Sample records for person centred continence

  1. Smart wireless continence management system for persons with dementia. (United States)

    Wai, Aung Aung Phyo; Fook, Victor Foo Siang; Jayachandran, Maniyeri; Biswas, Jit; Nugent, Chris; Mulvenna, Maurice; Lee, Jer-En; Kiat, Philp Yap Lian


    Incontinence is highly prevalent in the elderly population, especially in nursing home residents with dementia. It is a distressing and costly health problem that affects not only the patients but also the caregivers. Effective continence management is required to provide quality care, and to eliminate high labor costs and annoyances to the caregivers resulting from episodes of incontinence. This paper presents the design, development, and preliminary deployment of a smart wireless continence management system for dementia-impaired elderly or patients in institutional care settings such as nursing homes and hospitals. Specifically, the mote wireless platform was used to support the deployment of potentially large quantities of wetness sensors with wider coverage and with dramatically less complexity and cost. It consists of an intelligent signal relay mechanism so that the residents are free to move about in the nursing home or hospital and allows personalized continence management service. Preliminary results from a trial in a local nursing home are promising and can significantly improve the quality of care for patients.

  2. Person-centred healthcare research: a personal influence

    Directory of Open Access Journals (Sweden)

    * Corresponding author: University of Windesheim, Zwolle, The Netherlands Email: Submitted for publication: 3rd November 2017 Accepted for publication: 12th March 2018 Published: 16th May 2018 Abstract Context: This critical reflection is about the positive effects for educational and research settings of participation in a two-day programme entitled ‘Using participatory action research and appreciative inquiry to research healthcare practice’. Aims: To reflect on the journey of positive developments in research and education that started with participation in this programme. Using Caring Conversations (Dewar, 2011 as a reflective framework of questions, this article discusses the journey in order to encourage others to consider the approach of appreciative inquiry to bring to life the concept of co-creation in research and education. Conclusions and implications for practice: Participation in this programme has led to the implementation of a variety of actions in educational and research settings. Central to all these actions is an appreciative approach to co-creation as a counterpart to today’s prevailing problem-based viewpoint. A possible factor behind these developments was the power of vulnerability experienced during the programme, a shared process of transformational learning. Implications for practice: This critical reflection: Provides an invitation to shift from a problem-based focus to a positive revolution Provides an appreciative reflective story about the power of vulnerability as an inspiration for others to move out of their comfort zone and seek to discover their own exceptionality Supports a shift from a facilitator-led to a co-creation approach in doing research and teaching with older adults Keywords: Emotional touchpoints, appreciative inquiry, Caring Conversations, practice development, co-creation, transformational learning theory   IDEAS AND INFLUENCES Person-centred healthcare research: a personal influence Hazel M. Chapman


    Full Text Available This commentary assesses the contribution made by the person-centred healthcare research of McCormack et al (2017 to research methodology and our ability to evaluate an organisation’s claims to be person-centred. It discusses the importance of person-centred ethical approaches within rigorous research methodologies.

  3. Person-centred care in nursing documentation.

    LENUS (Irish Health Repository)

    Broderick, Margaret C


    BACKGROUND: Documentation is an essential part of nursing. It provides evidence that care has been carried out and contains important information to enhance the quality and continuity of care. Person-centred care (PCC) is an approach to care that is underpinned by mutual respect and the development of a therapeutic relationship between the patient and nurse. It is a core principle in standards for residential care settings for older people and is beneficial for both patients and staff (International Practice Development in Nursing and Healthcare, Chichester, Blackwell, 2008 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). However, the literature suggests a lack of person-centredness within nursing documentation (International Journal of Older People Nursing 2, 2007, 263 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). AIMS AND OBJECTIVES: To explore nursing documentation in long-term care, to determine whether it reflected a person-centred approach to care and to describe aspects of PCC as they appeared in nursing records. METHOD: A qualitative descriptive study using the PCN framework (Person-centred Nursing; Theory and Practice, Oxford, Wiley-Blackwell, 2010) as the context through which nursing assessments and care plans were explored. RESULTS: Findings indicated that many nursing records were incomplete, and information regarding psychosocial aspects of care was infrequent. There was evidence that nurses engaged with residents and worked with their beliefs and values. However, nursing documentation was not completed in consultation with the patient, and there was little to suggest that patients were involved in decisions relating to their care. IMPLICATIONS FOR PRACTICE: The structure of nursing documentation can be a major obstacle to the recording of PCC and appropriate care planning. Documentation

  4. Personal dosimetry in the PET Centre Prague

    International Nuclear Information System (INIS)

    Janeba, D.; Belohlavek, O.; Hermanska, J.


    This work is focused on radiation protection in the PET Centre Prague. The personal year dose equivalents of physicians, technologists and labtechnologists in the period 1997-2000 are presented. Dose equivalents are listed for each group as collective, mean and maximum dose equivalents and number of people in the evaluated group. There is an increase in the dose equivalents in 1999 when the PET scanner was installed. Later on, when personnel was trained and better local shielding was used, the increase is not much higher even though the number of patients investigated per day doubled. The radiation field measurements showed that the radiation dose equivalent rate outside the controlled area is on the background level of about 0.17-0.18 mSv/hour. (author)

  5. Attitudes towards aloneness during adolescence : A Person-Centred Approach

    NARCIS (Netherlands)

    Teppers, E.; Luyckx, K.; Vanhalst, J.; Klimstra, T.A.; Goossens, L.


    Benefits and disadvantages of solitude for adolescents are often highlighted. However, research focusing on adolescents' attitudes towards solitude and their associations with such disadvantages or benefits is rather limited. The present study provides a person-centred perspective on the

  6. Enhancing person-centred communication in NICU

    DEFF Research Database (Denmark)

    Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid


    Aims of this article were (a) to explore how parents of premature infants experience guided family-centred care (GFCC), and (b) to compare how parents receiving GFCC versus standard care (SC) describe nurse-parent communication in the neonatal intensive care unit....

  7. Storytelling in person-centred care. (United States)

    Chu, Elizabeth


    Storytelling is a powerful tool that can be used successfully to pass on knowledge, wisdom and expertise from educators to students. A story is more easily remembered and new concepts in nursing taught in story form are understood more readily. By the same token, the story of a resident's history allows caregivers to really understand who that person is and was, and in turn provide the care that will suit the unique needs of that resident. The person-centered care concept revolves around this uniqueness of person and the process of storytelling serves the understanding of the resident, the crafting of the care package itself, and communicating that knowledge to other caregivers.

  8. Development and Implementation of Person-Centred Nursing Documentation


    Daly, Susan


    Introduction: Irvine et al (2006) assert structured documentation can improve resident care by limiting vague narrative style entries. Nevertheless, in practice the personal and         individual aspects of care can only be recorded through a person-centred approach to care planning   (Broderick & Coffey 2012, Butterworth 2012, Prideaux 2011).  Nurses  are therefore challenged to balance the factual, non-speculative principles of good record keeping with a person-centred approach to writ...

  9. The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre

    Directory of Open Access Journals (Sweden)

    Ali Serdar Gozen


    Full Text Available Objective: To evaluate the effects of bladder neck reconstruction techniques on early continence after laparoscopic radical prostatectomy (LRP. Materials and methods: This non-randomized retrospective study analyzed prospectively collected data concerning LRP. In total, 3107 patients underwent LRP between March 1999 and December 2016. Exclusion criteria were preoperative urinary incontinence, previous history of external beam radiotherapy, co-morbities which may affect urinary continence such as diabetes mellitus and/or neurogenic disorders, irregular followup, and follow-up shorter than 24 months. All patients were divided into one of three groups, posterior reconstruction being performed in Group 1 (n = 112, anterior reconstruction in Group 2 (n = 762, and bladder neck sparing (BNS in Group 3 (n = 987. Demographic and pre-, peri-, and postoperative data were collected. Multivariate analyses were performed to determine factors affecting early continence after LRP. Results: 1861 patients were enrolled in the study. The mean follow-up period was 48.12 ± 29.8 months, and subjects’ mean age was 63.6 ± 6.2 years. There was no significant difference among the groups in terms of demographic or preoperative data. Postoperative data, including oncological outcomes, were similar among the groups. The level of early continence was higher in Group 3 than in the other groups (p < 0.001. Multivariate analyses identified BNS and age as parameters significantly affecting early continence levels after LRP (p < 0.001 and p < 0.001, respectively. Bladder neck reconstruction provided less earlier continence than BNS.

  10. Assuring measurement quality in person-centred healthcare (United States)

    Pendrill, L. R.


    Is it realistic to aspire to the same kind of quality-assurance of measurement in person-centred care, currently being implemented in healthcare globally, as is established in the physical sciences and engineering? Ensuring metrological comparability (‘traceability’) and reliably declaring measurement uncertainty when assessing patient ability or increased social capital are however challenging for subjective measurements often characterised by large dispersion. Drawing simple analogies between ‘instruments’ in the social sciences—questionnaires, ability tests, etc—and engineering instruments such as thermometers does not go far enough. A possible way forward, apparently equally applicable to both physical and social measurement, seems to be to model inferences in terms of performance metrics of a measurement system. Person-centred care needs person-centred measurement and a full picture of the measurement process when man acts as a measurement instrument is given in the present paper. This complements previous work by presenting the process, step by step, from the observed indication (e.g. probability of success, P success, of achieving a task), through restitution with Rasch measurement theory, to the measurand (e.g. task difficulty). Rasch invariant measure theory can yield quantities—‘latent’ (or ‘explanatory’) variables such as task challenge or person ability—with characteristics akin to those of physical quantities. Metrological references for comparability via traceability and reliable estimates of uncertainty and decision risks are then in reach even for perceptive measurements (and other qualitative properties). As a case study, the person-centred measurement of cognitive ability is examined, as part of the EU project EMPIR 15HLT04 NeuroMet, for Alzheimer’s, where better analysis of correlations with brain atrophy is enabled thanks to the Rasch metrological approach.

  11. Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent

    Directory of Open Access Journals (Sweden)

    Nwaka Solomon


    Full Text Available Abstract A pool of 38 pan-African Centres of Excellence (CoEs in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI, through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions.

  12. Do general radiographic examinations resemble a person-centred environment?

    International Nuclear Information System (INIS)

    Hayre, C.M.; Blackman, S.; Eyden, A.


    Aim and objective: It is argued whether general radiographic examinations adhere to a person-centred approach within the direct digital radiography (DDR) environment. General radiographic examinations continue to increase and constitute approximately 90% of all examinations undertaken in the clinical environment. This study explored the potential impact patients experience whilst undergoing general imaging examinations. Method: An ethnographic methodology provided insight of two general radiography environments in the United Kingdom (UK) using participant observation and semi-structured interviews. Findings: The findings highlighted an ‘in and out’ culture whereby patients are ‘hurried’ and ‘rushed’ out of X-ray rooms in response to increasing time pressures experienced by diagnostic radiographers. In addition, this study challenged that patients may begin to rank ‘speed’ and ‘waiting times’ above other elements of radiographic care thus presenting new challenges for radiographers within the clinical environment. Conclusion: It is asserted that radiographers should remain holistic healthcare professionals and not begin to resemble operators on the production line. Further, it challenges whether patients are beginning to rank aspects of radiographic care within contemporary practices. Advances in knowledge: Few studies have explored the radiographer–patient relationship within the DDR environment, yet this study provides insight of person-centred practices within contemporary practices. - Highlights: • Challenges whether the use of DDR conforms to a person-centred approach. • Challenges whether radiographers are ‘treating patients as persons’ using DDR. • Patients may begin to rank ‘speed’ and ‘waiting times’ above other aspects of radiographic care.

  13. The development of the Person-Centred Situational Leadership Framework: Revealing the being of person-centredness in nursing homes


    Lynch, Brighide M; McCance, Tanya; McCormack, Brendan; Brown, Donna


    Aims and objectives\\ud \\ud To implement and evaluate the effect of using the Person-Centred Situational Leadership Framework to develop person-centred care within nursing homes.\\ud \\ud \\ud Background\\ud \\ud Many models of nursing leadership have been developed internationally in recent years but do not fit with the emergent complex philosophy of nursing home care. This study develops the Person-Centred Situational Leadership Framework that supports this philosophy. It forms the theoretical ba...

  14. Organisational culture and change: implementing person-centred care. (United States)

    Carlström, Eric D; Ekman, Inger


    The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person-centred care (PCC) for patients with chronic heart failure. Surveys were sent out to 170 nurses. The survey included two instruments--the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC). The results indicate that a culture with a dominating focus on social competence decreases "routine seeking behaviour", i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well-defined framework. An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a change project. Managers can use instruments such as the ones used in this study to investigate and plan for change processes. Earlier studies of organisational culture and its impact on the performance of healthcare organisations have often investigated culture at the highest level of the organisation. In this study, the culture of the production units--i.e. the health workers in different hospital wards--was described. Hospital wards develop their own culture and the cultures of different wards are mirrored in the hospital.

  15. How to practice person-centred care: A conceptual framework. (United States)

    Santana, Maria J; Manalili, Kimberly; Jolley, Rachel J; Zelinsky, Sandra; Quan, Hude; Lu, Mingshan


    Globally, health-care systems and organizations are looking to improve health system performance through the implementation of a person-centred care (PCC) model. While numerous conceptual frameworks for PCC exist, a gap remains in practical guidance on PCC implementation. Based on a narrative review of the PCC literature, a generic conceptual framework was developed in collaboration with a patient partner, which synthesizes evidence, recommendations and best practice from existing frameworks and implementation case studies. The Donabedian model for health-care improvement was used to classify PCC domains into the categories of "Structure," "Process" and "Outcome" for health-care quality improvement. The framework emphasizes the structural domain, which relates to the health-care system or context in which care is delivered, providing the foundation for PCC, and influencing the processes and outcomes of care. Structural domains identified include: the creation of a PCC culture across the continuum of care; co-designing educational programs, as well as health promotion and prevention programs with patients; providing a supportive and accommodating environment; and developing and integrating structures to support health information technology and to measure and monitor PCC performance. Process domains describe the importance of cultivating communication and respectful and compassionate care; engaging patients in managing their care; and integration of care. Outcome domains identified include: access to care and Patient-Reported Outcomes. This conceptual framework provides a step-wise roadmap to guide health-care systems and organizations in the provision PCC across various health-care sectors. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

  16. Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study. (United States)

    Cederwall, Carl-Johan; Olausson, Sepideh; Rose, Louise; Naredi, Silvana; Ringdal, Mona


    To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Evolving Continents (United States)

    Hamilton, Warren

    Brian Windley succeeds very well indeed at the formidable task he sets for himself in this greatly revised second edition of a book that first appeared in 1977. He synthesizes primarily the tectonic and petrologic evolution of the continents and secondarily their economic geologic, stratigraphic, and biologic history. The book is organized in well-balanced time sequence and topical chapters, followed by a fine overview. The author describes examples, generalizes from them, and seeks understanding of variations with time and with depth of the process acting on continents within a plate tectonic framework.

  18. Person-centred Leadership: a relational approach to leadership derived through action research. (United States)

    Cardiff, Shaun; McCormack, Brendan; McCance, Tanya


    How does person-centred leadership manifest in clinical nursing. Person-centred practice fosters healthful relationships and is gaining increasing attention in nursing and healthcare, but nothing is known about the influence of a person-centred approach to leadership practice. Most leadership models used in nursing were originally developed outside of nursing. A three year participatory action research study where participant leaders planned, researched and learned from their practice development. After an orientation phase, four action spirals focused on: critical and creative reflective inquiries into leadership practice change; leading the implementation and evaluation of a new nursing system; facilitating storytelling sessions with staff and annually reflecting on personal leadership change. Multiple data gathering methods offered insight into leadership development from several perspectives. Critical and creative thematic data analysis revealed a set of attributes, relational processes and contextual factors that influenced the being and becoming of a person-centred leader. Comparing the findings with nursing leadership literature supports a conceptual framework for person-centred leadership. Person-centred leadership is a complex, dynamic, relational and contextualised practice that aims to enable associates and leaders achieve self-actualisation, empowerment and wellbeing. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. The impact of personality on person-centred care: a study of care staff in Swedish nursing homes. (United States)

    Elfstrand Corlin, Tinna; Kajonius, Petri J; Kazemi, Ali


    In this study, we explore how personal and situational factors relate to the provision of person-centred care (PCC) in nursing homes. Specifically, we focus on the relationship between the care staff's personality traits and provision of PCC and to what extent perceptions of the working environment influences this relationship. The ultimate goal of elderly care is to meet the older person's needs and individual preferences (PCC). Interpersonal aspects of care and the quality of relationship between the care staff and the older person are therefore central in PCC. A cross-sectional Swedish sample of elderly care staff (N = 322) completed an electronic survey including measures of personality (Mini-IPIP) and person-centred care (Individualized Care Inventory, ICI). A principal component analysis was conducted on the ICI-data to separate the user orientation (process quality) of PCC from the preconditions (structure quality) of PCC. Among the five factors of personality, neuroticism was the strongest predictor of ICI user orientation. ICI preconditions significantly mediated this relationship, indicating the importance of a supportive working environment. In addition, stress was introduced as a potential explanation and was shown to mediate the impact of neuroticism on ICI preconditions. Personality traits have a significant impact on user orientation, and the perception of a supportive and stress free working environment is an important prerequisite for achieving high-quality person-centred elderly care. Understanding how personality is linked to the way care staff interacts with the older person adds a new perspective on provision of person-centred elderly care. © 2016 John Wiley & Sons Ltd.

  20. The development of the Person-Centred Situational Leadership Framework: Revealing the being of person-centredness in nursing homes. (United States)

    Lynch, Brighide M; McCance, Tanya; McCormack, Brendan; Brown, Donna


    To implement and evaluate the effect of using the Person-Centred Situational Leadership Framework to develop person-centred care within nursing homes. Many models of nursing leadership have been developed internationally in recent years but do not fit with the emergent complex philosophy of nursing home care. This study develops the Person-Centred Situational Leadership Framework that supports this philosophy. It forms the theoretical basis of the action research study described in this article. This was a complex action research study using the following multiple methods: nonparticipatory observation using the Workplace Culture Critical Analysis Tool (n = 30); critical and reflective dialogues with participants (n = 39) at time 1 (beginning of study), time 2 (end of study) and time 3 (6 months after study had ended); narratives from residents at time 1 and time 2 (n = 8); focus groups with staff at time 2 (n = 12) and reflective field notes. Different approaches to analyse the data were adopted for the different data sources, and the overall results of the thematic analysis were brought together using cognitive mapping. The Person-Centred Situational Leadership Framework captures seven core attributes of the leader that facilitate person-centredness in others: relating to the essence of being; harmonising actions with the vision; balancing concern for compliance with concern for person-centredness; connecting with the other person in the instant; intentionally enthusing the other person to act; listening to the other person with the heart; and unifying through collaboration, appreciation and trust. This study led to a theoretical contribution in relation to the Person-Centred Practice Framework. It makes an important key contribution internationally to the gap in knowledge about leadership in residential care facilities for older people. The findings can be seen to have significant applicability internationally, across other care settings and contexts.

  1. Who should decide how much and what information is important in person-centred health care?

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn


    implicitly segues into the patient having made a 'good decision'. In person-centred health care, whether, in what form, and with what weight, 'information' is included as a criterion of decision quality is a matter for the person involved, to decide in the light of their own values, preferences, and time...

  2. An exploration of person-centred concepts in human services: A thematic analysis of the literature. (United States)

    Waters, Rebecca A; Buchanan, Angus


    Being 'person-centred' in the delivery of health and human services has become synonymous with quality care, and it is a core feature of policy reform in Australia and other Western countries. This research aimed to identify the uses, definitions and characteristics of the term 'person-centred' in the ageing, mental health and disability literature. A thematic analysis identified seven common core themes of person-centredness: honouring the person, being in relationship, facilitating participation and engagement, social inclusion/citizenship, experiencing compassionate love, being strengths/capacity focussed, and organisational characteristics. These suggest a set of higher-order experiences for people that are translated differently in different human services. There is no common definition of what it means to be person-centred, despite being a core feature of contemporary health and human service policy, and this suggests that its inclusion facilitates further misunderstanding and misinterpretation. A common understanding and policy conceptualisation of person-centredness is likely to support quality outcomes in service delivery especially where organisations work across human service groups. Further research into the application and service expressions of being 'person-centred' in context is necessary. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Person-centred web-based support--development through a Swedish multi-case study. (United States)

    Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela


    Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In

  4. The Experiential Model of the Person-Centred Record: a social constructionist grounded theory


    Mihelcic, Joanne


    The objective of this research was to explore the co-creation of person-centred records, to support memory, identity and personhood, with the person diagnosed with early stage dementia. This thesis describes the design of a second generation grounded theory methodology and applied archival research. With its postmodern, continuum and social constructionist influences second generation grounded theory sees a shift in how we understand the researcher’s interaction with participants in a study...

  5. Developing person-centred practice in hip fracture care for older people. (United States)

    Christie, Jane; Macmillan, Maureen; Currie, Colin; Matthews-Smith, Gerardine


    To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

  6. Can a Discrete Choice Experiment contribute to person-centred healthcare?

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn


    In person-centred decision making the relative importance of the considerations that matter to the person is elicited and combined, at the point of decision, with the best estimates available on the performance of the available options on those criteria. Whatever procedure is used to implement...... this in a clinical decision, average preferences emerging from group or subgroup research cannot contribute directly, since they can have only a statistical relationship with the preferences of the individual person. The precise relationship is knowable by eliciting those of the individual concerned, but there would...... of how this could happen, the ambiguity often arising from the use and positioning of the apostrophe in the words persons and patients. Only when the person opts out of preference provision and asks to be treated as ‘average’, can the results of a DCE have clinical relevance in genuinely person...

  7. A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol

    NARCIS (Netherlands)

    Hafskjold, L.; Sundler, A.J.; Holmstrom, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.


    INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

  8. A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.

    NARCIS (Netherlands)

    Hafskjold, L.; Sundler, A.J.; Holmström, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.


    Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

  9. Concepts of person-centred care: a framework analysis of five studies in daily care practices

    Directory of Open Access Journals (Sweden)



    Full Text Available Background: Person-centred care is used as a term to indicate a ‘made to measure’ approach in care. But what does this look like in daily practice? The person-centred nursing framework developed by McCormack and McCance (2010 offers specific concepts but these are still described in rather general terms. Empirical studies, therefore, could help to clarify them and make person-centredness more tangible for nurses. Aims: This paper describes how a framework analysis aimed to clarify the concepts described in the model of McCormack and McCance in order to guide professionals using them in practice. Methods: Five separate empirical studies focusing on older adults in the Netherlands were used in the framework analysis. The research question was: ‘How are concepts of person-centred care made tangible where empirical data are used to describe them?’ Analysis was done in five steps, leading to a comparison between the description of the concepts and the empirical significance found in the studies. Findings: Suitable illustrations were found for the majority of concepts. The results show that an empirically derived specification emerges from the data. In the concept of ‘caring relationship’ for example, it is shown that the personal character of each relationship is expressed by what the nurse and the older person know about each other. Other findings show the importance of values being present in care practices. Conclusions: The framework analysis shows that concepts can be clarified when empirical studies are used to make person-centred care tangible so nurses can understand and apply it in practice. Implications for practice: The concepts of the person-centred nursing framework are recognised when: Nurses know unique characteristics of the person they care for and what is important to them, and act accordingly Nurses use values such as trust, involvement and humour in their care practice Acknowledgement of emotions and compassion create

  10. How to make a particular case for person-centred patient care: A commentary on Alexandra Parvan. (United States)

    Graham, George


    In recent years, a person-centred approach to patient care in cases of mental illness has been promoted as an alternative to a disease orientated approach. Alexandra Parvan's contribution to the person-centred approach serves to motivate an exploration of the approach's most apt metaphysical assumptions. I argue that a metaphysical thesis or assumption about both persons and their uniqueness is an essential element of being person-centred. I apply the assumption to issues such as the disorder/disease distinction and to the continuity of mental health and illness. © 2018 John Wiley & Sons, Ltd.

  11. Developing collaborative person-centred practice: a pilot project on a palliative care unit. (United States)

    Hall, Pippa; Weaver, Lynda; Gravelle, Debbie; Thibault, Hélène


    Maximizing interprofessional collaborative patient-centred practice holds promise for improving patient care and creating satisfying work roles. In Canada's evolving health care system, there are demands for increased efficiency, cost-effectiveness, and quality improvement. Interprofessional collaboration warrants re-examination because maximizing interprofessional collaboration, especially nurse-physician collaboration, holds promise for improving patient care and creating satisfying work roles. A palliative care team seized the opportunity to pilot a different approach to patient and family care when faced with a reduction in medical staff. Grounded in a collaborative patient-centred practice approach, the Canadian Hospice Palliative Care Association's National Model to Guide Hospice Palliative Care (2002), and outcomes from program retreats and workgroups, a collaborative person-centred model of care was developed for a 12-bed pilot project. Preliminary findings show that the pilot project team perceived some specific benefits in continuity of care and interprofessional collaboration, while the presence of the physician was reduced to an average of 3.82 hours on the pilot wing, compared with 8 hours on the non-pilot wings. This pilot study suggests that a person-centred model, when focused on the physician-nurse dyad, may offer improved efficiency, job satisfaction and continuity of care on a palliative care unit. Incorporating all team members and developing strategies to successfully expand the model across the whole unit are the next challenges. Further research into the impact of these changes on the health care professionals, management and patients and families is essential.

  12. PeDaB - the personal dosimetry database at the research centre Juelich

    International Nuclear Information System (INIS)

    Geisse, C.; Hill, P.; Paschke, M.; Hille, R.; Schlaeger, M.


    In May, 1997 the mainframe based registration, processing and archiving of personal monitoring data at the research centre Juelich (FZJ) was transferred to a client server system. A complex database application was developed. The client user interface is a Windows based Microsoft ACCESS application which is connected to an ORACLE database via ODBC and TCP/IP. The conversion covered all areas of personal dosimetry including internal and external exposition as well as administrative areas. A higher degree of flexibility, data security and integrity was achieved. (orig.) [de

  13. The care-planning conference: Exploring aspects of person-centred interactions. (United States)

    Jobe, Ingela; Lindberg, Birgitta; Nordmark, Sofi; Engström, Åsa


    The aim of this study was to describe the care-planning conference from the participants' and researchers' perspectives, focusing on exploring aspects of person-centred interactions. A single-instrumental, qualitative case study design was used describing a care-planning conference taking place in the home of an older woman and her daughter. Data collection consisted of observation and digital recording of the care-planning conference and individual interviews with all the participants before and after the conference. Data were analysed in several phases: first, a narrative description followed by a general description and, thereafter, qualitative content analysis. The findings revealed that the care-planning conference conducted had no clear purpose and did not fulfil all parts of the planning process. Three themes emerged related to aspects of person-centred interactions. The theme "expectations meet reality" showed different expectations, and participants could not really connect during the conference. The theme "navigate without a map" revealed health professionals' lack of knowledge about the care-planning process. The theme "lose the forest for the trees" described that the conference was conducted only as part of the health professionals' duties. Management and healthcare professionals cannot automatically assume that they are delivering person-centred care. Healthcare professionals need to be sensitive to the context, use the knowledge and tools available and continuously evaluate and reassess the work carried out.

  14. Personality as predictor of customer service centre agent performance in the banking industry: An exploratory study

    Directory of Open Access Journals (Sweden)

    Linda Blignaut


    Research purpose: The aim of the study was to identify personality traits, as measured by the Occupational Personality Questionnaire 32r (item response theory scored version, including the more parsimonious Big Five personality traits, that may act as job performance predictors for customer service centre (CSC agents in the banking industry. Motivation for the study: This study provides an exploratory investigation of whether specific personality traits differ amongst CSC agents in the banking industry, based on their job performance. No published research in this field could be identified. Research design, approach and method: Purposive sampling was used to collect data from the entire CSC agent base of a particular banking group (N = 89. Responses were analysed by means of quantitative techniques. Main findings and practical/managerial implications: Results indicate that parsimonious traits of personality, expressed as the Big Five personality traits, predict job performance. The importance of carefully selecting suitable job performance criteria for a specific environment, however, emerged as a critical issue in performance prediction. Contribution: The study focuses attention on the importance of CSC agents’ performance as frontline staff in the banking industry and identifying valid criteria for selecting the most suitable agents. Providing a one-contact point of service such as a CSC is a fairly new approach in the South African banking industry and this study provides an initial investigation of personality traits that may serve as job performance predictors in this environment.

  15. Politics, policy and payment--facilitators or barriers to person-centred rehabilitation? (United States)

    Turner-Stokes, Lynne

    This paper explores the tensions between politics and payment in providing affordable services that satisfy the public demand for patient-centred care. The two main approaches taken by the UK Government to curtail the spiralling costs of healthcare have been to focus development in priority areas and to cap spending through the introduction of a fixed-tariff episode-based funding system. The National Service Framework for Long Term Neurological Conditions embraces many laudable principles of person-centred management, but the 'one-size-fits all' approach to reimbursement potentially cuts right across these. A series of tools have been developed to determine complexity of rehabilitation needs that will support the development of banded tariffs. A practical approach is also offered to demonstrate the cost-efficiency of rehabilitation services for people with complex needs, and help to ensure that they are not excluded from treatment because of their higher treatment costs. Whilst responding to public demand for person-centred care, we must recognize the current financial pressure on healthcare systems. Clinicians will have greater credibility if they routinely collect and share outcomes that demonstrate the economic benefits of intervention, as well the impact on health, function and quality of life.

  16. Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study. (United States)

    Sjögren, Karin; Lindkvist, Marie; Sandman, Per-Olof; Zingmark, Karin; Edvardsson, David


    Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics. A cross-sectional design was used. Residents ( n  = 1460) and staff ( n  = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents . Descriptive and comparative statistics, independent samples t-test, Chi 2 test, Eta Squared and Phi coefficient were used to analyse data. Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care. It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

  17. The tension between person centred and task focused care in an acute surgical setting: A critical ethnography


    Sharp, Sandra.; Mcallister, Margaret.; Broadbent, Mark.


    Problem: Person centred care is a key indicator of quality care and a policy direction in many hospitals yet some patients experience care that falls short of this standard.Background: Health services worldwide are prioritising the delivery of person centred in order to address historical concerns over patient safety and quality care and to improve workplace morale. Workplaceculture is known to affect nurses’ care giving.Question: This research aimed to uncover the cultural factors that hinde...

  18. Facilitating person-centred after-death care: unearthing assumptions, tradition and values through practice development

    Directory of Open Access Journals (Sweden)

    Barbara Anderson


    Full Text Available Background: West Park Healthcare Centre, a complex continuing care and rehabilitation setting in Ontario, Canada has implemented practice development as one method of facilitating person-centred, evidence-informed practices. West Park is planning the construction of a new hospital, with a target construction timeline of 2018-21. Practice development is an internationally established transformation model (Manley et al., 2008 that can breathe life into the necessary but often burdensome process of policy revision in healthcare settings. Aims: The aim of this article is to share how practice development was used to review and revise West Park’s after-death care policy. The process entailed an integration of a broad span of evidence and intentional challenge of ‘habit-based’ ways. Such an approach to policy revision is needed if practice leaders are to use evidence to help achieve transformative changes in practice. Conclusions: Our after death-care policy involved processes that were antithetical to our shared vision for person-centred practices. Unquestioned, longstanding traditional approaches to after-death care needed to be questioned. Through the transformative journey at personal and organisational levels of applying practice development principles to this process, we were successful in bringing forward a policy that supports end-of-life plans of care, choice and person-centred after-death care practices and language. Implications for practice: •\tHealthcare organisations can review after-death care by exploring different sources of evidence, including research, clinical experience, local audit and patient experience, to challenge taken-for-granted practices •\tConsultation with funeral professionals will be valuable in terms of establishing what they do and do not need from a healthcare organisation •\tFellow patients do not need to be ‘protected’ from the after-death care process and appreciate having a voice on how it is

  19. "Dignity": A central construct in nursing home staff understandings of quality continence care. (United States)

    Ostaszkiewicz, Joan; Tomlinson, Emily; Hutchinson, Alison M


    To explore nursing home staff members' beliefs and expectations about what constitutes "quality continence care" for people living in nursing homes. Most nursing home residents require assistance to maintain continence or manage incontinence. Best practice guidelines promote active investigation of incontinence, treatment of underlying potentially reversible causes, and initial conservative interventions to prevent, minimise and/or treat incontinence. Despite research showing the positive benefits of implementing active interventions, translating the findings of research into practice in nursing homes has been modest. Understanding the perspectives of individuals who provide continence care may help bridge the gap between evidence and practice. A qualitative exploratory descriptive design. Qualitative interviews were conducted with 19 nursing home staff: eight registered nurses, four enrolled nurses and seven personal care workers working in a nursing home in Australia between 2014-2015. Data were analysed inductively to identify themes and subthemes that described and explained staff beliefs about quality continence care in nursing homes. Participants' understanding and expectations about quality continence care were linked to beliefs about incontinence being an intractable and undignified condition in nursing homes. The key theme to emerge was "protecting residents' dignity" which was supported by the following six subthemes: (i) using pads, ii) providing privacy, (iii) knowing how to "manage" incontinence, (iv) providing timely continence care, (v) considering residents' continence care preferences and (vi) communicating sensitively. The findings provide new insight into the basis for continence care practices in nursing homes. Education about continence care should challenge beliefs that limit continence care practice to cleaning, containing and concealing incontinence. There is a need for a multidimensional framework that is informed by social, psychological

  20. A cyborg ontology in health care: traversing into the liminal space between technology and person-centred practice. (United States)

    Lapum, Jennifer; Fredericks, Suzanne; Beanlands, Heather; McCay, Elizabeth; Schwind, Jasna; Romaniuk, Daria


    Person-centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person-centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person-centred practice. Inspired by Haraway's work, we argue that healthcare practitioners who critically consider their cyborg ontology may begin the process to initiate and complicate the liminal and sought after space between technology and person-centred practice. In this paper, we draw upon Haraway's idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person-centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person-centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person-centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being. © 2012 Blackwell Publishing Ltd.

