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.

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.

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)

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)

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

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.

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.

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.)

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

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

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.

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...

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

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

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)

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

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....

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.

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

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

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

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.

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)

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.)

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.

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.

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.

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…

[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

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.

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.

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

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…

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.

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…

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.

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...

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.

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.

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)

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.

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)

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.

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…

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.

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...

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...

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.

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...

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.

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...

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

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.

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.

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,...

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

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.

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...

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.

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.

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.

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 (...

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.

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...

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.)

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...

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...

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

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

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.)

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 ...

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.

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)

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)

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…

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.

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.

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)

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

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

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.

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

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.

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...

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.

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...

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

Child Passenger Safety Technician Consultation in the Pediatric Primary Care Setting.

Science.gov (United States)

Burstein, Dina; Zonfrillo, Mark R; Baird, Janette; Mello, Michael J

2017-09-01

Correct use of a child safety seat (CSS) can reduce the risk of fatal motor vehicle crash-related injury by up to 71%; however, misuse rates for CSS are as high as 70%. We recruited 189 caregivers at 2 large suburban pediatric office practices; 94 in the intervention group and 95 in the control group. All participants completed a baseline survey and received a CSS safety brochure. Intervention participants had their CSS installation checked at enrollment by a certified child passenger safety (CPS) technician. Follow-up was conducted 4 months post enrollment. Intervention group participants had a 21.3% reduction in critical misuse at follow-up, whereas control participants critical misuse rate at follow-up was identical to the intervention group at baseline. A consult with a certified CPS technician, at the time of a routine visit to the pediatrician, resulted in a reduction in CSS misuse rates.

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.

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.

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...

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)

Enhancing pediatric safety: assessing and improving resident competency in life-threatening events with a computer-based interactive resuscitation tool

International Nuclear Information System (INIS)

Lerner, Catherine; Gaca, Ana M.; Frush, Donald P.; Ancarana, Anjanette; Hohenhaus, Sue; Seelinger, Terry A.; Frush, Karen

2009-01-01

Though rare, allergic reactions occur as a result of administration of low osmolality nonionic iodinated contrast material to pediatric patients. Currently available resuscitation aids are inadequate in guiding radiologists' initial management of such reactions. To compare radiology resident competency with and without a computer-based interactive resuscitation tool in the management of life-threatening events in pediatric patients. The study was approved by the IRB. Radiology residents (n=19; 14 male, 5 female; 19 certified in basic life support/advanced cardiac life support; 1 certified in pediatric advanced life support) were videotaped during two simulated 5-min anaphylaxis scenarios involving 18-month-old and 8-year-old mannequins (order randomized). No advance warning was given. In half of the scenarios, a computer-based interactive resuscitation tool with a response-driven decision tree was available to residents (order randomized). Competency measures included: calling a code, administering oxygen and epinephrine, and correctly dosing epinephrine. Residents performed significantly more essential interventions with the computer-based resuscitation tool than without (72/76 vs. 49/76, P<0.001). Significantly more residents appropriately dosed epinephrine with the tool than without (17/19 vs. 1/19; P<0.001). More residents called a code with the tool than without (17/19 vs. 14/19; P = 0.08). A learning effect was present: average times to call a code, request oxygen, and administer epinephrine were shorter in the second scenario (129 vs. 93 s, P=0.24; 52 vs. 30 s, P<0.001; 152 vs. 82 s, P=0.025, respectively). All the trainees found the resuscitation tool helpful and potentially useful in a true pediatric emergency. A computer-based interactive resuscitation tool significantly improved resident performance in managing pediatric emergencies in the radiology department. (orig.)

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...

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...

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.

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...

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...

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).

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,...

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,...

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…

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...

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

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....

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…

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...

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...

Next Generation Sequencing As an Aid to Diagnosis and Treatment of an Unusual Pediatric Brain Cancer

Directory of Open Access Journals (Sweden)

John Glod

2014-07-01

Full Text Available Classification of pediatric brain tumors with unusual histologic and clinical features may be a diagnostic challenge to the pathologist. We present a case of a 12-year-old girl with a primary intracranial tumor. The tumor classification was not certain initially, and the site of origin and clinical behavior were unusual. Genomic characterization of the tumor using a Clinical Laboratory Improvement Amendment (CLIA-certified next-generation sequencing assay assisted in the diagnosis and translated into patient benefit, albeit transient. Our case argues that next generation sequencing may play a role in the pathological classification of pediatric brain cancers and guiding targeted therapy, supporting additional studies of genetically targeted therapeutics.

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...

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.

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 ...

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...

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

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

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...

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.)

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.

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…

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

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...

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.

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

ENERGY STAR Certified Products - Lighting

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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...

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

ENERGY STAR Certified Vending Machines

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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...

ENERGY STAR Certified Residential Freezers

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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...

ENERGY STAR Certified Residential Refrigerators

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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...

ENERGY STAR Certified Smart Thermostats

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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...

ENERGY STAR Certified Residential Dishwashers

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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...

ENERGY STAR Certified Commercial Dishwashers

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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...

ENERGY STAR Certified Commercial Ovens

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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...

ENERGY STAR Certified Commercial Boilers

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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...

ENERGY STAR Certified Ventilating Fans

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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...

ENERGY STAR Certified Imaging Equipment

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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...

ENERGY STAR Certified Commercial Fryers

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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...

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.

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

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…

ENERGY STAR Certified Commercial Griddles

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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...

ENERGY STAR Certified Water Coolers

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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...

ENERGY STAR Certified Audio Video

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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...

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…

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)

ENERGY STAR Certified Roof Products

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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,...

ENERGY STAR Certified Pool Pumps

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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,...

Find a NCCAOM Certified Practitioner

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... 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 ...

ENERGY STAR Certified Ceiling Fans

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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,...

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.

"Booster" training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.

Science.gov (United States)

Sutton, Robert M; Niles, Dana; Meaney, Peter A; Aplenc, Richard; French, Benjamin; Abella, Benjamin S; Lengetti, Evelyn L; Berg, Robert A; Helfaer, Mark A; Nadkarni, Vinay

2011-05-01

To investigate the effectiveness of brief bedside "booster" cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Prospective, randomized trial. General pediatric wards at Children's Hospital of Philadelphia. Sixty-nine Basic Life Support-certified hospital-based providers. CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min(-1) and 38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p CPR compliance, 35% to 96% [p training combined with automated feedback: rate 48% to 100% [p CPR compliance, 30% to 100% [p CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests.

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 ...

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...

Benefits of mock oral examinations in a multi-institutional consortium for board certification in general surgery training.

Science.gov (United States)

Subhas, Gokulakkrishna; Yoo, Stephen; Chang, Yeon-Jeen; Peiper, David; Frikker, Mark J; Bouwman, David L; Silbergleit, Allen; Lloyd, Larry R; Mittal, Vijay K

2009-09-01

The Southeast Michigan Center for Medical Education (SEMCME) is a consortium of teaching hospitals in the Greater Detroit metropolitan area. SEMCME pools its resources for several educational means, including mock oral board examinations. The educational and cost benefits to mock oral examinations on a multi-institutional basis in preparation for the American Board of Surgery (ABS) certifying examination were analyzed. Ten-year multi-institution data from the mock oral examinations were correlated with ABS certifying examination pass rates. Mock oral examination scores were available for 107 of 147 graduates, which included 12 candidates who failed their certifying examination on the first attempt (pass rate = 89%). Four of 31 examinees who had a low score (4.9 or less) in their mock oral exams failed their certifying examination in their first attempt. The cost of running the mock examination was low (approximately $35/resident for 50 residents). When graduates from the last 10 years were surveyed, the majority of respondents believed that the mock oral examination helped in their success and with their preparation for the certifying examination. Thus, the many benefits of administering the examination with the resources of a consortium of hospitals result in the accurate reproduction of real-life testing conditions with reasonable overall costs per resident.

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…

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...

The Globalization of Pediatric Research: An Analysis of Clinical Trials Completed for Pediatric Exclusivity

Science.gov (United States)

Pasquali, Sara K.; Burstein, Danielle S.; Benjamin, Daniel K.; Smith, P. Brian; Li, Jennifer S.

2010-01-01

Background Recent studies have examined the globalization of clinical research. These studies focused on adult trials, and the globalization of pediatric research has not been examined to date. We evaluated the setting of published studies conducted under the US Pediatric Exclusivity Program, which provides economic incentives to pharmaceutical companies to conduct drug studies in children. Methods Published studies containing the main results of trials conducted from 1998–2007 under the Pediatric Exclusivity Provision were included. Data were extracted from each study and described, including the therapeutic area of drug studied, number of patients enrolled, number of sites, and location where the study was conducted, if reported. Results Overall, 174 trials were included (sample size 8–27,065 patients); 9% did not report any information regarding the location or number of sites where the study was conducted. Of those that did report this information, 65% were conducted in at least one country outside the US, and 11% did not have any sites in the US. Fifty-four different countries were represented and 38% of trials enrolled patients in at least one site located in a developing/transition country, including more than one third of infectious disease, cardiovascular, and allergy/immunology trials. Conclusions The majority of published pediatric trials conducted under the Pediatric Exclusivity Provision included sites outside of the US, and over a third of trials enrolled patients in developing/transition countries. While there are many potential benefits to the globalization of pediatric research, this trend also raises certain scientific and ethical concerns which require further evaluation. PMID:20732941

ENERGY STAR Certified Vending Machines

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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

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.

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

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.

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.

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

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

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.

[Authorized Qualifications of Staff Conducting Examinations in the Field of Clinical Microbiology].

Science.gov (United States)

Nishiyama, Hiroyuki

2015-04-01

Because of the increase in healthcare-associated infections, appearance of highly resistant bacteria, and that of emerging/re-emerging infectious diseases, it is necessary for the skills of clinical microbiological technologists and the associated technology to be improved. Technologist in Microbiology (4,717 certified) and Specialist in Microbiology (58 certified) are authorized qualifications in the field of examination for clinical microbiology, with a history of 60 years, and Clinical Microbiological Technologist (670 certified) and Infection Control Microbiological Technologist (ICMT) (528 certified) are necessary qualifications to become a member of an infection control team. As problems to be resolved, clarifying the relationships among the authorized qualifications, reconsidering the fairness of evaluating written examinations, and further consideration of the administration method for an increasing number of examinees need to be tackled.

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...

Upstairs downstairs: vertical integration of a pediatric service.

Science.gov (United States)

Racine, A D; Stein, R E; Belamarich, P F; Levine, E; Okun, A; Porder, K; Rosenfeld, J L; Schechter, M

1998-07-01

The combined effects of recent changes in health care financing and training priorities have compelled academic medical centers to develop innovative structures to maintain service commitments yet conform to health care marketplace demands. In 1992, a municipal hospital in the Bronx, New York, affiliated with a major academic medical center reorganized its pediatric service into a vertically integrated system of four interdependent practice teams that provided comprehensive care in the ambulatory as well as inpatient settings. One of the goals of the new system was to conserve inpatient resources. To describe the development of a new vertically integrated pediatric service at an inner-city municipal hospital and to test whether its adoption was associated with the use of fewer inpatient resources. A descriptive analysis of the rationale, goals, implementation strategies, and structure of the vertically integrated pediatric service combined with a before-and-after comparison of in-hospital resource consumption. A before-and-after comparison was conducted for two periods: the period before vertical integration, from January 1989 to December 1991, and the period after the adoption of vertical integration, from July 1992 to December 1994. Four measures of inpatient resource use were compared after adjustment for case mix index: mean certified length of stay per case, mean number of radiologic tests per case, mean number of ancillary tests per case, and mean number of laboratory tests per case. Difference-in-differences-in-differences estimators were used to control for institution-wide trends throughout the time period and regional trends in inpatient pediatric practice occurring across institutions. Results. In 1992, the Department of Pediatrics at the Albert Einstein College of Medicine reorganized the pediatric service at Jacobi Medical Center, one of its principal municipal hospital affiliates, into a vertically integrated pediatric service that combines ambulatory

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)

Pediatric fractures – an educational needs assessment of Canadian pediatric emergency medicine residents

Directory of Open Access Journals (Sweden)

Dixon AC

2015-06-01

Full Text Available Andrew C Dixon Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Objectives: To determine the gaps in knowledge of Canadian pediatric emergency medicine residents with regards to acute fracture identification and management. Due to their predominantly medical prior training, fractures may be an area of weakness requiring a specific curriculum to meet their needs. Methods: A questionnaire was developed examining comfort level and performance on knowledge based questions of trainees in the following areas: interpreting musculoskeletal X-rays; independently managing pediatric fractures, physical examination techniques, applied knowledge of fracture management, and normal development of the bony anatomy. Using modified Dillman technique the instrument was distributed to pediatric emergency medicine residents at seven Canadian sites. Results: Out of 43 potential respondents, 22 (51% responded. Of respondents, mean comfort with X-ray interpretation was 69 (62–76 95% confidence interval [CI] while mean comfort with fracture management was only 53 (45–63 95% CI; mean comfort with physical exam of shoulder 60 (53–68 95% CI and knee 69 (62–76 95% CI was low. Less than half of respondents (47%; 95% CI 26%–69% could accurately identify normal wrist development, correctly manage a supracondylar fracture (39%; 95% CI 20%–61%, or identify a medial epicondyle fracture (44%; 95% CI 24%–66%. Comfort with neurovascular status of the upper (mean 82; 95% CI 75–89 and lower limb (mean 81; 95% CI 74–87 was high. Interpretation: There are significant gaps in knowledge of physical exam techniques, fracture identification and management among pediatric emergency medicine trainees. A change in our current teaching methods is required to meet this need. Keywords: pediatric, fractures, education, radiologic interpretation

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...

Evaluation of Certified Teachers’ Perfomance at SMPN 6 Luwuk Banggai Regency, Indonesia

Directory of Open Access Journals (Sweden)

Suhartini Salingkat

2017-10-01

Full Text Available This study investigated certified teachers’ performance at SMPN 6 Luwuk of Banggai Regency, with a focus on the teachers’ performance in planning the lesson, implementing the lesson, and conducting the lesson evaluation. It lasted for nine months, from March to December 2011. Qualitative method was used. More specifically, the evaluation research method was followed which involves collecting, analyzing, and interpreting data for decision making. The evaluation system used in this study was based on the quality of the certified teachers’ performances. The real condition in the field is that many of the certified teachers are still unable to design lessons and implement them professionally as expected from certified teachers. Currently there are many teachers in need of trainings. This study showed that the quality of the performance of the certified teachers in SMPN 6 Luwuk in planning the lesson was low. This could indicate that the certification process has not yet resulted in an increase in the quality of performance of the certified teachers, particularly as long as the quality of their performance in planning lessons is concerned.

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.

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.

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...

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."

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...

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...

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...

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...

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...

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...

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...

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...

ENERGY STAR Certified Light Commercial HVAC

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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...

ENERGY STAR Certified Room Air Conditioners

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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...

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...

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.)

“Booster” training: Evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest

Science.gov (United States)

Sutton, Robert M.; Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay

2013-01-01

Objective To investigate the effectiveness of brief bedside “booster” cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Design Prospective, randomized trial. Setting General pediatric wards at Children’s Hospital of Philadelphia. Subjects Sixty-nine Basic Life Support–certified hospital-based providers. Intervention CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Measurements and Main Results Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min−1 and 38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p CPR compliance, 35% to 96% [p training combined with automated feedback: rate 48% to 100% [p CPR compliance, 30% to 100% [p CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests. PMID:20625336

Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

International Nuclear Information System (INIS)

Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y.; Hibbard, Roberta A.; Hicks, Ralph A.

2017-01-01

Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist. Two board-certified fellowship-trained neuroradiologists at an academic pediatric hospital independently interpreted the head CTs, compared their interpretations to determine inter-reader discrepancy rates, and resolved discrepancies to establish a consensus second interpretation. The primary interpretation was compared to the consensus second interpretation using the RADPEER trademark scoring system to determine the primary interpretation-second interpretation overall and major discrepancy rates. MRI and/or surgical findings were used to validate the primary interpretation or second interpretation when possible. The diagnosis of abusive head trauma was made using clinical and imaging data by a child abuse specialist to separate patients into abusive head trauma and non-abusive head trauma groups. Discrepancy rates were compared for both groups. Lastly, primary interpretations and second interpretations were evaluated for discussion of imaging findings concerning for abusive head trauma. There were statistically significant differences between primary interpretation-second interpretation versus inter-reader overall and major discrepancy rates (28% vs. 6%, P=0.0001; 16% vs. 1%, P=0.0001). There were significant differences in the primary interpretation-second interpretation overall and major discrepancy rates for abusive head trauma patients compared to non-abusive head trauma

Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

Energy Technology Data Exchange (ETDEWEB)

Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Hibbard, Roberta A.; Hicks, Ralph A. [Indiana University School of Medicine, Department of Pediatrics, Section of Child Protection Programs, Indianapolis, IN (United States)

2017-07-15

Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist. Two board-certified fellowship-trained neuroradiologists at an academic pediatric hospital independently interpreted the head CTs, compared their interpretations to determine inter-reader discrepancy rates, and resolved discrepancies to establish a consensus second interpretation. The primary interpretation was compared to the consensus second interpretation using the RADPEER trademark scoring system to determine the primary interpretation-second interpretation overall and major discrepancy rates. MRI and/or surgical findings were used to validate the primary interpretation or second interpretation when possible. The diagnosis of abusive head trauma was made using clinical and imaging data by a child abuse specialist to separate patients into abusive head trauma and non-abusive head trauma groups. Discrepancy rates were compared for both groups. Lastly, primary interpretations and second interpretations were evaluated for discussion of imaging findings concerning for abusive head trauma. There were statistically significant differences between primary interpretation-second interpretation versus inter-reader overall and major discrepancy rates (28% vs. 6%, P=0.0001; 16% vs. 1%, P=0.0001). There were significant differences in the primary interpretation-second interpretation overall and major discrepancy rates for abusive head trauma patients compared to non-abusive head trauma

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 ...

