Way Kanan and South Lampung. The respondents consisted of 30 farmers using certified seeds and 30 farmers using uncertified seeds. The study was conducted from January to May 2017. In addition, factors that influence farmer decision was analysed by logistic regression model. The results showed that decision making on the use of certified or uncertified palm seeds by farmers through the stages: introduction of problems or needs, searching of information, alternative evaluation, purchasing decisions, and post-purchase behaviour. Factors that significantly influence farmer's decision to use certified seeds were land area, seeds price, external influenced, and farmers’ perception.

  9. The role of a child life specialist in a pediatric radiology department

    International Nuclear Information System (INIS)

    McGee, Kristen

    2003-01-01

    Child life programming is predominantly developed in inpatient areas throughout major pediatric hospitals. However, the trend toward outpatient services has increased the need for facilities to develop child life positions to assist in the teaching demands of patients and families coming in for routine hospital visits. Since radiology is often the first experience for families, but not the last, it is essential to involve them in a positive experience. Imaging facilities serving pediatric patients are currently developing or considering child life programs. A certified child life specialist (CCLS) is committed to developing programming that enhances the child's understanding and involvement in their medical experience. This paper provides an outline of the responsibilities and areas of expertise of the CCLS in a pediatric radiology department. The reviewed program is based on, but not limited, to fluoroscopy. (orig.)

  10. The Anesthesiologist-Informatician: A Survey of Physicians Board-Certified in Both Anesthesiology and Clinical Informatics.

    Science.gov (United States)

    Poterack, Karl A; Epstein, Richard H; Dexter, Franklin

    2018-03-12

    All 36 physicians board-certified in both anesthesiology and clinical informatics as of January 1, 2016, were surveyed via e-mail, with 26 responding. Although most (25/26) generally expressed satisfaction with the clinical informatics boards, and view informatics expertise as important to anesthesiology, most (24/26) thought it unlikely or highly unlikely that substantial numbers of anesthesiology residents would pursue clinical informatics fellowships. Anesthesiologists wishing to qualify for the clinical informatics board examination under the practice pathway need to devote a substantive amount of worktime to informatics. There currently are options outside of formal fellowship training to acquire the knowledge to pass.

  11. Infant outcomes of certified nurse midwife attended home births: United States 2000 to 2004.

    Science.gov (United States)

    Malloy, M H

    2010-09-01

    Home births attended by certified nurse midwives (CNMs) make up an extremely small proportion of births in the United States (home deliveries compared with certified nurse midwife in-hospital deliveries in the United States as measured by the risk of adverse infant outcomes among women with term, singleton, vaginal deliveries. United States linked birth and infant death files for the years 2000 to 2004 were used for the analysis. Adverse neonatal outcomes including death were determined by place of birth and attendant type for in-hospital certified nurse midwife, in-hospital 'other' midwife, home certified nurse midwife, home 'other' midwife, and free-standing birth center certified nurse midwife deliveries. For the 5-year period there were 1 237 129 in-hospital certified nurse midwife attended births; 17 389 in-hospital 'other' midwife attended births; 13 529 home certified nurse midwife attended births; 42 375 home 'other' midwife attended births; and 25 319 birthing center certified nurse midwife attended births. The neonatal mortality rate per 1000 live births for each of these categories was, respectively, 0.5 (deaths=614), 0.4 (deaths=7), 1.0 (deaths=14), 1.8 (deaths=75), and 0.6 (deaths=16). The adjusted odds ratio (95% confidence interval) for neonatal mortality for home certified nurse midwife attended deliveries vs in-hospital certified nurse midwife attended deliveries was 2.02 (1.18, 3.45). Deliveries at home attended by CNMs and 'other midwives' were associated with higher risks for mortality than deliveries in-hospital by CNMs.

  12. Certification systems for sustainable neighbourhoods: What do they really certify?

    Energy Technology Data Exchange (ETDEWEB)

    Wangel, Josefin, E-mail: josefin.wangel@abe.kth.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden); Wallhagen, Marita, E-mail: marita.wallhagen@hig.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden); Department of Building, Energy and Environmental Engineering, University of Gävle, SE-801 76 Gävle (Sweden); Malmqvist, Tove, E-mail: tove.malmqvist@abe.kth.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden); Finnveden, Göran, E-mail: goran.finnveden@abe.kth.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden)

    2016-01-15

    Certification systems for sustainable neighbourhoods started to emerge around a decade ago. This study analysed the content, structure, weighting and indicators of two established certification systems for sustainable urban development – BREEAM Communities and LEED for Neighborhood Development. Several limitations of these systems were identified: both have a bias for procedure and feature indicators over indicators that assess actual performance; performance demands are set according to a relative understanding of sustainable development; the focus is on internal sustainability, while upstream and downstream impacts of construction are disregarded; the number and distribution of mandatory issues do not cover essential sustainability aspects; and the disproportionately large number of non-mandatory issues makes benchmarking difficult and signals that sustainability aspects are exchangeable. Altogether, this means that an area can be certified without being sustainable. Moreover, the lack of continuous development of certification requirements in the systems means that they risk exerting a conservative effect on urban development, rather than pushing it forward. - Highlights: • BREEAM-C and LEED-ND were analysed in terms of content and structure. • Specific attention was given to the type of indicators used for showing compliance. • In both systems procedure and feature indicators dominate over performance indicators. • Several other limitations of these certification systems were also identified. • Altogether the limitations imply that a certificate does not warrant sustainability.