  1. Centre of nuclear research experience in the control of personal exposition between 2002 - 2006

    International Nuclear Information System (INIS)

    Bayardo, Karina; Blanco, Daniel; Garcia, Fernando


    Full text: The control of the personal exposition in the public University is done by the Centre of Nuclear Research since 1999. A look at the last years permitted to note the increase in the Personal Dosimeter users. In this work we study the annual collective dose, the annual effective dose average and the different dose in each University area between 2002-2005. The annual effective dose limit for the Nuclear Regulatory Authority (Autoridad Reguladora Nuclear), are the suggested by the International Commission of Radiological Protection (ICRP). The actual application of the Basics Principles of Radiological Protection demand exposition levels as low as reasonable achievable (ALARA) considering economics and social factors. In this way we decrease the probability to induce illness in the expose personal and their descendants. The different dependences of the University where the service is given are: Faculty of Medicine (Radiology, Oncology, Clinical Oncology, Nuclear Medicine), Faculty of Chemistry (Radiochemistry), Faculty of Odontology (Radiology), Faculty of Veterinary (Radiology) and Faculty of Sciences (Centre of Nuclear Research). The number of users between 2002-2006 varied from 292 in year 2002 to 329 in the year 2006. We see a maximum of persons in the year 2004. The annual collective dose have been changing too, the lowest was 0.13 Sv.person in the year 2002 and the highest was 0.21 Sv.person in the year 2005. The annual collective dose permits the evaluation of the radiological impact of the radiation ionising manipulation in the University. In these 5 years the 96% of the annual effective dose average were under 4 mSv, and the 76% were smaller than the minimum detectable limit. This 76% were obtained in teach and researches areas. In the 4% higher than 4 mSv we can find areas where works with open radioactive sources like: Nuclear Medicine and Radiochemistry (Faulted de Pumice). In these places we detect annual effective doses of 15 mSv, these levels

  2. Making the most of person-centred education by integrating flipped and simulated teaching: An exploratory study. (United States)

    Saunders, Annette; Green, Rosy; Cross, Merylin


    Preparing a person-centred nursing workforce to work in diverse settings is a global health priority. Nursing students' first placement experience is a key transitional moment that shapes professional understanding and motivation to become a nurse. This paper reports the outcomes of combining flipped and simulated learning to enhance nursing students' understanding of person-centred care, the professional nursing role and preparation for placement. The study design was exploratory, the setting, an undergraduate nursing program in an Australian University. Participants included first year nursing students, academic tutors and clinical facilitators. Data collected via survey, semistructured interviews and focus group discussion were analysed descriptively and thematically. Over 90% of students surveyed considered the unit structure, content and resources prepared them well for placement. Pre-class preparation and simulated tutorial activities facilitated student engagement and knowledge translation. Students, tutors and clinical facilitators valued the person-centred approach. Tutors considered the unit materials and focus enhanced students' professional understanding. Clinical facilitators deemed students well-prepared for placement. These results from multiple perspectives, though limited, support combining the flipped classroom and person-centred simulation in nursing education as a strategy to prepare students for clinical placement, translate person-centred values into practice and promote professional understanding and role socialisation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. A person-centred analysis of teacher-child relationships in early childhood. (United States)

    Hughes, Kathleen; Bullock, Amanda; Coplan, Robert J


    Previously, the nature of teacher-child relationships (TCRs) has been explored through dimensions of close, conflicted, and dependent. However, this variable-centred approach is limited, as many relationships can be characterized by more than one characteristic or trait. A person-centred approach would allow for a greater understanding of the types of relationships that are formed and improved interpretation of the students' socio-emotional outcomes associated with that relationship. The primary goal of this study was to examine the socio-emotional functioning of young children who formed distinct types of TCRs. Participants were n = 202 kindergarten children (98 girls, 104 boys, Mage = 64.12 months, SD = 4.86). Multi-source assessment was employed with data collected from parent ratings, teacher reports, child interviews, and naturalistic observations in the classroom. Using quartile cut-offs, we identified children who formed conflicted, dependent, and 'combined' (conflicted and dependent) TCRs. Results indicated distinct patterns of socio-emotional functioning for each TCR group. For example, whereas children in conflicted TCRs evidenced greater externalizing difficulties, children with dependent TCRs had greater internalizing difficulties. Children who evidenced high levels of both conflicted and dependent TCRs displayed the most pervasive socio-emotional difficulties. Children who form TCRs characterized by high levels of both conflict and dependency displayed the most pervasive adjustment difficulties. Further investigation is needed to improve our understanding of this group and to assess the plausibility of early intervention strategies. © 2013 The British Psychological Society.

  4. The contributions of community learning centres (CLCs) to personal and community development in Myanmar (United States)

    Le, Ai Tam Pham


    Community learning centres (CLCs) have been widely established in the Asia-Pacific region as locally managed institutions that offer non-formal educational opportunities and community development activities. Myanmar officially has more than 3,000 centres, which is one of the highest numbers in the region. This article examines the operation of CLCs and their contributions to personal and community development in Padaung, Myanmar. The author's research is based on six weeks of fieldwork in Myanmar for data collection including semi-structured interviews, focus group discussions and informal conversations. Her findings suggest that CLCs can contribute to the improvement of both individuals' quality of life and communities' social capital, which facilitates mutually beneficial collective action. The findings also support the conclusion that CLCs can provide additional educational opportunities beyond the formal system, especially for adults and members of rural communities, e.g. farmers. However, due to constraints in terms of budget, implementing capacity and socio-economic factors, the outreach of CLC activities is still somewhat limited and has yet to reach its full potential.

  5. Incorporating person centred care principles into an ongoing comprehensive cancer management program: An experiential account

    Directory of Open Access Journals (Sweden)

    Vallath Nandini


    Full Text Available Recent research indicates a definite positive impact on treatment outcomes when an integrative approach that focuses on symptom control and quality of life is provided along with the standard therapeutic regimens. However implementation or practice of this approach is not seen widely due to the culture of medical training and practice. This article presents the initial development of a program for incorporating integrative care principles into an ongoing comprehensive cancer care program at a tertiary centre. The key purpose of the program being to develop, facilitate, and establish comprehensive and holistic processes including palliative care principles, that would positively enhance the quantity and quality of life of the person with disease, as well as create an environment that reflects and sustains this approach. The vision, objectives, goals, strategies, activities and results within the 7 months of implementation are documented. The new learnings gained during the process have also been noted in the hope that the model described may be used to conceptualize similar care giving facilities in other centres.

  6. Person-centred communication for emotional support in district nursing: SAGE and THYME model. (United States)

    Griffiths, Jane


    Patients on district nursing caseloads have multiple physical morbidities, and related emotional concerns. District nurses are ideally placed to assess and meet patients' emotional needs but in increasingly stretched workplaces, it is difficult to find time. There is also evidence that district nurses sometimes believe they lack skills to address patients' concerns. Traditional communication skills training is useful for encouraging patients to open up about their concerns, but less helpful at finding workable solutions. District nurses can be afraid to open a 'can of worms' of concerns that they are unable to deal with. SAGE and THYME is a person-centred, evidence-based communication skills model that addresses district nurses' concerns about time and skills. It provides a structure for conversations about concerns, and empowers patients to work with district nurses to find solutions. Research suggests that it is a promising model for district nursing practice.

  7. Paediatric International Nursing Study: using person-centred key performance indicators to benchmark children's services. (United States)

    McCance, Tanya; Wilson, Val; Kornman, Kelly


    The aim of the Paediatric International Nursing Study was to explore the utility of key performance indicators in developing person-centred practice across a range of services provided to sick children. The objective addressed in this paper was evaluating the use of these indicators to benchmark services internationally. This study builds on primary research, which produced indicators that were considered novel both in terms of their positive orientation and use in generating data that privileges the patient voice. This study extends this research through wider testing on an international platform within paediatrics. The overall methodological approach was a realistic evaluation used to evaluate the implementation of the key performance indicators, which combined an integrated development and evaluation methodology. The study involved children's wards/hospitals in Australia (six sites across three states) and Europe (seven sites across four countries). Qualitative and quantitative methods were used during the implementation process, however, this paper reports the quantitative data only, which used survey, observations and documentary review. The findings demonstrate the quality of care being delivered to children and their families across different international sites. The benchmarking does, however, highlight some differences between paediatric and general hospitals, and between the different key performance indicators across all the sites. The findings support the use of the key performance indicators as a novel method to benchmark services internationally. Whilst the data collected across 20 paediatric sites suggest services are more similar than different, benchmarking illuminates variations that encourage a critical dialogue about what works and why. The transferability of the key performance indicators and measurement framework across different settings has significant implications for practice. The findings offer an approach to benchmarking and celebrating

  8. Mind the gap: Person-centred delivery of mental health information to post-secondarystudents

    Directory of Open Access Journals (Sweden)

    Laura Lynne Armstrong


    Full Text Available Mental illnesses are rapidly escalating on university and college campuses. It is well known that postsecondary institutions are not doing enough to address mental health concerns: this represents a significant gap in our attempts to meet the mental health needs of young people. Deficits in mental health knowledge are now proposed as a major contributing factor to both stigma and low service access, but little research as explored this issue. There is also little research to date concerning what young people want to know about mental health and how best to disseminate mental health knowledge. Without such information, knowledge may not be shared in a person-centred, meaningful manner that youth will use. We explored these issues in the present study. First year postsecondary students (N = 271; n = 183 females; n = 85 males; n = 3 other from Ottawa, Ontario, Canada participated in the online survey. Almost half of the postsecondary youth participants, particularly males, had difficulty recognizing common mental illnesses, such as anxiety, eating disorders, and psychosis. Youth held inaccurate beliefs and stigma, as well as attitudes not in favour of help-seeking. They primarily wanted to know about symptoms of mental illnesses as well as how to cope with stress. Post-secondary students wanted to learn about mental health issues through public presentations, the Internet, and media. The present research suggests the need for an awareness and acknowledgement among policy-makers of first year post-secondary students' knowledge gaps and youth appropriate knowledge sharing. Assessing mental health knowledge, what post-secondary students want to know about mental health, and knowledge transfer preferences could aid in the development of a framework to address the significant gap in the mental health needs of post-secondary students in a person centred manner.

  9. An approach to understanding sleep and depressed mood in adolescents: person-centred sleep classification. (United States)

    Shochat, Tamar; Barker, David H; Sharkey, Katherine M; Van Reen, Eliza; Roane, Brandy M; Carskadon, Mary A


    Depressive mood in youth has been associated with distinct sleep dimensions, such as timing, duration and quality. To identify discrete sleep phenotypes, we applied person-centred analysis (latent class mixture models) based on self-reported sleep patterns and quality, and examined associations between phenotypes and mood in high-school seniors. Students (n = 1451; mean age = 18.4 ± 0.3 years; 648 M) completed a survey near the end of high-school. Indicators used for classification included school night bed- and rise-times, differences between non-school night and school night bed- and rise-times, sleep-onset latency, number of awakenings, naps, and sleep quality and disturbance. Mood was measured using the total score on the Center for Epidemiologic Studies-Depression Scale. One-way anova tested differences between phenotype for mood. Fit indexes were split between 3-, 4- and 5-phenotype solutions. For all solutions, between phenotype differences were shown for all indicators: bedtime showed the largest difference; thus, classes were labelled from earliest to latest bedtime as 'A' (n = 751), 'B' (n = 428) and 'C' (n = 272) in the 3-class solution. Class B showed the lowest sleep disturbances and remained stable, whereas classes C and A each split in the 4- and 5-class solutions, respectively. Associations with mood were consistent, albeit small, with class B showing the lowest scores. Person-centred analysis identified sleep phenotypes that differed in mood, such that those with the fewest depressive symptoms had moderate sleep timing, shorter sleep-onset latencies and fewer arousals. Sleep characteristics in these groups may add to our understanding of how sleep and depressed mood associate in teens. © 2017 European Sleep Research Society.

  10. Participatory design facilitates Person Centred Nursing in service improvement with older people: a secondary directed content analysis. (United States)

    Wolstenholme, Daniel; Ross, Helen; Cobb, Mark; Bowen, Simon


    To explore, using the example of a project working with older people in an outpatient setting in a large UK NHS Teaching hospital, how the constructs of Person Centred Nursing are reflected in interviews from participants in a Co-design led service improvement project. Person Centred Care and Person Centred Nursing are recognised terms in healthcare. Co-design (sometimes called participatory design) is an approach that seeks to involve all stakeholders in a creative process to deliver the best result, be this a product, technology or in this case a service. Co-design practice shares some of the underpinning philosophy of Person Centred Nursing and potentially has methods to aid in Person Centred Nursing implementation. The research design was a qualitative secondary Directed analysis. Seven interview transcripts from nurses and older people who had participated in a Co-design led improvement project in a large teaching hospital were transcribed and analysed. Two researchers analysed the transcripts for codes derived from McCormack & McCance's Person Centred Nursing Framework. The four most expressed codes were as follows: from the pre-requisites: knowing self; from care processes, engagement, working with patient's beliefs and values and shared Decision-making; and from Expected outcomes, involvement in care. This study describes the Co-design theory and practice that the participants responded to in the interviews and look at how the co-design activity facilitated elements of the Person Centred Nursing framework. This study adds to the rich literature about using emancipatory and transformational approaches to Person Centred Nursing development, and is the first study exploring explicitly the potential contribution of Co-design to this area. Methods from Co-design allow older people to contribute as equals in a practice development project, co-design methods can facilitate nursing staff to engage meaningfully with older participants and develop a shared

  11. Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. (United States)

    McCormack, Brendan; Dewing, Jan; Breslin, Liz; Coyne-Nevin, Ann; Kennedy, Kate; Manning, Mary; Peelo-Kilroe, Lorna; Tobin, Catherine; Slater, Paul


    To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people. The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the 'Person-Centred Nursing Index'. Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on 'technical' aspects of care, to one where 'intimate' aspects of care were more highly valued. The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships. © 2010 Blackwell Publishing Ltd.

  12. The Neutron Personal Dosimetry Service of the Centre for Radiation, Chemical and Environmental Hazards, PHE-UK

    International Nuclear Information System (INIS)

    Campo Blanco, X.


    The Centre for Radiation, Chemical and Environmental Hazards (CRCEH), that belongs to Public Health England (PHE), hosts the official Neutron Personal Dosimetry Service of the United Kingdom. They use etched-track detectors, made of a material called PADC (poly-allyl diglycol carbonate), to determinate de neutron personal dose. A two weeks visit has been made to this center, in order to learn about the facilities, the methods employed and the legislative framework of the Neutron Personal Dosimetry Service. In this work the main results of this visits are shown, which are interesting for the future development of an official neutron personal dosimetry service in Spain.

  13. The impact of organisational culture on the delivery of person-centred care in services providing respite care and short breaks for people with dementia. (United States)

    Kirkley, Catherine; Bamford, Claire; Poole, Marie; Arksey, Hilary; Hughes, Julian; Bond, John


    Ensuring the development and delivery of person-centred care in services providing respite care and short breaks for people with dementia and their carers has a number of challenges for health and social service providers. This article explores the role of organisational culture in barriers and facilitators to person-centred dementia care. As part of a mixed-methods study of respite care and short breaks for people with dementia and their carers, 49 telephone semi-structured interviews, two focus groups (N= 16) and five face-to-face in-depth interviews involving front-line staff and operational and strategic managers were completed in 2006-2007. Qualitative thematic analysis of transcripts identified five themes on aspects of organisational culture that are perceived to influence person-centred care: understandings of person-centred care, attitudes to service development, service priorities, valuing staff and solution-focused approaches. Views of person-centred care expressed by participants, although generally positive, highlight a range of understandings about person-centred care. Some organisations describe their service as being person-centred without the necessary cultural shift to make this a reality. Participants highlighted resource constraints and the knowledge, attitudes and personal qualities of staff as a barrier to implementing person-centred care. Leadership style, the way that managers' support and value staff and the management of risk were considered important influences. Person-centred dementia care is strongly advocated by professional opinion leaders and is prescribed in policy documents. This analysis suggests that person-centred dementia care is not strongly embedded in the organisational cultures of all local providers of respite-care and short-break services. Provider organisations should be encouraged further to develop a shared culture at all levels of the organisation to ensure person-centred dementia care. © 2011 Blackwell Publishing

  14. Assessors' use of personality traits in descriptions of assessment centre candidates : A five-factor model perspective

    NARCIS (Netherlands)

    Lievens, F.; de Fruyt, F.; van Dam, K.


    In assessment centres assessors are typically taught to note down behavioural observations. However, previous studies have shown that about 20% of assessor notes contain trait descriptors. Instead of regarding these descriptors as errors, this study examines their position in a personality

  15. "Putting Music On": Everyday Leisure Activities, Choice-Making and Person-Centred Planning in a Supported Living Scheme (United States)

    Hassan, Nedim


    Background: Person-centred planning, which commonly becomes formalised within services for people with learning disabilities through an Essential Lifestyle Plan (ELP), was intended to help place the choices of individuals at the forefront of service provision. However, beyond UK government policy rhetoric, scholars have raised issues regarding the…

  16. Reconciling concepts of space and person-centred care of the older person with cognitive impairment in the acute care setting. (United States)

    Rushton, Carole; Edvardsson, David


    Although a large body of literature exists propounding the importance of space in aged care and care of the older person with dementia, there is, however, only limited exploration of the 'acute care space' as a particular type of space with archetypal constraints that maybe unfavourable to older people with cognitive impairment and nurses wanting to provide care that is person-centred. In this article, we explore concepts of space and examine the implications of these for the delivery of care to older people who are cognitively impaired. Our exploration is grounded in theorisations of space offered by key geographers and phenomenologists, but also draws on how space has been constructed within the nursing literature that refers specifically to acute care. We argue that space, once created, can be created and that nursing has a significant role to play in the process of its recreation in the pursuit of care that is person-centred. We conclude by introducing an alternative logic of space aimed at promoting the creation of more salutogenic spaces that invokes a sense of sanctuary, safeness, and inclusion, all of which are essential if the care provided to the older person with cognitive impairment is apposite to their needs. The concept of 'person-centred space' helps to crystallize the relationship between space and person-centred care and implies more intentional manipulation of space that is more conducive to caring and healing. Significantly, it marks a return to Nightingale's wisdom, that is, to put the person in the best possible conditions for nature to act upon them. © 2016 John Wiley & Sons Ltd.

  17. Presenteeism, stress resilience, and physical activity in older manual workers: a person-centred analysis. (United States)

    Thogersen-Ntoumani, Cecilie; Black, Julie; Lindwall, Magnus; Whittaker, Anna; Balanos, George M


    This study used a person-centred approach to explore typologies of older manual workers based on presenteeism, stress resilience, and physical activity. Older manual workers ( n  = 217; 69.1% male; age range 50-77; M age = 57.11 years; SD = 5.62) from a range of UK-based organisations, representing different manual job roles, took part in the study. A cross-sectional survey design was used. Based on the three input variables: presenteeism, stress resilience and physical activity, four distinct profiles were identified on using Latent Profile Analysis. One group ('High sport/exercise and well-functioning'; 5.50%) engaged in high levels of sport/exercise and exhibited low levels of stress resilience and all types of presenteeism. Another profile ('Physically burdened'; 9.70%) reported high levels of work and leisure-time physical activity, low stress resilience, as well as high levels of presenteeism due to physical and time demands. A 'Moderately active and functioning' group (46.50%) exhibited moderate levels on all variables. Finally, the fourth profile ('Moderately active with high presenteeism'; 38.20%) reported engaging in moderate levels of physical activity and had relatively high levels of stress resilience, yet also high levels of presenteeism. The profiles differed on work affect and health perceptions largely in the expected directions. There were no differences between the profiles in socio-demographics. These results highlight complex within-person interactions between presenteeism, stress resilience, and physical activity in older manual workers. The identification of profiles of older manual workers who are at risk of poor health and functioning may inform targeted interventions to help retain them in the workforce for longer.

  18. Enhancing Connectedness Through Peer Training for Community-Dwelling Older People: A Person Centred Approach. (United States)

    Burmeister, Oliver K; Bernoth, Maree; Dietsch, Elaine; Cleary, Michelle


    Social interaction and connectedness is important to the mental health and wellbeing of older people. The aim of this research study was to facilitate and increase opportunities for social connectedness for older people living in regional areas through the use of technology training. Weekly technology training sessions were conducted at a Seniors Citizen's Club with a peer trainer (an experienced, retired computer teacher) and sessions were attended not only by the six study participants, but also by other club members, with up to 15 club members participating in sessions. Data analysis involved all documents generated by the project, including the individual interviews, researcher observations of training sessions, reports from the peer trainer and weekly diaries maintained by participants. Findings demonstrated that computer training at the Senior Citizens Club helped participants build group cohesion and to form tiered connections with partners, family, and friends with whom they no longer live. When the trainer is seen as a peer, and training is person-centred, older people are more receptive to learning, exploring, and experimenting with technology. Although only six people were involved in the in-depth evaluation part of the study, voluntary training with the trainer in the absence of any funding continues even to this present time. The outcome of this research reinforces the potential for technology facilitated tiered connectivity to enhance the quality of life for older people living in regional and rural Australia.

  19. Power, empowerment, and person-centred care: using ethnography to examine the everyday practice of unregistered dementia care staff. (United States)

    Scales, Kezia; Bailey, Simon; Middleton, Joanne; Schneider, Justine


    The social positioning and treatment of persons with dementia reflects dominant biomedical discourses of progressive and inevitable loss of insight, capacity, and personality. Proponents of person-centred care, by contrast, suggest that such loss can be mitigated within environments that preserve rather than undermine personhood. In formal organisational settings, person-centred approaches place particular responsibility on 'empowered' direct-care staff to translate these principles into practice. These staff provide the majority of hands-on care, but with limited training, recognition, or remuneration. Working within a Foucauldian understanding of power, this paper examines the complex ways that dementia care staff engage with their own 'dis/empowerment' in everyday practice. The findings, which are drawn from ethnographic studies of three National Health Service (NHS) wards and one private care home in England, are presented as a narrative exploration of carers' general experience of powerlessness, their inversion of this marginalised subject positioning, and the related possibilities for action. The paper concludes with a discussion of how Foucault's understanding of power may help define and enhance efforts to empower direct-care staff to provide person-centred care in formal dementia care settings. © 2016 Foundation for the Sociology of Health & Illness.

  20. Persons with physical disabilities’ experiences of rehabilitation services at Community Health Centres in Cape Town.

    Directory of Open Access Journals (Sweden)

    C.K. Kahonde


    Full Text Available Background: Rehabilitation is of fundamental importance for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it  is  important  to  seek  clients’  perspectives  of  the  rehabilitation  services and  to  incorporate  these  perspectives  into  the  planning  and  delivery  of rehabilitation  services.  The  aim  of  this  study  was  to  explore  the  persons with  physical  disabilities’  experiences  of  the  rehabilitation  services  they received at Community Health Centres (CHCs. Methods: In-depth  qualitative  interviews  were  used  to  collect  data.  Ten  persons  with  physical  disabilities,  who  had  received  rehabilitation  services at CHCs participated in the in-depth interviews. The interviews were tape-recorded and transcribed verbatim.  Thematic analysis was used to analyse the data.  Results: The  clients  experienced  problems  with  accessing  transport  and  obtaining  information  from  the  service providers. Experiences regarding clients’ involvement in the rehabilitation were varied. All the clients reported positive experiences regarding their interaction with service providers and family involvement. Conclusion: The experiences of the participants who accessed CHCs for rehabilitation were positive and negative. The service providers should therefore address the aspects of rehabilitation that were negatively experienced.

  1. Person-centred positive emotions, object-centred negative emotions: 2-year-olds generalize negative but not positive emotions across individuals. (United States)

    Vaish, Amrisha; Grossmann, Tobias; Woodward, Amanda


    Prior work suggests that young children do not generalize others' preferences to new individuals. We hypothesized (following Vaish et al., 2008, Psychol. Bull., 134, 383-403) that this may only hold for positive emotions, which inform the child about the person's attitude towards the object but not about the positivity of the object itself. It may not hold for negative emotions, which additionally inform the child about the negativity of the object itself. Two-year-old children saw one individual (the emoter) emoting positively or negatively towards one and neutrally towards a second novel object. When a second individual then requested an object, children generalized the emoter's negative but not her positive emotion to the second individual. Children thus draw different inferences from others' positive versus negative emotions: Whereas they view others' positive emotions as person centred, they may view others' negative emotions as object centred and thus generalizable across people. The results are discussed with relation to the functions and implications of the negativity bias. © 2015 The British Psychological Society.

  2. European Federation of Associations of Families of People with Mental Illness initiatives on person-centred care. (United States)

    Steffen, Sigrid


    European Federation of Associations of Families of People with Mental Illness is working towards the goal of shifting the emphasis of care for people with metal illness from the treatment of the symptoms to a more holistic approach of treating the whole person - in other words 'person-centred care'. It is also working with the Geneva conference on person-centred medicine and various interested groupings and organizations to ensure that the role of the family is fully recognized and supported. By engaging primarily with the medical community in bringing to fruition certain initiatives which European Federation of Associations of Families of People with Mental Illness considers as important to the success of person-centred care. To date, no formal reviews have taken place and feedback from the initiatives has been informal and anecdotal. Early reports from the various initiatives are positive. But they also indicate that there is still much work to be done in order for the concept to become a reality across the majority of European countries. © 2010 Blackwell Publishing Ltd.

  3. Practice what you preach: developing person-centred culture in inpatient mental health settings through strengths-based, transformational leadership. (United States)

    Beckett, Paul; Field, John; Molloy, Luke; Yu, Nickolas; Holmes, Douglas; Pile, Emily


    The experience of nursing staff and consumers in inpatient mental health wards is often reported as being negative. Efforts to improve culture and practice have had limited success, with ineffective leadership, staff resistance, and unresponsive organisational culture identified as common barriers to change. Practice development has been promoted as an approach to developing person-centred culture that enables professional development through participation, learning and empowerment. For person-centred practice to flourish, organisational leadership at all levels must reflect the same principles. In preparation for the opening of a new integrated mental health service, an inpatient mental health team participated in a practice development project. An action research approach was used to facilitate a series of "away days," initially with the nursing team and then other members of the multidisciplinary team (MDT). Transformational leadership principles were adopted in the facilitation of team activities underpinned by strengths and solution-focused practices. Evaluation of the project by staff members was very positive and there was a high level of participation in practice development activities. The project resulted in the creation of a development plan for the ward, which prioritised five key themes: person-centred care, personal recovery, strengths-based principles, and evidence-based and values-based care. The project outcomes highlight the importance of leadership, which parallels the ideals promoted for clinical practice.

  4. A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol. (United States)

    Hafskjold, Linda; Sundler, Annelie J; Holmström, Inger K; Sundling, Vibeke; van Dulmen, Sandra; Eide, Hilde


    This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people

  5. The effect of person-centred communication on parental stress in a NICU

    DEFF Research Database (Denmark)

    Weis, J; Zoffmann, Vibeke; Greisen, G


    To investigate the effect of the Guided Family-Centred Care intervention, developed by the lead author, on parental stress in a neonatal intensive care unit (NICU).......To investigate the effect of the Guided Family-Centred Care intervention, developed by the lead author, on parental stress in a neonatal intensive care unit (NICU)....

  6. Person-centred care after acute coronary syndrome, from hospital to primary care - A randomised controlled trial. (United States)

    Fors, Andreas; Ekman, Inger; Taft, Charles; Björkelund, Cecilia; Frid, Kerstin; Larsson, Maria Eh; Thorn, Jörgen; Ulin, Kerstin; Wolf, Axel; Swedberg, Karl


    To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome. 199 patients with acute coronary syndrome < 75 years were randomly assigned to person-centred care intervention or treatment as usual and followed for 6 months. In the intervention group a person-centred care process was added to treatment as usual, emphasising the patient as a partner in care. Care was co-created in collaboration between patients, physicians, registered nurses and other health care professionals and documented in a health plan. A team-based partnership across three health care levels included transparent knowledge about the disease and medical state to achieve agreed goals during recovery. Main outcome measure was a composite score of changes in general self-efficacy ≥ 5 units, return to work or prior activity level and re-hospitalisation or death. The composite score showed that more patients (22.3%, n=21) improved in the intervention group at 6 months compared to the control group (9.5%, n=10) (odds ratio, 2.7; 95% confidence interval: 1.2-6.2; P=0.015). The effect was driven by improved self-efficacy ≥ 5 units in the intervention group. Overall general self-efficacy improved significantly more in the intervention group compared with the control group (P=0.026). There was no difference between groups on re-hospitalisation or death, return to work or prior activity level. A person-centred care approach emphasising the partnership between patients and health care professionals throughout the care chain improves general self-efficacy without causing worsening clinical events. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Adjustable continence balloons

    DEFF Research Database (Denmark)

    Kjær, Line; Fode, Mikkel; Nørgaard, Nis


    Abstract Objective. This study aimed to evaluate the results of the Danish experience with the ProACT urinary continence device inserted in men with stress urinary incontinence. Material and methods. The ProACT was inserted in 114 patients. Data were registered prospectively. The main endpoints...... in urinary leakage > 50% was seen in 72 patients (80%). Complications were seen in 23 patients. All of these were treated successfully by removal of the device in the outpatient setting followed by replacement of the device. Another eight patients had a third balloon inserted to improve continence further....... Fourteen patients (12%) ended up with an artificial sphincter or a urethral sling. Sixty patients (63%) experienced no discomfort and 58 (61%) reported being dry or markedly improved. Overall, 50 patients (53%) reported being very or predominantly satisfied. Conclusions. Adjustable continence balloons seem...

  8. System-centred tobacco management: from 'whole-person' to 'whole-system' change. (United States)

    Bonevski, Billie


    Patient-centred tobacco management is a pragmatic approach for helping smokers achieve their goals in terms of either cessation or harm reduction. However, the success of the approach is dependent on clinicians embracing and delivering it as intended. There are a number of structural and systemic organisational barriers which are limiting clinician-delivered patient-centred tobacco dependence. In response, 'whole system' approaches which help support clinicians in the delivery of patient-centred tobacco management are required. Health system changes to support clinicians and facilitate the delivery of patient-centred tobacco management are worth further investigation, particularly in settings where tobacco smoking rates are high. © 2013 Australasian Professional Society on Alcohol and other Drugs.