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

ENERGY STAR Certified Room Air Cleaners

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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...

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...

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.

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)

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...

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.

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.

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.)

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.

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...

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

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.

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

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

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

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

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...

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.

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…

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.

Pediatric medicolegal autopsy in France: A forensic histopathological approach.

Science.gov (United States)

Delteil, Clémence; Tuchtan, Lucile; Torrents, Julia; Capuani, Caroline; Piercecchi-Marti, Marie-Dominique

2018-01-01

The aim of postmortem medicolegal examination in pediatric death is primarily to establish the circumstances and causes of death and to exclude child abuse. In France, pediatric death is systematically documented by medicolegal or medical autopsy. In case of medicolegal autopsy, the complementary examinations, requested and financed by justice, are rarely limited to a histopathological examination. However in medical autopsies other tools are available to the pathologist as toxicology, biochemistry and molecular biology. The purpose of this article is to evaluate the efficacy of forensic histopathology in pediatric forensic autopsies. We analyze the main causes of pediatric death in a forensic context. Between 2004 and 2015, 157 infant deaths were identified in Marseille university hospital. The forensic histopathology and autopsy reports of all 157 cases were available for systematic review. Medical or surgical causes represented 41,3% of deaths in our center, accidental causes 8.1% and child abuse 28,8%. The definitive diagnosis was made at autopsy in 30% of cases and at histopathological examination in 70% highlighting that forensic histopathology is an indispensable tool in pediatric medicolegal autopsies. Significant histological abnormalities may be detected in selected organs such as the brain, lungs, heart, liver, adrenal glands and kidneys in spite of macroscopically normal appearances. This justifies systematic sampling of all organs. Despite the implementation of the French sudden infant death protocol which recommends medical autopsies, too many pediatric autopsies are carried out in a medicolegal context. 30% of the cases remain without diagnosis at the end of the autopsy and histological examination. This number could be reduced by the contribution of others laboratory investigation. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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.

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.)

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...

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.

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...

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)

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

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...

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...

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...

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...

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...

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).

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

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.

Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program.

Science.gov (United States)

Goyal, Monika K; Mollen, Cynthia J; Hayes, Katie L; Molnar, Jennifer; Christian, Cindy W; Scribano, Philip V; Lavelle, Jane

2013-09-01

The objectives of this study were to describe the experience of a novel pediatric sexual assault response team (SART) program in the first 3 years of implementation and compare patient characteristics, evaluation, and treatment among subpopulations of patients. This was a retrospective chart review of a consecutive sample of patients evaluated at a pediatric emergency department (ED) who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with sex, menarchal status, and presence of injuries were measured using logistic regression. One hundred eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 (SD, 4.6) years. The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among girls (P < 0.01), but not by sex. Evidence of acute anogenital injury on physical examination was found in 20.6% of patients. As per the Centers for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal girls were more likely to undergo testing for sexually transmitted infections and pregnancy (P < 0.01) and to be offered pregnancy, sexually transmitted infection, and HIV prophylaxis (P < 0.01). In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on examination. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault.

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.

The Stress and Coping Responses of Certified Graduate Athletic Training Students

Science.gov (United States)

Reed, Sarah

2004-01-01

Objective: To assess the sources of stress and coping responses of certified graduate athletic training students. Design and Setting: We interviewed certified graduate athletic training students 3 times over a 9-month period. We transcribed the interviews verbatim and used grounded theory analytic procedures to inductively analyze the participants' sources of stress and coping responses. Subjects: Three male and 3 female certified graduate athletic training students from a postcertification graduate athletic training program volunteered to participate in this investigation. The participants were full-time graduate students, with a mean age of 23 years, who had worked an average of 1.5 years as certified athletic trainers at the time of the first interview. Measurements: We used grounded theory analytic procedures to inductively analyze the participants' sources of stress and coping responses. Results: A total of 6 general sources of stress and 11 coping dimensions were revealed. The stress dimensions were labeled athletic training duties, comparing job duties, responsibilities as student, time management, social evaluation, and future concerns. The coping responses were planning, instrumental social support, adjusting to job responsibilities, positive evaluations, emotional social support, humor, wishful thinking, religion, mental or behavioral disengagement, activities outside the profession, and other outcomes. Conclusions: Certified graduate athletic training students should be encouraged to use problem-focused (eg, seeking advice, planning) and emotion-focused (eg, positive evaluations, humor) forms of coping with stress. PMID:15173872

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...

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.

Differences in characteristics among new pediatric neurology patients: the effect of a newly established private pediatric neurology practice.

Science.gov (United States)

Van Cleave, Jeanne; Woodruff, Brian; Freed, Gary L

2008-01-01

To investigate changes in volume and characteristics of new patients referred when a private pediatric neurology practice (PP) opened in 2004 in an area served primarily by an academic medical center's (AMC) pediatric neurology practice. Retrospective analysis of medical and billing records to examine changes in volume, diagnosis, and sociodemographic factors of new patients at the AMC from July 2004 to June 2005; the PP during the same period; and the AMC during the year before. One year after the PP opened, 40% more new pediatric neurology patients were seen in this area than the year before. Compared with the AMC, PP saw a greater proportion of seizures (34% vs 26%, P 20 miles from the practice (32% vs 64%, P pediatric neurology patients in this area. After the PP opened, the AMC continued to care for most patients with rare diseases and fewer financial resources. Future research should examine whether the increase in volume reflects relief of pent-up demand or increased referral rates due to eased access, and should elucidate how differences in patient populations at academic and private subspecialty practices relate to access to subspecialty care and financial well-being of academic practices.

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)

Brown-McLean Syndrome in a Pediatric Patient

Science.gov (United States)

Tourkmani, Abdo Karim; Martinez, Jaime D.; Berrones, David; Juárez-Domínguez, Brenda Y.; Beltrán, Francisco; Galor, Anat

2015-01-01

The purpose of this manuscript is to report the case of a 12-year-old patient who presented for routine ophthalmic examination after congenital cataract surgery performed at 2 months of age. The patient was diagnosed with bilateral Brown-McLean syndrome by slit lamp examination. No treatment was required because the patient was asymptomatic and had a clear central cornea. This is the first described case of Brown-McLean syndrome in a pediatric patient, representing the importance of clinical examination in the pediatric age group after cataract surgery because of the risk for patients of developing peripheral edema. PMID:26034485

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' ...

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...

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...

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...

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 ...

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

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

Safety and usefulness of outreach clinic conducted by pediatric echosonographers

International Nuclear Information System (INIS)

Al Harbi, Badr; Al Akhfash, Ali A.; Al Ghamdi, Abdullah; Al-Mesned, Abdulrahman

2012-01-01

Outreach echocardiographic services led by cardiac sonographers may help district level hospitals in the management of patients suspected to have cardiac anomalies. However, the safety and utility of such an approach is not tested. We retrospectively reviewed our experience of patients seen in the outreach visits by the echocardiographers alone and subsequently reviewed in the pediatric cardiology clinic. Comparison between the diagnosis made by the echocardiographer and the consultant pediatric cardiologist were done. We defined safety as no change in patient management plan between the outreach evaluation and the pediatric cardiology clinic evaluation, and we defined usefulness as being beneficial, serviceable and of practical use. Two senior echocardiographic technicians did 41 clinic visits and over a period of 17 months, 623 patients were seen. Patients less than 3 months of age constitute 63% of the total patients seen. Normal echocardiographic examinations were found in 342 (55%) of patients. These patients were not seen in our cardiology clinic. Abnormal echocardiographic examinations were found in 281 (45%) of patients. Among the 281 patients with abnormal echos in the outreach visits, 251 patients (89.3%) were seen in the pediatric cardiology clinic. Comparing the results of the outreach clinic evaluation to that of the pediatric cardiology clinic, 73 patients (29%) diagnosed to have a minor CHD turned to have normal echocardiographic examinations. In all patients seen in both the outreach clinics and the pediatric tertiary cardiac clinics there was no change in patient's management plan. Outreach clinic conducted by pediatric echo sonographers could be useful and safe. It may help in reducing unnecessary visits to pediatric cardiology clinics, provide parental reassurance, and help in narrowing the differential diagnosis in critically ill patient unable to be transferred to tertiary cardiac centers provided it is done by experienced echosonographers

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.

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

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

Psycho-oncological care in certified cancer centres--a nationwide analysis in Germany.

Science.gov (United States)

Singer, Susanne; Dieng, Sebastian; Wesselmann, Simone

2013-06-01

Over the last few years, a nationwide voluntary certification system for cancer centres has been established in Germany. To qualify for certification, cancer centres must provide psycho-oncological care to every patient who needs it. The aim of this study was to find out how many patients have been treated by a psycho-oncologist in the certified centres. All cancer centres in Germany that were re-certified in 2010 provided data documenting how many patients with primary cancer received at least 30 min of psycho-oncological consultation in 2009. Data from n = 456 certified cancer centres were available. In the centres, a total of 36,165 patients were seen by a psycho-oncologist for at least 30 min, representing 37.3% of all patients in the centres. The highest percentage of patients who received psycho-oncological care was found in breast cancer centres (66.7%), and the lowest in prostate cancer centres (6.8%). Half of the patients (50.0%) in gynaecological cancer centres, 37.7% in colon cancer centres and 25.4% in lung cancer centres received psycho-oncological care. Compared with non-certified centres, the proportion of patients receiving psycho-oncological care in certified cancer centres has increased. Copyright © 2012 John Wiley & Sons, Ltd.

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses.

Science.gov (United States)

Saramma, P P; Raj, L Suja; Dash, P K; Sarma, P S

2016-04-01

Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. Tertiary care hospital, Prospective, repeated-measures design. A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3-4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. SPSS for Windows version 21.0. The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140). Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.

Quality control of pediatric chest X-rays in diagnostic centers with and without pediatric competence

International Nuclear Information System (INIS)

Alt, C.D.; Engelmann, D.; Schenk, J.P.; Troeger, J.

2006-01-01

Purpose: Radiation protection in pediatric radiology is very important because of the particular sensitivity of radiosensitive organs in younger patients. Optimized image quality supports radiation protection and should be targeted. In our study we examined the quality of pediatric chest X-rays at diagnostic centers (university hospitals and other large clinics). We then evaluated differences in image quality in departments without pediatric competence (R) and departments with pediatric competence (PR). Materials and Methods: Our study was based on 313 conventional chest X-rays from 207 patients (192 p.a./a.p. and 121 lateral, 43 from R, 258 from PR and 12 neither from R nor KR) and 38 digital chest X-rays from 26 patients (25 p.a./a.p. and 13 lateral, 1 from R and 37 from PR). All patients (age 0 - 18 years) are from Nephroblastoma-Study SIOP-93/01-GPOH. We examined all initial chest X-rays, which were sent to us for evaluation upon request between 4/3/2002 and 6/14/2002. The examined parameters were: exposure, centering of the X-rays/patient positioning, collimation and sharpness. The X-rays were evaluated on a scale from 1 (best result) to 5 (worst result), resulting in an overall score of A = optimum, B = minor problems, C = major problems, or D = unusable. The optical density, the center of the image and the relative field size were also measured. Statistical tests (Mann-Whitney-U and log regression) were carried out on the conventional images. The study was performed retrospectively. The exposure, sharpness and optical density of the digital X-rays were not analyzed. Results: In the case of all conventional X-rays, the quality of the centering of the X-rays/patient positioning and collimation was moderate (average scale value: 2.4 and 2.8), and the quality of the exposure and sharpness was good and very good (average scale value: 1.9 and 1.5). The quality of the chest X-rays in departments with additional pediatric radiological expertise was better mainly in

Extension of academic pediatric radiology to the community setting: experience in two sites

International Nuclear Information System (INIS)

Ecklund, K.; Share, J.C.

2000-01-01

Background. Children are better served by radiologists and technical personnel trained in the care of pediatric patients. However, a variety of obstacles may limit the access of children to dedicated pediatric imaging facilities. Objective. We designed and implemented two models for providing community-based imaging by academic pediatric radiologists. Materials and methods. The first site was an outpatient clinic staffed by physicians from the university-affiliated children's hospital. Imaging services included radiography, fluoroscopy, and ultrasound. The second site was a full-service community hospital radiology department staffed by a group practice, with pediatric imaging covered by the children's hospital radiologists. Facility, equipment, and protocol modifications were required to maintain quality standards. Success of these models was determined by volume statistics, referring physician/patient satisfaction surveys, and quality-assurance (QA) programs. Results. The outpatient satellite had a 48 % increase in total examinations from the first year to the second year and 87 % the third year. Pediatric examinations in the community hospital increased over 1000 % the first 7 months. Referring physicians reported increased diagnostic information and patient satisfaction compared to previous service. QA efforts revealed improved image quality when pediatric radiologists were present, but some continuing difficulties off-hours. Conclusion. We successfully implemented pediatric imaging programs in previously underserved communities. This resulted in increased pediatric radiologist supervision and interpretation of examinations performed on children and improved referring physician and patient satisfaction. (orig.)

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…

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

Recertification in allergy and immunology: an historical review with special emphasis on the 1983 examination.

Science.gov (United States)

Slavin, R G; Des Prez, L; Mansmann, H C; Meskauskas, J A; Pierson, W

1985-03-01

Recertification offers a method of evaluating a diplomate's cognitive knowledge of allergy and immunology. In 1983 candidates for the American Board of Allergy and Immunology recertification examination were offered the entire certifying examination but were informed that they would, for recertification purposes, be held responsible only for a subset of questions judged to be particularly clinically relevant. All 40 candidates elected to take the entire certifying examination. Differences between the performance of certifying and recertifying candidates on the recertifying questions were small. Except for the five-choice questions, the differences in performance between the two groups on the remaining questions were also small in an absolute sense. Recertification performance was not related to the time of original certification. Ninety-eight percent of the candidates completed a questionnaire after the examination. Ninety percent stated that they would encourage their colleagues to participate in the recertification process.

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.

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.

The Risk of Intraocular Pressure Elevation in Pediatric Non-infectious Uveitis

Science.gov (United States)

Kothari, Srishti; Foster, C. Stephen; Pistilli, Maxwell; Liesegang, Teresa L.; Daniel, Ebenezer; Sen, H. Nida; Suhler, Eric B.; Thorne, Jennifer E.; Jabs, Douglas A.; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James T.; Lawrence, Scott D.; Kempen, John H.

2015-01-01

Purpose To characterize the risk and risk factors for intraocular pressure (IOP) elevation in pediatric non-infectious uveitis. Design Multi-center retrospective cohort study. Participants Nine hundred sixteen children (1593 eyes) uveitis followed between January 1978 through December 2007 at five academic uveitis centers in United States. Methods Medical records review by trained, certified experts. Main outcome measures Prevalence and incidence of IOP≥21 and ≥30mmHg and incidence of a rise in IOP by ≥10mmHg. To avoid under ascertainment, outcomes were counted as present when IOP-lowering therapies were in use. Results Initially 251 (15.8%) and 46 eyes (2.9%) had IOP≥21 and ≥30mmHg, respectively. Factors associated with presenting IOP elevation included age 6–12 years (versus other pediatric ages), prior cataract surgery (adjusted odds ratio≥21mmHg [aOR21]=2.42, P=0.01), pars plana vitrectomy (adjusted odds ratio≥30mmHg[aOR30]=11.1, P=0.03), duration of uveitis ≥6 months (aORs30 up to 11.8, Puveitis. Statistically significant risk factors include IOP elevation or use of IOP-lowering treatment in the contralateral eye and local corticosteroid use – that demonstrated a dose-and route of administration-dependent relationship. In contrast, use of immunosuppressive drug therapy did not increase such risk. Pediatric eyes with non-infectious uveitis should be followed closely for IOP elevation when strong risk factors such as the use of local corticosteroids and contralateral IOP elevation are present. PMID:26233626

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.

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...

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...