  13. Towards a sustainably certifiable futures contract for biofuels

    International Nuclear Information System (INIS)

    Mathews, John A.

    2008-01-01

    How are biofuels to be certified as produced in a sustainable and responsible fashion? In the global debate over this issue, one party to the proceedings seems rarely to be mentioned-namely the commodities exchanges through which a global biofuels market is being created. In this contribution, I propose a solution to the problem of sustainability certification through a biofuels futures contract equipped with 'proof of origin' documentation. The proposal does not call for any radical break with current practice, extending existing certification procedures with a requirement for the vendor to provide documentation, probably in barcoded form, of the history of the biofuel offered for sale, including plantation and biorefinery where the biofuel was produced and subsequent blendings it may have undergone. The proposal is thus compatible with the blending practices of large global traders, whose activities are the source of the difficulties of other approaches to certification. It is argued that if such a sustainable futures contract for bioethanol (in the first instance) were to be introduced, then it would likely trade at a premium and become the primary vehicle for North-South trade in biofuels

  14. Burnout Risk and Protection Factors in Certified Nursing Aides.

    Science.gov (United States)

    Molero Jurado, María Del Mar; Pérez-Fuentes, María Del Carmen; Gázquez Linares, José Jesús Gázquez; Simón Márquez, María Del Mar; Martos Martínez, África

    2018-05-30

    Studies have found a higher risk of burnout among employees in the healthcare sector. As such, this study focused on Certified Nursing Aides (CNAs) who have shown a high prevalence of burnout and are therefore considered an especially vulnerable group. The objective of this study was to identify the relationships between some organizational, personal, and sociodemographic factors and burnout. The final study sample included 278 working CNAs with a mean age of 40.88 (SD = 9.41). To compile the data, an ad hoc questionnaire was used to collect sociodemographic information. To collect professional and employment information, we used the Brief Emotional Intelligence Inventory for Adults, the Brief Questionnaire on Perceived Social Support, and the General Self-Efficacy Scale. The results showed that Burnout Syndrome is significantly and negatively related to all the emotional intelligence factors, self-efficacy, and perceived social support. The risk of burnout is higher in younger persons and in permanently employed professionals. General self-efficacy and stress management act as protective factors against the likelihood of burnout. This study suggests that organizations should urge coaching and transformational leadership training programs to promote the wellbeing and organizational commitment of workers.

  15. Burnout Risk and Protection Factors in Certified Nursing Aides

    Directory of Open Access Journals (Sweden)

    María del Mar Molero Jurado

    2018-05-01

    Full Text Available Studies have found a higher risk of burnout among employees in the healthcare sector. As such, this study focused on Certified Nursing Aides (CNAs who have shown a high prevalence of burnout and are therefore considered an especially vulnerable group. The objective of this study was to identify the relationships between some organizational, personal, and sociodemographic factors and burnout. The final study sample included 278 working CNAs with a mean age of 40.88 (SD = 9.41. To compile the data, an ad hoc questionnaire was used to collect sociodemographic information. To collect professional and employment information, we used the Brief Emotional Intelligence Inventory for Adults, the Brief Questionnaire on Perceived Social Support, and the General Self-Efficacy Scale. The results showed that Burnout Syndrome is significantly and negatively related to all the emotional intelligence factors, self-efficacy, and perceived social support. The risk of burnout is higher in younger persons and in permanently employed professionals. General self-efficacy and stress management act as protective factors against the likelihood of burnout. This study suggests that organizations should urge coaching and transformational leadership training programs to promote the wellbeing and organizational commitment of workers.

  16. Towards a Certified Lightweight Array Bound Checker for Java Bytecode

    Science.gov (United States)

    Pichardie, David

    2009-01-01

    Dynamic array bound checks are crucial elements for the security of a Java Virtual Machines. These dynamic checks are however expensive and several static analysis techniques have been proposed to eliminate explicit bounds checks. Such analyses require advanced numerical and symbolic manipulations that 1) penalize bytecode loading or dynamic compilation, 2) complexify the trusted computing base. Following the Foundational Proof Carrying Code methodology, our goal is to provide a lightweight bytecode verifier for eliminating array bound checks that is both efficient and trustable. In this work, we define a generic relational program analysis for an imperative, stackoriented byte code language with procedures, arrays and global variables and instantiate it with a relational abstract domain as polyhedra. The analysis has automatic inference of loop invariants and method pre-/post-conditions, and efficient checking of analysis results by a simple checker. Invariants, which can be large, can be specialized for proving a safety policy using an automatic pruning technique which reduces their size. The result of the analysis can be checked efficiently by annotating the program with parts of the invariant together with certificates of polyhedral inclusions. The resulting checker is sufficiently simple to be entirely certified within the Coq proof assistant for a simple fragment of the Java bytecode language. During the talk, we will also report on our ongoing effort to scale this approach for the full sequential JVM.