  9. Reconciling conceptualizations of relationships and person-centred care for older people with cognitive impairment in acute care settings. (United States)

    Rushton, Carole; Edvardsson, David


    Relationships are central to enacting person-centred care of the older person with cognitive impairment. A fuller understanding of relationships and the role they play facilitating wellness and preserving personhood is critical if we are to unleash the productive potential of nursing research and person-centred care. In this article, we target the acute care setting because much of the work about relationships and older people with cognitive impairment has tended to focus on relationships in long-term care. The acute care setting is characterized by archetypal constraints which differentiate it from long-term care, in terms of acuity and haste, task-orientated work patterns and influence from "the rule of medicine," all of which can privilege particular types of relating. In this article, we drew on existing conceptualizations of relationships from theory and practice by tapping in to the intellectual resources provided by nurse researchers, the philosophy of Martin Buber and ANT scholars. This involved recounting two examples of dyadic and networked relationships which were re-interpreted using two complementary theoretical approaches to provide deeper and more comprehensive conceptualizations of these relationships. By re-presenting key tenets from the work of key scholars on the topic relationships, we hope to hasten socialization of these ideas into nursing into the acute care setting. First, by enabling nurses to reflect on how they might work toward cultivating relationships that are more salutogenic and consistent with the preservation of personhood. Second, by stimulating two distinct but related lines of research enquiry which focus on dyadic and networked relationships with the older person with cognitive impairment in the acute care setting. We also hope to reconcile the schism that has emerged in the literature between preferred approaches to care of the older person with cognitive impairment, that is person-centred care versus relationship-centred care

  10. Person-centred interactions between nurses and patients during medication activities in an acute hospital setting: qualitative observation and interview study. (United States)

    Bolster, Danielle; Manias, Elizabeth


    There is increasing emphasis on person-centred care within the literature and the health care context. It is suggested that a person-centred approach to medication activities has the potential to improve patient experiences and outcomes. This study set out to examine how nurses and patients interact with each other during medication activities in an acute care environment with an underlying philosophy of person-centred care. A qualitative approach was used comprising naturalistic observation and semi-structured interviews. The study setting was an acute care ward with a collaboratively developed philosophy of person-centre care, in an Australian metropolitan hospital. Eleven nurses of varying levels of experience were recruited to participate in observations and interviews. Nurses were eligible to participate if they were employed on the study ward in a role that incorporated direct patient care, including medication activities. A stratified sampling technique ensured that nurses with a range of years of clinical experience were represented. Patients who were being cared for by participating nurses during the observation period were recruited to participate unless they met the following exclusion criteria: those less than 18 years of age, non-English speaking patients, and those who were unable to give informed consent. Twenty-five patients were observed and 16 of those agreed to be interviewed. The results of the study generated insights into the nature of interactions between nurses and patients where person-centred care is the underlying philosophy of care. Three major themes emerged from the findings: provision of individualised care, patient participation and contextual barriers to providing person-centred care. While the participating nurses valued a person-centred approach and perceived that they were conducting medication activities in a person-centred way, some nurse-patient interactions during medication activities were centred on routines rather than


    Directory of Open Access Journals (Sweden)

    Tesler Kirill Igorevich


    The solution is to establish public rehabilitation centres that perform recreational, educational, sports, cultural, social, technological and production functions. This solution is most needed for blind and visually impaired people, because they experience particular problems in travelling in the urban environment. Establishment of the barrier-free environment can solve the problem of socialization of disabled people, because it contemplates all functional processes that they need. Integration of various functional units within public rehabilitation centres helps improve the living conditions of disabled people, and at the same time it contributes to the profitability of these centres as a whole and provides the necessary impetus boosting the development of techniques and technologies required for low mobility groups of people.

  12. Producing the BEANs needed for person-centred healthcare decision making requires translating the wisdom of the clinical crowd

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Eiring, Øystein; Nielsen, Jesper Bo

    Producing the BEANs needed for person-centred healthcare decision making requires translating the wisdom of the clinical crowd Mette Kjer Kaltoft, University of Southern Denmark Øystein Eiring, Norwegian Knowledge Centre for the Health Services Jesper Bo Nielsen, University of Southern Denmark...... requirement in relation to the BEANs only by assuming professionals are able to make up the shortfalls remaining after the peer-reviewed published products of scientific research have been fully exploited. Since the clinical judgement of individual professionals has never been subjected to scientific...... never get near to meeting the needs of practice. What is required is the translation of the wisdom of the clinical crowd through the processing of the beliefs of expert professionals into BEANs. The process must be appropriately analytically rigorous, but this should not be confounded with scientific...

  13. Patient-centred care: using online personal medical records in IVF practice.

    NARCIS (Netherlands)

    Tuil, W.S.; Hoopen, A.J. ten; Braat, D.D.M.; Vries Robbé, P.F. de; Kremer, J.A.M.


    BACKGROUND: Generic patient-accessible medical records have shown promise in enhancing patient-centred care for patients with chronic diseases. We sought to design, implement and evaluate a patient-accessible medical record specifically for patients undergoing a course of assisted reproduction (IVF

  14. The third person in the room: The needs of care partners of older people in home care services-A systematic review from a person-centred perspective. (United States)

    Anker-Hansen, Camilla; Skovdahl, Kirsti; McCormack, Brendan; Tønnessen, Siri


    To identify and synthesise the needs of care partners of older people living at home with assistance from home care services. "Ageing in place" is a promoted concept where care partners and home care services play significant roles. Identifying the needs of care partners and finding systematic ways of meeting them can help care partners to cope with their role. This study is based on the PRISMA reporting guidelines. The systematic review of qualitative and quantitative studies was guided by the Joanna Briggs Institute methodology. In total, 16 studies were included in the review, eleven qualitative and five quantitative. Three main categories were revealed in the analysis: the need for quality interaction, the need for a shared approach to care and the need to feel empowered. Care partners of older people have several, continuously unmet needs. A person-centred perspective can contribute new understandings of how to meet these needs. A knowledge gap has been identified regarding the needs of care partners of older people with mental health problems. There is a need to develop a tool for systematic collaboration between home care services and care partners, so that the identified needs can be met in a more thorough, systematic and person-centred way. The carers in home care services need competence to identify and meet the needs of care partners. The implementation of person-centred values in home care services can contribute to meet the needs of care partners to a greater extent than today. Future research on the needs of care partners of older people with mental health problems needs to be undertaken. © 2017 John Wiley & Sons Ltd.

  15. Study of the personal radiation dose received by nuclear medicine technologists working in a dedicated PET centre

    International Nuclear Information System (INIS)

    Robinson, C.N.; Wallace, A.B.; Young, A.B.; Ibbetson, V.J.


    The use of dedicated PET scanners is becoming more widespread throughout Australia and the world. PET imaging utilises short-lived (-108 min), high-energy (511 keV) gamma-ray emitters, that could result in a high radiation dose being received by staff. As part of a larger staff and area monitoring project, this paper discusses the personal dose equivalent, H p (10), received by PET staff working in a dedicated PET centre. The typical H (10) received by staff was approximately 31 μSv. The average daily administered activity to patients at Austin Health was 1280 MBq

  16. Person-Centred サイコドラマに関する一考察


    山田, 麻有美


    In the beginning of the 1900s, the Psychodrama, a sort of psychotherapeutic method for groups, was invented by J.L.Moreno. He was very charismatic and powerful. He trained his follower’s. They performed the Psychodrama world-wide. Through they developed their own techniques and schools, they made little theoretical development. The Person-Centred Psychodrama is one of these schools of psychodrama. It is used mainly in the UK and has been gaining acceptance. The purpose of this essay is to poi...

  17. Requirements for work of nurses and technicians in a centre for specialized health care of irradiated persons

    International Nuclear Information System (INIS)

    Blaha, M.; Pidrman, V.; Vanasek, J.; Brandova, J.


    Experience is presented with the training of nurses of the Centre of Specialized Health Care For Irradiated Persons of the Unit for Treatment of Hematological Diseases, which may serve as the model for the treatment of acute radiation syndrome. The concept of the training course is presented. The basic requirement is a nursing school diploma and a post-secondary training course (theoretical and practical, including the preparation of the work place, the treatment of patients, psychotherapy, microbial checks, etc.). Experience has shown that 2 to 3 years work in this field is needed to master the required theoretical knowledge and skills. (J.B.)

  18. Requirements for work of nurses and technicians in a centre for specialized health care of irradiated persons

    Energy Technology Data Exchange (ETDEWEB)

    Blaha, M; Pidrman, V; Vanasek, J; Brandova, J [Vojensky Lekarsky Vyzkumny a Doskolovaci Ustav J.E. Purkyne, Hradec Kralove (Czechoslovakia)


    Experience is presented with the training of nurses of the Centre of Specialized Health Care For Irradiated Persons of the Unit for Treatment of Hematological Diseases, which may serve as the model for the treatment of acute radiation syndrome. The concept of the training course is presented. The basic requirement is a nursing school diploma and a post-secondary training course (theoretical and practical, including the preparation of the work place, the treatment of patients, psychotherapy, microbial checks, etc.). Experience has shown that 2 to 3 years work in this field is needed to master the required theoretical knowledge and skills.

  19. [The continent ileostomy--indication and results]. (United States)

    Säuberli, H; Akovbiantz, A; Hahnloser, P


    Proctocolectomy with conventional ileostomy cures patients with severe ulcerative colitis, however ileostomy appliances had to be worn for the rest of their lives. The continent ileostomy as devised by Kock provides the patient with an intraabdominal ileal reservoir and a valve constructed by invaginating the efferent ileal segment into the reservoir. The patient empties his reservoir 2 to 3 times a day by inserting a catheter through the valve. Our experience with 45 patients is reported. In most cases the continent ileostomy was constructed as a second procedure after proctocolectomy. The construction of a continent ileostomy as a secondary procedure can be recommended in patients with proctocolectomy. It offers patients a life situation differing only insignificantly from that of normal persons.

  20. Teachers' conceptions of learning and teaching in student-centred medical curricula: the impact of context and personal characteristics. (United States)

    Jacobs, Johanna C G; van Luijk, Scheltus J; van der Vleuten, Cees P M; Kusurkar, Rashmi A; Croiset, Gerda; Scheele, Fedde


    Gibbs and Coffey (2004) have reported that teaching practices are influenced by teachers' conceptions of learning and teaching. In our previous research we found significant differences between teachers' conceptions in two medical schools with student-centred education. Medical school was the most important predictor, next to discipline, gender and teaching experience. Our research questions for the current study are (1) which specific elements of medical school explain the effect of medical school on teachers' conceptions of learning and teaching? How? and (2) which contextual and personal characteristics are related to conceptions of learning and teaching? How? Individual interviews were conducted with 13 teachers of the undergraduate curricula in two medical schools. Previously their conceptions of learning and teaching were assessed with the COLT questionnaire. We investigated the meanings they attached to context and personal characteristics, in relation to their conceptions of learning and teaching. We used a template analysis. Large individual differences existed between teachers. Characteristics mentioned at the medical school and curriculum level were 'curriculum tradition', 'support by educational department' and 'management and finances'. Other contextual characteristics were 'leadership style' at all levels but especially of department chairs, 'affordances and support', 'support and relatedness', and 'students' characteristics'. Personal characteristics were 'agency', 'experience with PBL (as a student or a teacher)','personal development', 'motivation and work engagement'and 'high content expertise'. Several context and personal characteristics associated with teachers' conceptions were identified, enabling a broader view on faculty development with attention for these characteristics, next to teaching skills.

  1. Experiencing Rights within Positive, Person-Centred Support Networks of People with Intellectual Disability in Australia (United States)

    Hillman, A.; Donelly, M.; Whitaker, L.; Dew, A.; Stancliffe, R. J.; Knox, M.; Shelley, K.; Parmenter, T. R.


    Background: This research describes issues related to human rights as they arose within the everyday lives of people in nine personal support networks that included adult Australians with an intellectual disability (ID). Method: The research was part of a wider 3-year ethnographic study of nine personal support networks. A major criterion for…

  2. Comparison of iPad applications with traditional activities using person-centred care approach: impact on well-being for persons with dementia. (United States)

    Leng, Fong Yoke; Yeo, Donald; George, Stacey; Barr, Christopher


    Professionals working with people with dementia need to develop new activities that occupy patients and increase positive emotions. Dementia care mapping is a reliable method of measuring well-being during activities with people with dementia. The iPad has many applications that may be suitable as a group activity for persons with dementia. Six people with dementia took part in two traditional and two iPad activities over two days. Well-being was recorded using dementia care mapping. Subjects displayed similar or better levels of well-being during iPad activities than traditional activities. A larger variation of behaviors was seen during iPad activities than traditional activities. With detailed planning using a person-centred care approach, iPad group activity has the potential to be as effective and engaging as other conventional activities in achieving well-being.

  3. [Continent ileostomy--indication and possibilities]. (United States)

    Hahnloser, P; Säuberli, H; Geroulanos, S; Schauwecker, H H; Kock, N G


    Proctocolectomy with conventional ileostomy cures patients with severe ulcerative colitis but ileostomy appliances must be worn for the rest of their lives. The continent ileostomy, as devised by Kock, provides the patient with an intraabdominal ileal reservoir and a valve constructed by invaginating the efferent ileal segment into the reservoir. The patient empties his reservoir 2-3 times a day by inserting a catheter through the valve. Our experience with 14 patients is reported. The continent ileostomy was in most cases constructed as a second procedure after proctocolectomy. Minor postoperative complications, such as abscess, fistula or partial luxation of the valve were easily corrected. One patient who underwent proctocolectomy and simultaneous construction of a continent ileostomy died in acute liver failure due to a severe preexisting cirrhosis. All the other patients are continent for feces and gas and do not need external appliances. The construction of a continent ileostomy as a secondary procedure can be recommended in patients with proctocolectomy. It offers patients a life situation with differs only insignificantly from that of normal persons.

  4. The realities of partnership in person-centred care: a qualitative interview study with patients and professionals. (United States)

    Wolf, Axel; Moore, Lucy; Lydahl, Doris; Naldemirci, Öncel; Elam, Mark; Britten, Nicky


    Although conceptual definitions of person-centred care (PCC) vary, most models value the involvement of patients through patient-professional partnerships. While this may increase patients' sense of responsibility and control, research is needed to further understand how this partnership is created and perceived. This study aims to explore the realities of partnership as perceived by patients and health professionals in everyday PCC practice. Qualitative study employing a thematic analysis of semistructured interviews with professionals and patients. Four internal medicine wards and two primary care centres in western Sweden. 16 health professionals based at hospital wards or primary care centres delivering person-centred care, and 20 patients admitted to one of the hospital wards. Our findings identified both informal and formal aspects of partnership. Informal aspects, emerging during the interaction between healthcare professionals and patients, without any prior guidelines or regulations, incorporated proximity and receptiveness of professionals and building a close connection and confidence. This epitomised a caring, respectful relationship congruent across accounts. Formal aspects, including structured ways of sustaining partnership were experienced differently. Professionals described collaborating with patients to encourage participation, capture personal goals, plan and document care. However, although patients felt listened to and informed, they were content to ask questions and felt less involved in care planning, documentation or exploring lifeworld goals. They commonly perceived participation as informed discussion and agreement, deferring to professional knowledge and expertise in the presence of an empathetic and trusting relationship. In our study, patients appear to value a process of human connectedness above and beyond formalised aspects of documenting agreed goals and care planning. PCC increases patients' confidence in professionals who are

  5. Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses. (United States)

    Feo, Rebecca; Conroy, Tiffany; Marshall, Rhianon J; Rasmussen, Philippa; Wiechula, Richard; Kitson, Alison L


    Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. © 2016 John Wiley & Sons Ltd.

  6. Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people's perceptions. (United States)

    Price, Kay; Grimmer, Karen; Foot, Jan


    Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens. Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview. Data were then analysed using a qualitative content analysis approach. Results The purpose of the 75+HA was not well understood by participants. Participant responses reveal that where, when, who and how a primary health professional conducted the 75+HA affected what older people talked about, the guidance they sought to deal with issues and, in turn, the actioning of issues that were discussed during the 75+HA. Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require. What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues affecting community-dwelling older people's health and well being. The aim of the 75+HA is to consider a broad range of factors that could affect physical, psychological and social functioning, which, in turn, affects overall health, and the capacity of older people to live independently in the community. Underlying the 75+HA is the importance of detecting early functional decline to enable healthy aging. What does this paper add

  7. Improving and ensuring best practice continence management in residential aged care. (United States)

    Heckenberg, Gayle


    Background  Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives •  Review the literature on best practice management of incontinence •  Evaluate current practice in continence management for elderly residents within residential aged care services •  Improve adherence to best practice strategies of care for incontinence •  Raise awareness within the nursing home of the best practice management of incontinence •  Promote appropriate and effective use of resources for continence management •  Deliver individualised person-centred care to residents. •  Ensure best practice in continence management Methods  The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results  Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness

  8. Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

    Directory of Open Access Journals (Sweden)

    Qarin Lood


    Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration. Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level. Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way. Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

  9. Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

    Directory of Open Access Journals (Sweden)

    Qarin Lood


    Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration.Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level.Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way.Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

  10. Art, music, story: The evaluation of a person-centred arts in health programme in an acute care older persons' unit. (United States)

    Ford, Karen; Tesch, Leigh; Dawborn, Jacqueline; Courtney-Pratt, Helen


    To evaluate the impact of an arts in health programme delivered by a specialised artist within an acute older person's unit. Acute hospitals must meet the increasingly complex needs of older people who experience multiple comorbidities, often including cognitive impairment, either directly related to their admission or longer term conditions, including dementia. A focus on physical illness, efficiency and tasks within an acute care environment can all divert attention from the psychosocial well-being of patients. This focus also decreases capacity for person-centred approaches that acknowledge and value the older person, their life story, relationships and the care context. The importance of arts for health and wellness, including responsiveness to individual need, is well established: however, there is little evidence about its effectiveness for older people in acute hospital settings. We report on a collaborative arts in health programme on an acute medical ward for older people. The qualitative study used collaborative enquiry underpinned by a constructivist approach to evaluate an arts programme that involved participatory art-making activities, customised music, song and illustration work, and enlivening the unit environment. Data sources included observation of art activities, semi-structured interviews with patients and family members, and focus groups with staff. Data were transcribed and thematically analysed using a line by line approach. The programme had positive impacts for the environment, patients, families and staff. The environment exhibited changes as a result of programme outputs; patients and families were engaged and enjoyed activities that aided recovery from illness; and staff also enjoyed activities and importantly learnt new ways of working with patients. An acute care arts in health programme is a carefully nuanced programme where the skills of the arts health worker are critical to success. Utilising such skill, continued focus on person

  11. Elbow Room for Best Practice? Montgomery, Patients' values, and Balanced Decision-Making in Person-Centred Clinical Care. (United States)

    Herring, Jonathan; Fulford, Kmw; Dunn, Michael; Handa, Ashoki


    The UK Supreme Court Montgomery judgment marks a decisive shift in the legal test of duty of care in the context of consent to treatment, from the perspective of the clinician (as represented by Bolam rules) to that of the patient. A majority of commentators on Montgomery have focused on the implications of the judgment for disclosure of risk. In this article, we set risk disclosure in context with three further elements of the judgment: benefits, options, and dialogue. These elements, we argue, taken together with risk disclosure, reflect the origins of the Montgomery ruling in a model of consent based on autonomy of patient choice through shared decision-making with their doctor. This model reflects recent developments in both law and medicine and is widely regarded (by the General Medical Council and others) as representing best practice in contemporary person-centred medicine. So understood, we suggest, the shift marked by Montgomery in the basis of duty of care is a shift in underpinning values: it is a shift from the clinician's interpretation about what would be best for patients to the values of (to what is significant or matters from the perspective of) the particular patient concerned in the decision in question. But the values of the particular patient do not thereby become paramount. The Montgomery test of duty of care requires the values of the particular patient to be balanced alongside the values of a reasonable person in the patient's position. We illustrate some of the practical challenges arising from the balance of considerations required by Montgomery with examples from surgical care. These examples show the extent to which Montgomery, in mirroring the realities of clinical decision-making, provides elbowroom for best practice in person-centred clinical care. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email:

  12. Personal Learning Environments in Higher Education Language Courses: An Informal and Learner-Centred Approach (United States)

    Laakkonen, Ilona


    The chapter discusses the potential of personal learning environments (PLE) based on Web 2.0 applications for language courses in higher education (HE). This novel approach to the use of information and communication technologies (ICT) in education involves learners in the design of learning environments, tools and processes. The chapter begins…

  13. A "client-centred activities of daily living" intervention for persons with stroke

    DEFF Research Database (Denmark)

    Guidetti, Susanne; Ranner, Maria; Tham, Kerstin


    OBJECTIVE: To compare changes regarding perceived participation, independence in activities of daily living (ADL) and life satisfaction between 3, 6 and 12 months after inclusion in a study of a client-centred ADL intervention and usual ADL intervention after stroke. DESIGN: A multicentre...... diagnosed with dementia, and were able to understand instructions. Data collection was performed by blinded assessors. The primary outcome, perceived participation, was assessed with the Stroke Impact Scale 3.0, domain 8. The secondary outcomes, participation, independence in ADL, and life satisfaction......, were assessed with validated instruments. For statistical power, 280 participants were required. Statistical analyses were performed on an intention-to-treat basis. RESULTS: There were no differences between the groups regarding changes in perceived participation, independence in ADL, or life...

  14. Experiences of the return to work process after stroke while participating in a person-centred rehabilitation programme. (United States)

    Öst Nilsson, Annika; Eriksson, Gunilla; Johansson, Ulla; Hellman, Therese


    In Sweden, less than 50% of those getting stroke in working age return to work (RTW). Effective rehabilitation programmes need to be developed and therapeutic aspects understood. To explore and describe how persons with stroke experience their RTW process while participating in a person-centred rehabilitation programme focusing on RTW. Seven persons with mild or moderate stroke were interviewed twice during the intervention in the vocational training phase using semi-structured interviews. Data were analysed using grounded theory. Having a coordinator by their side gave support and guidance during the RTW process. Knowledge of stroke, strategies and a straightforward communication created a structure for the RTW process. Expressing one's own wishes increased opportunities to influence and decide which path to follow in order to reach the goal. Straightforward, open and recurring communication facilitated the possibility to adapt to the situation. These aspects increased insight and awareness which facilitated the RTW process. The findings indicate that a precondition for a fruitful RTW process was that suitable platforms at work were created in which the actors involved could cooperate. This knowledge might also be valuable in the RTW process for people with other diagnosis.

  15. The impact of the Dementia ABC educational programme on competence in person-centred dementia care and job satisfaction of care staff. (United States)

    Rokstad, Anne Marie Mork; Døble, Betty Sandvik; Engedal, Knut; Kirkevold, Øyvind; Benth, Jūratė Šaltytė; Selbaek, Geir


    The objective of the study was to evaluate the impact of the Dementia ABC educational programme on the participants' competence in person-centred care and on their level of job satisfaction. The development of person-centred care for people with dementia is highly recommended, and staff training that enhances such an approach may positively influence job satisfaction and the possibility of recruiting and retaining competent care staff. The study is a longitudinal survey, following participants over a period of 24 months with a 6-month follow-up after completion of the programme. A total of 1,795 participants from 90 municipalities in Norway are included, and 580 from 52 municipalities completed all measurements. The person-centred care assessment tool (P-CAT) is used to evaluate person-centredness. The psychosocial workplace environment and job satisfaction questionnaire is used to investigate job satisfaction. Measurements are made at baseline, and after 12, 24 and 30 months. A statistically significant increase in the mean P-CAT subscore of person-centred practice and the P-CAT total score is found at 12, 24 and 30 months compared to baseline. A statistically significant decrease in scores in the P-CAT subscore for organisational support is found at all points of measurement compared to baseline. Statistically significant increases in satisfaction with workload, personal and professional development, demands balanced with qualifications and variation in job tasks as elements of job satisfaction are reported. The evaluation of the Dementia ABC educational programme identifies statistically significant increases in scores of person-centredness and job satisfaction, indicating that the training has a positive impact. The results indicate that a multicomponent training programme including written material, multidisciplinary reflection groups and workshops has a positive impact on the development of person-centred care practice and the job satisfaction of care

  16. Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument. (United States)

    Bala, Sidona-Valentina; Forslind, Kristina; Fridlund, Bengt; Samuelson, Karin; Svensson, Björn; Hagell, Peter


    Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics. A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic. The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87-1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire. A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested. Copyright © 2018 John Wiley & Sons, Ltd.

  17. A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care.

    Directory of Open Access Journals (Sweden)

    Denis Mukwege


    Full Text Available Denis Mukwege and Marie Berg describe the One Stop Centre at Panzi Hospital in Eastern Democratic Republic of Congo that provides care for girls and women who have been raped in combination with extreme bodily harm.

  18. A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care. (United States)

    Mukwege, Denis; Berg, Marie


    Denis Mukwege and Marie Berg describe the One Stop Centre at Panzi Hospital in Eastern Democratic Republic of Congo that provides care for girls and women who have been raped in combination with extreme bodily harm.

  19. The importance of person-centred care and co-creation of care for the well-being and job satisfaction of professionals working with people with intellectual disabilities


    Meer, Leontine; Nieboer, Anna; Finkenflügel, Harry; Cramm, Jane


    textabstractBackground: Person-centred care and co-creation of care (productive interactions between clients and professionals) are expected to lead to better outcomes for clients. Professionals play a prominent role in the care of people with intellectual disabilities at residential care facilities. Thus, person-centred care and co-creation of care may be argued to lead to better outcomes for professionals as well. This study aimed to identify relationships of person-centred care and co-crea...

  20. Person-centred planning: an example of best practices in the field of intellectual disability

    Directory of Open Access Journals (Sweden)

    Araceli Arellano Torres


    Full Text Available At present, the focus of supports in the field of intellectual disability is the individual, with special emphasis on decision-making by users of different services and, therefore, on the need of consultation. In that sense, Person Centered Planning (PCP becomes an example of best practice that leads the individuals as a central reference, in order to know what is desirable for them and make it possible. This practices requires the professional’s participation and involvement, to carry out all the changes that it implies. The purpose of this paper is to present a questionnaire, which is used to assess the perception of professionals on PCP methodology. The results of a pilot study (N = 18 are described, showing the importance of professional’s training. An organization that is really committed to this approach, will be more effective if it involves those who have to implement it, providing them training related to this best practice.

  1. Bonanza from the frozen continent

    Digital Repository Service at National Institute of Oceanography (India)

    Setty, M.G.A.P.

    Antarctica is a circumpolar continent surrounded by the Southern Ocean which is about 36 million sq kms and about 10% of the worlds oceans. Ice covers 98% of the continent and the rest is a non glacial terrain. Temperatures on Antarctica...

  2. Paleomagnetism continents and oceans

    CERN Document Server

    McElhinny, Michael W; Dmowska, Renata; Holton, James R; Rossby, H Thomas


    Paleomagnetism is the study of the fossil magnetism in rocks. It has been paramount in determining that the continents have drifted over the surface of the Earth throughout geological time. The fossil magnetism preserved in the ocean floor has demonstrated how continental drift takes place through the process of sea-floor spreading. The methods and techniques used in paleomagnetic studies of continental rocks and of the ocean floor are described and then applied to determining horizontal movements of the Earth''s crust over geological time. An up-to-date review of global paleomagnetic data enables 1000 millionyears of Earth history to be summarized in terms of the drift of the major crustal blocks over the surface of the Earth. The first edition of McElhinny''s book was heralded as a "classic and definitive text." It thoroughly discussed the theory of geomagnetism, the geologicreversals of the Earth''s magnetic field, and the shifting of magnetic poles. In the 25 years since the highly successful first editio...

  3. Effects and meanings of a person-centred and health-promoting intervention in home care services - a study protocol of a non-randomised controlled trial. (United States)

    Bölenius, Karin; Lämås, Kristina; Sandman, Per-Olof; Edvardsson, David


    The literature indicates that current home care service are largely task oriented with limited focus on the involvement of the older people themselves, and studies show that lack of involvement might reduce older people's quality of life. Person-centred care has been shown to improve the satisfaction with care and quality of life in older people cared for in hospitals and nursing homes, with limited published evidence about the effects and meanings of person-centred interventions in home care services for older people. This study protocol outlines a study aiming to evaluate such effects and meanings of a person-centred and health-promoting intervention in home aged care services. The study will take the form of a non-randomised controlled trial with a before/after approach. It will include 270 older people >65 years receiving home care services, 270 relatives and 65 staff, as well as a matched control group of equal size. All participants will be recruited from a municipality in northern Sweden. The intervention is based on the theoretical concepts of person-centredness and health-promotion, and builds on the four pedagogical phases of: theory apprehension, experimental learning, operationalization, and clinical supervision. Outcome assessments will focus on: a) health and quality of life (primary outcomes), thriving and satisfaction with care for older people; b) caregiver strain, informal caregiving engagement and relatives' satisfaction with care: c) job satisfaction and stress of conscience among care staff (secondary outcomes). Evaluation will be conducted by means of self-reported questionnaires and qualitative research interviews. Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services, and the results can point the way to establishing a more person-centred and health-promoting model for home care services for older people. NCT02846246 .

  4. Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial.

    NARCIS (Netherlands)

    Ven, G. van de; Draskovic, I.; Adang, E.M.M.; Donders, R.; Post, A.; Zuidema, S.U.; Koopmans, R.T.C.M.; Vernooij-Dassen, M.J.F.J.


    BACKGROUND: The effectiveness and efficiency of nursing-home dementia care are suboptimal: there are high rates of neuropsychiatric symptoms among the residents and work-related stress among the staff. Dementia-care mapping is a person-centred care method that may alleviate both the resident and the

  5. [The Kock continent urinary diversion]. (United States)

    Boyd, S D; Skinner, D G; Lieskovsky, G


    The continent ileal reservoir as conceived by Kock produces a low-pressure, high-capacity reservoir with continent and nonrefluxing valves constructed from ileum. From August 1982 through March 1988, 531 patients underwent continent urinary diversion via a Kock reservoir at our institution. Of these, 39 males had a Kock bladder substitution, while the rest underwent cutaneous Kock diversion. Early complications occurred in 16% of all patients, and there was an operative mortality rate of 1.9%. Surgical modifications of nipple fixation, which are discussed in detail in this paper, help to reduce late complications to less than 10%. Patient satisfaction with both procedures remains excellent.

  6. The role of leadership in the implementation of person-centred care using Dementia Care Mapping: a study in three nursing homes. (United States)

    Rokstad, Anne Marie Mork; Vatne, Solfrid; Engedal, Knut; Selbæk, Geir


    The aim of this study was to investigate the role of leadership in the implementation of person-centred care (PCC) in nursing homes using Dementia Care Mapping (DCM). Leadership is important for the implementation of nursing practice. However, the empirical knowledge of positive leadership in processes enhancing person-centred culture of care in nursing homes is limited. The study has a qualitative descriptive design. The DCM method was used in three nursing homes. Eighteen staff members and seven leaders participated in focus-group interviews centring on the role of leadership in facilitating the development process. The different roles of leadership in the three nursing homes, characterized as 'highly professional', 'market orientated' or 'traditional', seemed to influence to what extent the DCM process led to successful implementation of PCC. This study provided useful information about the influence of leadership in the implementation of person-centred care in nursing homes. Leaders should be active role models, expound a clear vision and include and empower all staff in the professional development process. © 2013 John Wiley & Sons Ltd.

  7. The answers are within me. An evaluation of a person centred counselling service for men at HMP Doncaster who have had experience of domestic violence 2005-2007


    Hamilton, P.; Wilkinson, K.; Meadows, L.; Cadet, N.


    This report is the second year evaluation of the person centred counselling service for male victims and perpetrators of domestic violence at HMP Doncaster in 2006/7. This report follows on from the previous year's evaluation, Raging Anger Within Me, which evaluated this project in 2005/6. Initiated by the Doncaster Rape and Sexual Abuse Counselling Centre (DRSACC), the second year of counselling service delivery was also funded by Lloyds TSB and the Tudor Trust.\\ud The report provides a back...