Parent assessment of medical student skills in ambulatory pediatrics

Directory of Open Access Journals (Sweden)

Erika Persson

2013-09-01

Full Text Available Background: Partnership with parents is a vital part of pediatric medical education, yet few studies have examined parent attitudes towards learners in pediatric settings. Methods: Questionnaires were used to determine parent and student assessment of professional and clinical skills (primary outcome and parent attitudes towards 3rd year medical students (secondary outcome at the University of Alberta. Chi Square, Kendall’s Tau and Kappa coefficients were calculated to compare parent and student responses in 8 areas: communication, respect, knowledge, listening, history taking, physical examination, supervision, and overall satisfaction. Results: Overall satisfaction with medical student involvement by parents was high: 56.7% of all parents ranked the encounter as ‘excellent’. Areas of lesser satisfaction included physician supervision of students. Compared to the parent assessment, students tended to underrate many of their skills, including communication, history taking and physical exam. There was no relationship between parent demographics and their attitude to rating any of the students’ skills. Conclusions: Parents were satisfied with medical student involvement in the care of their children. Areas identified for improvement included increased supervision of students in both history taking and physical examination. This is one of the largest studies examining parent attitudes towards pediatric students. The results may enhance undergraduate curriculum development and teaching in pediatric ambulatory clinics and strengthen the ongoing partnership between the community and teaching clinics.

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.)

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.

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.

Extension of academic pediatric radiology to the community setting: experience in two sites

Energy Technology Data Exchange (ETDEWEB)

Ecklund, K.; Share, J.C. [Children' s Hospital Medical Center, Boston, MA (United States). Dept. of Radiology

2000-01-01

Background. Children are better served by radiologists and technical personnel trained in the care of pediatric patients. However, a variety of obstacles may limit the access of children to dedicated pediatric imaging facilities. Objective. We designed and implemented two models for providing community-based imaging by academic pediatric radiologists. Materials and methods. The first site was an outpatient clinic staffed by physicians from the university-affiliated children's hospital. Imaging services included radiography, fluoroscopy, and ultrasound. The second site was a full-service community hospital radiology department staffed by a group practice, with pediatric imaging covered by the children's hospital radiologists. Facility, equipment, and protocol modifications were required to maintain quality standards. Success of these models was determined by volume statistics, referring physician/patient satisfaction surveys, and quality-assurance (QA) programs. Results. The outpatient satellite had a 48 % increase in total examinations from the first year to the second year and 87 % the third year. Pediatric examinations in the community hospital increased over 1000 % the first 7 months. Referring physicians reported increased diagnostic information and patient satisfaction compared to previous service. QA efforts revealed improved image quality when pediatric radiologists were present, but some continuing difficulties off-hours. Conclusion. We successfully implemented pediatric imaging programs in previously underserved communities. This resulted in increased pediatric radiologist supervision and interpretation of examinations performed on children and improved referring physician and patient satisfaction. (orig.)

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.

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…

Reimbursement for pediatric diabetes intensive case management: a model for chronic diseases?

Science.gov (United States)

Beck, Joni K; Logan, Kathy J; Hamm, Robert M; Sproat, Scott M; Musser, Kathleen M; Everhart, Patricia D; McDermott, Harrold M; Copeland, Kenneth C

2004-01-01

Current reimbursement policies serve as potent disincentives for physicians who provide evaluation and management services exclusively. Such policies threaten nationwide availability of care for personnel-intensive services such as pediatric diabetes. This report describes an approach to improving reimbursement for highly specialized, comprehensive pediatric diabetes management through prospective contracting for services. The objective of this study was to determine whether pediatric diabetes intensive case management services are cost-effective to the payer, the patient, and a pediatric diabetes program. A contract with a third-party payer was created to reimburse for 3 key pediatric diabetes intensive case management components: specialty education, 24/7 telephone access to an educator (and board-certified pediatric endocrinologist as needed), and quarterly educator assessments of self-management skills. Data were collected and analyzed for 15 months after signing the contract. Within the first 15 months after the contract was signed, 22 hospital admissions for diabetic ketoacidosis (DKA) occurred in 16 different patients. After hospitalizations for DKA, all 16 patients were offered participation in the program. All were followed during the subsequent 1 to 15 months of observation. Ten patients elected to participate, and 6 refused participation. Frequency of rehospitalization, emergency department visits, and costs were compared between the 2 groups. Among the 10 participating patients, there was only 1 subsequent DKA admission, whereas among the 6 who refused participation, 5 were rehospitalized for DKA on at least 1 occasion. The 10 patients who participated in the program had greater telephone contact with the team compared with those who did not (16 crisis-management calls vs 0). Costs (education, hospitalization, and emergency department visits) per participating patient were approximately 1350 dollars less than those for nonparticipating patients

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.)

Environmental-economic benefits and trade-offs on sustainably certified coffee farms

OpenAIRE

Haggar, Jeremy; Soto, Gabriela; Casanoves, Fernando; de Melo Virginio, Elias

2017-01-01

Coffee with diverse shade trees is recognized as conserving greater biodiversity than more intensive production methods. Sustainable certification has been proposed as an incentive to conserve shade grown coffee. With 40% of global coffee production certified as sustainable, evidence is needed to demonstrate whether certification supports the environmental benefits of shade coffee. Environmen-tal and economic data were taken from 278 coffee farms in Nicaragua divided between non-certified and...

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...

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...

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...

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...

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).

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.

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…

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.

Second Annual Meeting of the International Society of Pediatric Wound Care.

Science.gov (United States)

Keswani, Sundeep G

2015-10-01

The overarching goals of the International Society of Pediatric Wound Care (ISPeW) are to (1) set global standards for the assessment and treatment of pediatric wounds of varying etiologies; (2) provide a forum for international interprofessional collaboration among healthcare professionals, researchers, educators, and industry leaders dedicated to the care of pediatric wounds; (3) promote and support clinical research focused on the prevention, assessment, and treatment of pediatric wounds; (4) collaborate with wound care organizations worldwide on pediatric wound care issues; and (5) provide evidence-based pediatric wound care education to healthcare professionals, parents, and lay caregivers. This edition of Advances in Wound Care includes some of the work that was presented at the 2014 ISPeW meeting in Rome. The first article by Dr. Romanelli, is an in-depth description of the progression of skin physiology throughout its maturational stages and clinical implication. A cutting edge article by Dr. Timothy King then follows, with regard to scar prevention in postnatal tissues. This is followed by a comprehensive look at debridement techniques in pediatric trauma by Dr. Ankush Gosain. Next, is a cautionary article by Dr. Luca Spazzapan that examines the prevalence of diabetic foot ulcers in children and the potential for an epidemic. The last article in this series is from the keynote speaker, Dr. Amit Geffen, who eloquently examines the use of biomaterials to offload and prevent pediatric pressure ulcers.

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 ...

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.

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.

Spending on Hospital Care and Pediatric Psychology Service Use Among Adolescents and Young Adults With Cancer.

Science.gov (United States)

McGrady, Meghan E; Peugh, James L; Brown, Gabriella A; Pai, Ahna L H

2017-10-01

To examine the relationship between need-based pediatric psychology service use and spending on hospital care among adolescents and young adults (AYAs) with cancer. Billing data were obtained from 48 AYAs with cancer receiving need-based pediatric psychology services and a comparison cohort of 48 AYAs with cancer not receiving services. A factorial analysis of covariance examined group differences in spending for hospital care. Pending significant findings, a multivariate analysis of covariance was planned to examine the relationship between need-based pediatric psychology service use and spending for inpatient admissions, emergency department (ED) visits, and outpatient visits. Spending for hospital care was higher among AYAs receiving need-based pediatric psychology services than in the comparison cohort (p psychology services. The behavioral and psychosocial difficulties warranting need-based pediatric psychology services may predict higher health care spending. © The Author 2017. 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

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 ...

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...

Pediatric endocrine society survey of diabetes practices in the United States: What is the current state?

Science.gov (United States)

Guttmann-Bauman, I; Thornton, P; Adhikari, S; Reifschneider, K; Wood, M A; Hamby, T; Rubin, K

2018-03-26

The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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 ...

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

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 ...

Young children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS) followed in pediatric gastroenterology (PED-GI) vs primary pediatric care (PED): Differences in outcomes

Science.gov (United States)

The American Academy of Pediatrics suggests that children with recurrent abdominal pain without alarm signs be managed in pediatric rather than specialty care. However, many of these children are seen in tertiary care. In a longitudinal examination of physical and psychological symptoms, we hypothes...

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.

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…

Topical Review: Unique Contributions of Magnetic Resonance Imaging to Pediatric Psychology Research.

Science.gov (United States)

Jensen, Chad D; Duraccio, Kara M; Carbine, Kaylie M; Kirwan, C Brock

2016-03-01

This review aims to provide a brief introduction of the utility of magnetic resonance imaging (MRI) methods in pediatric psychology research, describe several exemplar studies that highlight the unique benefits of MRI techniques for pediatric psychology research, and detail methods for addressing several challenges inherent to pediatric MRI research. Literature review. Numerous useful applications of MRI research in pediatric psychology have been illustrated in published research. MRI methods yield information that cannot be obtained using neuropsychological or behavioral measures. Using MRI in pediatric psychology research may facilitate examination of neural structures and processes that underlie health behaviors. Challenges inherent to conducting MRI research with pediatric research participants (e.g., head movement) may be addressed using evidence-based strategies. We encourage pediatric psychology researchers to consider adopting MRI techniques to answer research questions relevant to pediatric health and illness. © 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.

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…

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.

Overweight and obesity: overrepresentation in the pediatric reconstructive burn population.

Science.gov (United States)

Mayes, Theresa; Gottschlich, Michele M; Allgeier, Chris; Khoury, Jane; Kagan, Richard J

2010-01-01

Pediatric burn patients are predisposed to excessive weight gain in the reconstructive period, but the cause is unclear. An overweight (OW) or obese (OB) condition is associated with numerous health risks, decreased physical function, and increased morbidity. The purpose of this study was to compare the frequency of OW status in reconstructive, pediatric burn patients with the prevalence in the US population. The authors reviewed the records of 1533 pediatric patients, >1 year from acute burn, admitted for an elective reconstructive procedure. Body mass index between 85th and 95th percentile, according to the National Center for Health Statistics for 2000 growth charts, was classified as OW, and body mass index >95th percentile was classified as OB. Frequency of OW and OB and racial disparity was calculated as a percentage of total patients and compared with pediatric data from National Health and Nutrition Examination Survey for 1999 to 2006, a nationally representative sample. The rate of OW and OB was 16.3 and 24.1%, respectively, in the authors' pediatric burn population. White patients had OW and OB rates of 15.9 and 23.6%, respectively, compared with 18.2 and 30.2%, respectively, in black patients. All OW and OB rates were outside the 95% confidence interval of the nationally representative National Health and Nutrition Examination Survey population. The rates of OW and OB in pediatric reconstructive burn patients exceed the US population standard across age and race stratifications. The prevention and treatment of excessive weight gain should be a component of rehabilitation in pediatric burns.

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.

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

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...

Development of benzene, toluene, ethylbenzene and xylenes certified gaseous reference materials

Science.gov (United States)

Brum, M. C.; Sobrinho, D. C. G.; Fagundes, F. A.; Oudwater, R. J.; Augusto, C. R.

2016-07-01

The work describes the production of certified gaseous reference materials of benzene, toluene, ethylbenzene and xylenes (BTEX) in nitrogen from the gravimetric production up to the long term stability tests followed by the certifying step. The uncertainty in the amount fractions of the compounds in these mixtures was approximately 4% (relative) for the range studied from 2 to 16 µmol/mol. Also the adsorption of the BTEX on the cylinder surface and the tubing were investigated as potential uncertainty source.

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.”

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...

The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomography

International Nuclear Information System (INIS)

Santos, Joana; Paulo, Graciano; Foley, Shane; Rainford, Louise; McEntee, Mark F.

2015-01-01

The volume of CT examinations has increased with resultant increases in collective dose values over the last decade. To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations. Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed. Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693). Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings. (orig.)

The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomography

Energy Technology Data Exchange (ETDEWEB)

Santos, Joana; Paulo, Graciano [Instituto Politecnico de Coimbra, ESTESC, DMIR, Coimbra (Portugal); Foley, Shane; Rainford, Louise [University College Dublin, School of Medicine and Medical Science, Health Science Centre, Dublin 4 (Ireland); McEntee, Mark F. [The University of Sydney, Faculty of Health Sciences, Cumberland Campus, Sydney (Australia)

2015-11-15

The volume of CT examinations has increased with resultant increases in collective dose values over the last decade. To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations. Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed. Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693). Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings. (orig.)

Obesity in pediatric ALL survivors: a meta-analysis.

Science.gov (United States)

Zhang, Fang Fang; Kelly, Michael J; Saltzman, Edward; Must, Aviva; Roberts, Susan B; Parsons, Susan K

2014-03-01

Previous studies of survivors of pediatric acute lymphoblastic leukemia (ALL) have drawn heterogeneous conclusions regarding the prevalence of obesity and risk factors for developing obesity in pediatric ALL survivors. We sought to determine the prevalence of obesity in pediatric ALL survivors and examine risk factors for obesity through a systematic review and meta-analysis. A MEDLINE search was performed from its inception through 2013. Studies met the inclusion criteria if they (1) included at least 10 survivors of pediatric ALL; (2) assessed the prevalence or indicators of obesity; and (3) compared obesity among ALL survivors to a reference population or external control group. Extracted data included patient and treatment characteristics, study design, population used for comparison, and prevalence of obesity. Forty-seven studies met the inclusion criteria. Despite significant heterogeneity among the studies (I(2) = 96%), the mean BMI z score in 1742 pediatric ALL survivors was 0.83 (95% confidence interval: 0.60-1.06), which corresponds to the 80th BMI percentile, indicating a significantly higher BMI in pediatric ALL survivors than the reference population. Subgroup analyses found a high prevalence of obesity in ALL survivors regardless of survivors' receipt of cranial irradiation, gender, or age at diagnosis. Obesity is prevalent in pediatric ALL survivors and is independent of patient- and treatment-related characteristics. Clinicians need to screen for obesity and its associated health conditions early in survivorship.

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...

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...

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...

The role of certified reference materials in material control and accounting

International Nuclear Information System (INIS)

Turel, S.P.

1979-01-01

One way of providing an adequate material control and accounting system for the nuclear fuel cycle is to calculate material unaccounted for (MUF) after a physical inventory and to compare the limit of error of the MUF value (LEMUF) against prescribed criteria. To achieve a meaningful LEMUF, a programme for the continuing determination of systematic and random errors is necessary. Within this programme it is necessary to achieve traceability of all Special Nuclear Material (SNM) control and accounting measurements to an International/National Measurement System by means of Certified Reference Materials. SNM measurements for control and accounting are made internationally on a great variety of materials using many diverse measurement procedures by a large number of facilities. To achieve valid overall accountability over this great variety of measurements there must be some means of relating all these measurements and their uncertainties to each other. This is best achieved by an International/National Measurement System (IMS/NMS). To this end, all individual measurement systems must be compatible to the IMS/NMS and all measurement results must be traceable to appropriate international/national Primary Certified Reference Materials. To obtain this necessary compatibility for any given SNM measurement system, secondary certified reference materials or working reference materials are needed for every class of SNM and each type of measurement system. Ways to achieve ''traceability'' and the various types of certified reference material are defined and discussed in this paper. (author)

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...

Examining changes in certification/licensure requirements and the international medical graduate examinee pool.

Science.gov (United States)

McKinley, Danette W; Hess, Brian J; Boulet, John R; Lipner, Rebecca S

2014-03-01

Changes in certification requirements and examinee characteristics are likely to influence the validity of the evidence associated with interpretations made based on test data. We examined whether changes in Educational Commission for Foreign Medical Graduates (ECFMG) certification requirements over time were associated with changes in internal medicine (IM) residency program director ratings and certification examination scores. Comparisons were made between physicians who were ECFMG-certified before and after the Clinical Skills Assessment (CSA) requirement. A multivariate analysis of covariance was conducted to examine the differences in program director ratings based on CSA cohort and whether the examinees emigrated for undergraduate medical education (national vs. international students). A univariate analysis of covariance was conducted to examine differences in scores from the American Board of Internal Medicine (ABIM) Internal Medicine Certification Examination. For both analyses, United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores were used as covariates. Results indicate that, of those certified by ECFMG between 1993 and 1997, 17 % (n = 1,775) left their country of citizenship for undergraduate medical education. In contrast, 38 % (n = 1,874) of those certified between 1999 and 2003 were international students. After adjustment by covariates, the main effect of cohort membership on the program director ratings was statistically significant (Wilks' λ = 0.99, F 5, 15391 = 19.9, P migration status was statistically significant and weak (Wilks' λ = 0.98, F 5,15391 = 45.3, P Internal Medicine Certification Examination scores based on whether or not CSA were required was statistically significant, although the magnitude of the association between these variables was very small. The findings suggest that the implementation of an additional evaluation of skills (e.g., history-taking, physical examination) as a

The socioeconomic impact of a pediatric ostomy in Uganda: a pilot study.