  17. Neutron activation analysis of certified samples by the absolute method

    Science.gov (United States)

    Kadem, F.; Belouadah, N.; Idiri, Z.

    2015-07-01

    The nuclear reactions analysis technique is mainly based on the relative method or the use of activation cross sections. In order to validate nuclear data for the calculated cross section evaluated from systematic studies, we used the neutron activation analysis technique (NAA) to determine the various constituent concentrations of certified samples for animal blood, milk and hay. In this analysis, the absolute method is used. The neutron activation technique involves irradiating the sample and subsequently performing a measurement of the activity of the sample. The fundamental equation of the activation connects several physical parameters including the cross section that is essential for the quantitative determination of the different elements composing the sample without resorting to the use of standard sample. Called the absolute method, it allows a measurement as accurate as the relative method. The results obtained by the absolute method showed that the values are as precise as the relative method requiring the use of standard sample for each element to be quantified.

  18. Mediated definite delegation - Certified Grid jobs in ALICE and beyond

    Science.gov (United States)

    Schreiner, Steffen; Grigoras, Costin; Litmaath, Maarten; Betev, Latchezar; Buchmann, Johannes

    2012-12-01

    Grid computing infrastructures need to provide traceability and accounting of their users’ activity and protection against misuse and privilege escalation, where the delegation of privileges in the course of a job submission is a key concern. This work describes an improved handling of Multi-user Grid Jobs in the ALICE Grid Services. A security analysis of the ALICE Grid job model is presented with derived security objectives, followed by a discussion of existing approaches of unrestricted delegation based on X.509 proxy certificates and the Grid middleware gLExec. Unrestricted delegation has severe security consequences and limitations, most importantly allowing for identity theft and forgery of jobs and data. These limitations are discussed and formulated, both in general and with respect to an adoption in line with Multi-user Grid Jobs. A new general model of mediated definite delegation is developed, allowing a broker to dynamically process and assign Grid jobs to agents while providing strong accountability and long-term traceability. A prototype implementation allowing for fully certified Grid jobs is presented as well as a potential interaction with gLExec. The achieved improvements regarding system security, malicious job exploitation, identity protection, and accountability are emphasized, including a discussion of non-repudiation in the face of malicious Grid jobs.

  19. Mediated definite delegation - Certified Grid jobs in ALICE and beyond

    International Nuclear Information System (INIS)

    Schreiner, Steffen; Buchmann, Johannes; Grigoras, Costin; Litmaath, Maarten; Betev, Latchezar

    2012-01-01

    Grid computing infrastructures need to provide traceability and accounting of their users’ activity and protection against misuse and privilege escalation, where the delegation of privileges in the course of a job submission is a key concern. This work describes an improved handling of Multi-user Grid Jobs in the ALICE Grid Services. A security analysis of the ALICE Grid job model is presented with derived security objectives, followed by a discussion of existing approaches of unrestricted delegation based on X.509 proxy certificates and the Grid middleware gLExec. Unrestricted delegation has severe security consequences and limitations, most importantly allowing for identity theft and forgery of jobs and data. These limitations are discussed and formulated, both in general and with respect to an adoption in line with Multi-user Grid Jobs. A new general model of mediated definite delegation is developed, allowing a broker to dynamically process and assign Grid jobs to agents while providing strong accountability and long-term traceability. A prototype implementation allowing for fully certified Grid jobs is presented as well as a potential interaction with gLExec. The achieved improvements regarding system security, malicious job exploitation, identity protection, and accountability are emphasized, including a discussion of non-repudiation in the face of malicious Grid jobs.

  20. Proposal for Certifying Expandable Planetary Surface Habitation Structures

    Science.gov (United States)

    Dorsey, John T.

    2011-01-01

    A factor-of-safety (FS) of 4.0 is currently used to design habitation structures made from structural soft goods. This approach is inconsistent with using a FS of 2.0 for metallic and polymeric composite pressure vessels as well as soft good structures such as space suits and parachutes. This inconsistency arises by using the FS to improperly account for the unknown effects of a variety of environmental and loading uncertainties. Using a 4.0 FS not only results in additional structural mass, it also makes it difficult to gain insight into the limitations of the material and/or product form and thus, it becomes difficult to make improvements. In order to bring consistency to the design and certification of expandable habitat structures, the approach used by the Federal Aviation Administration (FAA) to certify polymeric composite aircraft structures is used as a model and point of departure. A draft certification plan for Expandable Habitat Structures is developed in this paper and offered as an option for placing habitats made from soft goods on an equal footing with other structural implementations.