  8. Impact of person-centred care training and person-centred activities on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes: A cluster-randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Clive Ballard


    Full Text Available Agitation is a common, challenging symptom affecting large numbers of people with dementia and impacting on quality of life (QoL. There is an urgent need for evidence-based, cost-effective psychosocial interventions to improve these outcomes, particularly in the absence of safe, effective pharmacological therapies. This study aimed to evaluate the efficacy of a person-centred care and psychosocial intervention incorporating an antipsychotic review, WHELD, on QoL, agitation, and antipsychotic use in people with dementia living in nursing homes, and to determine its cost.This was a randomised controlled cluster trial conducted between 1 January 2013 and 30 September 2015 that compared the WHELD intervention with treatment as usual (TAU in people with dementia living in 69 UK nursing homes, using an intention to treat analysis. All nursing homes allocated to the intervention received staff training in person-centred care and social interaction and education regarding antipsychotic medications (antipsychotic review, followed by ongoing delivery through a care staff champion model. The primary outcome measure was QoL (DEMQOL-Proxy. Secondary outcomes were agitation (Cohen-Mansfield Agitation Inventory [CMAI], neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version [NPI-NH], antipsychotic use, global deterioration (Clinical Dementia Rating, mood (Cornell Scale for Depression in Dementia, unmet needs (Camberwell Assessment of Need for the Elderly, mortality, quality of interactions (Quality of Interactions Scale [QUIS], pain (Abbey Pain Scale, and cost. Costs were calculated using cost function figures compared with usual costs. In all, 847 people were randomised to WHELD or TAU, of whom 553 completed the 9-month randomised controlled trial. The intervention conferred a statistically significant improvement in QoL (DEMQOL-Proxy Z score 2.82, p = 0.0042; mean difference 2.54, SEM 0.88; 95% CI 0.81, 4.28; Cohen's D effect size 0

  9. Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients. (United States)

    Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky


    The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

  10. Inclusion of persons with mental illness in patient-centred medical homes: cross-sectional findings from Ontario, Canada. (United States)

    Steele, Leah S; Durbin, Anna; Sibley, Lyn M; Glazier, Richard


    In Ontario, Canada, the patient-centred medical home is a model of primary care delivery that includes 3 model types of interest for this study: enhanced fee-for-service, blended capitation, and team-based blended capitation. All 3 models involve rostering of patients and have similar practice requirements but differ in method of physician reimbursement, with the blended capitation models incorporating adjustments for age and sex, but not case mix, of rostered patients. We evaluated the extent to which persons with mental illness were included in physicians' total practices (as rostered and non-rostered patients) and were included on physicians' rosters across types of medical homes in Ontario. Using population-based administrative data, we considered 3 groups of patients: those with psychotic or bipolar diagnoses, those with other mental health diagnoses, and those with no mental health diagnoses. We modelled the prevalence of mental health diagnoses and the proportion of patients with such diagnoses who were rostered across the 3 medical home model types, controlling for demographic characteristics and case mix. Compared with enhanced fee-for-service practices, and relative to patients without mental illness, the proportions of patients with psychosis or bipolar disorders were not different in blended capitation and team-based blended capitation practices (rate ratio [RR] 0.91, 95% confidence interval [CI] 0.82-1.01; RR 1.06, 95% CI 0.96-1.17, respectively). However, there were fewer patients with other mental illnesses (RR 0.94, 95% CI 0.90-0.99; RR 0.89, 95% CI 0.85-0.94, respectively). Compared with expected proportions, practices based on both capitation models were significantly less likely than enhanced fee-for-service practices to roster patients with psychosis or bipolar disorders (for blended capitation, RR 0.92, 95% CI 0.90-0.93; for team-based capitation, RR 0.92, 95% CI 0.88-0.93) and also patients with other mental illnesses (for blended capitation

  11. A person-centred approach in medicine to reduce the psychosocial and existential burden of chronic and life-threatening medical illness. (United States)

    Grassi, Luigi; Mezzich, Juan E; Nanni, Maria Giulia; Riba, Michelle B; Sabato, Silvana; Caruso, Rosangela


    The psychiatric, psychosocial, and existential/spiritual pain determined by chronic medical disorders, especially if in advanced stages, have been repeatedly underlined. The right to approach patients as persons, rather than symptoms of organs to be repaired, has also been reported, from Paul Tournier to Karl Jaspers, in opposition and contrast with the technically-enhanced evidence-based domain of sciences that have reduced the patients to 'objects' and weakened the physician's identity deprived of its ethical value of meeting, listening, and treating subjects. The paper will discuss the main psychosocial and existential burden related to chronic and advanced medical illnesses, and the diagnostic and therapeutic implications for a dignity preserving care within a person-centred approach in medicine, examined in terms of care of the person (of the person's whole health), for the person (for the fulfilment of the person's health aspirations), by the person (with physicians extending themselves as total human beings), and with the person (working respectfully with the medically ill person).

  12. Îles et continents


    Resztak, Karolina; Sanson, Hervé


    Ce numéro huit de la revue Continents manuscrits, à l’enseigne des « Iles et continents », se veut un numéro de varias, une fois n’est pas coutume. Iles et continents car : du Congo aux Antilles, en passant par l’Amérique du Nord, le numéro assume sa géographie plurielle, polycentrée. Le panorama d’auteurs représentés dans la revue est riche et varié : de Joseph Zobel à Sony Labou Tansi, d’Aimé Césaire à Nathanaël, ou René Maran, c’est bien des cartographies mises en relation que ce numéro té...

  13. Conditional cooperation on three continents

    NARCIS (Netherlands)

    Kocher, M.G.; Cherry, T.; Kroll, S.; Netzer, R.; Sutter, M.


    We show in a public goods experiment on three continents that conditional cooperation is a universal behavioral regularity. Yet, the number of conditional cooperators and the extent of conditional cooperation are much higher in the U.S.A. than anywhere else.

  14. Teachers' conceptions of learning and teaching in student-centred medical curricula: the impact of context and personal characteristics

    NARCIS (Netherlands)

    Jacobs, J.C.G.; Luijk, S.J. van; Vleuten, C.P.M. van der; Kusurkar, R.A.; Croiset, G.; Scheele, F.


    BACKGROUND: Gibbs and Coffey (2004) have reported that teaching practices are influenced by teachers' conceptions of learning and teaching. In our previous research we found significant differences between teachers' conceptions in two medical schools with student-centred education. Medical school

  15. Transfer of nurse education to universities under a model of person-centred care: A consequence of changes in Spanish society during the democratic transition. (United States)

    Rodrigo, Olga; Caïs, Jordi; Monforte-Royo, Cristina


    In Spain the transfer of nurse education to universities was accompanied by a shift towards a model of person-centred care. To explore whether the change in nurses' professional profile (from physician assistant to providers of person-centred care) was a response to changing needs in Spanish society. Qualitative study. Theoretical sampling and in-depth interviews using an inductive analytical approach. Four categories described the nursing profession in Spain prior to the introduction of university training: the era of medical assistants; technologisation of hospitals; personal care of the patient based on Christian values; professional socialisation differentiated by gender. Further analysis showed that these categories could be subsumed under a broader core category: the transfer of nurse education to universities as part of Spain's transition to democracy. The transfer of nurse education to universities was one of several changes occurring in Spanish society during the country's transition to democratic government. The redefined public health system required a highly skilled workforce, with improved employment rights being given to female health professionals, notably nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The importance of continent tectonic study

    International Nuclear Information System (INIS)

    Carneiro, C.D.R.


    Some aspects of tectonic study in the continents are presented, including the use of methods that measure the isotope radioactive disintegration of some elements presents in rocks and the mineral distribution in African and South American continents. (author)

  17. Reclaiming the best of the biopsychosocial model of mental health care and 'recovery' for older people through a 'person-centred' approach. (United States)

    McKay, Roderick; McDonald, Regina; Lie, David; McGowan, Helen


    The 'biopsychosocial', 'person-centred care' (PCC) and 'recovery' models of care can be seen as distinct and competing paradigms. This paper proposes an integration of these valuable perspectives and suggestions for effective implementation in health services for the elderly. An overview of PCC and recovery models, and their application for older people with mental health problems, is provided. Their overlap and contrast with the familiar 'biopsychosocial' model of mental health care is considered, together with obstacles to implementation. Utilisation of PCC and recovery concepts allow clinicians to avoid narrow application of the biopsychosocial approach and encourages clinicians to focus on the person's right to autonomy, their values and life goals. Service reform and development is required to embed these concepts into core clinical processes so as to improve outcomes and the quality of life for older people with mental health problems.

  18. Dementia service centres in Austria: A comprehensive support and early detection model for persons with dementia and their caregivers - theoretical foundations and model description. (United States)

    Auer, Stefanie R; Span, Edith; Reisberg, Barry


    Despite the highly developed social services in Austria, the County of Upper Austria, one of the nine counties of Austria had only very limited specialized services for persons with dementia and their caregivers in 2001. Support groups existed in which the desire for more specialized services was voiced. In response to this situation, funding was received to develop a new structure for early disease detection and long term support for both the person with dementia and their caregivers. This article describes the development of the model of the Dementia Service Centres (DSCs) and the successes and difficulties encountered in the process of implementing the model in six different rural regions of Upper Austria. The DSC was described in the First Austrian Dementia Report as one of the potential service models for the future. © The Author(s) 2013.

  19. A personalized method for estimating centre of mass location of the whole body based on differentiation of tissues of a multi-divided trunk. (United States)

    Erdmann, Włodzimierz S; Kowalczyk, Radosław


    There are several methods for obtaining location of the centre of mass of the whole body. They are based on cadaver data, using volume and density of body parts, using radiation and image techniques. Some researchers treated the trunk as a one part only, while others divided the trunk into few parts. In addition some researchers divided the trunk with planes perpendicular to the longitudinal trunk's axis, although the best approach is to obtain trunk parts as anatomical and functional elements. This procedure was used by Dempster and Erdmann. The latter elaborated personalized estimating of inertial quantities of the trunk, while Clauser et al. gave similar approach for extremities. The aim of the investigation was to merge both indirect methods in order to obtain accurate location of the centre of mass of the whole body. As a reference location a direct method based on reaction board procedure, i.e. with a body lying on a board supported on a scale was used. The location of the centre of mass using Clauser's and Erdmann's method appeared almost identical with the location obtained with a direct method. This approach can be used for several situations, especially for people of different morphology, for the bent trunk, and for asymmetrical movements. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. The impact of a rehabilitation day centre program for persons suffering from schizophrenia on quality of life, social functioning and self-esteem. (United States)

    Štrkalj-Ivezić, Slađana; Vrdoljak, Marijo; Mužinić, Lana; Agius, Mark


    Presently few studies demonstrate improved outcomes in patients with schizophrenia treated in day rehabilitation centres. One reason is the absence of an evidence based protocol for rehabilitation in such centres. Hence further research is required to assess whether such a protocol will improve psychosocial outcomes. We performed a controlled evaluation study of a protocol based rehabilitation day program (RDC) for persons suffering from schizophrenia. Patients from the experimental group (N=50) were treated within the RDC for a 6 month period. The control group were patients on the waiting list for the RDC. Quality of life (MANSA), social functioning (OSA) and self-esteem (Rosenberg) were measured before and after the intervention. Statistically significant improvement was shown in social functioning measured by OSA (F(1,96)=33.7; pself esteem measured by Rosenberg scale (F(1,96)=84.5; pcompared with the control group, conversely, the control group outcomes deteriorated. An evidence based protocol for rehabilitation within the RDC lead to improved social outcomes and recovery for persons suffering from schizophrenia.

  1. Monistic dualism and the body electric: An ontology of disease, patient and clinician for person-centred healthcare. (United States)

    Pârvan, Alexandra


    Ontology is involved in medical care, because what both doctors and patients think the disease, the patient and the doctor are affects the giving and receiving of care, and hence the definition of medical care as profession. Going back to ancient philosophical views of disease as 'bounded entity' or as 'relation' (still echoed in contemporary theories and mindsets), I propose a way to think ontologically about disease that places it in necessary connection with the patient as person. Drawing on Augustine's views on disease, bodily integrity, and the human person as mind-body unit, I speak of 'monistic dualism' as the view where the unit and health of the person is continuously and personally generated by the mind's attention to and action on the body, whether the body is impaired or not. Monistic dualism is identified as the ontological position of both patients who are (or can become) healthy within illness and clinicians who are 'healthy' in their profession. It is what guides both to create what their body is in a personal state of integrity or health. This 'metaphysical body' is termed 'the body electric' in patients, and I argue that clinicians can attend properly to the diseased body by attending to patients' metaphysical body. As clinicians offer metaphysical care to themselves, employing monistic dualism to create their metaphysical body, they should not deny it to patients. Ontology cannot be part of medical care without making metaphysical care a requirement. © 2016 John Wiley & Sons, Ltd.

  2. [Continent colostomy and colon irrigation]. (United States)

    Kostov, D; Temelkov, T; Kiriazov, E; Ivanov, K; Ignatov, V; Kobakov, G


    The authors have studied a functional activity of a continent colostomy at 20 patients, undergone an abdomeno-perineal extirpation of rectum and carried out periodic colonirrigations, during a period of 6 months. A conus type, closed irrigating system has been used. The degree of an incontinency at patients has been compared before and after the beginning of the colonirrigations. The irrigating procedures have reduced spontaneous defications at patients during a week 28 times and have improved the quality of life significantly. The application of colostomy bags has been restricted in 8 (40%) patients. An intraluminal ultrasonographic investigation has been done at 12 (60%) patients at the end of 6 month irrigating period. No changes of the ultrasonographic image of the precolostomic segment of colon has been observed.

  3. Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial (United States)


    Background The effectiveness and efficiency of nursing-home dementia care are suboptimal: there are high rates of neuropsychiatric symptoms among the residents and work-related stress among the staff. Dementia-care mapping is a person-centred care method that may alleviate both the resident and the staff problems. The main objective of this study is to evaluate the effectiveness and cost-effectiveness of dementia-care mapping in nursing-home dementia care. Methods/Design The study is a cluster-randomised controlled trial, with nursing homes grouped in clusters. Studywise minimisation is the allocation method. Nursing homes in the intervention group will receive a dementia-care-mapping intervention, while the control group will receive usual care. The primary outcome measure is resident agitation, to be assessed with the Cohen-Mansfield Agitation Inventory. The secondary outcomes are resident neuropsychiatric symptoms, assessed with the Neuropsychiatric Inventory - Nursing Homes and quality of life, assessed with Qualidem and the EQ-5D. The staff outcomes are stress reactions, job satisfaction and job-stress-related absenteeism, and staff turnover rate, assessed with the Questionnaire about Experience and Assessment of Work, the General Health Questionnaire-12, and the Maastricht Job Satisfaction Scale for Health Care, respectively. We will collect the data from the questionnaires and electronic registration systems. We will employ linear mixed-effect models and cost-effectiveness analyses to evaluate the outcomes. We will use structural equation modelling in the secondary analysis to evaluate the plausibility of a theoretical model regarding the effectiveness of the dementia-care mapping intervention. We will set up process analyses, including focus groups with staff, to determine the relevant facilitators of and barriers to implementing dementia-care mapping broadly. Discussion A novelty of dementia-care mapping is that it offers an integral person-centred

  4. Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    van de Ven Geertje


    Full Text Available Abstract Background The effectiveness and efficiency of nursing-home dementia care are suboptimal: there are high rates of neuropsychiatric symptoms among the residents and work-related stress among the staff. Dementia-care mapping is a person-centred care method that may alleviate both the resident and the staff problems. The main objective of this study is to evaluate the effectiveness and cost-effectiveness of dementia-care mapping in nursing-home dementia care. Methods/Design The study is a cluster-randomised controlled trial, with nursing homes grouped in clusters. Studywise minimisation is the allocation method. Nursing homes in the intervention group will receive a dementia-care-mapping intervention, while the control group will receive usual care. The primary outcome measure is resident agitation, to be assessed with the Cohen-Mansfield Agitation Inventory. The secondary outcomes are resident neuropsychiatric symptoms, assessed with the Neuropsychiatric Inventory - Nursing Homes and quality of life, assessed with Qualidem and the EQ-5D. The staff outcomes are stress reactions, job satisfaction and job-stress-related absenteeism, and staff turnover rate, assessed with the Questionnaire about Experience and Assessment of Work, the General Health Questionnaire-12, and the Maastricht Job Satisfaction Scale for Health Care, respectively. We will collect the data from the questionnaires and electronic registration systems. We will employ linear mixed-effect models and cost-effectiveness analyses to evaluate the outcomes. We will use structural equation modelling in the secondary analysis to evaluate the plausibility of a theoretical model regarding the effectiveness of the dementia-care mapping intervention. We will set up process analyses, including focus groups with staff, to determine the relevant facilitators of and barriers to implementing dementia-care mapping broadly. Discussion A novelty of dementia-care mapping is that it offers an

  5. Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study. (United States)

    Surr, C A; Smith, S J; Crossland, J; Robins, J


    People with dementia occupy up to one quarter of acute hospital beds. However, the quality of care delivered to this patient group is of national concern. Staff working in acute hospitals report lack of knowledge, skills and confidence in caring for people with dementia. There is limited evidence about the most effective approaches to supporting acute hospital staff to deliver more person-centred care. This study aimed to evaluate the efficacy of a specialist training programme for acute hospital staff regarding improving attitudes, satisfaction and feelings of caring efficacy, in provision of care to people with dementia. A repeated measures design, with measures completed immediately prior to commencing training (T1), after completion of Foundation level training (T2: 4-6 weeks post-baseline), and following Intermediate level training (T3: 3-4 months post-baseline). One NHS Trust in the North of England, UK. 40 acute hospital staff working in clinical roles, the majority of whom (90%) were nurses. All participants received the 3.5 day Person-centred Care Training for Acute Hospitals (PCTAH) programme, comprised of two levels, Foundation (0.5 day) and Intermediate (3 days), delivered over a 3-4 months period. Staff demographics and previous exposure to dementia training were collected via a questionnaire. Staff attitudes were measured using the Approaches to Dementia Questionnaire (ADQ), satisfaction in caring for people with dementia was captured using the Staff Experiences of Working with Demented Residents questionnaire (SEWDR) and perceived caring efficacy was measured using the Caring Efficacy Scale (CES). The training programme was effective in producing a significant positive change on all three outcome measures following intermediate training compared to baseline. A significant positive effect was found on the ADQ between baseline and after completion of Foundation level training, but not for either of the other measures. Training acute hospital staff in

  6. "The more you know, the more you realise it is really challenging to do": Tensions and uncertainties in person-centred support for people with long-term conditions. (United States)

    Entwistle, Vikki A; Cribb, Alan; Watt, Ian S; Skea, Zoë C; Owens, John; Morgan, Heather M; Christmas, Simon


    To identify and examine tensions and uncertainties in person-centred approaches to self-management support - approaches that take patients seriously as moral agents and orient support to enable them to live (and die) well on their own terms. Interviews with 26 UK clinicians about working with people with diabetes or Parkinson's disease, conducted within a broader interdisciplinary project on self-management support. The analysis reported here was informed by philosophical reasoning and discussions with stakeholders. Person-centred approaches require clinicians to balance tensions between the many things that can matter in life, and their own and each patient's perspectives on these. Clinicians must ensure that their supportive efforts do not inadvertently disempower people. When attending to someone's particular circumstances and perspectives, they sometimes face intractable uncertainties, including about what is most important to the person and what, realistically, the person can or could do and achieve. The kinds of professional judgement that person-centred working necessitates are not always acknowledged and supported. Practical and ethical tensions are inherent in person-centred support and need to be better understood and addressed. Professional development and service improvement initiatives should recognise these tensions and uncertainties and support clinicians to navigate them well. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Situational analysis of communication of HIV and AIDS information to persons with visual impairment: a case of Kang'onga Production Centre in Ndola, Zambia. (United States)

    Chintende, Grace Nsangwe; Sitali, Doreen; Michelo, Charles; Mweemba, Oliver


    Despite the increases in health promotion and educational programs on HIV and AIDS, lack of information and communication on HIV and AIDS for the visually impaired persons continues. The underlying factors that create the information and communication gaps have not been fully explored in Zambia. It is therefore important that, this situational analysis on HIV and AIDS information dissemination to persons with visual impairments at Kang'onga Production Centre in Ndola was conducted. The study commenced in December 2014 to May 2015. A qualitative case study design was employed. The study used two focus group discussions with males and females. Each group comprised twelve participants. Eight in-depth interviews involving the visually impaired persons and five key informants working with visually impaired persons were conducted. Data was analysed thematically using NVIVO 8 software. Ethical clearance was sought from Excellency in Research Ethics and Science. Reference Number 2014-May-030. It was established that most visually impaired people lacked knowledge on the cause, transmission and treatment of HIV and AIDS resulting in misconceptions. It was revealed that health promoters and people working with the visually impaired did not have specific HIV and AIDS information programs in Zambia. Further, it was discovered that the media, information education communication and health education were channels through which the visually impaired accessed HIV and AIDS information. Discrimination, stigma, lack of employment opportunities, funding and poverty were among the many challenges identified which the visually impaired persons faced in accessing HIV and AIDS information. Integration of the visually impaired in HIV and AIDS programs would increase funding for economic empowerment and health promotions in order to improve communication on HIV and AIDS information. The study showed that, the visually impaired persons in Zambia are not catered for in the dissemination of HIV

  8. Empowerment, environment and person-centred care: A qualitative study exploring the hospital experience for adults with cognitive impairment. (United States)

    Prato, Laura; Lindley, Lyndsay; Boyles, Miriam; Robinson, Louise; Abley, Clare


    It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study ('Improving hospital care for adults with cognitive impairment') aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited. Data was collected via ethnographic, observational periods at each stage of the hospital journey and through the use of semi-structured interviews with relatives, carers and health care staff including: medical staff; nursing staff; physiotherapists and ward managers. Interpretive phenomenological analysis was used to facilitate data analysis. 52 hours 55 minutes of ethnographic observations and 18 interviews with ward staff and relatives were undertaken. Three superordinate themes emerged from the data as crucial in determining the quality of the hospital experience: valuing the person; activities of empowerment and disempowerment and the interaction of environment with patient well-being. Whether the patient's hospital experience was positive or negative was powerfully influenced by family involvement and ward staff actions and communication. Participants identified a requirement for a ward based activity service for patients with cognitive impairment. Further research must be undertaken focusing on the development of ward based activities for patients with cognitive impairment, alongside a move towards care which explores measures to improve and expand relative involvement in hospital care.

  9. Implementing Dementia Care Mapping to develop person-centred care: results of a process evaluation within the Leben-QD II trial. (United States)

    Quasdorf, Tina; Riesner, Christine; Dichter, Martin Nikolaus; Dortmann, Olga; Bartholomeyczik, Sabine; Halek, Margareta


    To evaluate Dementia Care Mapping implementation in nursing homes. Dementia Care Mapping, an internationally applied method for supporting and enhancing person-centred care for people with dementia, must be successfully implemented into care practice for its effective use. Various factors influence the implementation of complex interventions such as Dementia Care Mapping; few studies have examined the specific factors influencing Dementia Care Mapping implementation. A convergent parallel mixed-methods design embedded in a quasi-experimental trial was used to assess Dementia Care Mapping implementation success and influential factors. From 2011-2013, nine nursing units in nine different nursing homes implemented either Dementia Care Mapping (n = 6) or a periodic quality of life measurement using the dementia-specific instrument QUALIDEM (n = 3). Diverse data (interviews, n = 27; questionnaires, n = 112; resident records, n = 81; and process documents) were collected. Each data set was separately analysed and then merged to comprehensively portray the implementation process. Four nursing units implemented the particular intervention without deviating from the preplanned intervention. Translating Dementia Care Mapping results into practice was challenging. Necessary organisational preconditions for Dementia Care Mapping implementation included well-functioning networks, a dementia-friendly culture and flexible organisational structures. Involved individuals' positive attitudes towards Dementia Care Mapping also facilitated implementation. Precisely planning the intervention and its implementation, recruiting champions who supported Dementia Care Mapping implementation and having well-qualified, experienced project coordinators were essential to the implementation process. For successful Dementia Care Mapping implementation, it must be embedded in a systematic implementation strategy considering the specific setting. Organisational preconditions may need to

  10. The importance of person-centred care and co-creation of care for the well-being and job satisfaction of professionals working with people with intellectual disabilities. (United States)

    van der Meer, Leontine; Nieboer, Anna Petra; Finkenflügel, Harry; Cramm, Jane Murray


    Person-centred care and co-creation of care (productive interactions between clients and professionals) are expected to lead to better outcomes for clients. Professionals play a prominent role in the care of people with intellectual disabilities at residential care facilities. Thus, person-centred care and co-creation of care may be argued to lead to better outcomes for professionals as well. This study aimed to identify relationships of person-centred care and co-creation of care with the well-being and job satisfaction of professionals working with people with intellectual disabilities (PWID). A cross-sectional survey was conducted in 2015 among professionals working at a disability care organisation in the Netherlands. All 1146 professionals involved in the care of people with intellectual disabilities who required 24-hours care were invited to participate. The response rate was 41% (n = 466). Most respondents (87%) were female, and the mean age was 42.8 ± 11.5 years (22-65). The majority of respondents (70%) worked ≥22 hours per week and had worked for the organisation for ≥5 years (88%). Most of the respondents (76.8%) were direct care workers either in residential homes (59.3%) or in day activities (17.5%). After controlling for background variables, person-centred care and co-creation of care were associated positively with job satisfaction and well-being of professionals. The provision of person-centred care and co-creation of care may lead to better well-being and job satisfaction among professionals working with PWID. This finding is important, as such professionals often experience significant levels of work stress and burnout. © 2017 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

  11. The origin of continents and oceans

    National Research Council Canada - National Science Library

    Wegener, Alfred 1880-1930; Biram, John


    .... Wegener proposed that in the remote past the earth's continents were not separate (as now), but formed one supercontinent which later split apart, the fragments gradually drifting away from one another...

  12. Continence care is every nurse's business. (United States)

    Booth, Joanne

    Maintaining continence lies at the heart of a sense of adulthood and is essential to preserving dignity, a core and universal nursing value. This article explores the reasons why poor continence care was found at Mid Staffordshire Foundation Trust, the changes to the culture of the health service that led to it, and why it is so important for nurses to maintain patients' dignity. Recommendations for changing this culture in the future are discussed.

  13. Continent cecostomy. An account of 30 patients. (United States)

    Kock, N G; Myrvold, H E; Philipson, B M; Svaninger, G; Ojerskog, B


    In this paper, an account is given of our experience with continent colostomy in man. In five patients, the end-sigmoidostomy was provided with an intussusception valve. Evacuation of the bowel by irrigation through a catheter was laborious and time-consuming and this method was abandoned. In another group of 30 patients, the cecum was isolated from the rest of the colon and its distal end was provided with an intussusception valve. Of the 30 patients, eight were later given continent ileostomies, two were converted to conventional sigmoidostomies, and one patient with fecal incontinence preferred to have intestinal continuity reestablished. Thus, 19 patients still have continent cecostomies and are satisfied with their function. When comparing the function of the continent cecostomy with that of the continent ileostomy, however, it is obvious that the ileostomy function is superior. The experience obtained with this group of patients has resulted in a widening of the indications for constructing a continent ileostomy, including selected patients with various anorectal disorders.

  14. A web-based programme for person-centred learning and support designed for preschool children with long-term illness: a pilot study of a new intervention. (United States)

    Hellström, Anna-Lena; Simeonsdotter Svensson, Agneta; Pramling Samuelsson, Ingrid; Jenholt Nolbris, Margaretha


    For children living with long-term illness, school age is a risk period with regard to psychosocial ill health and poor compliance with treatment. There is a need for methods to promote health, well-being, and self-esteem. This study describes a new concept for supporting children, person-centred web-based learning and support, which has been tested in 12 preschool children and incorporates learning about feelings, relationships, and the right to integrity. SKYPE was used for conversations between the child and the web teacher. Methods. The programme was developed and tested in two steps. The conversations were tape-recorded and analysed using phenomenography. The questions addressed concerned the quality of the intervention process: accessibility of intervention, learning content and support, and identification of measurable items and patterns. Findings. The children found it interesting to communicate with their web teacher using SKYPE. The story about Max and Sara served as a good basis for discussion, and development was found in the learning process. The children were able to talk about relations and feelings and developed an understanding for use in new situations in their daily lives. Items and patterns that are useful for research and documentation were identified, for example, well-being, resources, needs, and wishes.

  15. A real-time monitoring study of the personal dose received by nuclear medicine technologists administering 18F-FDG in a high patient throughput PET centre

    International Nuclear Information System (INIS)

    Wallace, Anthony; U, Paul; Hickson, Kevin; Bradley, Jason; Welch, Jessica; Pathmaraj, Kunthi


    The rapid growth in PET studies has resulted in an increasing occupational radiation exposure to nuclear medicine staff. This project has used, a real-time, solid-state, 2 second resolution, personal dosimeter to monitor the occupational Hp(10) equivalent dose of nuclear medicine technologist (NMT) staff managing FDG patients. A detailed manual mapping of the patient management procedure, time dependence and distance relationships to the sources of exposure and their magnitudes was undertaken. Experimental results show, that a junior NMT may spend on average 52% of the close contact time (< 2 m) with the patient when administering an FDG dose compared to 36% of that time for the senior NMT. The average daily dose from isotope administration of a junior NMT and senior NMT is 15 μSv and 11.4 μSv respectively. Post-administration, escorting the patient into the scanner room and setting-up the patient on the PET scanner bed, takes approximately 27% of the junior NMT time to perform, which results in an average daily dose of 7.8 μSv. The senior NMT takes approximately 33% of their time for the same task, with an average daily dose of 10.3 μSv. Removing the patient from the scanner room and escorting them from the department takes about 21% of the junior NMT time giving 6.2 μSv of dose and 31% or 9.7 μSv for the senior NMT. At the conclusion of this study the typical daily dose received by NMT staff, working in close contact with FDG patients is approximately 29 μSv for junior NMT (4 - 5 mSv/yr) and 31.4 μSv (5 - 7 mSv/yr) for senior NMT. Currently this centre is performing approximately 3,400 FDG injections per year plus 50 research injections of various positron emitters. This occupational dose load is spread across 3 dedicated PET NMT staff and 1.5 EFT NMT staff rotating through PET centre from the nuclear medicine department and 1 EFT registrar physician. (author)

  16. Person-centred pain management for the patient with acute abdominal pain: an ethnography informed by the Fundamentals of Care framework. (United States)

    Avallin, Therese; Muntlin Athlin, Åsa; Sorensen, Erik Elgaard; Kitson, Alison; Björck, Martin; Jangland, Eva


    To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contribute to or detract from successful pain management for the patient with acute abdominal pain across the acute care pathway. Although pain management is a recognised human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance. Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework. Participant observation and informal interviews (92 hours) were performed at one emergency department and two surgical wards at a University Hospital during April - November 2015. Data includes 261 interactions between patients, aged ≥18 years seeking care for acute abdominal pain at the emergency department and admitted to a surgical ward (N = 31; aged 20-90 years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N =198). The observations revealed an organizational culture with considerable impact on how well pain was managed. Well managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics. Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Creating and facilitating change for Person-Centred Coordinated Care (P3C): The development of the Organisational Change Tool (P3C-OCT). (United States)

    Horrell, Jane; Lloyd, Helen; Sugavanam, Thavapriya; Close, James; Byng, Richard


    Person Centred Coordinated Care (P3C) is a UK priority for patients, carers, professionals, commissioners and policy makers. Services are developing a range of approaches to deliver this care with a lack of tools to guide implementation. A scoping review and critical examination of current policy, key literature and NHS guidelines, together with stakeholder involvement led to the identification of domains, subdomains and component activities (processes and behaviours) required to deliver P3C. These were validated through codesign with stakeholders via a series of workshops and cognitive interviews. Six core domains of P3C were identified as follows: (i) my goals, (ii) care planning, (iii) transitions, (iv) decision making (v), information and communication and (vi) organizational support activities. These were populated by 29 core subdomains (question items). A number of response codes (components) to each question provide examples of the processes and activities that can be actioned to achieve each core subdomain of P3C. The P3C-OCT provides a coherent approach to monitoring progress and supporting practice development towards P3C. It can be used to generate a shared understanding of the core domains of P3C at a service delivery level, and support reorganization of care for those with complex needs. The tool can reliably detect change over time, as demonstrated in a sample of 40 UK general practices. It is currently being used in four UK evaluations of new models of care and being further developed as a training tool for the delivery of P3C. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  18. The Neutron Personal Dosimetry Service of the Centre for Radiation, Chemical and Environmental Hazards, PHE-UK; Servicio de Dosimetría Personal Neutrónica del Centro para Emergencias Radiológicas, Químicas y Medioambientales, PHE-UK

    Energy Technology Data Exchange (ETDEWEB)

    Campo Blanco, X.