Science.gov (United States)

Muzira, Arlene; Kakembo, Nasser; Kisa, Phyllis; Langer, Monica; Sekabira, John; Ozgediz, Doruk; Fitzgerald, Tamara N

2018-04-01

Multiple pediatric surgical conditions require ostomies in low-middle-income countries. Delayed presentations increase the numbers of ostomies. Patients may live with an ostomy for a prolonged time due to the high backlog of cases with insufficient surgical capacity. In caring for these patients in Uganda, we frequently witnessed substantial socioeconomic impact of their surgical conditions. The operative log at the only pediatric surgery referral center in Uganda was reviewed to assess the numbers of children receiving ostomies over a 3-year period. Charts for patients with anorectal malformations (ARM) and Hirschsprung's disease (HD) were reviewed to assess delays in accessing care. Focus group discussions (FGD) were held with family members of children with ostomies based on themes from discussions with the surgical and nursing teams. A pilot survey was developed based on these themes and administered to a sample of patients in the outpatient clinic. During the period of January 2012-December 2014, there was one specialty-certified pediatric surgeon in the country. There were 493 ostomies placed for ARM (n = 234), HD (N = 114), gangrenous ileocolic intussusception (n = 95) and typhoid-induced intestinal perforation (n = 50). Primary themes covered in the FGD were: stoma care, impact on caregiver income, community integration of the child, impact on family unit, and resources to assist families. Many patients with HD and ARM did not present for colostomy until after 1 year of life. None had access to formal ostomy bags. 15 caregivers completed the survey. 13 (86%) were mothers and 2 (13%) were fathers. Almost half of the caregivers (n = 7, 47%) stated that their spouse had left the family. 14 (93%) caregivers had to leave jobs to care for the stoma. 14 respondents (93%) reported that receiving advice from other caregivers was beneficial. The burden of pediatric surgical disease in sub-Saharan Africa is substantial with significant disparities

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…

Relationship of Wound, Ostomy, and Continence Certified Nurses and Healthcare-Acquired Conditions in Acute Care Hospitals.

Science.gov (United States)

Boyle, Diane K; Bergquist-Beringer, Sandra; Cramer, Emily

The purpose of this study was to describe the (a) number and types of employed WOC certified nurses in acute care hospitals, (b) rates of hospital-acquired pressure injury (HAPI) and catheter-associated urinary tract infection (CAUTI), and (c) effectiveness of WOC certified nurses with respect to lowering HAPI and CAUTI occurrences. Retrospective analysis of data from National Database of Nursing Quality Indicators. The sample comprised 928 National Database of Nursing Quality Indicators (NDNQI) hospitals that participated in the 2012 NDNQI RN Survey (source of specialty certification data) and collected HAPI, CAUTI, and nurse staffing data during the years 2012 to 2013. We analyzed years 2012 to 2013 data from the NDNQI. Descriptive statistics summarized the number and types of employed WOC certified nurses, the rate of HAPI and CAUTI, and HAPI risk assessment and prevention intervention rates. Chi-square analyses were used to compare the characteristics of hospitals that do and do not employ WOC certified nurses. Analysis-of-covariance models were used to test the association between WOC certified nurses and HAPI and CAUTI occurrences. Just more than one-third of the study hospitals (36.6%) employed WOC certified nurses. Certified continence care nurses (CCCNs) were employed in fewest number. Hospitals employing wound care specialty certified nurses (CWOCN, CWCN, and CWON) had lower HAPI rates and better pressure injury risk assessment and prevention practices. Stage 3 and 4 HAPI occurrences among hospitals employing CWOCNs, CWCNs, and CWONs (0.27%) were nearly half the rate of hospitals not employing these nurses (0.51%). There were no significant relationships between nurses with specialty certification in continence care (CWOCN, CCCN) or ostomy care (CWOCN, COCN) and CAUTI rates. CWOCNs, CWCNs, and CWONs are an important factor in achieving better HAPI outcomes in acute care settings. The role of CWOCNs, CCCNs, and COCNs in CAUTI prevention warrants further

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.

CT of Normal Developmental and Variant Anatomy of the Pediatric Skull: Distinguishing Trauma from Normality.

Science.gov (United States)

Idriz, Sanjin; Patel, Jaymin H; Ameli Renani, Seyed; Allan, Rosemary; Vlahos, Ioannis

2015-01-01

The use of computed tomography (CT) in clinical practice has been increasing rapidly, with the number of CT examinations performed in adults and children rising by 10% per year in England. Because the radiology community strives to reduce the radiation dose associated with pediatric examinations, external factors, including guidelines for pediatric head injury, are raising expectations for use of cranial CT in the pediatric population. Thus, radiologists are increasingly likely to encounter pediatric head CT examinations in daily practice. The variable appearance of cranial sutures at different ages can be confusing for inexperienced readers of radiologic images. The evolution of multidetector CT with thin-section acquisition increases the clarity of some of these sutures, which may be misinterpreted as fractures. Familiarity with the normal anatomy of the pediatric skull, how it changes with age, and normal variants can assist in translating the increased resolution of multidetector CT into more accurate detection of fractures and confident determination of normality, thereby reducing prolonged hospitalization of children with normal developmental structures that have been misinterpreted as fractures. More important, the potential morbidity and mortality related to false-negative interpretation of fractures as normal sutures may be avoided. The authors describe the normal anatomy of all standard pediatric sutures, common variants, and sutural mimics, thereby providing an accurate and safe framework for CT evaluation of skull trauma in pediatric patients. (©)RSNA, 2015.

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%.

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...

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.

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...

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...

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

Enhancing the ED Approach to Pediatric Sexual Assault Care: Implementation of a Pediatric SART Program

Science.gov (United States)

Goyal, MK; Mollen, CJ; Hayes, KL; Molnar, J; Christian, CW; Scribano, PV; Lavelle, J

2013-01-01

Objective Describe the experience of a novel pediatric Sexual Assault Response Team (SART) program in the first three years of implementation, and compare patient characteristics, evaluation, and treatment among subpopulations of patients. Methods Retrospective chart review of a consecutive sample of patients evaluated at a pediatric ED who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with gender, menarchal status, and presence of injuries were measured using logistic regression. Results One hundred and eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 years (+/− 4.6 years). The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among females (p<0.01), but not by gender. Evidence of acute anogenital injury on physical exam was found in 20.6% of patients. As per the Center for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal females were more likely to undergo testing for sexually transmitted infections (STI) and pregnancy (p<0.01) and to be offered pregnancy, STI, and HIV prophylaxis (p<0.01). Conclusions In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on exam. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault. PMID:23974714

Development of certified reference material of mineral composition of natural water designed to control of turbidity measurement accuracy

Directory of Open Access Journals (Sweden)

Liudmila I. Gorjaeva

2017-01-01

Full Text Available Introduction. The results of development of a certified reference material (CRM of mineral composition of natural water are presented. A solution prepared from the material of the CRM specimen imitates mineral composition of natural surface water. The certified values are mass fractions of nitrate ions, chloride ions, fluoride ions, and total iron and turbidity according to formazine scale. Materials and methods. The certified values of mass concentrations of the components were determined using calculated experimental evaluation procedure;the certified turbidity value was determinedusing the certified turbidimetric method. Results. The relative expanded uncertainty (k = 2 of the certified turbidity values does not exceed 5 %, the same value for mass concentrationsis not more than 3.5 %. Relative standard uncertainty from heterogeneity does not exceed 1.0 %. The shelf life of the developed CRM is set to 3 years. Discussion and conclusion. Developed CRM was registered in the State Register of CRM's as GSO 10815-2016. The CRM is designed to control the accuracy of results of the certified characteristics measurements, including proficiency testing of laboratories using interlaboratory comparative tests. The CRM can be used for validation of measurement procedures.

Emergency radiology of the pediatric chest: What every radiologist should know

International Nuclear Information System (INIS)

Kirks, D.R.

1987-01-01

Radiology plays a critical role in the diagnosis, treatment, and follow-up of thoracic disease seen in the pediatric emergency room. The history and physical examination of a small infant or an ill child are less reliable than in the adult. Physical examination of the chest in an uncooperative infant is difficult or nonspecific at best and impossible at worst. This does not, however, negate the importance of an adequate history and physical examination before radiologic evaluation. Numerous chest abnormalities in children have a similar history and similar manifestations or physical examination despite specific radiolic features. Conversely, a nonspecific radiologic appearance may become diagnostic when interpreted in the proper clinical context. This paper presents an overview of emergency radiology of pediatric chest disease. The emphasis is on practical matters: acute pediatric chest conditions that are commonly seen in the emergency room, outpatient clinic, or private office are illustrated and discussed. Practical aspects of imaging techniques, interpretative approach, pulmonary infection, asthma, airway foreign body, hydrocarbon aspiration, and near-drowning are emphasized

Pediatric residents' learning styles and temperaments and their relationships to standardized test scores.

Science.gov (United States)

Tuli, Sanjeev Y; Thompson, Lindsay A; Saliba, Heidi; Black, Erik W; Ryan, Kathleen A; Kelly, Maria N; Novak, Maureen; Mellott, Jane; Tuli, Sonal S

2011-12-01

Board certification is an important professional qualification and a prerequisite for credentialing, and the Accreditation Council for Graduate Medical Education (ACGME) assesses board certification rates as a component of residency program effectiveness. To date, research has shown that preresidency measures, including National Board of Medical Examiners scores, Alpha Omega Alpha Honor Medical Society membership, or medical school grades poorly predict postresidency board examination scores. However, learning styles and temperament have been identified as factors that 5 affect test-taking performance. The purpose of this study is to characterize the learning styles and temperaments of pediatric residents and to evaluate their relationships to yearly in-service and postresidency board examination scores. This cross-sectional study analyzed the learning styles and temperaments of current and past pediatric residents by administration of 3 validated tools: the Kolb Learning Style Inventory, the Keirsey Temperament Sorter, and the Felder-Silverman Learning Style test. These results were compared with known, normative, general and medical population data and evaluated for correlation to in-service examination and postresidency board examination scores. The predominant learning style for pediatric residents was converging 44% (33 of 75 residents) and the predominant temperament was guardian 61% (34 of 56 residents). The learning style and temperament distribution of the residents was significantly different from published population data (P  =  .002 and .04, respectively). Learning styles, with one exception, were found to be unrelated to standardized test scores. The predominant learning style and temperament of pediatric residents is significantly different than that of the populations of general and medical trainees. However, learning styles and temperament do not predict outcomes on standardized in-service and board examinations in pediatric residents.

Revisit image control for pediatric chest radiography

Energy Technology Data Exchange (ETDEWEB)

Kohda, Ehiichi; Nagamoto, Masashi; Gomi, Tatsuya; Terada, Hitoshi; Kawawa, Yohko [Toho Univ., School of Medicine, Tokyo (Japan); Tsutsumi, Yoshiyuki; Masaki, Hidekazu [National Center for Child Health and Development, Tokyo (Japan); Shiraga, Nobuyuki [Kyousai Tachikawa Hospital, Tachikawa, Tokyo (Japan)

2007-02-15

The aim of this study was to analyze the fraction defectiveness and efficacy of the patient immobilization device (PID) for pediatric chest radiography. We examined 840 plain chest radiographs in six hospitals, including four children's hospitals and two general hospitals. The mean age of the patients was 1.9 years (range 0-5 years). Two boardqualified pediatric radiologists rated (into three grades, by consensus) the degree of inspiration, rotation, lordosis, scoliosis, and cutoff or coning as well as the quality of the chest radiographs. The incidence of ''poor'' and ''very poor'' quality examinations was 2/140 and 3/140 in each of two children's hospitals using PID. The corresponding figures were 9/139 and 17/140 in the two children's hospitals that did not use PID. The general hospital using PID had 14/140 ''poor'' and ''very poor'' examinations. The general hospital that did not use PID had 28/140 ''poor'' and ''very poor'' examinations. Thus, statistically better quality chest radiography was obtained with the use of PID (P<0.001). Likewise, rotation, lordosis, and scoliosis were less frequently diagnosed as present when PID was used (P<0.001, 0.001, 0.05). Cutoff or coning had no relation to the use of PID (P=0.13). No significant difference was found between the degree of inspiration and the use of PID (P=0.56). Fraction defectiveness in the general hospital that did not use PID was as much as 14 times higher than that of the children's hospitals that used PID. The patient immobilization device is recommended for hospitals with technologists not specifically trained for pediatric examination. (author)

Revisit image control for pediatric chest radiography

International Nuclear Information System (INIS)

Kohda, Ehiichi; Nagamoto, Masashi; Gomi, Tatsuya; Terada, Hitoshi; Kawawa, Yohko; Tsutsumi, Yoshiyuki; Masaki, Hidekazu; Shiraga, Nobuyuki

2007-01-01

The aim of this study was to analyze the fraction defectiveness and efficacy of the patient immobilization device (PID) for pediatric chest radiography. We examined 840 plain chest radiographs in six hospitals, including four children's hospitals and two general hospitals. The mean age of the patients was 1.9 years (range 0-5 years). Two boardqualified pediatric radiologists rated (into three grades, by consensus) the degree of inspiration, rotation, lordosis, scoliosis, and cutoff or coning as well as the quality of the chest radiographs. The incidence of ''poor'' and ''very poor'' quality examinations was 2/140 and 3/140 in each of two children's hospitals using PID. The corresponding figures were 9/139 and 17/140 in the two children's hospitals that did not use PID. The general hospital using PID had 14/140 ''poor'' and ''very poor'' examinations. The general hospital that did not use PID had 28/140 ''poor'' and ''very poor'' examinations. Thus, statistically better quality chest radiography was obtained with the use of PID (P<0.001). Likewise, rotation, lordosis, and scoliosis were less frequently diagnosed as present when PID was used (P<0.001, 0.001, 0.05). Cutoff or coning had no relation to the use of PID (P=0.13). No significant difference was found between the degree of inspiration and the use of PID (P=0.56). Fraction defectiveness in the general hospital that did not use PID was as much as 14 times higher than that of the children's hospitals that used PID. The patient immobilization device is recommended for hospitals with technologists not specifically trained for pediatric examination. (author)

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...

Credence quality coordination and consumers' willingness-to-pay for certified halal labelled meat.

Science.gov (United States)

Verbeke, Wim; Rutsaert, Pieter; Bonne, Karijn; Vermeir, Iris

2013-12-01

This paper reports on halal credence quality coordination and Muslim consumers' willingness to buy and pay for certified halal labelled meat at the supermarket and the Islamic butcher. Cross-sectional data were collected through a survey with 202 Muslim consumers in Belgium. Findings indicate that more acculturated and female consumers are more in favour of purchasing certified halal labelled meat in a supermarket. Important conditions are that supermarkets can provide a guarantee of separating halal from non-halal meat and of the organisation of adequate verification and control. Results further show that more Muslim consumers are willing to pay a price premium (of 13% on average) for halal labelled meat at the Islamic butcher shop than at the supermarket. The higher the importance attached to a certified halal label and the more distrust in the actual halal meat status, the higher the likelihood that a Muslim consumer is willing to pay a higher price for certified halal labelled meat at the Islamic butcher shop. Gender and generation determine the actual premium Muslim consumers are willing to pay. Copyright © 2013 Elsevier Ltd. All rights reserved.

Parent assessment of medical student skills in ambulatory pediatrics

OpenAIRE

Erika Persson; Christina Haines; Mia Lang

2013-01-01

Background: Partnership with parents is a vital part of pediatric medical education, yet few studies have examined parent attitudes towards learners in pediatric settings. Methods: Questionnaires were used to determine parent and student assessment of professional and clinical skills (primary outcome) and parent attitudes towards 3rd year medical students (secondary outcome) at the University of Alberta. Chi Square, Kendall’s Tau and Kappa coefficients were calculated to compare parent an...

40 CFR 1068.261 - What provisions apply for selling or shipping certified engines that are not yet in the certified...

Science.gov (United States)

2010-07-01

... assembly of the engine so it is in its certified configuration when final assembly is complete. This... following approaches: (i) Apply an additional removable label in a way that makes it unlikely that the... certification: (i) How you plan to use the provisions of this section. (ii) A detailed plan for auditing...

Impact of Music in Reducing Patient Anxiety During Pediatric Ultrasound.

Science.gov (United States)

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

2016-03-31

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 15 second intervals for a total of 1 minute, with mean values calculated prior to entering the procedure room, during the middle of the procedure, and after the procedure was completed. The total scan time was determined from the initial image acquisition until the last image recorded by the ultrasound technologist. At the completion of each procedure, the ultrasound technologist scored the ease of performance for the scan on a subjective scale of 1-10 based on prior experience. When utilizing music during pediatric ultrasounds examinations, our study demonstrated significantly decreased heart rate variability from pre-procedural to post-procedural periods. There was no statistical significant difference in total scan time or ultrasound technologist scoring between the two groups. This study demonstrates that music is an inexpensive and effective means of reducing anxiety during pediatric ultrasound as indicated by heart rate.