  1. Certified safe farm: identifying and removing hazards on the farm.

    Science.gov (United States)

    Rautiainen, R H; Grafft, L J; Kline, A K; Madsen, M D; Lange, J L; Donham, K J

    2010-04-01

    This article describes the development of the Certified Safe Farm (CSF) on-farm safety review tools, characterizes the safety improvements among participating farms during the study period, and evaluates differences in background variables between low and high scoring farms. Average farm review scores on 185 study farms improved from 82 to 96 during the five-year study (0-100 scale, 85 required for CSF certification). A total of 1292 safety improvements were reported at an estimated cost of $650 per farm. A wide range of improvements were made, including adding 9 rollover protective structures (ROPS), 59 power take-off (PTO) master shields, and 207 slow-moving vehicle (SMV) emblems; improving lighting on 72 machines: placing 171 warning decals on machinery; shielding 77 moving parts; locking up 17 chemical storage areas, adding 83 lockout/tagout improvements; and making general housekeeping upgrades in 62 farm buildings. The local, trained farm reviewers and the CSF review process overall were well received by participating farmers. In addition to our earlier findings where higher farm review scores were associated with lower self-reported health outcome costs, we found that those with higher farm work hours, younger age, pork production in confinement, beef production, poultry production, and reported exposure to agrichemicals had higher farm review scores than those who did not have these characteristics. Overall, the farm review process functioned as expected. encouraging physical improvements in the farm environment, and contributing to the multi-faceted CSF intervention program.

  2. Certification systems for sustainable neighbourhoods: What do they really certify?

    International Nuclear Information System (INIS)

    Wangel, Josefin; Wallhagen, Marita; Malmqvist, Tove; Finnveden, Göran

    2016-01-01

    Certification systems for sustainable neighbourhoods started to emerge around a decade ago. This study analysed the content, structure, weighting and indicators of two established certification systems for sustainable urban development – BREEAM Communities and LEED for Neighborhood Development. Several limitations of these systems were identified: both have a bias for procedure and feature indicators over indicators that assess actual performance; performance demands are set according to a relative understanding of sustainable development; the focus is on internal sustainability, while upstream and downstream impacts of construction are disregarded; the number and distribution of mandatory issues do not cover essential sustainability aspects; and the disproportionately large number of non-mandatory issues makes benchmarking difficult and signals that sustainability aspects are exchangeable. Altogether, this means that an area can be certified without being sustainable. Moreover, the lack of continuous development of certification requirements in the systems means that they risk exerting a conservative effect on urban development, rather than pushing it forward. - Highlights: • BREEAM-C and LEED-ND were analysed in terms of content and structure. • Specific attention was given to the type of indicators used for showing compliance. • In both systems procedure and feature indicators dominate over performance indicators. • Several other limitations of these certification systems were also identified. • Altogether the limitations imply that a certificate does not warrant sustainability.

  3. Professional profile of pediatric intensivists in Rio de Janeiro, southeastern Brazil.

    Science.gov (United States)

    Lacerda, Jandra Corrêa de; Barbosa, Arnaldo Prata; Cunha, Antonio José Ledo Alves da

    2011-12-01

    This study described the sociodemographic profile and professional qualifications of pediatric intensive care physicians in the State of Rio de Janeiro (RJ), southeastern Brazil. This investigation was an observational, cross-sectional and descriptive study that was conducted in neonatal, pediatric and mixed intensive care units in the State of Rio de Janeiro. Physicians working in the participating intensive care units voluntarily completed a semistructured and anonymous questionnaire. Questionnaires that were not returned within 30 days were considered lost, and questionnaires with less than 75% questions completed were excluded. The differences in neonatal and pediatric intensive care physicians' medical training were compared using the Chi-squared test with a 5% significance level. A total of 410 physicians were included in this study: 84% female, 48% between 30 and 39 years old and 45% with monthly incomes between US $1,700 to 2,700. Forty percent of these physicians worked exclusively in this specialty, and 72% worked in more than one intensive care unit. Only 50% of the participants had received specific training (either medical residency or specialization) in neonatology, and only 33% were board-certified specialists in this area. Only 27% of the physicians had received specific training in pediatric intensive care medicine, and only 17% were board-certified specialists (p professional activity; 49% were dissatisfied due to working conditions, 23% due to low incomes and 18% due to training-related issues. These results suggested that the medical qualifications of neonatal and pediatric intensive care physicians in the State of Rio de Janeiro, Brazil are inadequate, especially in pediatric intensive care medicine. A high level of dissatisfaction was reported, which may jeopardize the quality of medical assistance that is provided by these professionals.

  4. Simulation in pediatric anesthesiology.

    Science.gov (United States)

    Fehr, James J; Honkanen, Anita; Murray, David J

    2012-10-01

    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  5. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... the exam. MRI scanners are air-conditioned and well-lit. Music may be played through the headphones ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  6. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  7. NCI Pediatric Preclinical Testing Consortium

    Science.gov (United States)

    NCI has awarded grants to five research teams to participate in its Pediatric Preclinical Testing Consortium, which is intended to help to prioritize which agents to pursue in pediatric clinical trials.