    The Centre for Radiation, Chemical and Environmental Hazards (CRCEH), that belongs to Public Health England (PHE), hosts the official Neutron Personal Dosimetry Service of the United Kingdom. They use etched-track detectors, made of a material called PADC (poly-allyl diglycol carbonate), to determinate de neutron personal dose. A two weeks visit has been made to this center, in order to learn about the facilities, the methods employed and the legislative framework of the Neutron Personal Dosimetry Service. In this work the main results of this visits are shown, which are interesting for the future development of an official neutron personal dosimetry service in Spain.

  19. Manche centre

    International Nuclear Information System (INIS)


    After a general presentation of radioactivity and radioactive wastes and of the French national agency for the management of radioactive wastes (ANDRA), this brochure gives a general overview of the Manche low- and medium-level radioactive waste disposal centre: principles of storage safety, waste containers (first confinement barrier), storage facility and cover (second confinement barrier), the underground (third confinement barrier), the impact of the centre on its environment, and the control of radioactivity in the vicinity of the centre. (J.S.)

  20. Continence following radical retropubic prostatectomy using self-reporting instruments. (United States)

    Lepor, Herbert; Kaci, Ledia; Xue, Xiaonan


    We performed a global self-assessment of continence following radical retropubic prostatectomy (RRP) and determined how this global self-assessment of continence correlates with commonly used definitions of continence. Between October 2000 and February 2002 all men who underwent RRP were encouraged to complete the University of California-Los Angeles Prostate Cancer Index 3, 6, 12 and 24 months postoperatively. Beginning October 2002 a single question capturing the patient global self-assessment of continence status was added to the postoperative continence assessment. The study design was cross-sectional since only continence surveys submitted between October 2002 through February 2003 were evaluated. Sensitivity, specificity and kappa coefficient was determined for the relationship between the patient global assessment of continence vs the definition of continence based on pad requirement, problem due to incontinence and frequency of incontinence. Continence progressively improved 3 to 24 months following RRP for all continence outcomes. At 24 months following RRP 97.1% of men considered themselves continent, while 97.1%, 94.1% and 97.1% were considered continent using continence definitions, including the requirement of no or 1 pad in a 24-hour interval, no or slight bother due to incontinence and total control or occasional dribbling, respectively. Our 3 definitions of continence derived from responses to the University of California-Los Angeles Prostate Cancer Index had excellent agreement with patient global self-assessment of continence (kappa coefficients between 0.76 and 0.83). The majority of men achieve continence without invasive intervention following RRP. Final continence status should be ascertained at 24 months. The patient global assessment of continence provides face validity for other definitions of continence based on responses to validated self-administered questionnaires.

  1. Europe the continent with the lowest fertility

    NARCIS (Netherlands)

    Baird, D. T.; Collins, J.; Evers, J. L. H.; Leridon, H.; Lutz, W.; Velde, E. Te; Thevenon, O.; Crosignani, P. G.; Devroey, P.; Diedrich, K.; Fauser, B. C. J. M.; Fraser, L.; Geraedts, J. P. M.; Gianaroli, L.; Glasier, A.; Sunde, A.; Tarlatzis, B.; Van Steirteghem, A.; Veiga, A.


    INTRODUCTION: Although fertility rates are falling in many countries, Europe is the continent with the lowest total fertility rate (TFR). This review assesses trends in fertility rates, explores possible health and social factors and reviews the impact of health and social interventions designed to

  2. Collaborative action for person-centred coordinated care (P3C): an approach to support the development of a comprehensive system-wide solution to fragmented care. (United States)

    Lloyd, Helen M; Pearson, Mark; Sheaff, Rod; Asthana, Sheena; Wheat, Hannah; Sugavanam, Thava Priya; Britten, Nicky; Valderas, Jose; Bainbridge, Michael; Witts, Louise; Westlake, Debra; Horrell, Jane; Byng, Richard


    Fragmented care results in poor outcomes for individuals with complexity of need. Person-centred coordinated care (P3C) is perceived to be a potential solution, but an absence of accessible evidence and the lack of a scalable 'blue print' mean that services are 'experimenting' with new models of care with little guidance and support. This paper presents an approach to the implementation of P3C using collaborative action, providing examples of early developments across this programme of work, the core aim of which is to accelerate the spread and adoption of P3C in United Kingdom primary care settings. Two centrally funded United Kingdom organisations (South West Collaboration for Leadership in Applied Health Research and Care and South West Academic Health Science Network) are leading this initiative to narrow the gap between research and practice in this urgent area of improvement through a programme of service change, evaluation and research. Multi-stakeholder engagement and co-design are core to the approach. A whole system measurement framework combines outcomes of importance to patients, practitioners and health organisations. Iterative and multi-level feedback helps to shape service change while collecting practice-based data to generate implementation knowledge for the delivery of P3C. The role of the research team is proving vital to support informed change and challenge organisational practice. The bidirectional flow of knowledge and evidence relies on the transitional positioning of researchers and research organisations. Extensive engagement and embedded researchers have led to strong collaborations across the region. Practice is beginning to show signs of change and data flow and exchange is taking place. However, working in this way is not without its challenges; progress has been slow in the development of a linked data set to allow us to assess impact innovations from a cost perspective. Trust is vital, takes time to establish and is dependent on the

  3. Failed pelvic pouch substituted by continent ileostomy. (United States)

    Wasmuth, H H; Tranø, G; Wibe, A; Endreseth, B H; Rydning, A; Myrvold, H E


    The long-term failure rate of ileal pouch-anal anastomosis (IPAA) is 10-15%. When salvage surgery is unsuccessful, most surgeons prefer pouch excision with conventional ileostomy, thus sacrificing 40-50 cm of ileum. Conversion of a pelvic pouch to a continent ileostomy (CI, Kock pouch) is an alternative that preserves both the ileal surface and pouch properties. The aim of the study was to evaluate clinical outcome after the construction of a CI following a failed IPAA. During 1984-2007, 317 patients were operated with IPAA at St Olavs Hospital and evaluated for failure, treatment and outcome. Seven patients with IPAA failure had CI. Four patients with IPAA failure referred from other hospitals underwent conversion to CI and are included in the final analysis. Seven patients had a CI constructed from the transposing pelvic pouch and four had the pelvic pouch removed and a new continent pouch constructed from the distal ileum. Median follow up after conversion to CI was 7 years (0-17 years). Two CI had to be removed due to fistulae. One patient needed a revision of the nipple valve due to pouch loosening. At the end of follow-up, 8 of the 11 patients were fully continent. One patient with Crohn's disease had minor leakage. In patients with pelvic pouch failure, the possibility of conversion to CI should be presented to the patient as an alternative to pouch excision and permanent ileostomy. The advantage is the continence and possibly a better body image. Construction of a CI on a new ileal segment may be considered, but the consequences of additional small bowel loss and risk of malnutrition if the Kock pouch fails should be appraised.

  4. Spreading continents kick-started plate tectonics. (United States)

    Rey, Patrice F; Coltice, Nicolas; Flament, Nicolas


    Stresses acting on cold, thick and negatively buoyant oceanic lithosphere are thought to be crucial to the initiation of subduction and the operation of plate tectonics, which characterizes the present-day geodynamics of the Earth. Because the Earth's interior was hotter in the Archaean eon, the oceanic crust may have been thicker, thereby making the oceanic lithosphere more buoyant than at present, and whether subduction and plate tectonics occurred during this time is ambiguous, both in the geological record and in geodynamic models. Here we show that because the oceanic crust was thick and buoyant, early continents may have produced intra-lithospheric gravitational stresses large enough to drive their gravitational spreading, to initiate subduction at their margins and to trigger episodes of subduction. Our model predicts the co-occurrence of deep to progressively shallower mafic volcanics and arc magmatism within continents in a self-consistent geodynamic framework, explaining the enigmatic multimodal volcanism and tectonic record of Archaean cratons. Moreover, our model predicts a petrological stratification and tectonic structure of the sub-continental lithospheric mantle, two predictions that are consistent with xenolith and seismic studies, respectively, and consistent with the existence of a mid-lithospheric seismic discontinuity. The slow gravitational collapse of early continents could have kick-started transient episodes of plate tectonics until, as the Earth's interior cooled and oceanic lithosphere became heavier, plate tectonics became self-sustaining.

  5. Children with chronic continence problems: the challenges for families. (United States)

    Erickson, David V; Ray, Lynne D


    For families who are raising children with myelomeningocele, bowel and bladder incontinence presents unique challenges for everyday life. The Parenting and Childhood Chronicity model is used to describe the work of raising a child with a chronic condition in 6 areas, including medical care, adapted parenting, dealing with the systems, caring for siblings, maintaining relationships, and personal coping (keeping yourself going). This article provides an overview of the physiologic and developmental challenges inherent in this neural tube defect and illustrates the work that is involved in the child's care and the challenges of maintaining a balance in family life. Clinical implications are discussed, including the setting of appropriate expectations, providing parents with accurate information, ensuring that a focus on continence is not at the expense of other important aspects of the child's functioning, and supporting parents in their interaction with the school system. The medical team, consisting of nursing, urology, nephrology, and psychology working together, can be a strong support for families.

  6. 21 CFR 876.5030 - Continent ileostomy catheter. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continent ileostomy catheter. 876.5030 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent ileostomy catheter. (a) Identification. A continent ileostomy catheter is a flexible tubular device used as a form...

  7. [Functional anatomy of the male continence mechanism]. (United States)

    Schwalenberg, T; Neuhaus, J; Dartsch, M; Weissenfels, P; Löffler, S; Stolzenburg, J-U


    The basic structures and organs contributing to continence in men are far less well investigated than in women. This concerns anatomical and functional aspects as well. Especially the cooperation of single components and the dynamic anchoring in the pelvic floor require further investigation. An improved anatomical-functional interpretation is needed to generate therapeutic concepts orientated at the physiology of the bladder neck.Therefore, the focus of anatomical investigations should be on the external sphincter which is the main muscle responsible for urethral closure as well as on the connective tissue, smooth muscular and neuronal structures in the pelvis. The smooth muscular structures involved are the internal sphincter, the inner parts of the external sphincter, the urethral longitudinal musculature, and parts of the centrum perinei and of the ventral suspension apparatus which fixes the position of the bladder neck and seems to be vital for continence and initiation of micturition. These new findings imply an integral concept for men as was developed for women. A first step in this regard would be a consistent and updated anatomical nomenclature.

  8. Young Africans Tackle Their Continent's Environmental Issues (United States)

    Olwoch, Jane Mukarugwiza


    Young African Scientists Session at the Fourth International Geosphere-Biosphere Programme Congress; Cape Town, South Africa, 7 May 2008; Africa is often described as a unique and diverse continent. This is reflected in its biodiversity, economic and social circumstances, and diversity in culture and environment. The Young African Scientists (YAS) session at the International Geosphere-Biosphere Programme Congress was one of the congress's highlights. Global environmental change research in Africa was presented to an audience that included visiting international and national scientists, policy makers, and a group of schoolchildren. From the uniqueness of Africa's paleoclimate to the diversity and complexity of current and future impacts of environmental change on Africa, the session not only provided an overview of current projects but also highlighted the problems that are intertwined with poverty. This session was sponsored by the Global Change System for Analysis, Research, and Training (START).

  9. Evaluation design of Urban Health Centres Europe (UHCE): Preventive integrated health and social care for community-dwelling older persons in five European cities

    NARCIS (Netherlands)

    Franse, C.B. (Carmen B.); A.J. Voorham; Van Staveren, R. (Rob); E. Koppelaar (Elin); Martijn, R. (Rens); Valía-Cotanda, E. (Elisa); Alhambra-Borrás, T. (Tamara); Rentoumis, T. (Tasos); Bilajac, L. (Lovorka); Marchesi, V.V. (Vanja Vasiljev); Rukavina, T. (Tomislav); Verma, A. (Arpana); Williams, G. (Greg); Clough, G. (Gary); Garcés-Ferrer, J. (Jorge); F.U.S. Mattace Raso (Francesco); H. Raat (Hein)


    textabstractBackground: Older persons often have interacting physical and social problems and complex care needs. An integrated care approach in the local context with collaborations between community-, social-, and health-focused organisations can contribute to the promotion of independent living

  10. Evaluation design of Urban Health Centres Europe (UHCE): preventive integrated health and social care for community-dwelling older persons in five European cities

    NARCIS (Netherlands)

    A.J.J. Voorham; R. van Staveren; E. Koppelaar; L.F.J. Martijn; E. Valía-Cotanda; T. Alhambra-Borrás; T. Rentoumis; L. Bilajac; V. Vasiljev Marchesi; T. Rukavina; A. Verma; G. Williams; G. Clough; J. Garcés-Ferrer; F. Mattace Raso; H. Raat; C.B. Franse


    Older persons often have interacting physical and social problems and complex care needs. An integrated care approach in the local context with collaborations between community-, social-, and health-focused organisations can contribute to the promotion of independent living and quality of life. In

  11. Neighbourhood Centres – Organisation, Management and Finance

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    to identify different financial models and analyse economic sustainability. As regards organisational and management models data were collected through documentary sources and by means of personal interviews and field visits to ten centres. Even within the analysed limited population of centres economic...... public subsidy. Some of the centres have high number of users on a daily basis, whereas others are only rarely used. It is explored how organisation, management and financial set-up differs among the centres. Quantitative data on financial issues and annual accounts of fifteen centres were analysed...... and institutional sustainability varies significantly. In organisational terms centres range from fully-integrated in the municipal administration to independent voluntary managed centres. In terms of financial, or economic, models variation is less pronounced as all centres to some degree are dependent on current...

  12. The issue of personal safety on dolomite: A probability-based evaluation with respect to transient passage in a city centre


    Kirsten, H A D; Heath, G J; Venter, I S; Oosthuizen, A C


    ABSTRACT For the past fifty years empirical knowledge guided the development of rules regarding population density on dolomite land. The insatiable demand for land, the improvement in transportation infrastructure and the associated need for improving the functionality of towns require that these rules on the risk of personal injury and damage to assets are revisited from a more scientific perspective. Probability theory provides a basis for decision-making in this regard. SANS 1936:2012 defi...

  13. Contrasting introduction scenarios among continents in the worldwide invasion of the banana fungal pathogen Mycosphaerella fijiensis. (United States)

    Robert, S; Ravigne, V; Zapater, M-F; Abadie, C; Carlier, J


    Reconstructing and characterizing introduction routes is a key step towards understanding the ecological and evolutionary factors underlying successful invasions and disease emergence. Here, we aimed to decipher scenarios of introduction and stochastic demographic events associated with the global spread of an emerging disease of bananas caused by the destructive fungal pathogen Mycosphaerella fijiensis. We analysed the worldwide population structure of this fungus using 21 microsatellites and 8 sequence-based markers on 735 individuals from 37 countries. Our analyses designated South-East Asia as the source of the global invasion and supported the location of the centre of origin of M. fijiensis within this area. We confirmed the occurrence of bottlenecks upon introduction into other continents followed by widespread founder events within continents. Furthermore, this study suggested contrasting introduction scenarios of the pathogen between the African and American continents. While potential signatures of admixture resulting from multiple introductions were detected in America, all the African samples examined seem to descend from a single successful founder event. In combination with historical information, our study reveals an original and unprecedented global scenario of invasion for this recently emerging disease caused by a wind-dispersed pathogen. © 2012 Blackwell Publishing Ltd.

  14. Perceptions and attitudes towards exercise among Chinese elders - the implications of culturally based self-management strategies for effective health-related help seeking and person-centred care. (United States)

    Liu, Zhenmi; Speed, Shaun; Beaver, Kinta


    Encouraging the uptake of physical activity among a culturally diverse elderly population presents a challenge for health-care providers across the world. Little is known about the health-care needs of these populations, for example the increasingly ageing group of Chinese elders in many parts of the world who are now facing later life and increasing challenges to their health. This study aimed to explore behaviours and attitudes towards exercise among older Chinese immigrants in the UK to provide insights into the health of Chinese populations in the UK and elsewhere. A Grounded Theory approach using purposive and theoretical sampling with in-depth semi-structured interviews. Chinese elders were recruited from Chinese communities in the North West of England. Thirty-three participants were interviewed face-to-face and audio-recorded. Participants self-managed exercise based on cultural perceptions of health and ingrained Chinese values. Professional support and information was lacking and relied on folk norms rather than person-centred recommendations for healthy living. Inappropriate exercise regimes could act as a substitute for seeking health-related advice when exercise was often used as a self-monitored barometer to assess their perceived health status. Chinese elders may undertake inappropriate exercise, leading to high-risk situations, if appropriate professional information is not provided. Health-care practitioners should devote attention to understanding Chinese elders' attitudes towards exercise, as this may ultimately lead to successful health promotion activities. A person-centred approach that acknowledges and works with self-management practices is advocated. © 2012 John Wiley & Sons Ltd.

  15. Children's Centre "3 in 1 - together" (United States)

    Gancheva, Hristina


    . Today there are baking houses in 13 countries on 3 continents - Israel, Palestine, Brazil, Italy, Peru, Egypt, South Africa, South Korea, the USA, Romania, Russia and Japan. The idea of making bread destroys any differences and brings people together. We are all crumbs of the common bread. "Historians" - "History is useful not because we read the past in it, but the future" - J.B.Say. The young historians explore the past of their homeland. They write down the memories of eyewitnesses of some important events in the community. The most impressive for the kids are the memories of the people about the gardeners of old time and the flood of 1943 in Zlataritsa. This involves the heroism of the people for saving their fellow citizens and the reconstruction of the damages. This all told by the coeval Vasil Uzunov. The activity in the center is documented in a register written by the kids and popularizes this form of media. In the centre every child finds itself and appreciates the opportunities for self-expression and team work, builds a positive attitude to its own personality and the personality of the one next to him. A kid there reveals its creativity, realizes the unity of diversity, forms a positive and a responsible attitude to the nature, rationalize universal values, makes friends, and feels useful and significant. The most wonderful thing in a friendship is not when somebody gives you help or smile or a good companion, but when both inspire for life, which we receive when we know that somebody believes in us. Do not search for strength and confidence out of yourself, because they're inside you. They were always there.

  16. Our Continent, Our Future: African Perspectives on Structural ...

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

    Our Continent, Our Future: African Perspectives on Structural Adjustment ... Our Continent, Our Future presents the emerging African perspective on this complex issue. ... approach to structural adjustment, and it does so with the input and support ... Committee of the Association of African Universities, the International Board ...

  17. A continent in chaos: Africa's environmental issues. (United States)

    Clay, R


    Half of Africa's almost 450 million inhabitants have no access to health services, while two-thirds lack safe drinking water, according to a 1991 report by the World Bank. Most Africans are also seriously affected by poverty, civil war, indoor and outdoor pollutants, diarrhea-causing microbes, tropical diseases such as malaria, rapid population growth, inadequate sanitation and sewage treatment, poor environmental management, corrupt government policies, desertification and deforestation, mining, and the overuse of pesticides and insecticides. Environmentally-related diseases compromise the continent's productivity, making it more difficult to generate revenue to fight the environmental health problems. Industrial pollutants remain rare, however, since almost 80% of sub-Saharan Africa remains pastoral or agro-pastoral. Even so, urbanization is exposing growing numbers of sub-Saharan Africans to hazardous and toxic wastes. Developing countries ship their most dangerous wastes to Africa because their own domestic environmental laws and the high costs of disposal make it difficult and expensive to dispose of them at home. The author discusses population growth in Africa; the lack of good data on the environment and health in Africa; infant and child mortality; water, sewage, and garbage; agriculture, mining, and industry; and sustainable development and the future.

  18. The mind electric: Challenges to clinical categories from a person-centred perspective and the possibilities of metaphysics and art for clinician, patient, and treatment. (United States)

    Pârvan, Alexandra


    The paper proposes that frameworks typical to metaphysics and art could be used in clinical treatment in somatic and psychiatric contexts to ensure improved care. The concept of the "body electric" of somatic patients which I introduced in previous work is developed further and paired with the "mind electric" of psychiatric patients. Both are defined as a patient's personally generated metaphysical possibility of being healthy-within-illness which is experientially actualized. Both concepts are used here to explore the alternative and the serious challenges to treatment approaches focused on clinical categories, disease, provision, and promotion of standardized or "black-box" therapies. An argument against the idea implied by the hope for such mass treatments and corresponding overreliance on science, namely, that health comes from fixing and regularizing, is developed based on cultural history and the evidenced fact that personally assumed health, just like art and metaphysics, is transgressive of scientific data, and accommodates the untrue, the impossible or the irregular as actual and normal. Because normality is created only with the help of disorder and from within it for chronic patients, clinicians should offer them the metaphysical care they need to produce and actualize their possibility of irregular normality or their body/mind electric. Better treatments can only be provided when scientific advances will be matched with advances in the humanistic competence of clinicians. © 2018 John Wiley & Sons, Ltd.

  19. Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Thyrian Jochen


    Full Text Available Abstract Background The provision of appropriate medical and nursing care for people with dementia is a major challenge for the healthcare system in Germany. New models of healthcare provision need to be developed, tested and implemented on the population level. Trials in which collaborative care for dementia in the primary care setting were studied have demonstrated its effectiveness. These studies have been conducted in different healthcare systems, however, so it is unclear whether these results extend to the specific context of the German healthcare system. The objective of this population-based intervention trial in the primary care setting is to test the efficacy and efficiency of implementing a subsidiary support system on a population level for persons with dementia who live at home. Methods and study design The study was designed to assemble a general physician-based epidemiological cohort of people above the age of 70 who live at home (DelpHi cohort. These people are screened for eligibility to participate in a trial of dementia care management (DelpHi trial. The trial is a cluster-randomised, controlled intervention trial with two arms (intervention and control designed to test the efficacy and efficiency of implementing a subsidiary support system for persons with dementia who live at home. This subsidiary support system is initiated and coordinated by a dementia care manager: a nurse with dementia-specific qualifications who delivers the intervention according to a systematic, detailed protocol. The primary outcome is quality of life and healthcare for patients with dementia and their caregivers. This is a multidimensional outcome with a focus on four dimensions: (1 quality of life, (2 caregiver burden, (3 behavioural and psychological symptoms of dementia and (4 pharmacotherapy with an antidementia drug and prevention or suspension of potentially inappropriate medication. Secondary outcomes include the assessment of dementia

  20. Continous Infusion of Remifentanil Plus Ketamine Compared with Continous Remifentanil for Pain Relief in Labour

    Directory of Open Access Journals (Sweden)

    Anooshe Khajehdehi


    Full Text Available Abstract Background and objective: Pain relief during labour is an important determinant of a women’s birth experience. There are numerous pain relief techniques which can be used either with or without pain medication. The aim of our study was to compare the effect of remifentanil alone and its effect in pain relief while using with ketamine during labour. Methods: After obtaining informed consent and approval of hospital ethics committee, 40 women with gestational age between 38 and 42 weeks gestation in early labour were recruited for this study. They were randomly allocated into two groups: group RK (20 cases received 25 μg remifentanil as a starting dose and continuous infusion of 0.06 μg/kg/min remifentanil plus 0.5 mg/kg/h ketamine for 4 hours via pump and group R (20 cases received 25 μg remifentanil as a starting dose and continous infusion of 0.06 μg/kg/min remifentanil. Results: The baseline of pain scores were similar in both groups (5.75 ± 2.51 vs 7 ± 2.45, p= 0.12 but after 30 minutes to 120 minutes the VAS scores were significantly higher in R group (p< 0.001. The rate of patients who were satisfied (excellent and very good in RK was 80% but in R group was 45% (p = 0.03. Nausea and vomiting were significantly higher in R group (p<0.05. Conclusion: The remifentanil plus ketamine produced better pain relief during labour with continous monitoring than continous remifentanil with no adverse effects for mothers and infants.


    Directory of Open Access Journals (Sweden)

    V. A. Perepechay


    Full Text Available The paper presents the technical characteristics of radical prostatectomy (RPE for early continence recovery in patients with prostate cancer. Restoration of the fascial structures of the small pelvis after RPE has been found to promote early urinary continence recovery. A method for total restoration of the fascial structures of the small pelvis (an operation after A. Tewari and a procedure for performing posterior suspension of urethrocystic neoanastomosis in Denonvilliers’ fascia length deficit are considered, which show the similar results in the time of continence recovery.

  2. Factors predicting early return of continence after radical prostatectomy. (United States)

    Sandhu, Jaspreet S; Eastham, James A


    Success of radical prostatectomy is measured by control of cancer and return of urinary and sexual function. Urinary incontinence is generally considered the greatest impairment in immediate postoperative urinary function. Multiple factors are associated with earlier return of urinary continence after radical prostatectomy. These factors can be divided into those known prior to surgery, and therefore possibly not modifiable, and factors that can be controlled during surgery or surgical planning. In addition, various postoperative maneuvers can help hasten urinary continence. This article examines the effect of known factors related to early return of urinary continence after radical prostatectomy.

  3. Development and Validation of the Role Profile of the Nurse Continence Specialist: A Project of the International Continence Society. (United States)

    Paterson, Janice; Ostaszkiewicz, Joan; Suyasa, I Gede Putu Darma; Skelly, Jennifer; Bellefeuille, Lesley

    Although nurses have specialized in the management of incontinence, bladder, bowel, and pelvic floor dysfunction for more than 30 years, there is a lack of awareness and underutilization of their role. This article describes a 6-year project to define, characterize, and validate a role profile of the Nurse Continence Specialist. Data collection used a 2-phase, mixed-methods design. Phase 1 of the project resulted in a draft Nurse Continence Specialist role profile and Phase 2 led to validation of the draft profile. The result was a broad consensus about what constitutes the specific skill set for Nurse Continence Specialist specialization within nursing.

  4. Scheduling participants of Assessment Centres

    DEFF Research Database (Denmark)

    Lysgaard, Jens; Løber, Janni

      Assessment Centres are used as a tool for psychologists and coaches to observe a number of dimensions in a person's behaviour and test his/her potential within a number of chosen focus areas. This is done in an intense course, with a number of different exercises which expose each participant...... Centres usually last two days and involve 3-6 psychologists or trained coaches as assessors. An entire course is composed of a number of rounds, with each round having its individual duration. In each round, the participants are divided into a number of groups with prespecifed pairing of group sizes...

  5. Preferential rifting of continents - A source of displaced terranes (United States)

    Vink, G. E.; Morgan, W. J.; Zhao, W.-L.


    Lithospheric rifting, while prevalent in the continents, rarely occurs in oceanic regions. To explain this preferential rifting of continents, the total strength of different lithospheres is compared by integrating the limits of lithospheric stress with depth. Comparisons of total strength indicate that continental lithosphere is weaker than oceanic lithosphere by about a factor of three. Also, a thickened crust can halve the total strength of normal continental lithosphere. Because the weakest area acts as a stress guide, any rifting close to an ocean-continent boundary would prefer a continental pathway. This results in the formation of small continental fragments or microplates that, once accreted back to a continent during subduction, are seen as displaced terranes. In addition, the large crustal thicknesses associated with suture zones would make such areas likely locations for future rifting episodes. This results in the tendency of new oceans to open along the suture where a former ocean had closed.

  6. Literature review of factors affecting continence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Dalibor Pacik


    Full Text Available Radical prostatectomy (RP is the most common cause of stress urinary incontinence (UI in men. Several anatomic structures affect or may affect urinary continence - urethral sphincter, levator ani muscle, puboprostatic ligaments, bladder neck, endopelvic fascia, neurovascular bundle - and understanding of the anatomy of pelvic floor and urethra is crucial for satisfactory functional outcome of the procedure. Surgical techniques implemented to improve continence rates include nerve-sparing procedure, bladder neck preservation/plication, urethral length preservation, musculofascial reconstruction, puboprostatic ligaments preservation or seminal vesicle preservation. Perioperative (preoperative and postoperative pelvic floor muscle training (PFMT aims to shorten the duration of postoperative UI and thus, improve early continence rates postoperatively. In the review, complex information regarding anatomical, intra- and perioperative factors affecting urinary continence after RP is provided, including description of important anatomical structures, possible implications for surgical technique and evaluation of different PFMT strategies in perioperative period.

  7. The utilization and valuation of the program CONTIN

    International Nuclear Information System (INIS)

    Yu Weizhong; Sun Yizhan


    The updated analysis program CONTIN(PALS2) based on the Laplace inversion of positron annihilation spectra has been studied comprehensively. The principle and utilization of the program have been explained exhaustively. Three auxiliary programs have been made to help the transportation of data and adjustment of the data's pattern. Four experiments have been made, the results computed by program CONTIN(PALS2) have been analyzed, and compared with those by POSIREONFIT program

  8. Fission track imaging of the Australian continent

    International Nuclear Information System (INIS)

    Gleadow, A.; Kohn, B.; O'Sullivan, P.; Brown, R.; Gallagher, K.


    Full text: Techniques to reconstruct the thermal histories of rocks in the low-temperature environment of the upper crust have previously found important applications in such areas as sedimentary basin analysis, the evolution of convergent orogenic belts and studies of extensional tectonic environments. Increasingly large sets of thermochronology data are now becoming available on an even larger scale from the apatite fission-track system (for temperatures <∼110 deg C). Additional information is also now starting to emerge at even lower temperatures (<∼75 deg C) from the apatite (U-Th)/He system. The results from such systems can be used in novel ways to examine and visualise the evolution of the upper part of the continental crust. Quantitative modelling has brought a new dimension to this work and forward-modelling procedures are now well established which give 'best fit' thermal histories for temperatures less than about 110 deg C. In many cases the modelled thermal histories provide a proxy for rock transport towards the surface as overlying material is removed by denudation. Such information allows a reconstruction of the denudation history of the land surface. Applying these modelling procedures to large regional arrays of fission-track data means that the thermal history information can now be integrated with other regional data sets to provide an important new perspective on crustal and surface evolution. Apatite fission track analysis has now been completed on nearly 3000 surface outcrop samples across Australia under an AGCRC project to image the thermotectonic evolution of the exposed basement rocks of the continent. The samples analysed are mostly from rocks of broadly granitic composition and the apatites separated from these are overwhelmingly fluorapatites, which are consistent in their fission-track annealing properties with those on which the numerical annealing models are based. By interpolating the calculated thermal histories a series of

  9. Technical support and emergency centre

    International Nuclear Information System (INIS)

    Bohun, L.; Kapisovsk y, M.


    This paper presents technical support and emergency management center which will be on two places: Mochovce NPP Emergency Centre (Technical support center and Support working center) and Reserve Emergency Centre in Levice (Reserve emergency center and Environmental Evaluation Center). The main aims of the emergency management centers are: the management and coordination of all persons and organisations; provision of the all information needed to evaluation of the accident and its mitigation; continuous evaluation of the potential or real radiological consequences; taking measure for an early notification of the governmental bodies and the organizations, warning and protection of the public; and other aims. In the next part the data for technical support and emergency centre are discussed

  10. [Pseudo-continent perineal colostomy. Results and techniques]. (United States)

    Lasser, P; Dubé, P; Guillot, J M; Elias, D


    This prospective study was conducted to assess functional results obtained after pseudo-continent perineal colostomy using the Schmidt procedure. Functional outcome was assessed in 40 patients who had undergone amputation of the rectum for cancer and pseudo-continent perineal colostomy reconstruction between 1989 and 1995 in our institution. The cancer pathology, operative procedure and post-operative care were noted. Morbidity, functional outcome and degree of patient satisfaction were recorded. Mean follow-up was 45 months (18-87) in 100% of the patients. There were no operative deaths. Twenty patients had post-operative complications and 2 patients required early conversion to definitive abdominal colostomy due to severe perineal complications. Function outcome showed normal continence in 4 patients, air incontinence in 23, occasional minimal leakage in 9 and incontinence requiring iliac colostomy in 2. Eighty-six percent of the patients were highly satisfied or satisfied with their continence capacity. Pseudo-continent perineal colostomy is a reliable technique which can be proposed as an alternative to left iliac colostomy after amputation of the rectum for cancer if a rigorous procedure is applied: careful patient selection, informed consent, rigorous surgical procedure, daily life-long irrigation of the colon.