Impact of music in reducing patient anxiety during pediatric ultrasound

Directory of Open Access Journals (Sweden)

Andrew Kesselman

2016-03-01

Full Text Available 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 15 second intervals for a total of 1 minute, with mean values calculated prior to entering the procedure room, during the middle of the procedure, and after the procedure was completed. The total scan time was determined from the initial image acquisition until the last image recorded by the ultrasound technologist. At the completion of each procedure, the ultrasound technologist scored the ease of performance for the scan on a subjective scale of 1-10 based on prior experience. When utilizing music during pediatric ultrasounds examinations, our study demonstrated significantly decreased heart rate variability from pre-procedural to post-procedural periods. There was no statistical significant difference in total scan time or ultrasound technologist scoring between the two groups. This study demonstrates that music is an inexpensive and effective means of reducing anxiety during pediatric ultrasound as indicated by heart rate.

Utility of MR imaging in pediatric spinal cord injury

International Nuclear Information System (INIS)

Felsberg, G.J.; Tien, R.D.; Osumi, A.K.; Cardenas, C.A.

1995-01-01

We evaluated the utility of MR imaging in pediatric patients with acute and subacute spinal cord injuries. MR imaging of 22 pediatric patients with suspected traumatic spinal cord injuries was reviewed. MR findings were correlated with physical examination and compared to available radiographs and CT examinations performed at time of presentation. Twelve patients had abnormalities on MR imaging. Seven had spinal cord contusions; five contusions were hemorrhagic. Five of seven patients with cord contusion had normal radiographs and CT exams. Six patients with normal radiographs and CT examinations had abnormal MR studies revealing cord contusion, ligamentous injury, disc herniation, and epidural hematoma. MR is useful in initial evaluation of pediatric patients with spinal cord injuries and in prognosis of future neurologic function. In the setting of spinal cord symptomatology and negative radiographic studies, MR imaging should be performed. Surgically correctable causes of cord compression demonstrated by MR imaging include disc herniation, epidural hematoma, and retropulsed fracture fragments. The entity of spinal cord injury without radiographic abnormality is a diagnosis of exclusion which should only be made after radiologic investigation with radiographs, high-resolution thin-section CT, and MR imaging. (orig.)

MASTERS OF ANALYTICAL TRADECRAFT: CERTIFYING THE STANDARDS AND ANALYTIC RIGOR OF INTELLIGENCE PRODUCTS

Science.gov (United States)

2016-04-01

AU/ACSC/2016 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY MASTERS OF ANALYTICAL TRADECRAFT: CERTIFYING THE STANDARDS AND ANALYTIC RIGOR OF...establishing unit level certified Masters of Analytic Tradecraft (MAT) analysts to be trained and entrusted to evaluate and rate the standards and...cues) ideally should meet or exceed effective rigor (based on analytical process).4 To accomplish this, decision makers should not be left to their

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

KAUST Repository

Simoes, Filipa R. F.

2016-10-25

Inductively coupled plasma optical emission spectroscopy (ICP-OES) is a common, relatively low cost, and straightforward analytical technique for the study of trace quantities of metals in solid materials, but its applicability to nanocarbons (e.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

Gender Differences in the Authorship of Original Research in Pediatric Journals, 2001-2016.

Science.gov (United States)

Fishman, Michael; Williams, Wadsworth A; Goodman, Denise M; Ross, Lainie Friedman

2017-12-01

To examine the gender of authors of original research in 3 high-impact pediatric journals between 2001 and 2016, given the importance of publishing on academic promotion, and to compare authorship gender with the percentage of women on editorial boards and with academic faculty composition. We assessed the prevalence of female first and senior (last-listed) authorship of original research articles published in 3 pediatric-focused journals Pediatrics, JAMA Pediatrics (entitled Archives of Pediatric and Adolescent Medicine until 2013), and The Journal of Pediatrics. We also examined the gender breakdown of the main editors and the broader editorial boards of these journals. In addition, we examined whether junior female faculty co-authored with male or female senior faculty. Of 3895 original articles, 22 were excluded because the gender of either the first or senior author could not be determined from the name. An analysis of authorship by year showed increasing female representation across the selected journals in both first (39.8% in 2001, 57.7% in 2016) and senior (28.6% in 2001, 38.1% in 2016) authors, respectively. Editorial boards also showed increasing female representation (17.8% in 2001 to 39.8% in 2016). Junior female faculty were more likely to co-author with senior female women (female first and last author); the gap remained unchanged despite the increasing number of women entering pediatrics. Women are underrepresented as authors and editors, although the gap is closing. Junior women are less likely to co-author with senior men, which may be a disservice given current gender disparities in promotion and leadership. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

The ALARA (as low as reasonably achievable) concept in pediatric interventional and fluoroscopic imaging: striving to keep radiation doses as low as possible during fluoroscopy of pediatric patients - a white paper executive summary

International Nuclear Information System (INIS)

Strauss, Keith J.; Kaste, Sue C.

2006-01-01

ALARA represents a practice mandate adhering to the principle of keeping radiation doses to patients and personnel As Low As Reasonably Achievable. This concept is strongly endorsed by the Society for Pediatric Radiology, particularly in the use of procedures and modalities involving higher radiation doses such as CT and fluoroscopic examinations of pediatric patients. There is no doubt that medical imaging, which has undergone tremendous technological advances in recent decades, is integral to patient care. However, these technological advances generally precede the knowledge of end-users concerning the optimal use and correct operation of the resulting imaging equipment, and such knowledge is essential to minimizing potential risks to the patients. Current imaging methods must be optimized for radiation dose reduction in pediatric patients who might be as much as ten times more radiosensitive than adults. Unlike straightforward radiographic examinations, radiation dose to the patient during fluoroscopy is dependent on the operator's training, experience with the fluoroscope, and efficiency in completing a diagnostic study. The range of pediatric radiation doses from fluoroscopy is wide because this examination is performed not only by pediatric radiologists but also by general radiologists who occasionally care for children, interventional cardiologists, gastroenterologists, urologists and others. Thus, a venue where multidisciplinary interaction by this variety of operators can occur serves to improve pediatric patient care

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....

Automated simultaneous assembly of multi-stage testing for the uniform CPA examination

NARCIS (Netherlands)

Breithaupt, Krista; Ariel, A.; Veldkamp, Bernard P.

2004-01-01

Some solutions used in the assembly of the computerized Uniform Certified Public Accountancy (CPA) licensing examination are offered as practical alternatives for operational programs producing large numbers of forms. The Uniform CPA examination will be offered as an adaptive multi-stage test (MST)

Development of a Certified Reference Material (NMIJ CRM 7203-a) for Elemental Analysis of Tap Water.

Science.gov (United States)

Zhu, Yanbei; Narukawa, Tomohiro; Inagaki, Kazumi; Miyashita, Shin-Ichi; Kuroiwa, Takayoshi; Ariga, Tomoko; Kudo, Izumi; Koguchi, Masae; Heo, Sung Woo; Suh, Jung Ki; Lee, Kyoung-Seok; Yim, Yong-Hyeon; Lim, Youngran

2017-01-01

A certified reference material (CRM), NMIJ CRM 7203-a, was developed for the elemental analysis of tap water. At least two independent analytical methods were applied to characterize the certified value of each element. The elements certified in the present CRM were as follows: Al, As, B, Ca, Cd, Cr, Cu, Fe, K, Mg, Mn, Mo, Na, Ni, Pb, Rb, Sb, Se, Sr, and Zn. The certified value for each element was given as the (property value ± expanded uncertainty), with a coverage factor of 2 for the expanded uncertainty. The expanded uncertainties were estimated while considering the contribution of the analytical methods, the method-to-method variance, the sample homogeneity, the long-term stability, and the concentrations of the standard solutions for calibration. The concentration of Hg (0.39 μg kg -1 ) was given as the information value, since loss of Hg was observed when the sample was stored at room temperature and exposed to light. The certified values of selected elements were confirmed by a co-analysis carried out independently by the NMIJ (Japan) and the KRISS (Korea).

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.

CWSP Certified Wireless Security Professional Official Study Guide, Exam PW0-204

CERN Document Server

Coleman, David D; Harkins, Bryan E

2010-01-01

Sybex is now the official publisher for Certified Wireless Network Professional, the certifying vendor for the CWSP program. This guide covers all exam objectives, including WLAN discovery techniques, intrusion and attack techniques, 802.11 protocol analysis. Wireless intrusion-prevention systems implementation, layer 2 and 3 VPNs used over 802.11 networks, and managed endpoint security systems. It also covers enterprise/SMB/SOHO/Public-Network Security design models and security solution implementation, building robust security networks, wireless LAN management systems, and much more.

Utility of hand-held echocardiography in outpatient pediatric cardiology management.

Science.gov (United States)

Riley, Alan; Sable, Craig; Prasad, Aparna; Spurney, Christopher; Harahsheh, Ashraf; Clauss, Sarah; Colyer, Jessica; Gierdalski, Marcin; Johnson, Ashley; Pearson, Gail D; Rosenthal, Joanna

2014-12-01

Adult patient series have shown hand-held echocardiography (echo) units (HHE) to be accurate for rapid diagnosis and triage. This is the first study to evaluate the ability of HHE to inform decision making in outpatient pediatric cardiology. New pediatric cardiology patients in outpatient clinics staffed by six pediatric cardiologists (experience 1-17 years) were prospectively enrolled if an echocardiogram (echo) was ordered during their initial visit. After history and physical examination and before a standard echo, the cardiologists performed a bedside HHE examination (GE Vscan 1.7-3.8 MHz), documented findings, and made a clinical decision. Diagnoses and decisions based on HHE were compared with final management after the standard echo. The study enrolled 101 subjects (ages 9 days to 19 years). The cardiologists considered HHE imaging adequate for decision making for 80 of the 101 subjects. For 77 of the 80 subjects with acceptable HHE imaging (68/68 normal and 9/12 abnormal standard echoes), the HHE-based primary diagnoses and decisions agreed with the final management. The sensitivity of HHE was 75 % (95 % confidence interval [CI] 43-94 %) and the positive predictive value 100 % (95 % CI 66-100 %) for pediatric heart disease. The agreement between standard echocardiography and HHE imaging was substantial (κ = 0.82). Excluding one of the least experienced cardiologists, HHE provided the basis for correct cardiac diagnoses and management for all the subjects with acceptable HHE imaging (58/58 normal and 9/9 abnormal echoes). In outpatient pediatric cardiology, HHE has potential as a tool to complement physical examination. Further investigation is needed to evaluate how value improves with clinical experience.

Benchmarks for Support and Outcomes for Internal Medicine-Pediatrics Residency Programs: A 5-Year Review.

Science.gov (United States)

Aronica, Michael; Williams, Ronald; Dennar, Princess E; Hopkins, Robert H

2015-12-01

Combined internal medicine and pediatrics (medicine-pediatrics) residencies were Accreditation Council for Graduate Medical Education (ACGME) accredited separately from their corresponding categorical residencies in June 2006. We investigated how ACGME accreditation of medicine-pediatrics programs has affected the levels of support (both financial and personnel), the National Resident Matching Program (NRMP) match rate, performance on the board examination, and other graduate outcomes. From 2009 through 2013 we sent an annual SurveyMonkey online survey to members of the Medicine-Pediatrics Program Directors Association. Questions pertained to program characteristics, program director support, recruitment, ambulatory training, and graduate data. More than 79% of responders completed the entire survey for each year (sample size was 60 program directors). Compared to the time prior to accreditation of the specialty, there was an increase in program directors who are dually trained (89% versus 93%), an increase in program director salary ($134,000 before accreditation versus $185,000 in 2013, P Pediatrics examination was comparable to that for pediatrics residents. Since accreditation, a larger number of residents are choosing careers in hospital medicine. Our data show widespread improved support for medicine-pediatrics programs since the 2006 start of ACGME accreditation.

Introduction to special issue: moving forward in pediatric neuropsychology.

Science.gov (United States)

Daly, Brian P; Giovannetti, Tania; Zabel, T Andrew; Chute, Douglas L

2011-08-01

This special issue of The Clinical Neuropsychologist focuses on advances in the emerging subspecialty of pediatric neuropsychology. The national and international contributions in this issue cover a range of key clinical, research, training, and professional issues specific to pediatric neuropsychology. The genesis for this project developed out of a series of talks at the Philadelphia Pediatric Neuropsychology Symposium in 2010, hosted by the Stein Family Fellow, the Department of Psychology of the College of Arts and Sciences at Drexel University, and the Philadelphia Neuropsychology Society. Articles that explore clinical practice issue focus on the assessment of special medical populations with congenital and/or acquired central nervous system insults. Research articles investigate the core features of developmental conditions, the use of technology in neuropsychological research studies, and large sample size genomic, neuropsychological, and imaging studies of under-represented populations. The final series of articles examine new considerations in training, advocacy, and subspecialty board certification that have emerged in pediatric neuropsychology. This introductory article provides an overview of the articles in this special issue and concluding thoughts about the future of pediatric neuropsychology.

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...

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...

Intraoperative imaging of pediatric vocal fold lesions using optical coherence tomography

Science.gov (United States)

Benboujja, Fouzi; Garcia, Jordan A.; Beaudette, Kathy; Strupler, Mathias; Hartnick, Christopher J.; Boudoux, Caroline

2016-01-01

Optical coherence tomography (OCT) has been previously identified as a promising tool for exploring laryngeal pathologies in adults. Here, we present an OCT handheld probe dedicated to imaging the unique geometry involved in pediatric laryngoscopy. A vertical cavity surface emitting laser-based wavelength-swept OCT system operating at 60 frames per second was coupled to the probe to acquire three-dimensional (3-D) volumes in vivo. In order to evaluate the performance of the proposed probe and system, we imaged pediatric vocal fold lesions of patients going under direct laryngoscopy. Through this in vivo study, we extracted OCT features characterizing each pediatric vocal fold lesion, which shows a great potential for noninvasive laryngeal lesion discrimination. We believe OCT vocal fold examination in 3-D will result in improved knowledge of the pediatric anatomy and could aid in managing pediatric laryngeal diseases.

Obesity prevention in pediatrics: A pilot pediatric resident curriculum intervention on nutrition and obesity education and counseling.

Science.gov (United States)

Gonzalez, Jose L; Gilmer, Loise

2006-09-01

Obesity is a highly burdensome public health issue associated with premature death, multiple comorbid disabilities and staggering healthcare costs. Between 1980-2000, the prevalence of obesity among children and adolescents nearly tripled. Obesity subjects youth to social stigmatization and discrimination. These economic and personal burdens mandate targeted prevention and detection educational programs for all individuals at risk. The most cost-effective method of approaching this obesity epidemic is through education of health professionals. As part of an "Obesity Prevention in Pediatrics" curriculum, postgraduate-year (PGY)-2 residents first observed and then participated in the dietary evaluation and counseling of pediatric patients and their families. Attitudinal questionnaires, multiple-choice knowledge examinations and a pre-established checklist of desired skills and behaviors provided evaluation of the curriculum's effect on the participants' ability and willingness to manage actually obese or at-risk pediatric patients and their families. Attitudinal survey and knowledge test scores from control PGY-3 residents generally confirmed that their knowledge and counseling skills on obesity prevention and management were well below expectation. Following participation in the curriculum, study residents' knowledge tended to improve, as did their level of comfort in counseling obese and at-risk children, adolescents and their parents. Implementation of an "Obesity Prevention in Pediatrics" curriculum appears to improve participants' knowledge base as well as their skills and level of personal comfort in the recognition, evaluation and management, including counseling, of both obese and at-risk pediatric patients and their families.

Pediatric Academic Productivity: Pediatric Benchmarks for the h- and g-Indices.

Science.gov (United States)

Tschudy, Megan M; Rowe, Tashi L; Dover, George J; Cheng, Tina L

2016-02-01

To describe h- and g-indices benchmarks in pediatric subspecialties and general academic pediatrics. Academic productivity is measured increasingly through bibliometrics that derive a statistical enumeration of academic output and impact. The h- and g-indices incorporate the number of publications and citations. Benchmarks for pediatrics have not been reported. Thirty programs were selected randomly from pediatric residency programs accredited by the Accreditation Council for Graduate Medical Education. The h- and g-indices of department chairs were calculated. For general academic pediatrics, pediatric gastroenterology, and pediatric nephrology, a random sample of 30 programs with fellowships were selected. Within each program, an MD faculty member from each academic rank was selected randomly. Google Scholar via Harzing's Publish or Perish was used to calculate the h-index, g-index, and total manuscripts. Only peer-reviewed and English language publications were included. For Chairs, calculations from Google Scholar were compared with Scopus. For all specialties, the mean h- and g-indices significantly increased with academic rank (all P calculation using different bibliographic databases only differed by ±1. Mean h-indices increased with academic rank and were not significantly different across the pediatric specialties. Benchmarks for h- and g-indices in pediatrics are provided and may be one measure of academic productivity and impact. Copyright © 2016 Elsevier Inc. All rights reserved.

Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

Science.gov (United States)

Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

2012-01-01

To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

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

Effects of Sleep Deprivation on Cognitive Ability and Skills of Pediatrics Residents.

Science.gov (United States)

Storer, James S.; And Others

1989-01-01

The cognitive and skills performances of sleep-deprived pediatrics residents were measured by using questions like those on the pediatrics board certification examination and using tasks that required coordination and dexterity. Implications of findings are discussed in the context of the controversy over the structure and process of medical…

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...

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...