  8. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... need to be returned to the transducer for analysis. top of page This page was reviewed on ... using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric ...

  9. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... in CT scans should have no immediate side effects. Risks The risk of serious allergic reaction to ... Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific ...

  10. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... your child. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... A child being prepared for a CT scan. View full size with caption Pediatric Content Some imaging ...

  11. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses special ... the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  12. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Imaging? Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique ... with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ...

  13. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) ... are the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a ...

  14. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... MRI) exam. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Catheter Angiography Magnetic Resonance, ...

  15. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... scans, your doctor may ask you to withhold food and drink for several hours before your child's ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  16. Pediatric psoriasis: an update

    Directory of Open Access Journals (Sweden)

    Nanette B Silverberg

    2009-10-01

    Full Text Available Nanette B SilverbergPediatric and Adolescent Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, NY, USAAbstract: Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. Keywords: psoriasis, autoimmunity, Streptococcus, etanercept, calcipotriene, topical corticosteroids

  17. Geographic proximity to specialized pediatric neurosurgical care in the contiguous United States.

    Science.gov (United States)

    Ahmed, Abdul-Kareem; Duhaime, Ann-Christine; Smith, Timothy R

    2018-04-01

    OBJECTIVE Absent from an analysis of supply is consideration of the geographic distribution of pediatric neurosurgeons. Several patient socioeconomic metrics are known to be associated with outcome in pediatric neurosurgical diseases, such as hydrocephalus. The purpose of this study was to determine current geographic proximity to pediatric neurosurgical care using professional society databases. This study also sought to establish how socioeconomic factors are related to distance to care, using federal government-collected data. METHODS A list of currently practicing American Board of Pediatric Neurological Surgery (ABPNS)-certified neurosurgeons was compiled (ABPNS group). A separate list of practicing members of the Joint Pediatric Section (JPS) of the American Association of Neurological Surgeons/Congress of Neurological Surgeons was prepared (JPS group). Current primary practice locations were collected from each professional society database for each ABPNS or JPS neurosurgeon and were charted using ArcGIS mapping software (ESRI, version 10.3) on a United States Census Bureau map. The straight distance from the centroid of each zip code tabulation area (ZCTA) to the nearest neurosurgeon was determined by group type of neurosurgeon (ABPNS vs ABPNS + JPS). ZCTA-level data on demographic and socioeconomic factors were acquired from the American Community Survey, including data in children and young adults (0-18 or 0-24 years old) and the general population. These data were compared by distance to care and by groups of neurosurgeons (Pearson's chi-square analysis; the threshold of significance was set at 0.05). RESULTS Three hundred fifty-five practicing neurosurgeons providing pediatric care were located, of whom 215 surgeons were certified by the ABPNS and 140 were JPS members only. The analysis showed that 1 pediatric neurosurgeon is in practice for every 289,799 persons up to the age of 24 years. The average distance between a ZCTA and the nearest pediatric

  18. PET imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Shulkin, B.L.

    2004-01-01

    High-quality PET imaging of pediatric patients is challenging and requires attention to issues commonly encountered in the practice of pediatric nuclear medicine, but uncommon to the imaging of adult patients. These include intravenous access, fasting, sedation, consent, and clearance of activity from the urinary tract. This paper discusses some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients. (orig.)

  19. Pediatric Electrocardiographic Imaging (ECGI) Applications

    Science.gov (United States)

    Silva, Jennifer N. A.

    2014-01-01

    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  20. Personal and Environmental Characteristics Predicting Burnout Among Certified Athletic Trainers at National Collegiate Athletic Association Institutions

    Science.gov (United States)

    Kania, Michelle L; Meyer, Barbara B; Ebersole, Kyle T

    2009-01-01

    Context: Recent research in the health care professions has shown that specific personal and environmental characteristics can predict burnout, which is a negative coping strategy related to stressful situations. Burnout has been shown to result in physiologic (eg, headaches, difficulty sleeping, poor appetite), psychological (eg, increased negative self-talk, depression, difficulty in interpersonal relationships), and behavioral (eg, diminished care, increased absenteeism, attrition) symptoms. Objective: To examine the relationship between selected personal and environmental characteristics and burnout among certified athletic trainers (ATs). Design: Cross-sectional survey. Setting: A demographic survey that was designed for this study and the Maslach Burnout Inventory–Human Services Survey. Patients or Other Participants: A total of 206 ATs employed at National Collegiate Athletic Association (NCAA) institutions as clinical ATs volunteered. Main Outcome Measure(s): We assessed personal and environmental characteristics of ATs with the demographic survey and measured burnout using the Maslach Burnout Inventory–Human Services Survey. Multiple regression analyses were performed to examine relationships between specific personal and environmental characteristics and each of the 3 subscales of burnout (emotional exhaustion, depersonalization, personal accomplishment). Results: Most ATs we surveyed experienced low to average levels of burnout. Personal characteristics predicted 45.5% of the variance in emotional exhaustion (P teachers. The results also support the Cognitive-Affective Model of Athletic Burnout proposed by Smith. Finally, these results indicate new areas of concentration for burnout research and professional practice. PMID:19180220