  11. Study on sediments from Almirantado Bay in the Antarctica continent

    International Nuclear Information System (INIS)

    Gomes, Marcelo da Silva; Montone, Rosalinda Carmela; Weber, Rolf Roland


    The Antarctic Continent is relatively free from human activities but it already comes presenting low levels of environmental contamination for anthropogenic sources. The anthropogenic contamination can be taken mainly to the continent through different manners for the marine and atmospheric currents. This work has as objective to analyze samples of sediments from Antarctic Continent in the area of Almirantado Bay, where the Brazilian Station of Resource Comandante Ferraz is located. The concentrations of ten metallic elements (Ni, Cu, Zn, Cd, Sn, Pb, U, Al, Fe and Li) were analyzed in twelve collection sites along the whole Bay. AAS and HR-ICPMS accomplished the analyses of those metallic elements. It was verified in the obtained results that a variation does not exist in the concentrations obtained among the collection sites, indicating a homogeneity in the area and there is no evidence of polluting source, at least at those obtained concentration levels. (author)

  12. A Geological Model for the Evolution of Early Continents (Invited) (United States)

    Rey, P. F.; Coltice, N.; Flament, N. E.; Thébaud, N.


    Geochemical probing of ancient sediments (REE in black shales, strontium composition of carbonates, oxygen isotopes in zircons...) suggests that continents were a late Archean addition at Earth's surface. Yet, geochemical probing of ancient basalts reveals that they were extracted from a mantle depleted of its crustal elements early in the Archean. Considerations on surface geology, the early Earth hypsometry and the rheology and density structure of Archean continents can help solve this paradox. Surface geology: The surface geology of Archean cratons is characterized by thick continental flood basalts (CFBs, including greenstones) emplaced on felsic crusts dominated by Trondhjemite-Tonalite-Granodiorite (TTG) granitoids. This simple geology is peculiar because i/ most CFBs were emplaced below sea level, ii/ after their emplacement, CFBs were deformed into relatively narrow, curviplanar belts (greenstone basins) wrapping around migmatitic TTG domes, and iii/ Archean greenstone belts are richly endowed with gold and other metals deposits. Flat Earth hypothesis: From considerations on early Earth continental geotherm and density structure, Rey and Coltice (2008) propose that, because of the increased ability of the lithosphere to flow laterally, orogenic processes in the Archean produced only subdued topography (continents, Flament et al. (2008) proposed a theory for the hypsometry of the early Earth showing that, until the late Archean, most continents were flooded and Earth was largely a water world. From this, a model consistent with many of the peculiar attributes of Archean geology, can be proposed: 1/ Continents appeared at Earth's surface at an early stage during the Hadean/Archean. However, because they were i/ covered by continental flood basalts, ii/ below sea level, and iii/ deprived of modern-style mountain belts and orogenic plateaux, early felsic

  13. Early reported rectal sensation predicts continence in anorectal anomalies. (United States)

    Skerritt, Clare; Tyraskis, Athanasios; Rees, Clare; Cockar, Iram; Kiely, Edward


    Straining at stool is an automatic reflex in babies and implies the presence of rectal sensation. We hypothesised that early reported rectal sensation would predict future continence in children with anorectal anomalies. The aim of this study is to determine if early straining at stool was a useful predictor of future continence in infants born with high anorectal malformations. A retrospective case note review of prospectively collected clinical information was performed with institutional review board approval. All patients with intermediate/high anorectal malformation operated on by a single surgeon from 1984 to 2010 were included. After stoma closure, parents were asked: The responses were noted within the first year of stoma closure and then all patients were followed up until they were at least 3 ½years old and continence could be assessed using the Krickenbeck outcome classification. Data were compared using Fisher's exact test and sensitivity, specificity and positive predictive value (PPV) were calculated. Forty-eight patients were included in the study. Sixteen (33%) were female (12 cloacal malformation, 3 rectovaginal fistula, 1 rectal atresia) and 32 (66%) were male (6 rectovesical fistulae, 22 rectourethral fistulae, 4 no fistula). Median follow-up was 9.7years (range 3.5-17.9). Twenty-one children were noted by their parents to exhibit early straining at stool after stoma closure. Twenty of them achieved long term continence. The sensitivity of early straining as a predictor for long term continence was 77%, specificity 95% and positive predictive value 95%. The presence of early rectal sensation reported by parents is a good predictor of long term continence. This allows more informed discussion with families in the early years of life. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey. (United States)

    Cooper, Claudia; Marston, Louise; Barber, Julie; Livingston, Deborah; Rapaport, Penny; Higgs, Paul; Livingston, Gill


    There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours. 1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory. Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident's interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54%) of care home staff reported carrying out or observing potentially abusive or neglectful behaviours at least sometimes in the preceding 3 months; some abuse was reported as happening "at least sometimes" in 91/92 care homes. Neglect was most frequently reported: making a resident wait for care (n = 399, 26%), avoiding a resident with challenging behaviour (n = 391, 25%), giving residents insufficient time for food (n = 297, 19%), and taking insufficient care when moving residents (n = 169, 11%). 1.1% of staff reported physical and 5% verbal abuse. More staff reported abusive/neglectful behaviour in homes with higher staff burnout-depersonalisation scores (adjusted odds ratio 1.191, CI 1.052-1.349). Staff anonymous reports of abusive behaviour and neglect could be used to monitor care quality, as cases currently reported are probably tip of the iceberg, and be an outcome in intervention studies.

  15. Logistic centres in the Hungarian traffic network -A Current Smvey

    Directory of Open Access Journals (Sweden)

    Geza Schubert


    Full Text Available As Europe's economic integration proceeds, Hungary- situatedin the continent's geometric centre - is called upon to accommodatea huge volume of transit traffic. Congestion on thecountry's highways, already a serious problem, makes it desirableto shift transit freight traffic onto railways. For this purpose,and also to make transportation generally more efficient,the so-called logistic service centres are being established. Theseare expected to play a decisive role in the European freight trafficnetwork. An expeditious extension of their services is urgentlyneeded.

  16. Impact of aerosols from the Asian Continent on the adjoining ...

    Indian Academy of Sciences (India)

    J. Earth Syst. Sci. ... aerosol impact on weather and climate, which is ... factor in climate models. The impact of aerosols from the Asian Continent .... as cloudy. Such data grids generated for each month in different years for the period of study.

  17. Our Continent, Our Future: African Perspectives on Structural ...

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

    Our Continent, Our Future: African Perspectives on Structural Adjustment ... Our Future presents the emerging African perspective on this complex issue. ... This important book should be read by students, professors, academics, and ... the Council for the Development of Social Research in Africa in Dakar, Senegal.

  18. a simple test to predict faecal continence before colostomy closure

    African Journals Online (AJOL)

    reconstituted with water to a consistency that matches the surgeon's notion of normal faeces. ... there be no leakage the colostomy can be reversed. The study was a .... 100 mmHg, more than a quarter of matched continent controls also had a ...

  19. Human-centred Governance

    DEFF Research Database (Denmark)

    Bason, Christian


    Design approaches are now being applied all over the world as a powerful approach to innovating public policies and services. Christian Bason, author of Leading public design: Discovering human-centred governance, argues that by bringing design methods into play, public managers can lead change...... with citizens at the centre, and discover a new model for steering public organisations: human-centred governance....

  20. The Search for Centre (United States)

    Nunes, April


    This paper acknowledges the importance of a dancer's centre but likewise highlights the problematic nature of the communication of this concept from dance teacher to student. After a brief introduction of orthodox approaches in finding centre, this paper suggests a method of locating centre through the ancient somatic technique.

  1. The CCCB is a cultural centre, not a tourist centre

    Directory of Open Access Journals (Sweden)

    Elena Xirau


    Full Text Available Last February, Barcelona's Centre of Contemporary Culture (CCCB celebrated its first ten years in existence. During this time, this institution has looked to be a showcase to the most modern and innovative cultural expressions focused on reflecting on the concept of the city. In this interview, Josep Ramoneda offers his personal view, as the CCCB's director. He talks of how this cultural project was born, of how the concept of the institution took shape in the CCCB, of its relations with Barcelona's Strategic Plan, of how the project has evolved, of the architectural remodelling of the Casa de la Caritat building for its conversion into a cultural centre, of the relations with other institutions and its future.

  2. CMS Centre at CERN

    CERN Multimedia


    A new "CMS Centre" is being established on the CERN Meyrin site by the CMS collaboration. It will be a focal point for communications, where physicists will work together on data quality monitoring, detector calibration, offline analysis of physics events, and CMS computing operations. Construction of the CMS Centre begins in the historic Proton Synchrotron (PS) control room. The historic Proton Synchrotron (PS) control room, Opened by Niels Bohr in 1960, will be reused by CMS to built its control centre. TThe LHC@FNAL Centre, in operation at Fermilab in the US, will work very closely with the CMS Centre, as well as the CERN Control Centre. (Photo Fermilab)The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Contro...

  3. The problem of early continence recovery after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    A. A. Kachmazov


    Full Text Available Background. The highest rate of incontinence after radical prostatectomy (RP is observed in the first 2–6 months after surgery. In order  to decrease the period of incontinence, virous surgical methods aimed at preservation and reconstruction of structures participating  in the mechanism of urine retention has been developed and improved.The study objective is to evaluate effectiveness of an original method of formation of an urethral anastomosis in the early continence recovery.Materials and methods. Data on 126 patients who underwent retropubic RP were analyzed. Depending on the method of urethral anastomosis formation, patients were divided into 2 groups: in the 1st group (n = 52 the patients underwent PR with urethra suspension m. levator ani, in the 2nd (n = 74 – standard RP. In the 1st group, 6 ligatures were applied to the anterior and posterior urethra walls: at the 12 and 6 hour projections through the mucosa, submucosa, and smooth muscle; at the 10, 2, 4, and 8 hour projections – more laterally with capture of the m. levator ani medial margins. Continence recovery was evaluated on days 1, 7, and 14 after urinary catheter removal and then at days 30, 90, 180, and 365 after RP. The criteria of continence were absence of urine leakage at rest and during physical activity and a necessity of using a safety liner.Results. There weren’t any significant differences at day 1 after urinary catheter removal between the two groups (р > 0.05. In the 1st group, continence values at days 30, 90, and 180 after RP were significantly higher (57.7, 69.2, and 71.1 %, respectively compared to the 2nd group (35.1, 41.9, and 51.3 %, respectively (р <0.05.Conclusion. Results of this work show significant benefits of RP with urethra suspension m. levator ani compared to standard RP per continence recovery criteria at days 7, 14, 30, 90, and 180 after the surgery. The technique of urethra suspension m. levator ani is easy to perform and ensures

  4. Mantle temperature under drifting deformable continents during the supercontinent cycle (United States)

    Yoshida, Masaki


    The thermal heterogeneity of the Earth's mantle under the drifting continents during a supercontinent cycle is a controversial issue in earth science. Here, a series of numerical simulations of mantle convection are performed in 3D spherical-shell geometry, incorporating drifting deformable continents and self-consistent plate tectonics, to evaluate the subcontinental mantle temperature during a supercontinent cycle. Results show that the laterally averaged temperature anomaly of the subcontinental mantle remains within several tens of degrees (±50 °C) throughout the simulation time. Even after the formation of the supercontinent and the development of subcontinental plumes due to the subduction of the oceanic plates, the laterally averaged temperature anomaly of the deep mantle under the continent is within +10 °C. This implies that there is no substantial temperature difference between the subcontinental and suboceanic mantles during a supercontinent cycle. The temperature anomaly immediately beneath the supercontinent is generally positive owing to the thermal insulation effect and the active upwelling plumes from the core-mantle boundary. In the present simulation, the formation of a supercontinent causes the laterally averaged subcontinental temperature to increase by a maximum of 50 °C, which would produce sufficient tensional force to break up the supercontinent. The periodic assembly and dispersal of continental fragments, referred to as the supercontinent cycle, bear close relation to the evolution of mantle convection and plate tectonics. Supercontinent formation involves complex processes of introversion, extroversion or a combination of these in uniting dispersed continental fragments, as against the simple opening and closing of individual oceans envisaged in Wilson cycle. In the present study, I evaluate supercontinent processes in a realistic mantle convection regime. Results show that the assembly of supercontinents is accompanied by a

  5. The Adult Education Centre

    Directory of Open Access Journals (Sweden)

    Olga Drofenik


    Full Text Available The Adult Education Centre has drafted the professional foundations for the Master Plan for Adult Education which, according to the provisions stipulated in the Adult Education Act, will be adopted by the Parliament. The Master Plan specifies the goals, priority target groups, priority areas and a draft financial projection. The professional foundations include the ratings of adult education in studies about adult education trends in Slovenia and abroad. The paper presents research results relevant to the Master Plan and documents issued by international organizations, including research into the Decisive Global Factors of EC Development after 1992, the Report of Ministers of the OECD, and the Economic Development Strategy of Slovenia . All the above-mentioned documents emphasize the importance of life­long learning in achieving a more fulfilling personal life, faster economic growth and maintenance of social ties. In principle, the same views are shared in Slovenia. However, in practice the "multi-dimensional" nature of adult education often gives way to "education for production". This is why we especially stress the importance of adult education in the social and cultural context.

  6. Madagascar: Heads It's a Continent, Tails It's an Island (United States)

    de Wit, Maarten J.

    Neither geologists nor biologists have a definition that is capable of classifying Madagascar unambiguously as an island or a continent; nor can they incorporate Malagasy natural history into a single model rooted in Africa or Asia. Madagascar is a microcosm of the larger continents, with a rock record that spans more than 3000 million years (Ma), during which it has been united episodically with, and divorced from, Asian and African connections. This is reflected in its Precambrian history of deep crustal tectonics and a Phanerozoic history of biodiversity that fluctuated between cosmopolitanism and parochialism. Both vicariance and dispersal events over the past 90 Ma have blended a unique endemism on Madagascar, now in decline following rapid extinctions that started about 2000 years ago.

  7. A review of continent scale hydrological datasets available for Africa


    Bonsor, H.C.


    As rainfall becomes less reliable with predicted climate change the ability to assess the spatial and seasonal variations in groundwater availability on a large-scale (catchment and continent) is becoming increasingly important (Bates, et al. 2007; MacDonald et al. 2009). The scarcity of observed hydrological data, or difficulty in obtaining such data, within Africa means remotely sensed (RS) datasets must often be used to drive large-scale hydrological models. The different ap...

  8. What is important for continent catheterizable stomas: angulations or extension?

    Directory of Open Access Journals (Sweden)

    Marcelo L. Vilela


    Full Text Available OBJECTIVE: We developed an experimental ex-vivo model to define factors that may influence continence of catheterizable channels by urinary and colonic stomas based on the principle of imbrication of the outlet tube. MATERIALS AND METHODS: From 20 pigs, colon specimens with 25 cm length were obtained and a transverse flap with 3.0 cm length x 1.5 cm width in the average point of the intestine was tubulated to create an efferent tube. With the tube configured, it was embedded by 3 seromuscular stitches far 0.5 cm each other. A pressure study of both intra-luminal surface and channel was then conducted during the filling of the submerse piece with environmental air in a water container, to define the efferent channel continence. The study was repeated after the progressive release of suture stitches until only one stitch remains. RESULTS: Channel continence analyzed in each segment in three different valve length situations, making a total of 20 segments, revealed that with 3 stitches (1.5 cm valve the maximum average pressure prior to overflow was 54 cm H2O; 53.65 cm H2O with 2 stitches (1.0 cm of valve, and 55.45 cm H2O with only one stitch (0.5 cm of valve, which are the same values. The record at the segment explosion pressure was 67.87 cm H2O. CONCLUSION: The study showed that angulation of channel with colon, maintained by only one stitch (0.5 cm imbrication was more important than a larger extension of the valve, represented by 3 suture stitches (1.5 cm imbrication in order to allow continence to the efferent channel.

  9. Colon pouch (Mainz III) for continent urinary diversion. (United States)

    Stolzenburg, Jens-Uwe; Schwalenberg, Thilo; Liatsikos, Evangelos N; Sakelaropoulos, George; Rödder, Kilian; Hohenfellner, Rudolph; Fisch, Margit


    To evaluate the use of a continent cutaneous pouch made exclusively of colon (Mainz pouch III), as excellent results with the Mainz pouch III in irradiated patients suggested that the indication for this type of urinary diversion could be extended. The outcome of 24 patients with continent cutaneous urinary diversions using colon segments (Mainz pouch III) was investigated retrospectively. Overall, 22 of the patients had a malignant disease and two a benign disease; 16 had a hysterectomy and pelvic exenteration for gynaecological tumours; two men with a rhabdomyosarcoma of the prostate had a radical cystoprostatectomy; one woman had pelvic exenteration for bladder cancer; one man had a simultaneous rectum resection due to infiltrating rectal cancer, and another a left nephrectomy with cystectomy for concomitant kidney and bladder tumour. Benign indications were hyper-reflexive bladder after polytrauma and two cases of neurogenic bladder dysfunction. Eighteen patients had radiotherapy (32-48 Gy) before the urinary diversion. The mean (range) follow-up was 35 (12-65) months. The mean pouch capacity was 293.8 mL. Three patients died during the follow-up (two from disease progression and one suicide); 20 patients were fully continent, four with reduced pouch capacity (<300 mL) had slight incontinence and are wearing a protective pad (band-aid at the umbilicus). All patients use intermittent self-catheterization (mean catheterization frequency 6.8/day, range 6-12). Complications related to the pouch were one outlet stenosis that required revision. Postoperative pouchograms showed asymptomatic reflux in four patients. None of the patients developed metabolic acidosis or diarrhoea. The Mainz pouch III is an alternative to other types of continent urinary diversion.

  10. Multiple sclerosis and continence issues: an exploratory study. (United States)

    Wollin, Judy; Bennie, Mary; Leech, Christine; Windsor, Carol; Spencer, Nancy

    The study described in this article aimed to identify issues relating to incontinence and assess the impact of referral to a continence adviser on the lives of people with multiple sclerosis (MS). The study design used an in-depth, two-phase anonymous mail survey within a general community as nominated by the participants. Fifty-six people participated in phase 1 and eleven people completed phase 2. The results indicated that incontinence is a problem for the vast majority of participants--people with MS. One-third of the eligible participants took up the option of a consultation, assessment and treatment from a continence nurse. Reasons for not taking up the visit from the continence nurse included 'managing OK', 'didn't think it would help', 'embarrassed' and 'too busy'. Increasing awareness of urinary incontinence in the community is important and education needs to focus on at-risk groups in presenting the range of options available to assist people experiencing incontinence.

  11. SAP Nuclear Competence Centre

    International Nuclear Information System (INIS)

    Andrlova, Z.


    In this issue we continue and introduce the SAP Nuclear Competence Centre and its head Mr. Igor Dzama. SAP Nuclear Competence Centrum is one of the fi rst competence centres outside ENEL headquarters. It should operate in Slovakia and should have competencies within the whole Enel group. We are currently dealing with the issues of organisation and funding. We are trying to balance the accountability to the NPP directors and to the management of the competence centres at Enel headquarters; we are looking at the relations between the competence centres within the group and defining the services that we will provide for the NPPs. author)

  12. Canadian Irradiation Centre

    International Nuclear Information System (INIS)


    The Canadian Irradiation Centre is a non-profit cooperative project between Atomic Energy of Canada Limited, Radiochemical Company and Universite du Quebec, Institut Armand-Frappier, Centre for Applied Research in Food Science. The Centre's objectives are to develop, demonstrate and promote Canada's radiation processing technology and its applications by conducting applied research; training technical, professional and scientific personnel; educating industry and government; demonstrating operational and scientific procedures; developing processing procedures and standards, and performing product and market acceptance trials. This pamphlet outlines the history of radoation technology and the services offered by the Canadian Irradiation Centre

  13. How Do People Make Continence Care Happen? An Analysis of Organizational Culture in Two Nursing Homes (United States)

    Lyons, Stacie Salsbury


    Purpose: Although nursing homes (NHs) are criticized for offering poor quality continence care, little is known about the organizational processes that underlie this care. This study investigated the influence of organizational culture on continence care practices in two NHs. Design and Methods: This ethnographic study explored continence care…

  14. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin


    In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

  15. Groundwater systems of the Indian Sub-Continent

    Directory of Open Access Journals (Sweden)

    Abhijit Mukherjee


    Full Text Available The Indian Sub-Continent is one of the most densely populated regions of the world, hosting ∼23% of the global population within only ∼3% of the world's land area. It encompasses some of the world's largest fluvial systems in the world (River Brahmaputra, Ganges and Indus Basins, which hosts some of the highest yielding aquifers in the world. The distribution of usable groundwater in the region varies considerably and the continued availability of safe water from many of these aquifers (e.g. Bengal Basin is constrained by the presence of natural contaminants. Further, the trans-boundary nature of the aquifers in the Indian Sub-Continent makes groundwater resource a potentially politically sensitive issue, particularly since this region is the largest user of groundwater resources in the world. Indeed, there is considerable concern regarding dwindling well yield and declining groundwater levels, even for the highly productive aquifers. Though irrigation already accounts for >85% of the total ground water extraction of the region, there is a mounting pressure on aquifers for food security of the region. Highly variable precipitation, hydrogeological conditions and predicted, impending climate change effects provide substantial challenges to groundwater management. The observed presence of natural groundwater contaminants together with the growing demand for irrigated food production and predicted climate change further complicate the development of strategies for using groundwater resources sustainably. We provide an introduction and overview of 11 articles, collated in this special issue, which describe the current condition of vulnerable groundwater resources across the Indian Sub-Continent.

  16. A Zn isotope perspective on the rise of continents. (United States)

    Pons, M-L; Fujii, T; Rosing, M; Quitté, G; Télouk, P; Albarède, F


    Zinc isotope abundances are fairly constant in igneous rocks and shales and are left unfractionated by hydrothermal processes at pH 1‰ during the ~2.35 Ga Great Oxygenation Event. By 1.8 Ga, BIF δ(66) Zn has settled to the modern value of FeMn nodules and encrustations (~0.9‰). The Zn cycle is largely controlled by two different mechanisms: Zn makes strong complexes with phosphates, and phosphates in turn are strongly adsorbed by Fe hydroxides. We therefore review the evidence that the surface geochemical cycles of Zn and P are closely related. The Zn isotope record echoes Sr isotope evidence, suggesting that erosion starts with the very large continental masses appearing at ~2.7 Ga. The lack of Zn fractionation in pre-2.9 Ga BIFs is argued to reflect the paucity of permanent subaerial continental exposure and consequently the insignificant phosphate input to the oceans and the small output of biochemical sediments. We link the early decline of δ(66) Zn between 3.0 and 2.7 Ga with the low solubility of phosphate in alkaline groundwater. The development of photosynthetic activity at the surface of the newly exposed continents increased the oxygen level in the atmosphere, which in turn triggered acid drainage and stepped up P dissolution and liberation of heavy Zn into the runoff. Zinc isotopes provide a new perspective on the rise of continents, the volume of carbonates on continents, changing weathering conditions, and compositions of the ocean through time. © 2013 Blackwell Publishing Ltd.

  17. Promoting Simulation Globally: Networking with Nursing Colleagues Across Five Continents. (United States)

    Alfes, Celeste M; Madigan, Elizabeth A

    Simulation education is gaining momentum internationally and may provide the opportunity to enhance clinical education while disseminating evidence-based practice standards for clinical simulation and learning. There is a need to develop a cohesive leadership group that fosters support, networking, and sharing of simulation resources globally. The Frances Payne Bolton School of Nursing at Case Western Reserve University has had the unique opportunity to establish academic exchange programs with schools of nursing across five continents. Although the joint and mutual simulation activities have been extensive, each international collaboration has also provided insight into the innovations developed by global partners.

  18. The DIY Digital Medical Centre. (United States)

    Timmis, James Kenneth; Timmis, Kenneth


    Healthcare systems worldwide are confronted with major economic, organizational and logistical challenges. Historic evolution of health care has led to significant healthcare sector fragmentation, resulting in systemic inefficiencies and suboptimal resource exploitation. To attain a sustainable healthcare model, fundamental, system-wide improvements that effectively network, and ensure fulfilment of potential synergies between sectors, and include and facilitate coherent strategic planning and organisation of healthcare infrastructure are needed. Critically, they must be specifically designed to sustainably achieve peak performance within the current policy environment for cost-control, and efficiency and quality improvement for service delivery. We propose creation of a new healthcare cluster, to be embedded in existing healthcare systems. It consists of (i) local 24/7 walk-in virtually autonomous do-it-yourself Digital Medical Centres performing routine diagnosis, monitoring, prevention, treatment and standardized documentation and health outcome assessment/reporting, which are online interfaced with (ii) regional 24/7 eClinician Centres providing on-demand clinical supervision/assistance to Digital Medical Centre patients. Both of these are, in turn, online interfaced with (iii) the National Clinical Informatics Centre, which houses the national patient data centre (cloud) and data analysis units that conduct patient- and population-level, personalized and predictive(-medicine) intervention optimization analyses. The National Clinical Informatics Centre also interfaces with biomedical research and prioritizes and accelerates the translation of new discoveries into clinical practice. The associated Health Policy Innovation and Evaluation Centre rapidly integrates new findings with health policy/regulatory discussions. This new cluster would synergistically link all health system components in a circular format, enable not only access by all arms of the health

  19. Conservation education in Madagascar: three case studies in the biologically diverse island-continent. (United States)

    Dolins, Francine L; Jolly, Alison; Rasamimanana, Hantanirina; Ratsimbazafy, Jonah; Feistner, Anna T C; Ravoavy, Florent


    Few Malagasy children and adults are aware of the rare and unique fauna and flora indigenous to their island-continent, including flagship lemur species. Even the Malagasy ancestral proverbs never mentioned lemurs, but these same proverbs talked about the now extinct hippopotamus. Madagascar's geography, history, and economic constraints contribute to severe biodiversity loss. Deforestation on Madagascar is reported to be over 100,000 ha/year, with only 10-15% of the island retaining natural forest [Green & Sussman, 1990]. Educating children, teacher-training, and community projects about environmental and conservation efforts to protect the remaining natural habitats of endangered lemur species provide a basis for long-term changes in attitudes and practices. Case studies of three conservation education projects located in different geographical regions of Madagascar, Centre ValBio, Madagacar Wildlife Conservation Alaotra Comic Book Project, and The Ako Book Project, are presented together with their ongoing stages of development, assessment, and outcomes. We argue that while nongovernmental organizational efforts are and will be very important, the Ministry of Education urgently needs to incorporate biodiversity education in the curriculum at all levels, from primary school to university. (c) 2009 Wiley-Liss, Inc.

  20. Archean komatiite volcanism controlled by the evolution of early continents. (United States)

    Mole, David R; Fiorentini, Marco L; Thebaud, Nicolas; Cassidy, Kevin F; McCuaig, T Campbell; Kirkland, Christopher L; Romano, Sandra S; Doublier, Michael P; Belousova, Elena A; Barnes, Stephen J; Miller, John


    The generation and evolution of Earth's continental crust has played a fundamental role in the development of the planet. Its formation modified the composition of the mantle, contributed to the establishment of the atmosphere, and led to the creation of ecological niches important for early life. Here we show that in the Archean, the formation and stabilization of continents also controlled the location, geochemistry, and volcanology of the hottest preserved lavas on Earth: komatiites. These magmas typically represent 50-30% partial melting of the mantle and subsequently record important information on the thermal and chemical evolution of the Archean-Proterozoic Earth. As a result, it is vital to constrain and understand the processes that govern their localization and emplacement. Here, we combined Lu-Hf isotopes and U-Pb geochronology to map the four-dimensional evolution of the Yilgarn Craton, Western Australia, and reveal the progressive development of an Archean microcontinent. Our results show that in the early Earth, relatively small crustal blocks, analogous to modern microplates, progressively amalgamated to form larger continental masses, and eventually the first cratons. This cratonization process drove the hottest and most voluminous komatiite eruptions to the edge of established continental blocks. The dynamic evolution of the early continents thus directly influenced the addition of deep mantle material to the Archean crust, oceans, and atmosphere, while also providing a fundamental control on the distribution of major magmatic ore deposits.

  1. Climate control of terrestrial carbon exchange across biomes and continents

    Energy Technology Data Exchange (ETDEWEB)

    Yi Chuixiang; Wolbeck, John; Xu Xiyan [School of Earth and Environmental Sciences, Queens College, City University of New York, NY 11367 (United States); Ricciuto, Daniel [Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831 (United States); Li Runze [Department of Statistics, Pennsylvania State University, University Park, PA 16802 (United States); Nilsson, Mats [Department of Forest Ecology, Swedish University of Agricultural Sciences, SE-901 83 Umeaa (Sweden); Aires, Luis [CESAM and Department of Environmental Engineering, School of Technology and Management, Polytechnic Institute of Leiria (Portugal); Albertson, John D [Department of Civil and Environmental Engineering, Duke University, Durham, NC 22708-0287 (United States); Ammann, Christof [Federal Research Station Agroscope Reckenholz-Taenikon, Reckenholzstrasse 191, 8046 Zuerich (Switzerland); Arain, M Altaf [School of Geography and Earth Sciences, McMaster University, Hamilton, ON, L8S 4K1 (Canada); De Araujo, Alessandro C [Instituto Nacional de Pesquisas da Amazonia, Programa LBA, Campus-II, Manaus-Amazonas 69060 (Brazil); Aubinet, Marc [University of Liege, Gembloux Agro-Bio Tech, Unit of Biosystem Physics, 2 Passage des Deportes, 5030 Gembloux (Belgium); Aurela, Mika [Finnish Meteorological Institute, Climate Change Research, FI-00101 Helsinki (Finland); Barcza, Zoltan [Department of Meteorology, Eoetvoes Lorand University, H-1117 Budapest, Pazmany setany 1/A (Hungary); Barr, Alan [Climate Research Division, Environment Canada, Saskatoon, SK, S7N 3H5 (Canada); Berbigier, Paul [INRA, UR1263 EPHYSE, Villenave d' Ornon F-33883 (France); Beringer, Jason [School of Geography and Environmental Science, Monash University, Clayton, Victoria 3800 (Australia); Bernhofer, Christian [Institute of Hydrology and Meteorology, Dresden University of Technology, Pienner Strasse 23, D-01737, Tharandt (Germany)


    Understanding the relationships between climate and carbon exchange by terrestrial ecosystems is critical to predict future levels of atmospheric carbon dioxide because of the potential accelerating effects of positive climate-carbon cycle feedbacks. However, directly observed relationships between climate and terrestrial CO{sub 2} exchange with the atmosphere across biomes and continents are lacking. Here we present data describing the relationships between net ecosystem exchange of carbon (NEE) and climate factors as measured using the eddy covariance method at 125 unique sites in various ecosystems over six continents with a total of 559 site-years. We find that NEE observed at eddy covariance sites is (1) a strong function of mean annual temperature at mid- and high-latitudes, (2) a strong function of dryness at mid- and low-latitudes, and (3) a function of both temperature and dryness around the mid-latitudinal belt (45 deg. N). The sensitivity of NEE to mean annual temperature breaks down at {approx} 16 deg. C (a threshold value of mean annual temperature), above which no further increase of CO{sub 2} uptake with temperature was observed and dryness influence overrules temperature influence.

  2. Experimental study of faecal continence and colostomy irrigation. (United States)

    O'Bichere, A; Sibbons, P; Doré, C; Green, C; Phillips, R K


    Colostomy irrigation is a useful method of achieving faecal continence in selected conditions, but remains largely underutilized because it is time consuming. This study investigated the effect of modifying irrigation technique (route, infusion regimen and pharmacological manipulation) on colonic emptying time in a porcine model. An end-colostomy and caecostomy were fashioned in six pigs. Twenty markers were introduced into the caecum immediately before colonic irrigation. Irrigation route (antegrade or retrograde), infusion regimen (tap water, polyethylene glycol (PEG), 1.5 per cent glycine) and pharmacological agent (glyceryl trinitrate (GTN) 0.25 mg/kg, diltiazem 3.9 mg/kg, bisacodyl 0.25 mg/kg) were assigned to each animal at random. Colonic transit was assessed by quantifying cumulative expelled markers (CEM) and stool every hour for 12 h. Mean CEM at 6 h for bisacodyl, GTN and diltiazem were 18.17, 12.17 and zero respectively; all pairwise differences in means were significant (P irrigation. PEG and glycine enhance emptying similar to bisacodyl and GTN solution. These findings show promise for improved faecal continence by colostomy irrigation and may justify construction of a Malone conduit at the time of colostomy in selected patients who wish to irrigate. Presented in part to the British Society of Gastroenterology in Glasgow, UK, March 1999, and published in abstract form as Gut 1999; 44(Suppl 1): A135

  3. Continents as lithological icebergs: The importance of buoyant lithospheric roots (United States)

    Abbott, D.H.; Drury, R.; Mooney, W.D.