Characteristic and Preferences of Green Consumer Stratification As Bases to Formulating Marketing Strategies of Ecolabel-Certified Furniture

OpenAIRE

Ririn Wulandari; Budi Suharjo; Agus W. Soehadi; Herry Purnomo

2012-01-01

International furniture markets certify ecolabel has been growing, but the domestic market has not yet developed. Unfortunate, because these products have two advantages that ensure environmental sustainability and promote a furniture market. This study was expected to open and developed the domestic market for ecolabel-certified furniture. The aim of this study was to develop marketing strategies for ecolabel-certified furniture on each of green consumer stratifications. Consumer stratificat...

Pediatric radiologists: who we are and what we do. Results of a membership survey of the Society for Pediatric Radiology - 1999

International Nuclear Information System (INIS)

Goske, M.J.; Lieber, M.; Lebowitz, R.L.; Ablin, D.; Royal, S.

2000-01-01

Background. There is a need for reliable monitoring of workforce trends in the field of pediatric radiology by the Society for Pediatric Radiology. In addition, the Society should periodically assess itself as to its mission and relevance to its members via membership surveys. Objective. The Membership Committee of the Society for Pediatric Radiology, 1999, conducted a 54-question survey to determine the makeup of its members, job profiles, satisfaction with services of the Society for Pediatric Radiology, and its official journal, Pediatric Radiology. Materials and methods. Seven hundred fifty surveys were given to active members of the Society for Pediatric Radiology in the United States and Canada. There were 275 surveys returned for an overall response of 37%. Results. Mean age of members is 48 years with 99 % of respondents working. Membership is 34 % female and 66 % male. Women members of the Society are younger (45 vs 49 years, P = 0.0012) and work less hours (47.8 vs 51.0, P = 0.0135) than men. Fifty-seven percent of respondents practice in a freestanding children's hospital, 29 % in a ''children's hospital within a hospital,'' and 14 % are in community hospitals or an office-based practice. Eighty-two percent of the responding pediatric radiologist's time is spent in performing examination on children, with only 18 % spent on adult work or administration. Forty-eight percent work at more than one office. Sixty-one percent worked evenings or weekends, excluding night call. Two hundred twenty-two of 275 respondents had received a Certificate of Added Qualification. The meeting ''for CME credit'' was considered the most important benefit of Society membership. Most respondents read select articles in Pediatric Radiology. There was sentiment to decrease esoteric case reports in favor of review articles. Only 19 % of respondents submitted their articles to Pediatric Radiology initially. Conclusion. Pediatric radiologists are a diverse membership with the common

Serum tumor markers in pediatric osteosarcoma: a summary review

Directory of Open Access Journals (Sweden)

Savitskaya Yulia A

2012-03-01

Full Text Available Abstract Osteosarcoma is the most common primary high-grade bone tumor in both adolescents and children. Early tumor detection is key to ensuring effective treatment. Serum marker discovery and validation for pediatric osteosarcoma has accelerated in recent years, coincident with an evolving understanding of molecules and their complex interactions, and the compelling need for improved pediatric osteosarcoma outcome measures in clinical trials. This review gives a short overview of serological markers for pediatric osteosarcoma, and highlights advances in pediatric osteosarcoma-related marker research within the past year. Studies in the past year involving serum markers in patients with pediatric osteosarcoma can be assigned to one of four categories, i.e., new approaches and new markers, exploratory studies in specialized disease subsets, large cross-sectional validation studies, and longitudinal studies, with and without an intervention. Most of the studies have examined the association of a serum marker with some aspect of the natural history of pediatric osteosarcoma. As illustrated by the many studies reviewed, several serum markers are emerging that show a credible association with disease modification. The expanding pool of informative osteosarcoma-related markers is expected to impact development of therapeutics for pediatric osteosarcoma positively and, it is hoped, ultimately clinical care. Combinations of serum markers of natural immunity, thyroid hormone homeostasis, and bone tumorigenesis may be undertaken together in patients with pediatric osteosarcoma. These serum markers in combination may do better. The potential effect of an intrinsic dynamic balance of tumor angiogenesis residing within a single hormone (tri-iodothyronine is an attractive concept for regulation of vascularization in pediatric osteosarcoma.

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...

Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems.

Science.gov (United States)

D'Alessandro, Donna; Kingsley, Peggy

2002-01-01

The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

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.

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.

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.

ENERGY STAR Certified Non-AHRI Central Air Conditioner Equipment and Air Source Heat Pump

Science.gov (United States)

Certified models meet all ENERGY STAR requirements as listed in the Version 5.0 ENERGY STAR Program Requirements for Air Source Heat Pump and Central Air Conditioner Equipment that are effective as of September 15, 2015. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=airsrc_heat.pr_crit_as_heat_pumps Listed products have been submitted to EPA by ENERGY STAR partners that do not participate in the AHRI certification program. EPA will continue to update this list with products that are certified by EPA-recognized certification bodies other than AHRI. The majority of ENERGY STAR products, certified by AHRI, can be found on the CEE/AHRI Verified Directory at http://www.ceedirectory.org/

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

Certified Reference Material IAEA-446 for radionuclides in Baltic Sea seaweed

DEFF Research Database (Denmark)

Pham, M.K.; Benmansour, M.; Carvalho, F.P.

2014-01-01

A Certified Reference Material (CRM) for radionuclides in seaweed (Fucus vesiculosus) from the Baltic Sea (IAEA-446) is described and the results of the certification process are presented. The 40K, 137Cs, 234U and 239þ240Pu radionuclides were certified for this material, and information values...... for 12 other radionuclides (90Sr, 99Tc, 210Pb (210Po), 226Ra, 228Ra, 228Th, 230Th, 232Th, 235U, 238U, 239Pu and 240Pu) are presented. The CRM can be used for Quality Assurance/Quality Control of analysis of radionuclides in seaweed and other biota samples, as well as for development and validation...

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

CWAP Certified Wireless Analysis Professional Official Study Guide Exam PW0-270

CERN Document Server

Westcott, David A; Miller, Ben; Mackenzie, Peter

2011-01-01

The official study guide for the Certified Wireless Analysis Professional certification from CWNPFour leading wireless experts thoroughly prepare you for the vendor-neutral CWAP exam administered by CWNP, the industry leader for enterprise Wi-Fi training and certification.  This official study guide not only covers all exam objectives for the CWAP exam, it also prepares you to administer and troubleshoot complex enterprise WLAN environments.Covers all exam objectives for the Certified Wireless Analysis Professional (CWAP) examCovers 802.11 physical (PHY) and 802.11 MAC layer frame formats and

78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting

Science.gov (United States)

2013-08-08

...] Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting AGENCY: Food and Drug... of Subcommittee: Pediatric Ethics Subcommittee of the Pediatric Advisory Committee. General Function... pediatric ethical issues. Date and Time: The meeting will be held on September 9, 2013, from 8 a.m. to 5:30...

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 ...

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.

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.

Clinical analysis of bronchoscopic electrocoagulation in pediatric patients

Science.gov (United States)

Ni, Caiyun; Yu, Huafeng; Han, Xiaorong; Meng, Chen; Zhang, Yanqing

2014-01-01

This study is to explore the efficacy and safety of bronchoscopic electrocoagulation treatment for pediatric disease of poor ventilation. Seventy pediatric patients of airway stenosis and obstruction as well as pharyngeal and laryngeal cysts received bronchoscopic electrocoagulation treatment, including 15 cases of epiglottic cyst, 13 cases of cicatricial hyperplasia of fibrous tissue after trachea intubation, 5 cases of foreign body in bronchus and 37 cases of endobronchial tuberculosis. Before and after the last electrocoagulation treatment, treatment efficacy was evaluated by examining the patients’ clinical presentations and lesions in airway under bronchoscope, examining chest CT and pulmonary function, and estimating pulmonary atelectasis and ventilation function. Seventy cases of pediatric patients were treated by bronchoscopic electrocoagulation, with the total treatment number of 106 times. Among them, 66 cases were treated with marked efficacy and 4 cases were with effective treatment. There was no invalid treatment. The treatment efficacy was 100% without complications. Bronchoscopic electrocoagulation treatment is a fast, effective and safe therapeutic method in treating airway stenosis and obstruction, such as foreign body in bronchus, granulation tissue hyperplasia, and epiglottic cysts. It is worthy of being widely applied in clinic. PMID:25664086

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)

Validity of Level of Supervision Scales for Assessing Pediatric Fellows on the Common Pediatric Subspecialty Entrustable Professional Activities.

Science.gov (United States)

Mink, Richard B; Schwartz, Alan; Herman, Bruce E; Turner, David A; Curran, Megan L; Myers, Angela; Hsu, Deborah C; Kesselheim, Jennifer C; Carraccio, Carol L

2018-02-01

Entrustable professional activities (EPAs) represent the routine and essential activities that physicians perform in practice. Although some level of supervision scales have been proposed, they have not been validated. In this study, the investigators created level of supervision scales for EPAs common to the pediatric subspecialties and then examined their validity in a study conducted by the Subspecialty Pediatrics Investigator Network (SPIN). SPIN Steering Committee members used a modified Delphi process to develop unique scales for six of the seven common EPAs. The investigators sought validity evidence in a multisubspecialty study in which pediatric fellowship program directors and Clinical Competency Committees used the scales to evaluate fellows in fall 2014 and spring 2015. Separate scales for the six EPAs, each with five levels of progressive entrustment, were created. In both fall and spring, more than 300 fellows in each year of training from over 200 programs were assessed. In both periods and for each EPA, there was a progressive increase in entrustment levels, with second-year fellows rated higher than first-year fellows (P < .001) and third-year fellows rated higher than second-year fellows (P < .001). For each EPA, spring ratings were higher (P < .001) than those in the fall. Interrater reliability was high (Janson and Olsson's iota = 0.73). The supervision scales developed for these six common pediatric subspecialty EPAs demonstrated strong validity evidence for use in EPA-based assessment of pediatric fellows. They may also inform the development of scales in other specialties.

48 CFR 15.403 - Obtaining certified cost or pricing data.

Science.gov (United States)

2010-10-01

... or pricing data. 15.403 Section 15.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403 Obtaining certified cost or pricing data. ...

Barriers and facilitators to sexual and reproductive health communication between pediatric oncology clinicians and adolescent and young adult patients: The clinician perspective.

Science.gov (United States)

Frederick, Natasha N; Campbell, Kevin; Kenney, Lisa B; Moss, Kerry; Speckhart, Ashley; Bober, Sharon L

2018-04-26

Sexual and reproductive health (SRH) is identified by adolescent and young adult (AYA) patients with cancer as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to investigate the attitudes and perceptions of pediatric oncology clinicians towards discussing SRH with AYAs, and to understand perceived barriers to effective communication in current practice. Pediatric oncology clinicians (physicians, certified nurse practitioners, and physician assistants) participated in semi-structured qualitative interviews investigating attitudes about SRH communication with AYAs and barriers to such conversations. Twenty-two clinicians participated from seven institutions in the Northeastern United States. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach. Interviews with pediatric oncology clinicians revealed the following five primary themes: the role for pediatric oncology clinicians to discuss SRH, the focus of current SRH conversations on fertility, the meaning of "sexual health" as safe sex and contraception only, clinician-reported barriers to SRH conversations, and the need for education and support. Communication barriers included lack of knowledge/experience, lack of resources/referrals, low priority, parents/family, patient discomfort, clinician discomfort, time, and lack of rapport. Clinicians identified resource and support needs, including formal education and SRH education materials for patients and families. Although the study participants identified a role for pediatric oncology clinicians in SRH care for AYA patients with cancer, multiple barriers interfere with such discussions taking place on a regular basis. Future efforts must focus on resource development and provider education and training in SRH to optimize the care provided to this unique patient population. © 2018 Wiley Periodicals, Inc.

Sports Nutrition Knowledge, Perceptions, Resources, and Advice Given by Certified CrossFit Trainers

OpenAIRE

Cassie Maxwell; Kyle Ruth; Carol Friesen

2017-01-01

Background: CrossFit is a large, growing force in the fitness community. Currently, Level 1 and 2 CrossFit certification classes do not include nutrition education. The purpose of this study was to identify sports nutrition knowledge, perceptions, resources, and advice given by Certified CrossFit Trainers. Methods: An online questionnaire that measured these four constructs was placed on a private Facebook community, open only to certified CrossFit trainers, for 10 days. Results: Complete sur...

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...

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.

How Do US Pediatric Residency Programs Teach and Evaluate Community Pediatrics and Advocacy Training?

Science.gov (United States)

Lichtenstein, Cara; Hoffman, Benjamin D; Moon, Rachel Y

2017-07-01

In 2013, the Accreditation Council for Graduate Medical Education updated requirements for training in community pediatrics and advocacy in pediatric residency programs. In light of this update, the aim of this study was to better understand how community pediatrics is being taught and evaluated in pediatric residency programs in the United States. Cross-sectional exploratory study using a Web-based survey of pediatric residency program directors in September 2014. Questions focused on teaching and evaluation of 10 community pediatrics competencies. Of 85 programs (43% response rate), 30% offered a separate training track and/or 6-block individualized curriculum in community pediatrics or advocacy. More than 75% required all residents to learn 7 of 10 competencies queried. Respondents in urban settings were more likely to teach care of special populations (P = .02) and public speaking (P pediatrics and advocacy teaching among responding US pediatric residency programs. Although respondents reported a variety of teaching and evaluation methods, there were few statistically significant differences between programs. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Attention for pediatric interventional radiology

International Nuclear Information System (INIS)

Zhu Ming; Cheng Yongde

2005-01-01

Radiological interventions possess wide utilization in the diagnosis and treatment for pediatric patients. Pediatric interventional radiology is an important branch of interventional radiology and also an important branch of pediatric radiology. Pediatric interventional radiology has grown substantially over the last 30 years, radiologists closely cooperation with surgeons and other physicians providing a new horizon in the management of pediatric diseases in western countries. It includes pediatric cardiac interventional radiology, pediatric neuro-interventional radiology, pediatric vascular interventional radiology, pediatric nonvascular interventional radiology, pediatric tumor interventional radiology and others. In the United States, every children hospital which owns two hundred beds has to have special trained interventional radiologists in radiologic department installing with advanced digital subtraction angiographic equipment. Interventional therapeutic procedures and diagnostic angiography have been proceeding more and more for the congenital and acquired diseases of children. The promising results give use uprising and interventional therapy as an alternative or a replacement or supplement to surgical operation. Pediatric interventional radiology is rather underdeveloped in China with a few special pediatric interventional radiologist, lack of digital subtraction angiography equipment. Pediatric radiologists have no enough field for interventional procedures such as pediatric neuro-interventional radiology and pediatric vascular interventional radiology. In the contrary adult interventional radiologists do have better interventional jobs in China and Pediatric cardiologists also share the same trend. They perform angiocardiography for congenital heart diseases and treat congenital heart disease with interventional procedures including balloon dilation of valves and vessels, coil embolization of collaterals, patent ducts and other arterial fistulae

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

Impact of Supplier Management Strategies on the Organizational Performance of ISO 9001 Certified Organizations

OpenAIRE

Fonseca, Luis Miguel; Lima, Vanda Marlene

2015-01-01

Purpose: The purpose of this article is to discuss the impact of Supplier orientation and the resulting Supply Chain Management (SCM) approach, on the organizational performance of ISO 9001 Quality Management Systems certified organizations. Methodology/Approach: Following a literature review, a full structural conceptual model was proposed. An online survey was administered to managers of Portuguese organizations with certified ISO 9001 Quality Management Systems. Descriptive Statistics a...

Patient doses in CT with special emphasis on pediatric patients in Algeria

International Nuclear Information System (INIS)

Khelassi-Toutaoui, Nadia; Merad, Ahmed; Toutaoui, Aek; Bairi, Souad; Tsapaki, Virginia; Mansouri, Boudjema

2008-01-01

Full text: Purpose: To estimate the frequency of CT examinations in children 0-15 years of age, to investigate whether exposure factors for children are different than for adults and to evaluate patient dose, as part of an International Atomic Energy Agency (IAEA) project on Radiation Protection of patients and Medical Exposure Control (RAF 9033). Material and Methods: Two CT machines were included in the study. Weighted computed tomography dose index (CTDI w ). Results: Pediatric CT examinations accoutered for 12-20% of the total exams performed in the CT facilities. For head, chest and abdomen examinations, mAs were reduced for pediatric patients, mainly on an arbitrary manner. One of the CT machines allowed change of kV and in that case kV was reduced for pediatric patients. Chest, Chest-High Resolution, Abdomen, Lumbar spine and Pelvis CTDI w and DLP were lower and IAEA guidance levels in almost all types of exams. It was observed, however, that DLP in one hospital was almost double than the other hospital that was mostly attributed to larger extent of scan length. ) for a single slice and dose length product (DLP) for a complete examination were used to evaluate patient dose. Kilovoltage (kV) and mAs were the exposure factors investigated. Conclusion: The study showed that pediatric examinations reach up to 1/5 of the total exams performed. It is encouraging that exposure factors are reduced, but a more standard method of reduction should be applied. Patient doses were lower that IAEA standards. Further optimization could be done by reducing scan length. (author)

Structural equation modeling in pediatric psychology: overview and review of applications.