  1. Nontraditional roles for certified pharmacy technicians in a pharmaceutical company.

    Science.gov (United States)

    Fung, Stacey M; Gilmour, Christine; McCracken, David; Shane, Korban; Matsuura, Gary

    2006-01-01

    To describe nontraditional roles for Certified Pharmacy Technicians (CPhTs) within pharmaceutical industry. Drug information department within a large biotechnology/pharmaceutical organization. The Medical Communications department within Genentech uses a skills-mix staffing model in which employees with varying educational and training backgrounds work as a team on meeting the informational needs of consumers and health professionals who contact the company. One position within the department is that of Medical Communications Associate, responsible primarily for managing product inquiries. Medical Communications Associates have degrees in life sciences or an equivalent combination of education and experience, including a minimum of 2 years of related experience in the health care industry. Currently, four of the seven Medical Communications Associates in the department are CPhTs. Not applicable. Ability to recruit CPhTs for Medical Communications Associate positions, and job satisfaction of those hired into these positions. Critical basic skills needed for the Medical Communications Associate position include strong computer literacy, ability to multitask, and ability to work in an environment with frequent interruptions. Strong oral and written communications skills, customer service skills, ability to deal with stressful situations, product-specific knowledge, ability to work on a daily basis with Medical Communications Pharmacists, and knowledge of medical terminology are also important. The skills set of CPhTs matches these requirements, as evidenced by the experiences of the four staff members who have worked in the department for a total of 17 person-years. This nontraditional role for CPhTs can be rewarding and beneficial to all, affording an unique opportunity within the pharmaceutical industry. The skill set and experience of CPhTs can be used in the nontraditional pharmacy practice setting of drug information.

  2. Medically certified sickness absence among health care workers.

    Science.gov (United States)

    Khawaja, Rajab Ali; Sikander, Raheel; Khawaja, Asad Ali; Jareno, Rechel Joy Macadaan; Halepota, Aurangzeb Taj

    2012-09-01

    To compare the days and spells of sickness absence among males versus females and Saudi nationals versus expatriate employees of King Khalid University Hospital, Riyadh, and to identify the cause of sickness absence. The cross-sectional, descriptive study comprised 3117 King Khalid University Hospital employees. Records of physician-certified sickness absence from January 1 to June 30, 2009, were obtained from the employee health clinic's register. Absence rate, frequency, duration and severity were assessed and compared between genders and nationalities, and causes were noted. SPSS version 16 and student's t test were used for statistical analyses and comparison. A total of 377 (12.1 %) employees had 416 spells of sickness absence with 639 sick-off days (mean: 1.54 +/- 0.85). The probability of sickness absence was higher among Saudi (OR=1.33) and female (OR=1.39) employees. The association of sickness absence was not found among the absentees with either gender (p= 0.335) or nationality (p = 0.086). Almost all spells of sick-off days were of short duration. Longer spells were mainly due to chicken pox which was found to be more among the expatriates. Heavy absenteeism was found only among the Saudis. The most common causes of sickness absence were acute upper respiratory infection, diseases of musculoskeletal system and the digestive system. The rate, frequency and duration of absence due to sickness in the study were higher among Saudi and female employees. The rate of absence, with passage of time, has increased significantly among Saudi nationals.

  3. Sedation and Monitoring in the Pediatric Patient during Gastrointestinal Endoscopy.

    Science.gov (United States)

    Chung, Hyun Kee; Lightdale, Jenifer R

    2016-07-01

    Sedation is a fundamental component of pediatric gastrointestinal procedures. The 2 main types of sedation for pediatric endoscopy remain general anesthesia and procedural sedation. Although anesthesiologist-administered sedation protocols are more common, there is no ideal regimen for endoscopy in children. This article discusses specific levels of sedation for endoscopy as well as various regimens that can be used to achieve each. Risks and considerations that may be specific to performing gastrointestinal procedures in children are reviewed. Finally, potential future directions for sedation and monitoring that may change the practice of pediatric gastroenterology and ultimately patient outcomes are examined. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Children's (Pediatric) Magnetic Resonance Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  5. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  6. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging ( ... the limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a ...

  7. Pediatric nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  8. Sleeping beauties in pediatrics.

    Science.gov (United States)

    Završnik, Jernej; Kokol, Peter

    2016-10-01

    Sleeping beauties (SBs) in science have been known for few decades; however, it seems that only recently have they become popular. An SB is a publication that "sleeps" for a long time and then almost suddenly awakes and becomes highly cited. SBs present interesting findings in science. Pediatrics research literature has not yet been analyzed for their presence, and 5 pediatrics SBs were discovered in this research. Their prevalence was approximately 0.011%. Some environments or periods are more "SB fertile" than others: 3 of 5 SBs were published in the journal Pediatrics, 4 originated from the United States, and 4 were published in the period from 1992 to 1993. No institutions or authors published more than 1 SB.