    An understanding of the formation of new continental crust provides an important guide to locating the oldest terrestrial rocks and minerals. We evaluated the crustal thicknesses of the thinnest stable continental crust and of an unsubductable oceanic plateau and used the resulting data to estimate the amount of mantle melting which produces permanent continental crust. The lithospheric mantle is sufficiently depleted to produce permanent buoyancy (i.e., the crust is unsubductable) at crustal thicknesses greater than 25-27 km. These unsubductable oceanic plateaus and hotspot island chains are important sources of new continental crust. The newest continental crust (e.g., the Ontong Java plateau) has a basaltic composition, not a granitic one. The observed structure and geochemistry of continents are the result of convergent margin magmatism and metamorphism which modify the nascent basaltic crust into a lowermost basaltic layer overlain by a more silicic upper crust. The definition of a continent should imply only that the lithosphere is unsubductable over ??? 0.25 Ga time periods. Therefore, the search for the oldest crustal rocks should include rocks from lower to mid-crustal levels.

  4. Climate control of terrestrial carbon exchange across biomes and continents

    International Nuclear Information System (INIS)

    Yi Chuixiang; Wolbeck, John; Xu Xiyan; Ricciuto, Daniel; Li Runze; Nilsson, Mats; Aires, Luis; Albertson, John D; Ammann, Christof; Arain, M Altaf; De Araujo, Alessandro C; Aubinet, Marc; Aurela, Mika; Barcza, Zoltan; Barr, Alan; Berbigier, Paul; Beringer, Jason; Bernhofer, Christian


    Understanding the relationships between climate and carbon exchange by terrestrial ecosystems is critical to predict future levels of atmospheric carbon dioxide because of the potential accelerating effects of positive climate-carbon cycle feedbacks. However, directly observed relationships between climate and terrestrial CO 2 exchange with the atmosphere across biomes and continents are lacking. Here we present data describing the relationships between net ecosystem exchange of carbon (NEE) and climate factors as measured using the eddy covariance method at 125 unique sites in various ecosystems over six continents with a total of 559 site-years. We find that NEE observed at eddy covariance sites is (1) a strong function of mean annual temperature at mid- and high-latitudes, (2) a strong function of dryness at mid- and low-latitudes, and (3) a function of both temperature and dryness around the mid-latitudinal belt (45 deg. N). The sensitivity of NEE to mean annual temperature breaks down at ∼ 16 deg. C (a threshold value of mean annual temperature), above which no further increase of CO 2 uptake with temperature was observed and dryness influence overrules temperature influence.

  5. Effectiveness of a new standardised Urinary Continence Physiotherapy Programme for community-dwelling older women in Hong Kong. (United States)

    Leong, B S; Mok, Nicola W


    To examine the effectiveness of a standardised Urinary Continence Physiotherapy Programme for older Chinese women with stress, urge, or mixed urinary incontinence. A controlled trial. Six elderly community health centres in Hong Kong. A total of 55 women aged over 65 years with mild-to-moderate urinary incontinence. Participants were randomly assigned to the intervention group (n=27) where they received eight sessions of Urinary Continence Physiotherapy Programme for 12 weeks. This group received education about urinary incontinence, pelvic floor muscle training with manual palpation and verbal feedback, and behavioural therapy. The control group (n=28) was given advice and an educational pamphlet on urinary incontinence. There was significant improvement in urinary symptoms in the intervention group, especially in the first 5 weeks. Compared with the control group, participants receiving the intervention showed significant reduction in urinary incontinence episodes per week with a mean difference of -6.4 (95% confidence interval, -8.9 to -3.9; t= -5.3; PIncontinence Impact Questionnaire Short Form modified Chinese (Taiwan) version. The subjective perception of improvement, measured by an 11-point visual analogue scale, was markedly better in the intervention group (mean, 8.7; standard deviation, 1.0; 95% confidence interval, 8.4-9.1) than in the control group (mean, 1.4; standard deviation, 0.7; 95% confidence interval, 1.2-1.7; t=33.9; Ptreatment satisfaction in the intervention group was 9.5 (standard deviation, 0.8) as measured by an 11-point visual analogue scale. This study demonstrated that the Urinary Continence Physiotherapy Programme was effective in alleviating urinary symptoms among older Chinese women with mild-to-moderate heterogeneous urinary incontinence.

  6. Continent-wide risk assessment for the establishment of nonindigenous species in Antarctica (United States)

    Chown, Steven L.; Huiskes, Ad H. L.; Gremmen, Niek J. M.; Lee, Jennifer E.; Terauds, Aleks; Crosbie, Kim; Frenot, Yves; Hughes, Kevin A.; Imura, Satoshi; Kiefer, Kate; Lebouvier, Marc; Raymond, Ben; Tsujimoto, Megumu; Ware, Chris; Van de Vijver, Bart; Bergstrom, Dana Michelle


    Invasive alien species are among the primary causes of biodiversity change globally, with the risks thereof broadly understood for most regions of the world. They are similarly thought to be among the most significant conservation threats to Antarctica, especially as climate change proceeds in the region. However, no comprehensive, continent-wide evaluation of the risks to Antarctica posed by such species has been undertaken. Here we do so by sampling, identifying, and mapping the vascular plant propagules carried by all categories of visitors to Antarctica during the International Polar Year's first season (2007–2008) and assessing propagule establishment likelihood based on their identity and origins and on spatial variation in Antarctica's climate. For an evaluation of the situation in 2100, we use modeled climates based on the Intergovernmental Panel on Climate Change's Special Report on Emissions Scenarios Scenario A1B [Nakićenović N, Swart R, eds (2000) Special Report on Emissions Scenarios: A Special Report of Working Group III of the Intergovernmental Panel on Climate Change (Cambridge University Press, Cambridge, UK)]. Visitors carrying seeds average 9.5 seeds per person, although as vectors, scientists carry greater propagule loads than tourists. Annual tourist numbers (∼33,054) are higher than those of scientists (∼7,085), thus tempering these differences in propagule load. Alien species establishment is currently most likely for the Western Antarctic Peninsula. Recent founder populations of several alien species in this area corroborate these findings. With climate change, risks will grow in the Antarctic Peninsula, Ross Sea, and East Antarctic coastal regions. Our evidence-based assessment demonstrates which parts of Antarctica are at growing risk from alien species that may become invasive and provides the means to mitigate this threat now and into the future as the continent's climate changes. PMID:22393003

  7. The Bruce Energy Centre

    International Nuclear Information System (INIS)

    Jones, R.I.


    The Bruce Energy Centre Development Corporation is a joint venture of the Ontario Energy Corporation and 6 private companies formed to market surplus steam from the Bruce Nuclear Power Development. The corporation will also sell or lease land near Bruce NPD. The Bruce Energy Centre has an energy output of 900 BTU per day per dollar invested. Potential customers include greenhouse operators, aquaculturalists, food and beverage manufacturers, and traditional manufacturers

  8. The Aube centre

    International Nuclear Information System (INIS)


    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)


    DEFF Research Database (Denmark)

    De Chiffre, Leonardo

    The objective of this Annual Report is to give a general introduction to CGM as well as to give an account of the tasks carried out using the facilities of CGM's Instrument Centre during 1998 and 1999.......The objective of this Annual Report is to give a general introduction to CGM as well as to give an account of the tasks carried out using the facilities of CGM's Instrument Centre during 1998 and 1999....

  10. Clinical value of colonic irrigation in patients with continence disturbances. (United States)

    Briel, J W; Schouten, W R; Vlot, E A; Smits, S; van Kessel, I


    Continence disturbances, especially fecal soiling, are difficult to treat. Irrigation of the distal part of the large bowel might be considered as a nonsurgical alternative for patients with impaired continence. This study is aimed at evaluating the clinical value of colonic irrigation. Thirty-two patients (16 females; median age, 47 (range, 23-72) years) were offered colonic irrigation on an ambulatory basis. Sixteen patients suffered from fecal soiling (Group I), whereas the other 16 patients were treated for fecal incontinence (Group II). Patients were instructed by enterostomal therapists how to use a conventional colostomy irrigation set to obtain sufficient irrigation of the distal part of their large bowel. Patients with continence disturbances during the daytime were instructed to introduce 500 to 1,000 ml of warm (38 degrees C) water within 5 to 10 minutes after they passed their first stool. In addition, they were advised to wait until the urge to defecate was felt. Patients with soiling during overnight sleep were advised to irrigate during the evening. To determine clinical outcome, a detailed questionnaire was used. Median duration of follow-up was 18 months. Ten patients discontinued irrigation within the first month of treatment. Symptoms resolved completely in two patients. They believed that there was no need to continue treatment any longer. Irrigation had no effect in two patients. Despite the fact that symptoms resolved, six patients discontinued treatment because they experienced pain (n = 2) or they considered the irrigation to be too time-consuming (n = 4). Twenty-two patients are still performing irrigations. Most patients irrigated the colon in the morning after the first stool was passed. Time needed for washout varied between 10 and 90 minutes. Frequency of irrigations varied from two times per day to two times per week. In Group I, irrigation was found to be beneficial in 92 percent of patients, whereas 60 percent of patients in Group II

  11. Anorectal function in patients with complete rectal prolapse. Differences between continent and incontinent individuals. (United States)

    Roig, J V; Buch, E; Alós, R; Solana, A; Fernández, C; Villoslada, C; García-Armengol, J; Hinojosa, J


    A study is made of the alterations in anorectal physiology among rectal prolapse patients, evaluating the differences between fecal continent and incontinent individuals. Eighteen patients with complete rectal prolapse were divided into two groups: Group A (8 continent individuals) and Group B (10 incontinent women), while 22 healthy women were used as controls (Group C). Clinical exploration and perineal level measurements were performed, along with anorectal manometry, electrophysiology, and anorectal sensitivity to electrical stimuli. The main antecedents of the continent subjects were excess straining efforts, while the incontinent women presented excess straining and complex deliveries. Pathological perineal descent was a frequent finding in both groups, with a hypotonic anal canal at rest (p rest than the continent women (p rest, regardless of whether they are continent to feces or not. Continent patients have less pudendal neuropathy and therefore less pressure alterations at voluntary sphincter squeeze than incontinent individuals.

  12. Social Work in a Developing Continent: The Case of Africa

    Directory of Open Access Journals (Sweden)

    Christopher Chitereka


    Full Text Available Social work is a professional approach to ameliorating social problems. It is generally understood as a helping profession that utilizes professionally qualified personnel who use its knowledge base to help people tackle their social problems (Mupedziswa, 2005. Nevertheless, in developing countries, social work is a relatively young profession which was influenced by colonialism in its formation. The type of social work practiced in these countries largely mirrors the one that is being practiced in Britain, France and Portugal among others. Utilizing the continent of Africa as a case study, this article argues that social work practice in Africa tends to be curative or remedial in nature and is not adequately addressing people’s problems. It therefore proposes a paradigm shift from remedial to a social development paradigm if it is to make an impact in the 21st century.

  13. International Continence Society Good Urodynamic Practices and Terms 2016

    DEFF Research Database (Denmark)

    Rosier, Peter F W M; Schaefer, Werner; Lose, Gunnar


    AIMS: The working group initiated by the ICS Standardisation Steering Committee has updated the International Continence Society Standard "Good Urodynamic Practice" published in 2002. METHODS: On the basis of the manuscript: "ICS standard to develop evidence-based standards," a new ICS Standard......). RESULTS: This evidence-based ICS-GUP2016 has newly or more precisely defined more than 30 terms and provides standards for the practice, quality control, interpretation, and reporting of urodynamics; cystometry and pressure-flow analysis. Furthermore, the working group has included recommendations for pre......-testing information and for patient information and preparation. On the basis of earlier ICS standardisations and updating according to available evidence, the practice of uroflowmetry, cystometry, and pressure-flow studies are further detailed. CONCLUSION: ICS-GUP2016 updates and adds on to ICS-GUP2002 to improve...

  14. Radon at the Mauna Loa Observatory: transport from distant continents

    International Nuclear Information System (INIS)

    Whittlestone, S.; Robinson, E.; Ryan, S.


    Continuous measurements of radon have been made at an altitude of 3400m at the Mauna Loa Observatory, Hawaii. Concentrations ranged from about 20 to more than 700mBq m -3 . These were similar to values at remote Macquarie I., some 2000 km south of Australia in the Southern Ocean. At Mauna Loa, the radon concentrations could usually be separated into free tropospheric and island influenced categories on the basis of local meteorological observations. On one occasion a long range transport event from Asia brought relatively high radon concentrations to Mauna Loa and persisted for several days. The Asian origin of this event was supported by wind trajectories. This measurement program demonstrates the value of radon data in evaluating air transport models and the influence of transport from distant continents on baseline atmospheric measurements. (author)

  15. Using a handbook to improve nurses' continence care. (United States)

    Williams, K; Roe, B; Sindhu, F

    Nursing care should be based on sound research evidence with demonstrated clinical effectiveness. Dissemination of this research evidence is, therefore, of paramount importance. A study using focus groups was undertaken during 1993-1994 to evaluate the dissemination of a clinical handbook for continence care to qualified nurses, in relation to reported nursing practice in care of the elderly wards/units in one health authority. A total of 124 nurses participated in the study and 98 variables were included. Improvements were recorded in nurses' responses between the pre-test and post-test for 84 (86 per cent) variables in the experimental group and 58 (59 per cent) in the control group. This demonstrates the positive value of the clinical handbook as a method of disseminating research evidence.

  16. Electricity in Africa or the continent of paradoxes

    International Nuclear Information System (INIS)

    Heuraux, Christine


    This article first proposes an overview of the present situation of the electricity sector in Africa: the continent is an energy giant because of all the resources it possesses, but an electricity dwarf regarding its present and actual capacities. The author outlines the differences between potential and actual productions, gives an overview of the current status of supply and of production capacities. She comments the status of electricity demand, electricity consumption and electricity markets in the different parts of Africa (data of electricity consumption, of global, urban and rural electrification in Northern Africa, Western Africa, Central Africa, Eastern Africa, Southern Africa with or without South Africa), and issues related to costs and tariffs. She proposes some explanations for the observed discrepancies between African regions and countries: history, too small markets supported by too fragile economies, political and economic failures. Then, she discusses how to favour a durable development of the African electricity sector

  17. Plants of the American continent with antimalarial activity

    Directory of Open Access Journals (Sweden)

    Ingrid R. Mariath

    Full Text Available Malaria is a human parasitic disease caused by protozoa species of the Plasmodium genus. This disease has affected populations of the tropical and subtropical regions. About 500 million new cases occur annually on the world and therefore it is considered an emerging disease of important public health problem. In this context, the natural products as vegetables species have their bioactive molecules as targets for pharmacological, toxicological and phytochemical studies towards the development of more effective medicines for the treatment of many diseases. So this work intends to aid the researchers in the study of natural products to the treatment of malaria. In this review, 476 plants of the American continent were related for the antimalarial activity and of these vegetables species 198 were active and 278 inactive for some type of Plasmodium when they were evaluated through of in vitro or in vivo bioassays models.

  18. Plasmodium vivax Diversity and Population Structure across Four Continents. (United States)

    Koepfli, Cristian; Rodrigues, Priscila T; Antao, Tiago; Orjuela-Sánchez, Pamela; Van den Eede, Peter; Gamboa, Dionicia; van Hong, Nguyen; Bendezu, Jorge; Erhart, Annette; Barnadas, Céline; Ratsimbasoa, Arsène; Menard, Didier; Severini, Carlo; Menegon, Michela; Nour, Bakri Y M; Karunaweera, Nadira; Mueller, Ivo; Ferreira, Marcelo U; Felger, Ingrid


    Plasmodium vivax is the geographically most widespread human malaria parasite. To analyze patterns of microsatellite diversity and population structure across countries of different transmission intensity, genotyping data from 11 microsatellite markers was either generated or compiled from 841 isolates from four continents collected in 1999-2008. Diversity was highest in South-East Asia (mean allelic richness 10.0-12.8), intermediate in the South Pacific (8.1-9.9) Madagascar and Sudan (7.9-8.4), and lowest in South America and Central Asia (5.5-7.2). A reduced panel of only 3 markers was sufficient to identify approx. 90% of all haplotypes in South Pacific, African and SE-Asian populations, but only 60-80% in Latin American populations, suggesting that typing of 2-6 markers, depending on the level of endemicity, is sufficient for epidemiological studies. Clustering analysis showed distinct clusters in Peru and Brazil, but little sub-structuring was observed within Africa, SE-Asia or the South Pacific. Isolates from Uzbekistan were exceptional, as a near-clonal parasite population was observed that was clearly separated from all other populations (FST>0.2). Outside Central Asia FST values were highest (0.11-0.16) between South American and all other populations, and lowest (0.04-0.07) between populations from South-East Asia and the South Pacific. These comparisons between P. vivax populations from four continents indicated that not only transmission intensity, but also geographical isolation affect diversity and population structure. However, the high effective population size results in slow changes of these parameters. This persistency must be taken into account when assessing the impact of control programs on the genetic structure of parasite populations.

  19. Earth's first stable continents did not form by subduction. (United States)

    Johnson, Tim E; Brown, Michael; Gardiner, Nicholas J; Kirkland, Christopher L; Smithies, R Hugh


    The geodynamic environment in which Earth's first continents formed and were stabilized remains controversial. Most exposed continental crust that can be dated back to the Archaean eon (4 billion to 2.5 billion years ago) comprises tonalite-trondhjemite-granodiorite rocks (TTGs) that were formed through partial melting of hydrated low-magnesium basaltic rocks; notably, these TTGs have 'arc-like' signatures of trace elements and thus resemble the continental crust produced in modern subduction settings. In the East Pilbara Terrane, Western Australia, low-magnesium basalts of the Coucal Formation at the base of the Pilbara Supergroup have trace-element compositions that are consistent with these being source rocks for TTGs. These basalts may be the remnants of a thick (more than 35 kilometres thick), ancient (more than 3.5 billion years old) basaltic crust that is predicted to have existed if Archaean mantle temperatures were much hotter than today's. Here, using phase equilibria modelling of the Coucal basalts, we confirm their suitability as TTG 'parents', and suggest that TTGs were produced by around 20 per cent to 30 per cent melting of the Coucal basalts along high geothermal gradients (of more than 700 degrees Celsius per gigapascal). We also analyse the trace-element composition of the Coucal basalts, and propose that these rocks were themselves derived from an earlier generation of high-magnesium basaltic rocks, suggesting that the arc-like signature in Archaean TTGs was inherited from an ancestral source lineage. This protracted, multistage process for the production and stabilization of the first continents-coupled with the high geothermal gradients-is incompatible with modern-style plate tectonics, and favours instead the formation of TTGs near the base of thick, plateau-like basaltic crust. Thus subduction was not required to produce TTGs in the early Archaean eon.

  20. Clustered and transient earthquake sequences in mid-continents (United States)

    Liu, M.; Stein, S. A.; Wang, H.; Luo, G.


    Earthquakes result from sudden release of strain energy on faults. On plate boundary faults, strain energy is constantly accumulating from steady and relatively rapid relative plate motion, so large earthquakes continue to occur so long as motion continues on the boundary. In contrast, such steady accumulation of stain energy does not occur on faults in mid-continents, because the far-field tectonic loading is not steadily distributed between faults, and because stress perturbations from complex fault interactions and other stress triggers can be significant relative to the slow tectonic stressing. Consequently, mid-continental earthquakes are often temporally clustered and transient, and spatially migrating. This behavior is well illustrated by large earthquakes in North China in the past two millennia, during which no single large earthquakes repeated on the same fault segments, but moment release between large fault systems was complementary. Slow tectonic loading in mid-continents also causes long aftershock sequences. We show that the recent small earthquakes in the Tangshan region of North China are aftershocks of the 1976 Tangshan earthquake (M 7.5), rather than indicators of a new phase of seismic activity in North China, as many fear. Understanding the transient behavior of mid-continental earthquakes has important implications for assessing earthquake hazards. The sequence of large earthquakes in the New Madrid Seismic Zone (NMSZ) in central US, which includes a cluster of M~7 events in 1811-1812 and perhaps a few similar ones in the past millennium, is likely a transient process, releasing previously accumulated elastic strain on recently activated faults. If so, this earthquake sequence will eventually end. Using simple analysis and numerical modeling, we show that the large NMSZ earthquakes may be ending now or in the near future.

  1. CYGNSS Surface Wind Validation and Characteristics in the Maritime Continent (United States)

    Asharaf, S.; Waliser, D. E.; Zhang, C.; Wandala, A.


    Surface wind over tropical oceans plays a crucial role in many local/regional weather and climate processes and helps to shape the global climate system. However, there is a lack of consistent high quality observations for surface winds. The newly launched NASA Cyclone Global Navigation Satellite System (CYGNSS) mission provides near surface wind speed over the tropical ocean with sampling that accounts for the diurnal cycle. In the early phase of the mission, validation is a critical task, and over-ocean validation is typically challenging due to a lack of robust validation resources that a cover a variety of environmental conditions. In addition, it can also be challenging to obtain in-situ observation resources and also to extract co-located CYGNSS records for some of the more scientifically interesting regions, such as the Maritime Continent (MC). The MC is regarded as a key tropical driver for the mean global circulation as well as important large-scale circulation variability such as the Madian-Julian Oscillation (MJO). The focus of this project and analysis is to take advantage of local in-situ resources from the MC regions (e.g. volunteer shipping, marine buoys, and the Year of Maritime Continent (YMC) campaign) to quantitatively characterize and validate the CYGNSS derived winds in the MC region and in turn work to unravel the complex multi-scale interactions between the MJO and MC. This presentation will show preliminary results of a comparison between the CYGNSS and the in-situ surface wind measurements focusing on the MC region. Details about the validation methods, uncertainties, and planned work will be discussed in this presentation.

  2. National audit of continence care: laying the foundation. (United States)

    Mian, Sarah; Wagg, Adrian; Irwin, Penny; Lowe, Derek; Potter, Jonathan; Pearson, Michael


    National audit provides a basis for establishing performance against national standards, benchmarking against other service providers and improving standards of care. For effective audit, clinical indicators are required that are valid, feasible to apply and reliable. This study describes the methods used to develop clinical indicators of continence care in preparation for a national audit. To describe the methods used to develop and test clinical indicators of continence care with regard to validity, feasibility and reliability. A multidisciplinary working group developed clinical indicators that measured the structure, process and outcome of care as well as case-mix variables. Literature searching, consensus workshops and a Delphi process were used to develop the indicators. The indicators were tested in 15 secondary care sites, 15 primary care sites and 15 long-term care settings. The process of development produced indicators that received a high degree of consensus within the Delphi process. Testing of the indicators demonstrated an internal reliability of 0.7 and an external reliability of 0.6. Data collection required significant investment in terms of staff time and training. The method used produced indicators that achieved a high degree of acceptance from health care professionals. The reliability of data collection was high for this audit and was similar to the level seen in other successful national audits. Data collection for the indicators was feasible to collect, however, issues of time and staffing were identified as limitations to such data collection. The study has described a systematic method for developing clinical indicators for national audit. The indicators proved robust and reliable in primary and secondary care as well as long-term care settings.

  3. Continent-Ocean Interactions Within East Asian Marginal Seas (United States)

    Clift, Peter; Kuhnt, Wolfgang; Wang, Pinxian; Hayes, Dennis

    The study of the complex interactions between continents and oceans has become a leading area for 21st century earth cience. In this volume, continent—ocean interactions in tectonics, arc-continent collision, sedimentology, and climatic volution within the East Asian Marginal Seas take precedence. Links between oceanic and continental climate, the sedimentology of coastal and shelf areas, and the links between deformation of continental and oceanic lithosphere are also discussed. As an introduction to the science presented throughout the volume, Wang discusses many of the possible interactions between the tectonic evolution of Asia and both regional and global climate. He speculates that uplift of central Asia in the Pliocene may have triggered the formation of many of the major rivers that drain north through Siberia into the Arctic Ocean. He also argues that it is the delivery of this fresh water that allows the formation of sea ice in that area and triggered the start of Northern Hemispheric glaciation. This may be one of the most dramatic ways in which Asia has shaped the Earth's climate and represents an alternative to the other competing models that have previously emphasized the role of oceanic gateway closure in Central America. Moreover, his proposal for major uplift of at least part of Tibet and Mongolia as late as the Pliocene, based on the history of drainage evolution in Siberia, supports recent data from the southern Tarim Basin and from the Qilian Shan and Qaidam and Jiuxi Basins in northeast Tibet that indicate surface uplift at that time. Constraining the timing and patterns of Tibetan surface uplift is crucial to testing competing models for strain accommodation in Asia following India—Asia collision.

  4. Know Your Personal Computer

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 1; Issue 11. Know Your Personal Computer 5. The CPU Base Instruction Set and Assembly Language Programming. Siddhartha Kumar Ghoshal ... Supercomputer Education and Research Centre, Indian Institute of Science, Bangalore 560 012, India ...

  5. The Malone antegrade continence enema for neurogenic and structural fecal incontinence and constipation. (United States)

    Koyle, M A; Kaji, D M; Duque, M; Wild, J; Galansky, S H


    Problems of fecal elimination are commonly encountered by the pediatric urologist and surgeon. The Malone antegrade continence enema has been described as a means to administer a large volume enema via a continent catheterizable appendicocecostomy, resulting in reliable fecal elimination. Of 22 patients undergoing this procedure 16 reported total continence 4 months or longer after surgery. Complications are relatively minor and tap water appears to be a safe solution for the antegrade continence enema. A nonrefluxing, imbricated appendicocecostomy is preferable to prevent cutaneous fecal or gas leaks.

  6. Continent at a Crossroads: Prosperity, Justice, and Security in South America

    National Research Council Canada - National Science Library

    Scott, Frances K


    This Special Bibliography Series, Number 107, "Continent at the Crossroads: Prosperity, Justice, and Security in South America," was developed by Social Sciences Bibliographer and Reference Librarian Frances K...

  7. Energy centre microgrid model

    Energy Technology Data Exchange (ETDEWEB)

    Pasonen, R.


    A simulation model of Energy centre microgrid made with PSCAD simulation software version 4.2.1 has been built in SGEM Smart Grids and Energy Markets (SGEM) work package 6.6. Microgrid is an autonomous electric power system which can operate separate from common distribution system. The idea of energy centre microgrid concept was considered in Master of Science thesis 'Community Microgrid - A Building block of Finnish Smart Grid'. The name of energy centre microgrid comes from a fact that production and storage units are concentrated into a single location, an energy centre. This centre feeds the loads which can be households or industrial loads. Power direction flow on the demand side remains same compared to the current distribution system and allows to the use of standard fuse protection in the system. The model consists of photovoltaic solar array, battery unit, variable frequency boost converter, inverter, isolation transformer and demand side (load) model. The model is capable to automatically switch to islanded mode when there is a fault in outside grid and back to parallel operation mode when fault is removed. The modelled system responses well to load changes and total harmonic distortion related to 50Hz base frequency is kept under 1.5% while operating and feeding passive load. (orig.)

  8. A reference regional nuclear fuel centre

    International Nuclear Information System (INIS)


    A nuclear fuel centre groups the facilities for spent fuel reprocessing, plutonium fuel fabrication, waste conditioning, and interim storage on a single site. The technical aspects of safety and protection, and the socio-economic consequences of two types of centre have been studied. The reference centre has an initial reprocessing capacity of 1500 tonnes. This capacity is quadrupled by the construction of two new units in 15 years. The other centre considered is a quarter of this size. A description is given of the processes used, the personal and capital requirements for construction and operation of the plant, the transport of radioactive waste and products, and the quantities involved. The local radiological impact is low and could be further reduced to a level well below that of natural radioactivity. The resulting increase in economic activity, employment, income redistribution and the new infrastructure requirements are estimated for a rural or semi-rural region. Measures to prevent tension are proposed. The impact of the host country's balance of payments, finances, employment situation and technological knowhow is evaluated. The original centre is compared with equivalent facilities scattered geographically

  9. The ideal Atomic Centre

    International Nuclear Information System (INIS)

    Mas, R.


    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [fr

  10. Netherlands Reactor Centre

    International Nuclear Information System (INIS)



    Briefly reviews the last year's work of the twenty year old Netherlands Reactor Centre (RCN) in the fields of reactor safety, fissile material, nuclear fission, non-nuclear energy systems and overseas co-operation. The annual report thus summarised is the last one to appear under the name of RCN. The terms of reference of the organisation having been broadened to include research into energy supply in general, it is to be known in future as the Netherlands Energy Research Centre (ECN). (D.J.B.)

  11. The Structural Integrity Centre

    International Nuclear Information System (INIS)

    Tomkins, B.


    The paper concerns the development and work of the Structural Integrity Centre (SIC) at Risley Nuclear Laboratories, United Kingdom. The centre was set up to provide authoritative advice to plant designers and operators on the integrity and life assessment of structures and components across the reactor projects in the United Kingdom. A description is given of the structure and role of the SIC, as well as the Structural Integrity Assessment work. The assessment methods are described for thermally loaded structures and welded structures. Finally, defect significance assessment and environmental effects are outlined. (U.K.)

  12. The paediatric cardiac centre for Africa--proceedings of the March 2012 symposium. (United States)

    Kinsley, Robin H; Edwin, Frank; Entsua-Mensah, Kow


    The Pediatric Cardiac Centre for Africa (PCCA) was opened by national patron Mr Nelson Mandela on November 7, 2003. In 2008, the Centre's international pediatric cardiac symposium was introduced as a learning forum for pediatric cardiac surgeons and cardiologists in the continent. The symposium has consistently grown in attendance and attracted distinguished leaders in the field. The 2012 symposium featured Dr. Thomas Spray of Children's Hospital of Philadelphia, Dr. David Barron of Birmingham Children's Hospital, and Dr. John Brown of Indiana University School of Medicine as guest speakers. Experience of the Fontan procedure, the small aortic root, hypoplastic left heart syndrome, right ventricular outflow tract reconstruction, transposition of the great arteries, and interrupted aortic arch were the highlights of the symposium. In the "African Corner," centers in South Africa, Ghana, and Angola presented work done from across the African continent.

  13. International research centre launched

    International Nuclear Information System (INIS)


    Full text: The first scientific research and educational institution to be set up on a completely international basis was officially inaugurated in Trieste on 5 October 1964 by the Director General of IAEA, Dr. Sigvard Eklund, when he opened the first seminar of the International Centre for Theoretical Physics. As evidence of the international nature of the institution he noted that the scientists who would work and teach there during the first year represented sixteen different countries. By the end of 1964, the Centre building was nearing completion and three of the five floors were occupied. A successful symposium had been held on the subject of plasma physics, and a score of professors and fellows were at work, from Bulgaria, Czechoslovakia, Greece, India, Japan, Jordan, the Netherlands, Norway, Pakistan, Poland, the United Kingdom, and the United States. A dozen scientific papers had been issued as preprints. The main purpose of the Centre is to foster the advancement of theoretical physics through training and research; at first the chief subject will be high-energy and elementary particle physics. Plasma physics, low energy physics and solid-state physics will also be dealt with. Special attention is paid to the needs of the developing countries. Of the 25 fellows selected for the academic year 1964-65, more than half are from South America, Africa and Asia. In conjunction with the Research Centre, there is an Advanced School for theoretical Physics to provide graduate training for fellows who need such preparation before they embark upon research. The Centre works under the guidance of a Scientific Council comprising the president, Prof. M. Sandoval-Vallarta (Nuclear Energy Commission of Mexico); Prof. A. Abragam (Saclay, France); Prof. R. Oppenheimer (Institute for Advanced Study, Princeton, USA); Dr. V. Soloviev (Dubna, USSR); Prof V.F. Weiskopf (Director General, CERN) ; Prof Abdus Salam (Imperial College, London) ; Prof. P. Budini (University of Trieste

  14. GOCE observations for Mineral exploration in Africa and across continents (United States)

    Braitenberg, Carla


    The gravity anomaly field over the whole Earth obtained by the GOCE satellite is a revolutionary tool to reveal geologic information on a continental scale for the large areas where conventional gravity measurements have yet to be made (e.g. Alvarez et al., 2012). It is, however, necessary to isolate the near-surface geologic signal from the contributions of thickness variations in the crust and lithosphere and the isostatic compensation of surface relief (e.g. Mariani et al., 2013) . Here Africa is studied with particular emphasis on selected geological features which are expected to appear as density inhomogeneities. These include cratons and fold belts in the Precambrian basement, the overlying sedimentary basins and magmatism, as well as the continental margins. Regression analysis between gravity and topography shows coefficients that are consistently positive for the free air gravity anomaly and negative for the Bouguer gravity anomaly (Braitenberg et al., 2013; 2014). The error and scatter on the regression is smallest in oceanic areas, where it is a possible tool for identifying changes in crustal type. The regression analysis allows the large gradient in the Bouguer anomaly signal across continental margins to be removed. After subtracting the predicted effect of known topography from the original Bouguer anomaly field, the residual field shows a continent-wide pattern of anomalies that can be attributed to regional geological structures. A few of these are highlighted, such as those representing Karoo magmatism, the Kibalian foldbelt, the Zimbabwe Craton, the Cameroon and Tibesti volcanic deposits, the Benue Trough and the Luangwa Rift. A reconstruction of the pre-break up position of Africa, South and North America is made for the residual GOCE gravity field obtaining today's gravity field of the plates forming West Gondwana. The reconstruction allows the positive and negative anomalies to be compared across the continental fragments, and so helps

  15. Recent Aeromagnetic Anomaly views of the Antarctic continent (United States)

    Ferraccioli, F.