Science.gov (United States)

Nelson, Timothy D; Aylward, Brandon S; Steele, Ric G

2008-08-01

To describe the use of structural equation modeling (SEM) in the Journal of Pediatric Psychology (JPP) and to discuss the usefulness of SEM applications in pediatric psychology research. The use of SEM in JPP between 1997 and 2006 was examined and compared to leading journals in clinical psychology, clinical child psychology, and child development. SEM techniques were used in psychology research, although investigations employing these methods are becoming more prevalent. Despite its infrequent use to date, SEM is a potentially useful tool for advancing pediatric psychology research with a number of advantages over traditional statistical methods.

Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits.

Science.gov (United States)

Zlotnick, Cheryl; Tam, Tammy; Ye, Yu

2017-10-01

Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

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.

Multidisciplinary Management of Pediatric Sports-Related Concussion.

Science.gov (United States)

Ellis, Michael J; Ritchie, Lesley J; McDonald, Patrick J; Cordingley, Dean; Reimer, Karen; Nijjar, Satnam; Koltek, Mark; Hosain, Shahid; Johnston, Janine; Mansouri, Behzad; Sawyer, Scott; Silver, Norm; Girardin, Richard; Larkins, Shannon; Vis, Sara; Selci, Erin; Davidson, Michael; Gregoire, Scott; Sam, Angela; Black, Brian; Bunge, Martin; Essig, Marco; MacDonald, Peter; Leiter, Jeff; Russell, Kelly

2017-01-01

To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.

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 ...

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...

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...

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.

Developing the Blueprint for a General Surgery Technical Skills Certification Examination: A Validation Study.

Science.gov (United States)

de Montbrun, Sandra; Louridas, Marisa; Szasz, Peter; Harris, Kenneth A; Grantcharov, Teodor P

There is a recognized need to develop high-stakes technical skills assessments for decisions of certification and resident promotion. High-stakes examinations requires a rigorous approach in accruing validity evidence throughout the developmental process. One of the first steps in development is the creation of a blueprint which outlines the potential content of examination. The purpose of this validation study was to develop an examination blueprint for a Canadian General Surgery assessment of technical skill certifying examination. A Delphi methodology was used to gain consensus amongst Canadian General Surgery program directors as to the content (tasks or procedures) that could be included in a certifying Canadian General Surgery examination. Consensus was defined a priori as a Cronbach's α ≥ 0.70. All procedures or tasks reaching a positive consensus (defined as ≥80% of program directors rated items as ≥4 on the 5-point Likert scale) were then included in the final examination blueprint. Two Delphi rounds were needed to reach consensus. Of the 17 General Surgery Program directors across the country, 14 (82.4%) and 10 (58.8%) program directors responded to the first and second round, respectively. A total of 59 items and procedures reached positive consensus and were included in the final examination blueprint. The present study has outlined the development of an examination blueprint for a General Surgery certifying examination using a consensus-based methodology. This validation study will serve as the foundational work from which simulated model will be developed, pilot tested and evaluated. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Dose survey of pediatric and adult patients in Sudan

International Nuclear Information System (INIS)

Mohamadain, K.E.M.; Azevedo, A.C.P.; And others

2006-01-01

A survey of radiation doses to children and adults from diagnostic radiography has been carried out in seven hospitals in Sudan. In four hospitals only pediatric examinations were died. In two hospitals only adult patients were recorded and in one hospital both kinds of patients (pediatric and adults) were evaluated. For pediatric patients only chest x-ray examination was evaluated and children were divided according to age ranges: from (0-1) and 5) years for chest AP only and from (5-10) and (10-15) for chest PA. For adult patients the examinations were chest AP and PA, abdomen AP and skull AP and PA. Entrance Surface Dose SD) and the Effective Dose (E) were calculated using the Dose Cal software. The mean ESD r children, measured in p.Gy, ranged from (45-53) and (53-56) for (0-1) and (1-5) years, respectively and from (55-71) and (68-85) for (5-10) and (10-15) years, respectively. In two of le pediatric hospitals the mean ESD values were greater than the CEC Reference Dose Levels. In El bulk and Si nar hospitals the values ranged from 167-261 and 186-308 μGy for the age ranges (0-1) and (1-5) respectively and 167-194 and 279-312 μGy for the age ranges of (5-10) and (10-15) respectively. For adult patients the ESD and E dose values evaluated in Alfisal hospital presented values comparable with the CEC Reference Dose Level. However for Alshorta hospital the values were higher for the chest AP and PA with results for ESD 0.446 and 0.551 mGy respectively

Parent assessment of medical student’s skills in ambulatory pediatrics

OpenAIRE

Persson, Erika; Haines, Christina; Lang, Mia

2013-01-01

Background Partnership with parents is a vital part of pediatric medical education, yet few studies have examined parent attitudes towards learners in pediatric settings. Methods Questionnaires were used to determine parent and student assessment of professional and clinical skills (primary outcome) and parent attitudes towards 3rd year medical students (secondary outcome) at the University of Alberta. Chi Square, Kendall’s Tau and Kappa coefficients were calculated to compare parent and stud...

The role of imaging in pediatric radiation oncology

International Nuclear Information System (INIS)

Stowe, S.M.

1985-01-01

The pediatric radiation oncologist is involved in treating a different spectrum of tumors that is generally seen by the adult radiation oncologist. More than one-third of pediatric patients with malignancies suffer from acute lymphocytic leukemia and lymphomas. Approximately one-quarter of the patients have primary tumors of the brain and central nervous system, while the remaining patients mostly present with mesenchymal sarcomas as opposed to the carcinomas more generally seen in adult practice. Pediatric tumors are frequently deep seated and therefore more difficult to evaluate by physical examination that the typical adult epithelial tumors. In the following sections, the various tumor types and locations are discussed with reference to the specific imaging requirements for each of the groups. This is preceded by a brief introduction to modern radiation oncology in order to clarify the role of these modalities

Experimentally Generated Random Numbers Certified by the Impossibility of Superluminal Signaling

Science.gov (United States)

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

Random numbers are an important resource for applications such as numerical simulation and secure communication. However, it is difficult to certify whether a physical random number generator is truly unpredictable. Here, we exploit the phenomenon of quantum nonlocality in a loophole-free photonic Bell test experiment to obtain data containing randomness that cannot be predicted by any theory that does not also allow the sending of signals faster than the speed of light. To certify and quantify the randomness, we develop a new protocol that performs well in an experimental regime characterized by low violation of Bell inequalities. Applying an extractor function to our data, we obtain 256 new random bits, uniform to within 10- 3 .

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.

VCA-DVC VMware certified associate on vSphere study guide VCAD-510

CERN Document Server

Schmidt, Robert

2015-01-01

Use this expert guide to prepare for the VCA-DCV exam VCA-DCV VMware Certified Associate on vSphere Study Guide: VCAD-510 is a comprehensive study guide for the VMware Certified Associate - Data Center Virtualization exam. Hands-on examples, real-world scenarios, and expert review questions cover the full exam blueprint, and the companion website offers a suite of tools to help you prepare for the exam including practice exams, electronic flashcards, and a glossary of key terms. In addition, the website includes videos that demonstrate how to complete the more challenging tasks. Focused on p

School Library Policy and Legal Opinions of Texas Public School Principals and Certified Librarians

OpenAIRE

Andrew Shupala

2006-01-01

This study involved a survey of the attitudes of Texas public school principals and certified librarians, perceptions andexperiences with regard to school library policy for media selection, and procedures for responding to complaints againstlibrary media. Analysis of the data included a methodology of mixed-methods explanatory design. Selection of the principalsand certified librarians was proportionate and stratified according to the state's 20 Education Service Centerregions. Of the 1,036 ...

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.

The Stored Waste Examination Pilot Plant program at the INEL

International Nuclear Information System (INIS)

McKinley, K.B.; Anderson, B.C.; Clements, T.L.; Hinckley, J.P.; Mayberry, J.L.; Smith, T.H.

1983-01-01

Since 1970, defense transuranic waste has been placed into 20-year retrievable storage at the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory (INEL). A major objective of the U.S. Department of Energy (DOE) Nuclear Waste Management Program is to remove all retrievably stored transuranic waste from the INEL. The January 1981 DOE Record of Decision on the Waste Isolation Pilot Plant (WIPP) stated, ''The WIPP facility will dispose of defense transuranic waste stored retrievably at the Idaho National Engineering Laboratory.'' After retrieval and before shipment, processing may be necessary to prepare the waste for acceptance, handling, and enhanced long-term isolation in the WIPP. However, some of the waste is certifiable to the WIPP waste acceptance criteria without container opening or waste processing. To minimize costs, the Stored Waste Examination Pilot Plant (SWEPP) is being developed to certify INEL stored transuranic waste without container opening or waste processing. The SWEPP certification concept is based on records assessment, nondestructive examination techniques, assay techniques, health physics examinations, and limited opening of containers at another facility for quality control

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. ...

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.

Conceptualization and treatment of chronic abdominal pain in pediatric gastroenterology practice.

Science.gov (United States)

Schurman, Jennifer V; Hunter, Heather L; Friesen, Craig A

2010-01-01

The aim of this study was to examine how children with abdominal pain presently are viewed, assessed, and treated by pediatric gastroenterologists across North America, as well as how perspectives have changed since initial release of the Rome criteria for functional gastrointestinal disorders approximately 15 years ago. One hundred seventy-four full members of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition completed a pediatric gastroenterology practice survey designed by the authors in 2006. The responses were examined for practice patterns and specific knowledge/use of the Rome criteria. The responses were also compared with historical data from 151 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition members who completed a similar survey in 1992. There were few changes in the evaluation, treatment, or outcomes for children with abdominal pain for the past 15 years. Knowledge of the Rome criteria was common, but use in practice was not; several specific problems with the criteria were identified. A mismatch also appeared between belief in the importance of psychological factors in the creation/maintenance of pediatric abdominal pain and integration of these factors as part of standard evaluation and treatment. Finally, controversy emerged regarding both the term "functional" and the importance of histologic inflammation in the pathophysiology of pediatric abdominal pain. The evolution and dissemination of the Rome criteria for the past 15 years have not substantially changed evaluation or treatment practices for children with abdominal pain. Many areas of inconsistency and controversy remain. More focused research is needed to better understand this common pain condition and to establish an effective treatment program that can be disseminated across practitioners.

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 ...

Pediatric mandibular fractures: a free hand technique.

Science.gov (United States)

Davison, S P; Clifton, M S; Davison, M N; Hedrick, M; Sotereanos, G

2001-01-01

The treatment of pediatric mandibular fractures is rare, controversial, and complicated by mixed dentition. To determine if open mandibular fracture repair with intraoral and extraoral rigid plate placement, after free hand occlusal and bone reduction, without intermaxillary fixation (IMF), is appropriate and to discuss postoperative advantages, namely, maximal early return of function and minimal oral hygiene issues. A group of 29 pediatric patients with a mandibular fracture were examined. Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years (age range, 1-17 years) were treated using IMF. All patients were treated by the same surgeon (G.S.). Surgical time for plating was reduced by 1 hour, the average time to place patients in IMF. The patients who underwent open reduction internal fixation without IMF ate a soft mechanical diet by postoperative day 3 compared with postoperative day 16 for those who underwent IMF. Complication rates related to fixation technique were comparable at 20% for those who did not undergo IMF and 33% for those who did. We believe that free hand reduction is a valuable technique to reduce operative time for pediatric mandibular fractures. It maximizes return to function while minimizing the oral hygiene issues and hardware removal of intermaxillary function.

Using an iPad for Basic Communication Between Spanish-Speaking Families and Nurses in Pediatric Acute Care: A Feasibility Pilot Study.

Science.gov (United States)

Jackson, Kylie H; Mixer, Sandra J

2017-08-01

The growing number of Spanish speakers in the United States poses communication challenges for healthcare providers. Language barriers in pediatric acute care have been associated with an increased risk for adverse events, longer hospital stays, and decreased quality of care. In addition, clinicians' usage of interpreter services is inconsistent. In fact, nurses often lack interpreter support during daily bedside care. Nursing staff at a pediatric children's hospital in the southeastern United States identified bedside communication with Spanish-speaking patients and families as a clinical challenge. To address this challenge, a basic communication interface, UTalk version 1.0 (the author is the owner and proprietor), supported by an Apple iPad, was developed by the researcher with input from nursing staff, a certified medical interpreter, and Spanish-speaking community members. A feasibility pilot study of the interface's usability and engagement was conducted on the hospital's pediatric medical-surgical unit through qualitative interviews with nurse-family dyads. Three themes emerged from the data: UTalk-facilitated communication, UTalk needs improvement, and interpreter miscommunication. These findings indicate that a mobile digital device interface is a feasible method for augmenting bedside communication with Spanish-speaking patients and families. These results also may serve as a reference for the development of similar mobile device interfaces. Further research with a larger sample size is needed.

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

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...

Should pediatric emergency physicians be decentralized in the medical community?

Science.gov (United States)

Sacchetti, Alfred; Benjamin, Lee; Soriano, Annie R; Ponce, Marie Grace; Baren, Jill

2014-08-01

Pediatric emergency physicians (PEPs) are well established as primary emergency department (ED) providers in dedicated pediatric centers and university settings. However, the optimum role of these subspecialists is less well defined in the community hospital environment. This study examined the impact on the ED care of children after the introduction of 10 PEPs into a simulated medical community. A computer-generated community was created, containing 10 community hospitals treating 250,000 pediatric ED patients. Children requiring ED treatment received their care at the closest ED to their location. Ten PEPs were introduced into the community, and their impact on patient care was examined under 2 different models. In a restrictive model, the PEPs established 2 full-time pediatric EDs within the 2 busiest hospitals, whereas, in a distributive model, the PEPs were distributed throughout the 8 busiest hospitals. In the 8-hospital model, the PEPs provided direct patient care along with the general emergency physicians in that facility and also provided educational, administrative, and performance improvement support for the department. In the restrictive model, the PEPs impacted the care of 100% of the children presenting for treatment at their 2 practice sites. In the distributive model, impact included the direct patient care by the PEP but also included changes produced in the care provided by the general emergency physicians at the site. Three different levels of impact were considered for the presence of the PEPs: a low-impact version in which the PEPs' presence only impacted 25% of the children at that site, a moderate-impact version in which the impact affected 50% of the children, and a high-impact version in which the impact affected 75% of the children. A secondary analysis was performed to account for the possibility of patients self-diverting from the closest ED to 1 of the pediatric EDs in the restrictive model. In the restrictive model, the addition of 10

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.

Commentary: Pediatric Epilepsy: A Good Fit for Pediatric Psychologists

Science.gov (United States)

Modi, Avani; Smith, Gigi

2011-01-01

While there are an abundance of pediatric neuropsychologists working with youth with epilepsy (YWE), other subspecialty psychologists have played minimal roles in clinical and research endeavors in pediatric epilepsy. Thus, the purpose of this commentary was to describe (a) the needs of YWE due to the intermittent nature of seizures and difficulties with disease management, (b) increased risk for psychosocial comorbidities, (c) limited access to care, and (d) provide recommendations for how pediatric psychologists can become involved in the clinical care and research activities for YWE. PMID:21148174

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 ...

Relationship between internal medicine program board examination pass rates, accreditation standards, and program size.

Science.gov (United States)

Falcone, John L; Gonzalo, Jed D

2014-01-19

To determine Internal Medicine residency program compliance with the Accreditation Council for Graduate Medical Education 80% pass-rate standard and the correlation between residency program size and performance on the American Board of Internal Medicine Certifying Examination. Using a cross-sectional study design from 2010-2012 American Board of Internal Medicine Certifying Examination data of all Internal Medicine residency pro-grams, comparisons were made between program pass rates to the Accreditation Council for Graduate Medical Education pass-rate standard. To assess the correlation between program size and performance, a Spearman's rho was calculated. To evaluate program size and its relationship to the pass-rate standard, receiver operative characteristic curves were calculated. Of 372 Internal Medicine residency programs, 276 programs (74%) achieved a pass rate of =80%, surpassing the Accreditation Council for Graduate Medical Education minimum standard. A weak correlation was found between residency program size and pass rate for the three-year period (p=0.19, pInternal Medicine residency programs complied with Accreditation Council for Graduate Medical Education pass-rate standards, a quarter of the programs failed to meet this requirement. Program size is positively but weakly associated with American Board of Internal Medicine Certifying Examination performance, suggesting other unidentified variables significantly contribute to program performance.

Computed radiography dose optimization in pediatric patients

International Nuclear Information System (INIS)

Juste, B.; Verdu, G.; Tortosa, R.; Villaescusa, J.I.