  9. Pediatric nuclear cardiology

    International Nuclear Information System (INIS)

    Gelfand, M.J.; Hannon, D.W.

    1987-01-01

    Nuclear cardiology methods have had less impact upon pediatric cardiology than upon adult cardiology. Most pediatric heart disease results from congenital malformations of the heart and great vessels, which is usually discovered in infancy, and is most often treated definitively in infancy or early childhood. Unfortunately, nuclear medicine techniques are limited in their spatial resolution - structures that overlie each other are separated with difficulty. As a result, nuclear cardiology is usually of limited value in the anatomic characterization of the congenital heart abnormalities. Nevertheless, it has been useful in the detection and quantification of the pathophysiologic consequences of many congenital cardiac malformations. The authors review application of nuclear medicine in pediatric cardiology, and attempt to assess each in terms of its clinical utility

  10. Pediatric nuclear medicine

    International Nuclear Information System (INIS)

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base

  11. Radiology illustrated. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology

    2014-11-01

    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  12. Development of a certified reference materials for composition of citric acid

    Directory of Open Access Journals (Sweden)

    D. H. Kulev

    2014-01-01

    Full Text Available The paper presents a summary of analyzing Technical Regulations of the Customs Union TR TC 029/2012 "Safety Requirements for Food Additives, Flavorings and Technological Processing Aids". Information on certified reference materials (RMs for composition of citric acid is provided. Certified characteristics of the RM are, on the one hand, mass fraction of the base substance and, on the other hand, mass fraction of impurities - toxic elements (lead, arsenic, cadmium, mercury. The first batches of the given RMs are produced, which are registered in the State Register of the approved types of certified reference materials GS010300-2013 and GS010143-2012.

  13. Management of pediatric radiation dose using Fuji computed radiography

    International Nuclear Information System (INIS)

    MacCutcheon, D.W.

    2004-01-01

    This paper describes the technical details of Fuji Computed Radiography (FCR) and its use as it relates to managing pediatric dose for X-ray examinations. Since its introduction in 1983, Fuji (Fuji Photo Film Co., Ltd.) has developed an extensive set of menu selections with default processing algorithms and corresponding display processing parameters modified for all pediatric exam types. Continued development of imaging plate technology, FCR reader design and image processing have all contributed to improving image quality and creating the opportunity to lower the dose required for pediatric exams. Fuji continues to advance CR and electronic imaging technologies; some of these developments, that may enable lower dose examinations for pediatric imaging in the future, are also described in this paper. (orig.)

  14. Risk in pediatric anesthesia.

    Science.gov (United States)

    Paterson, Neil; Waterhouse, Peter

    2011-08-01

    Risk in pediatric anesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with small patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of closed malpractice claims. Both minor and major morbidity occur most commonly in infants and children under three, especially those with severe co-morbidities. Knowledge of risk profiles in pediatric anesthesia is a starting point for the reduction of risk. © 2010 Blackwell Publishing Ltd.

  15. Contact Dermatitis in Pediatrics.

    Science.gov (United States)

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

    2016-08-01

    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. Copyright 2016, SLACK Incorporated.

  16. Pediatric glaucoma: current perspectives

    Directory of Open Access Journals (Sweden)

    Marchini G

    2014-05-01

    Full Text Available Giorgio Marchini, Marco Toscani, Francesca Chemello Eye Clinic, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy Abstract: “Childhood glaucoma” is a heterogeneous group of severe pediatric conditions often associated with significant visual loss and characterized by elevated intraocular pressure (IOP and optic-disk cupping. Successful IOP control is crucial but challenging and most often achieved surgically, with medical therapy playing a supportive role. There are many classifications of childhood glaucoma, but they can simply be divided into primary, in which a developmental abnormality of the anterior chamber angle only exists, and secondary, in which aqueous outflow is reduced due to independent mechanisms that secondarily impair the function of the filtration angle. The worldwide prevalence of childhood blindness ranges from 0.03% in high-income countries to 0.12% in undeveloped countries. The majority of cases do not have an identified genetic mutation and, where the mutation is known, the genes often account for only a small proportion of cases. Several pathogenetic mechanisms are known to contribute to the development of childhood glaucoma. Whatever the cause, it results in a reduced aqueous outflow at the level of the trabecular meshwork. Age of onset and magnitude of the elevated IOP largely determine the clinical manifestation the high variability of clinical manifestations. Glaucoma from any cause in a neonate and infant is characterized by the classic triad of epiphora, photophobia, and blepharospasm, and could be associated with eye enlargement (buphthalmos and Haab striae. The eye examination, usually performed under general anesthesia, includes: tonometry, anterior-segment examination, gonioscopy, corneal diameter and axial length measurement, dilated fundoscopy with optic-nerve-head evaluation. Medical therapy, considering the high frequency of side effects, is generally used as

  17. Pediatric Obesity: Looking into Treatment

    Directory of Open Access Journals (Sweden)