2008-01-01

Radiation dose reduction in pediatric X-ray imaging is especially important because of children radiation sensitivity. For any radiographic examination performed at a fixed radiographic tube potential, the patient absorbed dose is directly proportional to the value of milliampere-seconds (mAs) selected by the operator. Nevertheless, reducing X-ray exposure has the unavoidable disadvantage of increasing the quantum noise in the resultant image. The objective of this work is to identify the minimum tube current setting required for maintaining accurate examinations, to modify, if required, the daily protocols applied at La Fe de Valencia Universitary Hospital. To accomplish this goal, a noise addition software has been developed in order to study the diagnostic accuracy as a function of reducing dose by artificially increasing the image noise. The noise addition tool has been applied to several thorax images acquired from pediatric unit to simulate new lower dose radiographies and allow medical researchers to study how lower dose affects the patient pneumonia diagnosis. (author)

Pediatric dental chair vs. traditional dental chair: A pediatric dentist′s poll

Directory of Open Access Journals (Sweden)

Khushboo Barjatya

2015-01-01

Full Text Available Objective: Proper positioning of the child patient, can not only have positive ramifications for the operator′s posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. Study Design: The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Results: Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. Conclusion: During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.

Office-based deep sedation for pediatric ophthalmologic procedures using a sedation service model.

Science.gov (United States)

Lalwani, Kirk; Tomlinson, Matthew; Koh, Jeffrey; Wheeler, David

2012-01-01

Aims. (1) To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2) To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR) setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62-100). There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient) as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

Office-Based Deep Sedation for Pediatric Ophthalmologic Procedures Using a Sedation Service Model

Directory of Open Access Journals (Sweden)

Kirk Lalwani

2012-01-01

Full Text Available Aims. (1 To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2 To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62–100. There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

Transuranic waste examination quality assurance at the Idaho National Engineering Laboratory

International Nuclear Information System (INIS)

Bower, J.M.

1987-01-01

Since 1954, defense-generated transuranic (TRU) waste has been received at the Radioactive Waste Management Complex (RWMC) at the Idaho National Engineering Laboratory (INEL). A major objective of the Department of Energy (DOE) Nuclear Waste Management Programs is the proper management of the defense-generated TRU waste. The Stored Waste Examination Pilot Plant (SWEPP) is providing nondestructive examination and assay of retrievably stored contact handled TRU waste in order to certify it to the Waste Isolation Pilot Plant Waste Acceptance Crtieria (WIPP-WAC). SWEPP's capabilities for certifying contact handled waste containers include weighing, real-time radiographic examination, fissile material assay examination, container integrity examination, radiological surveys and labeling of waste containers. These processes involve not only instrument accuracy but also a wide range of technician interpretation from moderate on the assay to 100% on the radiograph. This, therefore, requires a variety of quality assurance techniques to ensure that the examinations and certifications are being performed correctly. The purpose of this paper is to discuss the methods utilized by SWEPP for checking on the examination process and to ensure that waste certifications are being properly performed. Included is the application of the quality assurance techniques to each examination system, the management of the data generated by the examination, and the verifications to ensure accurate certification. 1 ref

Chest CT findings in pediatric Wegener's granulomatosis

International Nuclear Information System (INIS)

Levine, Daniel; Akikusa, Jonathan; Manson, David; Silverman, Earl; Schneider, Rayfel

2007-01-01

Although pulmonary involvement occurs in the majority of children and adolescents with Wegener's granulomatosis (WG), relatively little has been published regarding the CT imaging manifestations in this group of patients. To determine the frequency and types of chest CT abnormalities in active pediatric WG (pWG). The study was a retrospective examination of 29 chest CT examinations performed at diagnosis (n=14) and during disease flares (n=15) in 18 children. The most common abnormalities were nodules (seen in 90% of examinations), ground-glass opacification (52%), and air-space opacification (45%). Of examinations with nodules, 73% demonstrated nodules >5 mm in diameter and 69% demonstrated more than five nodules; 17% had cavitary lesions. The only abnormality with a significant difference in prevalence between diagnosis and disease flares was air-space opacification, present in 71% and 20%, respectively (P < 0.01). In accordance with the findings of published adult studies and at variance with those of prior pediatric studies, our findings indicate that chest CT abnormalities in active pWG are frequent, most commonly comprising nodules and ground-glass opacification, which may be difficult to detect on plain radiography. We therefore advocate the routine use of chest CT for all affected patients, both at the time of presentation and during disease flares. (orig.)

Relationship between candidate communication ability and oral certification examination scores.

Science.gov (United States)

Lunz, Mary E; Bashook, Philip G

2008-12-01

Structured case-based oral examinations are widely used in medical certifying examinations in the USA. These orals assess the candidate's decision-making skills using real or realistic patient cases. Frequently mentioned but not empirically evaluated is the potential bias introduced by the candidate's communication ability. This study aimed to assess the relationship between candidate communication ability and medical certification oral examination scores. Non-doctor communication observers rated a random sample of 90 candidates on communication ability during a medical oral certification examination. The multi-facet Rasch model was used to analyse the communication survey and the oral examination data. The multi-facet model accounts for observer and examiner severity bias. anova was used to measure differences in communication ability between passing and failing candidates and candidates grouped by level of communication ability. Pearson's correlations were used to compare candidate communication ability and oral certification examination performance. Candidate separation reliability values for the communication survey and the oral examination were 0.85 and 0.97, respectively, suggesting accurate candidate measurement. The correlation between communication scores and oral examination scores was 0.10. No significant difference was found between passing and failing candidates for measured communication ability. When candidates were grouped by high, moderate and low communication ability, there was no significant difference in their oral certification examination performance. Candidates' communication ability has little relationship to candidate performance on high-stakes, case-based oral examinations. Examiners for this certifying examination focused on assessing candidate decision-making ability and were not influenced by candidate communication ability.

Perioperative pulmonary aspiration is infrequent and low risk in pediatric anesthetic practice.

Science.gov (United States)

Kelly, Christopher J; Walker, Robert W M

2015-01-01

Recent studies have reported perioperative pulmonary aspiration in pediatric practice to be an uncommon problem associated with low morbidity and mortality. This paper examines the recent publications in both the adult and pediatric literature and looks at some of the potential risk factors involved, both patient and anesthetic, in the development of aspiration of gastric contents. We also look at the risk of severe morbidity following pulmonary aspiration and speculate on possible reasons behind the assertion that pulmonary aspiration in pediatric anesthetic practice is rare and a low-risk event. © 2014 John Wiley & Sons Ltd.

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 ...

Children's (Pediatric) Nuclear Medicine

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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 ...

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 ...

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 ...

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...

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

OpenAIRE

Daniel C. Humphrey; Julia E. Koppich; Heather J. Hough

2005-01-01

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 large...

18 CFR 41.10 - Examination of accounts.

Science.gov (United States)

2010-04-01

... thereafter until December 31, 1975, the services of an independent certified public accountant, or independent licensed public accountant, certified or licensed by a regulatory authority of a State or other...) Beginning January 1, 1976, and each year thereafter, only independent certified public accountants, or...

Obesity after pediatric liver transplantation: prevalence and risk factors.

Science.gov (United States)

Sundaram, Shikha S; Alonso, Estella M; Zeitler, Phil; Yin, Wanron; Anand, Ravinder

2012-12-01

Pediatric obesity has become a significant public health concern. The historical focus in pediatric liver transplant (LT) has been undernutrition, with limited knowledge regarding obesity. Therefore, we sought to determine the prevalence of obesity in pediatric LT, compare it to National Health and Nutrition Examination Surveys (NHANES) data, and identify risk factors for obesity in pediatric LT. SPLIT, which collects pediatric LT data at 39 centers, was queried for subjects ages 2 to 18 years at follow-up, LT between 1995 and 2007, and with at least 1 body mass index measured 1 to 5 years after LT. Of 1706 individuals included, 44% had biliary atresia (47% boys, 58% white, mean age at LT 4.6 years). Of these individuals, 19% were obese at 1 year and 18% at 3 years, higher than in the general pediatric population reported by 2003-2004 NHANES, whereas 11% obesity at 5 years after LT was similar to NHANES data. Using logistic regression, Hispanic ethnicity (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.19-2.23), steroid use at follow-up (OR 1.48, 95% CI 1.23-1.77), overweight (OR 4.34, 95% CI 2.91-6.68), and obesity (OR 10.62, 95% CI 5.9-19.65) at LT independently predicted post-LT obesity. These findings suggest a need to broaden standard care to include obesity assessment and intervention in routine pre- and posttransplant care.

Cross-sectional imaging in pediatric neck masses

International Nuclear Information System (INIS)

Koenigsberg, R.A.; Patel, M.; Horowitz, C.

1990-01-01

This paper reports on US, CT, and MR imaging that demonstrates unique roles in the evaluation of pediatric neck masses. The causes of these masses range from infections/abscesses to primary and secondary tumors. The purpose of this paper is to review pediatric neck masses and the current role of cross-sectional imaging. Seventy-one examinations of the neck by means of CT, US, and MR imaging on 62 patients aged 1-21 y were retrospectively reviewed. Diseases were categorized according to benign versus malignant causes. Benign: 9 abscesses/cellulitis, 5 thyroglossal duct cysts, 3 branchial cleft cysts, 2 parotid cysts, 2 benign enlarged lumphadenopathies, 2 cystic hydromas, 1 ranula, and 1 hematoma

Radiation doses in pediatric radiology: influence of regulations and standards

International Nuclear Information System (INIS)

Suleiman, O.H.

2004-01-01

The benefits of X-ray examinations contribute to the quality of modern medicine; however the risk of using X-rays, a carcinogen, has always been a concern. This concern is heightened for pediatric patients, who have a much greater sensitivity to the carcinogenic effects of radiation than adults. The principle of as low as reasonably achievable, or ALARA, is essential for minimizing the radiation dose patients receive, especially for pediatric patients. In order to keep radiation doses ALARA, one must know the dose patients receive. The determination of radiation dose in a standard way is therefore necessary so that these doses can be compared with practice, and for meaningful comparison against voluntary standards. In extreme situations, where public health needs may require mandatory standards, or regulations, the quantitative measurement and calculation of radiation dose becomes essential. How some radiation dose metrics and standards have evolved, including the value of different metrics such as entrance air kerma, organ dose, and effective dose will be presented. Recent pediatric X-ray studies, whether or not dedicated pediatric equipment is necessary, and recent initiatives by the Food and Drug Administration for pediatric population will be discussed. (orig.)

5 CFR 1330.405 - Procedures for certifying agency appraisal systems.

Science.gov (United States)

2010-01-01

... Certification for Pay Purposes § 1330.405 Procedures for certifying agency appraisal systems. (a) General. To... senior employees based on appraisals of their relative performance against performance expectations in... responsibilities— (A) The performance standards, requirements, or expectations for the employees they supervise to...

Dehydration treatment practices among pediatrics-trained and non-pediatrics trained emergency physicians.

Science.gov (United States)

Nunez, Jeranil; Liu, Deborah R; Nager, Alan L

2012-04-01

We sought to survey emergency physicians in the United States regarding the management of pediatric dehydration secondary to acute gastroenteritis. We hypothesized that responses from physicians with dedicated pediatric training (PT), that is, board certification in pediatrics or pediatric emergency medicine, would differ from responses of physicians with no dedicated pediatric training (non-PT). An anonymous survey was mailed to randomly selected members of the American College of Emergency Physicians and sent electronically to enrollees of Brown University pediatric emergency medicine listserv. The survey consisted of 17 multiple-choice questions based on a clinical scenario depicting a 2-year-old with acute gastroenteritis and moderate dehydration. Questions asked related to treatment preferences, practice setting, and training information. One thousand sixty-nine surveys were received: 997 surveys were used for data analysis, including 269 PT physicians and 721 non-PT physicians. Seventy-nine percent of PT physicians correctly classified the scenario patient as moderately dehydrated versus 71% of non-PT physicians (P = 0.063). Among those who correctly classified the patient, 121 PT physicians (58%) and 350 non-PT physicians (68%) would initially hydrate the patient with intravenous fluids. Pediatrics-trained physicians were more likely to initially choose oral or nasogastric hydration compared with non-PT physicians (P = 0.0127). Pediatrics-trained physicians were less likely to perform laboratory testing compared with the non-PT group (n = 92, 45%, vs n = 337, 66%; P dehydrated children, significantly more PT physicians, compared with non-PT physicians, follow established guidelines.

Defense Waste Management Plan for buried transuranic-contaminated waste, transuranic-contaminated soil, and difficult-to-certify transuranic waste

International Nuclear Information System (INIS)

1987-06-01

GAO recommended that DOE provide specific plans for permanent disposal of buried TRU-contaminated waste, TRU-contaminated soil, and difficult-to-certify TRU waste; cost estimates for permanent disposal of all TRU waste, including the options for the buried TRU-contaminated waste, TRU-contaminated soil, and difficult-to-certify TRU waste; and specific discussions of environmental and safety issues for the permanent disposal of TRU waste. Purpose of this document is to respond to the GAO recommendations by providing plans and cost estimates for the long-term isolation of the buried TRU-contaminated waste, TRU-contaminated soil, and difficult-to-certify TRU waste. This report also provides cost estimates for processing and certifying stored and newly generated TRU waste, decontaminating and decommissioning TRU waste processing facilities, and interim operations

A Study on the Preferences of Consumers of Halal - Certified Products A Case Study of İstanbul

Directory of Open Access Journals (Sweden)

Hüseyin Özdemir

2014-03-01

Full Text Available In this study, consumer’s demographic characteristics, the attitude of halal food and religious life styles aimed to investigate whether there is a significant relationship between preference of halal certified products. The target population of the study is the markets costumers, products are sold is halal certified in İstanbul. The sample of the study is 400 costumers over the age of 18, who agreed to participate in the study. The data collection technique used in the survey technique. Frequency distribution analysis of the data, descriptive statistic, t–test, one-factor analysis of variance and Pearson correlation matrix tests were used for analysis of the data. Of the analyzed demographic variables, gender and income level was found significant difference between religious life style. Marital status, job –carrier and income was a found significant difference between the attitude of halal food. Marital status, job –carrier, income and education was found significant difference between the preference of the halal-certified product. Also there are weak significant relationship between religious life styles and the attitude of halal food, there are very weak significant relationship between religious life styles and preference of halal certified products and there are weak significant relationship between the attitude of halal food and preference of halal certified products

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.)

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

Science.gov (United States)

Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

2016-02-01

Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

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

Understanding psychological distress among pediatric cancer caregivers.

Science.gov (United States)

Nam, Gina E; Warner, Echo L; Morreall, Deborah K; Kirchhoff, Anne C; Kinney, Anita Y; Fluchel, Mark

2016-07-01

Few studies have examined distress in caregivers of pediatric cancer patients. We evaluated the association of socioeconomic, demographic, and patient clinical factors on caregivers' self-reported psychological distress associated with having a child with cancer. N = 366 pediatric cancer caregivers completed a self-administered questionnaire from July 2010 to July 2012. The Impact of Event Scale (IES), along with two subscales "intrusion" and "avoidance" measured caregiver cancer-specific distress, with higher scores indicating greater distress. Multivariable linear regression models were used to calculate coefficients (β) and 95 % confidence intervals (95 % CI) of IES by socioeconomic, demographic, and clinical factors. Average caregiver IES score was 31.2 (standard deviation (SD) = 16.9, range 0-75). Mean intrusion score was 18.1 (SD 9.8, range 0-35) and avoidance score was 12.8 (SD 9.0, range 0-40). Caregivers with household incomes psychological distress for caregivers of pediatric oncology patients. These findings underscore the importance of developing and testing interventions aimed at evaluating and addressing the psychosocial needs for high-risk caregivers in addition to those of patients.

[Analysis of qualifications of medical and health institutions and certified doctors for providing occupational disease diagnosis in China].

Science.gov (United States)

Wang, Huan-qiang; Li, Tao; Qi, Fang; Wu, Rui; Nie, Wu; Yu, Chen

2013-10-01

To investigate the qualifications and current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in China and to provide a reference for developing relevant policies. Work reports and questionnaires survey were used to investigate the qualifications of all medical and health institutions and certified doctors for providing occupational disease diagnosis in China and their acceptance and diagnosis of occupational disease cases from 2006 to 2010. The rate for the work reports was 100%, and the response rate for the questionnaires was 71.0%. By the end of 2010, in the 31 provincial-level regions (excluding Hong Kong, Macao, and Taiwan) in China, there had been 503 medical and health institutions which were qualified for providing occupational disease diagnosis, including 207 centers for disease control and prevention, accounting for 41.2%, 145 general hospitals, accounting for 28.8%, 69 enterprise-owned hospitals, accounting for 13.7%, and 64 institutes or centers for occupational disease prevention and control, accounting for 12.7%; 4986 certified doctors got the qualification for providing occupational disease diagnosis, with 9.4 certified doctors on average in each institution, and there was 0.65 certified doctor per 100 000 employees. In addition, 16.5% of the institutions got all the qualifications for diagnosing 9 occupational diseases, and 17.1% of the institutions got the qualification for diagnosing one occupational disease. Each certified doctor accepted diagnosis of 16.8 cases of occupational diseases on average every year. A national occupational disease diagnosis network has been established in China, but the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors. It is essential to further strengthen the development of regional qualified medical and health institutions and training of qualified