    Marcella Malavolti

    2009-11-01

    Full Text Available Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care practitioners as well as pediatricians with expertise in obesity treatment is necessary. Because many obese patients suffer obesity-associated cardiovascular, metabolic and other health complications that could increase the severity of obesity, it is fundamental not only to identify the child prone to obesity as early as possible, but to recognize, treat and monitor obesity-related diseases during adolescence. This short review outlines the treatment of pediatric obesity that may have applications in the primary care setting. It examines current information on eating behavior, sedentary behavior, and details studies of multidisciplinary, behavior-based, obesity treatment programs. We also report the less common and more aggressive forms of treatment, such as medication and bariatric surgery. We emphasize that health care providers have the potential to improve outcomes by performing early identification, helping families create the best possible home environment, and by providing structured guidance to obese children and their families.

  18. Trichoscopy in pediatric age group

    Directory of Open Access Journals (Sweden)

    Subrata Malakar

    2018-01-01

    Full Text Available Approach to trichology in the pediatric age group is based on the clinical expertise of the dermatologist and investigative techniques. Currently, the trichoscope is an indispensible, noninvasive tool in the diagnosis of trichological disorders. It not only highlights the subtle tricoscopic points invisible to the naked eye but also serves as a prognostic and monitoring tool in therapeutic management. Trichoscopy goes a long way in improving the diagnostic and clinical acumen of the physician. In the pediatric age group, trichoscopy deals with pattern analysis ranging from hair shaft patterns to follicular, perifollicular, and interfollicular patterns. It not only describes the key trichoscopic features of noncicatricial alopecias, cicatricial alopecias, and genetic hair shaft defects but also helps to delineate various trichological mimics from each other. For compiling data, all trichology cases presenting to a tertiary care center were examined and photographed with a Fotofinder, DermLite Foto II Pro, and DermLite DL 3N. All trichological data were analyzed, and interpretations were based on the literature available.

  19. Exploring the meaning of practicing classroom inquiry from the perspectives of National Board Certified Science Teachers

    Science.gov (United States)

    Karaman, Ayhan

    Inquiry has been one of the most prominent terms of the contemporary science education reform movement (Buck, Latta, & Leslie-Pelecky, 2007; Colburn, 2006; Settlage, 2007). Practicing classroom inquiry has maintained its central position in science education for several decades because science education reform documents promote classroom inquiry as the potential savior of science education from its current problems. Likewise, having the capabilities of teaching science through inquiry has been considered by National Board for Professional Teaching Standards [NBPTS] as one of the essential elements of being an accomplished science teacher. Successful completion of National Board Certification [NBC] assessment process involves presenting a clear evidence of enacting inquiry with students. Despite the high-profile of the word inquiry in the reform documents, the same is not true in schools (Crawford, 2007). Most of the science teachers do not embrace this type of approach in their everyday teaching practices of science (Johnson, 2006; Luera, Moyer, & Everett, 2005; Smolleck, Zembal-Saul, & Yoder, 2006; Trumbull, Scarano, & Bonney, 2006). And the specific meanings attributed to inquiry by science teachers do not necessarily match with the original intentions of science education reform documents (Matson & Parsons, 2006; Wheeler, 2000; Windschitl, 2003). Unveiling the various meanings held by science teachers is important in developing better strategies for the future success of science education reform efforts (Jones & Eick, 2007; Keys & Bryan, 2001). Due to the potential influences of National Board Certified Science Teachers [NBCSTs] on inexperienced science teachers as their mentors, examining inquiry conceptions of NBCSTs is called for. How do these accomplished practitioners understand and enact inquiry? The purpose of this dissertation research study was twofold. First, it investigated the role of NBC performance assessment process on the professional development

  20. Geographic distribution of childhood diabetes and obesity relative to the supply of pediatric endocrinologists in the United States.

    Science.gov (United States)

    Lee, Joyce M; Davis, Matthew M; Menon, Ram K; Freed, Gary L

    2008-03-01

    To determine the geographic distribution of childhood diabetes and obesity relative to the supply of US pediatric endocrinologists. Estimation of observed and "index" ratios of children with diabetes (by region and division) and obesity (body mass index >/=95th % for age and sex) (by region and state) to board-certified pediatric endocrinologists. At the national level, the ratio of children with diabetes to pediatric endocrinologists is 290:1, and the ratio of obese children to pediatric endocrinologists is 17,741:1. Ratios of children with diabetes to pediatric endocrinologists in the Midwest (370:1), South (335:1), and West (367:1) are twice as high as in the Northeast (144:1). Across states, there is up to a 19-fold difference in the observed ratios of obese children to pediatric endocrinologists. Under conditions of equitably distributed endocrinologist supply, variation across states would be mitigated considerably. The distribution of children with diabetes and obesity does not parallel the distribution of pediatric endocrinologists in the United States, due largely to geographic disparities in endocrinologist supply. Given the large burden of obese children to endocrinologists, multidisciplinary models of care delivery are essential for the US health care system to address the needs of children with diabetes and obesity.