    Antarctica is a keystone within the Gondwana and Rodinia supercontinents. However, despite intense geological research along the coastal fringes of Antarctica, the interior of the continent remains one of the most poorly understood regions on Earth. Aeromagnetic investigations are a useful tool to help disclose the structure and the evolution of continents from the Precambrian to the Cenozoic and Antarctica is no exception. Here I review a variety of aeromagnetic studies in East and West Antarctica performed since the completion of the first generation ADMAP -Antarctic Digital Magnetic Anomaly Project- in 2001. In western Dronning Maud, in East Antarctica, aeromagnetic data help delineate the extent of the Jurassic Jutulstraumen subglacial rift that is flanked by remnants of a Grenvillian-age (ca 1.1. Ga) igneous province and magmatic arc. Different magnetic signatures appear to characterize the Coats Land block but reconnaissance surveys are insufficient to fully delineate the extent and significance of the Coats Land block, a possible tectonic tracer of Laurentia within Rodinia (Loewy et al., 2011). Further in the interior of East Antarctica, a mosaic of distinct and hitherto largely unknown Precambrian provinces has recently been revealed by combining aeromagnetic and satellite magnetic data with models of crustal thickness constrained by gravity modeling and seismology (Ferraccioli et al., 2011, Nature). A major collisional suture may lie between the Archean Ruker Province and an inferred Proterozoic Gamburtsev Province but the age of final assembly of central East Antarctica remains uncertain and controversial. I favour a Grenville-age collisional event (linked to Rodinia assembly) or possibly older Paleoproteroic collision, followed by intraplate reactivation, as opposed to Neoproterozoic or Early Cambrian collision linked to East-West Gondwana assembly (Boger, 2011). New aerogeophysical surveys over Prince Elizabeth and Queen Mary Land could test this

  16. Centre for Political and

    African Journals Online (AJOL)


    and definitions will be published and the data translated into the official ... The Centre provides a terminological and subject-related service to lecturers and ... postgraduate students in international politics, political studies and .... obtain financial contributions (cf. .... making of authoritative and enforceable rules (laws) for.

  17. Implementing Responsibility Centre Budgeting (United States)

    Vonasek, Joseph


    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  18. Fuel cycle centres

    International Nuclear Information System (INIS)

    Hagen, M.


    The concept of co-locating and integrating fuel cycle facilities at one site is discussed. This concept offers considerable advantages, especially in minimizing the amount of radioactive material to be transported on public roads. Safeguards and physical protection as relating to such an integrated system of facilities are analysed in detail, also industrial and commercial questions. An overall risk-benefit evaluation turns out to be in favour of fuel cycle centres. These centres seem to be specifically attractive with regard to the back end of the fuel cycle, including on-site disposal of radioactive wastes. The respective German approach is presented as an example. Special emphasis is given to the site selection procedures in this case. Time scale and cost for the implementation of this concept are important factors to be looked at. Since participation of governmental institutions in these centres seems to be indispensable their respective roles as compared to industry must be clearly defined. The idea of adjusting fuel cycle centres to regional rather than national use might be an attractive option, depending on the specific parameters in the region, though results of existing multinational ventures are inconclusive in this respect. Major difficulties might be expected e.g. because of different national safety regulations and standards as well as commercial conditions among partner countries. Public acceptance in the host country seems to be another stumbling block for the realization of this type of multinational facilities

  19. Budapest Training Technology Centre. (United States)

    Budapest Training Technology Centre (Hungary).

    The Budapest Training Technology Centre (BTTC) grew out of a 1990 agreement calling for Great Britain to help Hungary develop and implement open and flexible training methods and technology-based training to support the labor force development and vocational training needs resulting from Hungary's transition to a market economy. The BTTC would be…

  20. Official Centre Hospitality

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

    Sylvain Dufour

    Approved by the Management Executive Committee. - 1 -. Version 3.1.0 effective 2017-06-28. Official Centre Hospitality. 1. Objective. 2. Application. 3. Definitions. 4. Roles and Responsibilities. 5. Authorization. 6. Consultants and Contractors. 7. Reimbursement. 1. Objective. To define the circumstances under which ...

  1. Academic Drug Discovery Centres

    DEFF Research Database (Denmark)

    Kirkegaard, Henriette Schultz; Valentin, Finn


    Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic...

  2. ATLAS Visitors Centre

    CERN Multimedia

    claudia Marcelloni


    ATLAS Visitors Centre has opened its shiny new doors to the public. Officially launched on Monday February 23rd, 2009, the permanent exhibition at Point 1 was conceived as a tour resource for ATLAS guides, and as a way to preserve the public’s opportunity to get a close-up look at the experiment in action when the cavern is sealed.

  3. Urethral pressure response patterns induced by squeeze in continent and incontinent women. (United States)

    Teleman, Pia M; Mattiasson, Anders


    Our aim was to compare the urethral pressure response pattern to pelvic floor muscle contractions in 20-27 years old, nulliparous continent women (n = 31) to that of continent (n = 28) and formerly untreated incontinent (n = 59) (53-63 years old) women. These women underwent urethral pressure measurements during rest and repeated pelvic muscle contractions. The response to the contractions was graded 0-4. The young continent women showed a mean urethral pressure response of 2.8, the middle-aged continent women 2.2 (NS vs young continent), and the incontinent women 1.5 (p continent, p continent). Urethral pressures during rest were significantly higher in the younger women than in both groups of middle-aged women. The decreased ability to increase urethral pressure on demand seen in middle-aged incontinent women compared to continent women of the same age as well as young women seems to be a consequence of a neuromuscular disorder rather than of age.

  4. Comparison of symptom severity and treatment response in patients with incontinent and continent overactive bladder

    NARCIS (Netherlands)

    Michel, Martin C.; de La Rosette, Jean J. M. C. H.; Piro, Maria; Schneider, Tim


    Purpose: Two thirds of patients with overactive bladder (OAB) are continent, but our knowledge on the treatment of the syndrome is largely based on studies with incontinent patients. Therefore, we have explored baseline symptoms and treatment responses to tolterodine in continent relative to

  5. Earth's early O2 cycle suppressed by primitive continents (United States)

    Smit, Matthijs A.; Mezger, Klaus


    Free oxygen began to accumulate in Earth's surface environments between 3.0 and 2.4 billion years ago. Links between oxygenation and changes in the composition of continental crust during this time are suspected, but have been difficult to demonstrate. Here we constrain the average composition of the exposed continental crust since 3.7 billion years ago by compiling records of the Cr/U ratio of terrigenous sediments. The resulting record is consistent with a predominantly mafic crust prior to 3.0 billion years ago, followed by a 500- to 700-million-year transition to a crust of modern andesitic composition. Olivine and other Mg-rich minerals in the mafic Archaean crust formed serpentine minerals upon hydration, continuously releasing O2-scavenging agents such as dihydrogen, hydrogen sulfide and methane to the environment. Temporally, the decline in mafic crust capable of such process coincides with the first accumulation of O2 in the oceans, and subsequently the atmosphere. We therefore suggest that Earth's early O2 cycle was ultimately limited by the composition of the exposed upper crust, and remained underdeveloped until modern andesitic continents emerged.

  6. Volcanic passive margins: another way to break up continents. (United States)

    Geoffroy, L; Burov, E B; Werner, P


    Two major types of passive margins are recognized, i.e. volcanic and non-volcanic, without proposing distinctive mechanisms for their formation. Volcanic passive margins are associated with the extrusion and intrusion of large volumes of magma, predominantly mafic, and represent distinctive features of Larges Igneous Provinces, in which regional fissural volcanism predates localized syn-magmatic break-up of the lithosphere. In contrast with non-volcanic margins, continentward-dipping detachment faults accommodate crustal necking at both conjugate volcanic margins. These faults root on a two-layer deformed ductile crust that appears to be partly of igneous nature. This lower crust is exhumed up to the bottom of the syn-extension extrusives at the outer parts of the margin. Our numerical modelling suggests that strengthening of deep continental crust during early magmatic stages provokes a divergent flow of the ductile lithosphere away from a central continental block, which becomes thinner with time due to the flow-induced mechanical erosion acting at its base. Crustal-scale faults dipping continentward are rooted over this flowing material, thus isolating micro-continents within the future oceanic domain. Pure-shear type deformation affects the bulk lithosphere at VPMs until continental breakup, and the geometry of the margin is closely related to the dynamics of an active and melting mantle.

  7. Mid-Continent Rift: Rift, LIP, or Both? (United States)

    Stein, C. A.; Stein, S. A.; Kley, J.; Hindle, D.; Keller, G. R., Jr.


    North America's Midcontinent Rift (MCR) is traditionally considered to have formed by midplate extension and volcanism ~1.1 Ga that ended due to compression from the Grenville orogeny, the ~1.3 - ~0.98 Ga assembly of Amazonia (Precambrian northeast South America), Laurentia (Precambrian North America), and other continents into the supercontinent of Rodinia. We find that a more plausible scenario is that it formed as part of the rifting of Amazonia from Laurentia and became inactive once seafloor spreading was established. The MCR has aspects both of a continental rift - a segmented linear depression filled with sedimentary and igneous rocks - and a large igneous province (LIP). Comparison of areas and volumes for a range of continental LIPS shows that the MCR volcanic rocks are significantly thicker than the others. The MCR flood basalts have steeper dips and thicker overlying sediments than other continental flood basalts, and were deposited in a subsiding basin after most extension ended, indicating that they are better viewed as post-rift than syn-rift rocks. Hence we view the MCR as a LIP deposited in crust weakened by rifting, and thus first a rift and then a LIP.

  8. Continent Idiopathic Vesicovaginal Fistula Coexisting with Moyamoya Disease

    Directory of Open Access Journals (Sweden)

    İbrahim Güven Kartal


    Full Text Available Vesicovaginal fistula (VVF is the abnormal anatomic communication between the female bladder and vagina. Usually presents itself as continuous urinary incontinence. There are many etiologic risk factors such as obstetric trauma, pelvic surgery, infections, congenital abnormalities, foreign materials, malignancy and pelvic radiation (1. Due to high education and sociocultural levels, the incidence seems to be low in the developed countries. On the other hand, in the developing countries, there is an obviously high incidence and prevalence. Considering the low level of medical informative feed-back mechanisms and poor obstetrics health care services, it seems very hard to keep VVF patient data that can be used for epidemiological research studies. In those areas, due to high maternal mortality and obstetric complications, the incidence of VVF is significantly increased (2. In this paper, we report a female patient with known moyamoya disease and a stable right ovarian cyst who was regularly followed up by the departments of neurology, gynecology and presented with radiological and cystoscopy findings of incidentally diagnosed asymptomatic continent VVF.

  9. International Continence Society supported pelvic physiotherapy education guideline. (United States)

    Bakker, Els; Shelly, Beth; Esch, Fetske H; Frawley, Helena; McClurg, Doreen; Meyers, Peter


    To provide a guideline of desired knowledge, clinical skills and education levels in Pelvic Physiotherapy (PT). Physiotherapy (PT) involves "using knowledge and skills unique to physiotherapists" and, "is the service only provided by, or under the direction and supervision of a physiotherapist." 1 METHODS: The PT Committee, within the body of the International Continence Society (ICS), collected information regarding existing educational levels for pelvic floor PT. Through face to face and on on-line discussion consensus was reached which was summarized in three progressive educational levels based on knowledge and skills and brought together in a guideline. The guideline was submitted to all physiotherapists and the Educational Committee of the ICS, and after approval, submitted to the Executive Board of the ICS. The guideline lists, in a progressive way, knowledge areas and skills to be achieved by education. It is broad and allows for individual interpretation based on local situations regarding education and healthcare possibilities. It is intended to be dynamic and updated on a regular basis. The proposed Pelvic PT education guideline is a dynamic document that allows course creators to plan topics for continuing course work and to recognize educational level of a therapist in the field of Pelvic PT. This education guideline can be used to set minimum worldwide standards resulting in higher skill levels for local pelvic physiotherapists and thereby better patient care outcome. © 2018 Wiley Periodicals, Inc.

  10. Representations of OxyContin in North American Newspapers and Medical Journals

    Directory of Open Access Journals (Sweden)

    Emma Whelan


    Full Text Available Following the approval of OxyContin (Purdue Pharma, Canada for medical use, the media began to report the use of OxyContin as a street drug, representing the phenomenon as a social problem. Meanwhile, the pain medicine community has criticized the inaccurate and one-sided media coverage of the OxyContin problem. The authors of this study aimed to contribute to an understanding of both sides of this controversy by analyzing the coverage of OxyContin in newspapers and medical journals. The analyses revealed inconsistent messages about the drug from physicians in the news media and in medical journals, which has likely contributed to the drug’s perception as a social problem. The authors suggest ways to address the lack of medical consensus surrounding OxyContin. The results of this study may help resolve the concerns and conflicts surrounding this drug and other opioids.

  11. Dealing with the other between the ethical and the moral: albinism on the African continent. (United States)

    Imafidon, Elvis


    Albinism is a global public health issue but it assumes a peculiar nature in the African continent due, in part, to the social stigma faced by persons with albinism (PWAs) in Africa. I argue that there are two essential reasons for this precarious situation. First, in the African consciousness, albinism is an alterity or otherness. The PWA in Africa is not merely a physical other but also an ontological other in the African community of beings, which provides a hermeneutic for the stigmatising separateness or difference of the PWA. The second reason hinges on a distinction drawn by Jürgen Habermas between the ethical point of view and the moral point of view. While the former consists of the ethos, customs, or idea of the good shared by a group of persons with a shared tradition or way of life, the latter consists of what is good for all and transcends particular traditions or ways of life. Consequently, the African ethical point of view, the ethics of solidarity, justifies within the African worldview the established alterity and, by implication, stigmatization of PWAs. On this view, actions that promote harmony and prevent discord and disequilibrium among accepted beings in the African community are permissible. I further show that unless there is a change in the physical and ontological conception of PWAs and a leap from the ethical point of view to the moral point of view, the negative attitudes toward PWAs will not change. The leap to the moral point of view does not suggest an abandonment of the ethical point of view but only recommends that the two meet halfway in respect for universally accepted norms of human actions. To achieve this, I will show that much needs to be done in the areas of policy formulation, law, health care services, and education.

  12. Elderly Care Centre (United States)

    Wagiman, Aliani; Haja Bava Mohidin, Hazrina; Ismail, Alice Sabrina


    The demand for elderly centre has increased tremendously abreast with the world demographic change as the number of senior citizens rose in the 21st century. This has become one of the most crucial problems of today's era. As the world progress into modernity, more and more people are occupied with daily work causing the senior citizens to lose the care that they actually need. This paper seeks to elucidate the best possible design of an elderly care centre with new approach in order to provide the best service for them by analysing their needs and suitable activities that could elevate their quality of life. All these findings will then be incorporated into design solutions so as to enhance the living environment for the elderly especially in Malaysian context.

  13. International Data Centre (IDC)

    International Nuclear Information System (INIS)

    Johansson, P.


    The presentation outlines the International Data Centre (Indc) mission, objective and historical background. The Indc progressive commissioning and organizational plans are presented on charts. The IMS stations providing data to Indc operations and the global communication infrastructure are plotted on world maps. The various types of IMS data are thus listed as seismic, hydroacoustic, infrasound and radionuclide. Finally Indc products and services together with its main achievements are listed

  14. Wetland dynamics influence mid-continent duck recruitment (United States)

    Anteau, Michael J.; Pearse, Aaron T.; Szymankski, Michael L.


    Recruitment is a key factor influencing duck population dynamics. Understanding what regulates recruitment of ducks is a prerequisite to informed habitat and harvest management. Quantity of May ponds (MP) has been linked to recruitment and population size (Kaminski and Gluesing 1987, Raveling and Heitmeyer 1989). However, wetland productivity (quality) is driven by inter-annual hydrological fluctuations. Periodic drying of wetlands due to wet-dry climate cycles releases nutrients and increases invertebrate populations when wet conditions return (Euliss et al. 1999). Wetlands may also become wet or dry within a breeding season. Accordingly, inter-annual and intra-seasonal hydrologic variation potentially influence duck recruitment. Here, we examined influences of wetland quantity, quality, and intra-seasonal dynamics on recruitment of ducks. We indexed duck recruitment by vulnerability-corrected age ratios (juveniles/adult females) for mid-continent Gadwall (Anas strepera). We chose Gadwall because the majority of the continental population breeds in the Prairie Pothole Region (PPR), where annual estimates of MP exist since 1974. We indexed wetland quality by calculating change in MP (?MP) over the past two years (?MP = 0.6[MPt – MPt-1] + 0.4[MPt – MPt-2]). We indexed intra-seasonal change in number of ponds by dividing the PPR mean standardized precipitation index for July by MP (hereafter summer index). MP and ?MP were positively correlated (r = 0.65); therefore, we calculated residual ?MP (?MPr) with a simple linear regression using MP, creating orthogonal variables. Finally, we conducted a multiple regression to examine how MP, ?MPr, and summer index explained variation in recruitment of Gadwall from 1976–2010. Our model explained 67% of the variation in mid-continent Gadwall recruitment and all three hydrologic indices were positively correlated with recruitment (Figure 1). Type II semi-partial R2 estimates indicated that MP accounted for 41%, ?MPr

  15. Historical centres: changing definitions

    Directory of Open Access Journals (Sweden)

    Roberta Lazzarotti


    Full Text Available Since the end of the Second World War, the architectural and planning culture has been showing a fluctuating attention to the theme of historical centres and their enhancement. First of all this uneven progress explains the difficulty to reach a homogeneous definition and this is still lacking. During a long phase of this period, the historical parts of the town were considered as objects to be preserved in an integral way, as urban monuments. This is mostly due to the high symbolic value of these settlements, that represent fundamental landmarks. Identity building and empowerment of local communities are indispensable conditions for any development programme, especially in the case of centres or other historic environments at risk of abandonment. The progressive evolution of this concept brings awareness of the impossibility of separating – either in analytical or in planning terms ­ historical centres from their urban and territorial contexts, which are linked by mutual, deep relationships. This article attempts to retrace the steps signaled by the publication of international documents and conventions, from the Charter of Gubbio (1960 to the Charter of Krakow and the European Landscape Convention (2000; they obviously represent particular points of view, not exhaustive of the richness of the positions in the debate, but extremely significant in terms of diffusion and consensus.

  16. Stable Isotopes in Precipitation over Indonesia Maritime Continent

    Energy Technology Data Exchange (ETDEWEB)

    Ichiyanagi, K. [Graduate School of Science and Technology, Kumamoto University, and Japan Agency for Marine-Earth Science and Technology (JAMSTEC) (Japan); Suwarman, R. [Graduate School of Science and Technology, Kumamoto University (Japan); Yamanaka, M. D. [Japan Agency for Marine-Earth Science and Technology (JAMSTEC) (Japan)


    Daily variability of stable isotopes in precipitation was observed at 6 stations in the Indonesian Maritime Continent from 2000 to 2006. The annual mean {delta}{sup 18}O at Bukit Kototabang (GAW), Jambi, and Makassar are heavier than those for others. The precipitation amount effect was observed only at Denpasar and Makassar. There are 2 groups resulting from the local Meteoric Water line; (1) slope is nearly 7.0 and high d-excess more than 10 at GAW, Denpasar, and Manado, (2) slope is around 7.4 and low d-excess less than 7.5 per mille at Jambi, Makassar, and Palau. Seasonal variability of {delta}{sup 18}O and d-excess were classified into three patterns. There are no seasonal variations in {delta}{sup 18}O and d-excess at GAW and Jambi, but clear seasonal variations at Denpasar (DPS) and Makassar (MKS). Due to the amount effect, {delta}{sup 18}O in precipitation is high when the precipitation amount is low from May to october. In contrast, the amount effect is not significant and d-excess is constant throughout the year in Manado and Palau. The {delta}{sup 18}O in precipitation at 2 stations located in sumatra Island corresponded with the Madden-Jullian Oscillation index, while those for the other 4 stations in more easterly locations did not. This finding indicates that water vapour evaporated from the Indian Ocean can reach the Island of sumatra, but can't reach more easterly locations. (author)

  17. Smoke aerosol transport patterns over the Maritime Continent (United States)

    Xian, Peng; Reid, Jeffrey S.; Atwood, Samuel A.; Johnson, Randall S.; Hyer, Edward J.; Westphal, Douglas L.; Sessions, Walter


    Smoke transport patterns over the Maritime Continent (MC) are studied through a combination of approaches, including a) analyzing AODs obtained from satellite products; b) aerosol transport modeling with AOD assimilation along with the atmospheric flow patterns; c) analyzing smoke wet deposition distributions; and d) examining forward trajectories for smoke events defined in this study. It is shown that smoke transport pathways are closely related to the low-level atmospheric flow, i.e., during June-Sept, smoke originating from the MC islands with a dominant source over central and southern Sumatra, and southern and western Borneo, is generally transported northwestward south of the equator and northeastward north of the equator with the cross-equatorial flow, to the South China Sea (SCS), the Philippines and even further to the western Pacific. During the October-November transitional period, smoke transport paths are more zonally oriented compared to June-September. Smoke originating from Java, Bali, Timor etc, and southern New Guinea, which are in the domain of easterlies and southeasterlies during the boreal summer (June-November), is generally transported westward. It is also found that smoke transport over the MC exhibits multi-scale variability. Smoke typically lives longer and can be transported farther in El Niño years and later MJO phases compared with non El Niño years and earlier MJO phases. During El Niño periods there is much stronger westward transport to the east tropical Indian Ocean. Finally, orographic effect on smoke transport over the MC is also clearly discernable.

  18. MONTI as continent catheterized stoma using serosal-lined trough "Ghoneim Abolenin" technique in ileocystoplasty

    Directory of Open Access Journals (Sweden)

    Mohammed T Sammour


    Full Text Available It is a great challenge to select and perform continent mechanism in a stoma for urinary reservoir. A new technique by combining MONTI ileal conduit with the serosal lined trough in order to achieve continent catheterizable stoma to the umbilicus as a part of augmentation ileocystoplasty. We applied serosal-lined trough as a continent mechanism with MONTI ileal tube in 12 years smart girl underwent ileocystoplasty for neuropathic bladder due to meylomeningocele in whom continence failed to be achieved by using Mitrofanoff with submucosal tunnel of the bladder as continent mechanism before, also the previous operation included left to right transuretero-ureterostomy, ureterocystoplasty and reimplantation of the right ureter. The patient became completely continent; she was able to do self-catheterization easily through the umbilical stoma using 16-French catheter and was able to wash the mucous easily. The capacity of the augmented bladder was 300ccs. She became independent from her mother and stopped using diapers, anticholinergic and antibiotics. Combining MONTI conduit with serosal-lined extramural valve trough (The Ghoneim technique is an effective continent technique and gives wider channel for catheterization and washing out the mucous.

  19. Modified Le Bag Pouch after Radical Cystectomy: Continence, Uro dynamic Results and Morbidity

    International Nuclear Information System (INIS)

    Nassar, O.A.H.


    To revaluate ileocolonic pouch for ortho-topic neobladder reconstruction, a cohort of patients with bladder cancer was selected to undergo radical cystectomy and modified Le Bag pouch. Evaluation concentrates on continence and associated morbidity observed on close follow-up. Patients and Methods: A total of 37 patients including 16 females with T2 3 bladder cancer (19 transitional, 15 : squamous and 3 adenocarcinoma) were treated by radical cystectomy and totally detubularized ileocolic neobladder. Post operative morbidity, continence and urodynamic studies were evaluated. Mean time to have full daytime continence was tested against age, gender, postoperative complications, technique of pouch creation either stapler or hand suture and adjuvant irradiation. Results: Cystometry 12 months post surgery showed 493 ml median capacity with basal and maximum reservoir median pressures of 16 and 38 cm H 2 O respectively. Uro-flowmetry had maximum voiding volume of 370ml, voiding time 45s and maximum flow rate of 11.6ml/s. Within the first 2 months post operative 44% were continent by day, 33% by night and 67% had stress incontinence. By 12 months post surgery 89% were continent by day, 73% by night and 27% had stress incontinence. Two years post surgery 94% were continent by day and 81 % had complete day and night control of uri-ne. Urinary leakage was the most frequent early complication (10.8%). Late complications were urinary tract infection (13.5%), metabolic acidosis (13.5%) and reflux (10.8%). Pouch over distension (5.4%) was consistent with bladder neck obstruction. Patient's gender and postoperative morbidity were statistically significant factors to increase the mean time to continence; whereas, age, use of stapler and adjuvant radiotherapy had no significant effect. Conclusion: Modified Le Bag pouch is a simple technique with adequate pouch capacity that offers excellent slowly progressing continence rates with minor morbidity rate. Post operative morbidity and

  20. The thermal influence of continents on a model-generated January climate (United States)

    Spar, J.; Cohen, C.; Wu, P.


    Two climate simulations were compared. Both climate computations were initialized with the same horizontally uniform state of rest. However, one is carried out on a water planet (without continents), while the second is repeated on a planet with geographically realistic but flat (sea level) continents. The continents in this experiment have a uniform albedo of 0.14, except where snow accumulates, a uniform roughness height of 0.3 m, and zero water storage capacity. Both runs were carried out for a 'perpetual January' with solar declination fixed at January 15.

  1. The “potato road” and biogeographic history of potato cyst nematode populations from different continents

    Directory of Open Access Journals (Sweden)

    Or Violeta


    Full Text Available The general opinion about the introduction of potato in Europe is the one regarding the direction from South America to Spain and subsequent distribution to other continents. Some historical data point out an alternative road. The potato spread from its place of origin to other continents in the light of parasite-host relationship, relying on nematode molecular data, is discussed in the present work. Biogeographic history of potato cyst nematode populations from different continents is in congruence with historical records. [Projekat Ministarstva nauke Republike Srbije, br. TR 31018 i br. III 46007

  2. Climate controls on fire pattern in African and Australian continents (United States)

    Zubkova, M.; Boschetti, L.; Abatzoglou, J. T.


    Studies have primarily attributed the recent decrease in global fire activity in many savanna and grassland regions as detected by the Global Fire Emission Database (GFEDv4s) to anthropogenic changes such as deforestation and cropland expansion (Andela et al. 2017, van der Werf et al. 2008). These changes have occurred despite increases in fire weather season length (Jolly et al. 2015). Efforts to better resolve retrospective and future changes in fire activity require refining the host of influences on societal and environmental factors on fire activity. In this study, we analyzed how climate variability influences interannual fire activity in Africa and Australia, the two continents most affected by fire and responsible for over half of the global pyrogenic emissions. We expand on the analysis presented in Andela et al. (2017) by using the most recent Collection 6 MODIS MCD64 Burned Area Product and exploring the explanatory power of a broader suite of climate variables that have been previously shown to explain fire variability (Bowman et al. 2017). We examined which climate metrics show a strong interannual relationship with the amount of burned area and fire size accounting for antecedent and in-season atmospheric conditions. Fire characteristics were calculated using the 500m resolution MCD64A1 product (2002-2016); the analysis was conducted at the ecoregion scale, and further stratified by landcover using a broad aggregation (forest, shrublands and grasslands) of the Landcover CCI maps (CCI-LC, 2014); all agricultural areas fires were excluded from the analysis. The results of the analysis improve our knowledge of climate controls on fire dynamics in the most fire-prone places in the world which is critical for statistical fire and vegetation models. Being able to predict the impact of climate on fire activity has a strategic importance in designing future fire management scenarios, help to avoid degradation of biodiversity and ecosystem services and improve

  3. BRICS: challenges of cooperation on the African continent

    Directory of Open Access Journals (Sweden)

    Vladimir Ivanovich Yurtaev


    Full Text Available The happening paradigm shift of development both the kernel of world economy, and its periphery appearing by the hostage of limitation of financial resources updates task of judgment of the happening processes, especially with participation of the Brazil, Russia, India, China and South Africa (BRICS or the countries of the “big economies” which are looking for new formats of entry into worldwide policy. Also the problem of correlation of the monopolar structure of a world economic system which has arisen in the conditions of globalization of economies at the end of the 20th century with processes of forming of the new centers of world economic power is actual, including - in Africa, under the influence of an exit to the world scene of China and other countries of BRICS, disappearance of the so-called “second world”, opposition mitigation “East-West” and increase of contradictions on an axis “North-South”. The countries of Africa at the beginning of the second decade of the third millennium are more and more considerably involved in process of globalization which signs can be found everywhere on the African continent. First of all, it is necessary to pay attention on much the increased dynamics of political process, especially in North Africa where under the influence of “the Arab spring” scales and depth of the happened transformation of a socio-political context were shown, civilization breaks and perspective scenarios of development were more accurately designated. To conformably new challenges questions of regional integration have come under the spotlight in Africa, search of solutions of global problems of mankind in Africa is conducted (poverty, hunger, diseases, refugees, etc. new formats of interaction of the states for the benefit of effective development are developed. It is possible that in so dynamic and turbulent socio-political and economic situation regional vector of interaction and interregional international

  4. A Surface Wave's View of the Mid-Continent Rift (United States)

    Foster, A. E.; Darbyshire, F. A.; Schaeffer, A. J.


    The presence of the Mid-Continent Rift (MCR), a 1.1Ga failed rift in central North America, raises many questions. We address the following: what lasting effects has it had on the continental lithosphere? Though many studies have looked at the area with a variety of data types, the combination of USArray Transportable Array stations to the south, permanent and temporary Canadian stations to the north, and SPREE stations in strategic locations crossing the rift provide a new opportunity for a regional surface-wave study. We select 80 stations with roughly 200 km spacing, resulting in dense path coverage of a broad area centered on the MCR. We use teleseismic data for all earthquakes from January 2005-August 2016 with a magnitude greater than 6.0, amounting to over 1200 events, and we make Rayleigh wave two-station dispersion measurements for all station pairs with suitable event-station geometry. We invert these measurements for anisotropic phase-velocity maps at periods of 20-200 s, yielding information not only on the wave speed but also the current fabric of the lithosphere, a complicated record of strain from formation, through modification from orogeny, attempted rifting, and hotspot interaction, to present day plate motion. We observe a clear signature of the MCR at short (20-25 s) periods, with the slowest phase-velocity anomaly in the region aligning with the strongest gravity anomaly. At increasing periods, and thus greater depths, this slowest anomaly shifts to beneath the center of Lake Superior (30-40 s). Eventually, it appears to merge with a slow anomaly to the north associated with the Nipigon Embayment, and contrasts sharply with an adjacent fast anomaly in the western Superior Province. In our preliminary anisotropy results, we observe weak anisotropy at the latitude of the MCR and to the south, whereas to the north of the MCR we find strong anisotropy. This is similar to the spatial variations in magnitude of delay times from shear-wave splitting

  5. 77 FR 35959 - Atlas Pipeline Mid-Continent WestTex, LLC; Pioneer Natural Resources USA, Inc.; Notice of... (United States)


    ... Mid-Continent WestTex, LLC; Pioneer Natural Resources USA, Inc.; Notice of Application Take notice that on May 30, 2012, Atlas Pipeline Mid-Continent WestTex, LLC (Atlas) and Pioneer Natural Resources... President and General Counsel, Atlas Pipeline Mid-Continent, LLC, 110 W. 7th Street, Suite 2300, Tulsa, OK...

  6. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen


    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...

  7. Town Centre Redevelopment Strategies

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    After many years of urban growth Danish downtowns are facing some important choices. Shall the stake one-sidedly be on the town centres as driving forces for growth and 'city marketing', or do they still have a role to play in a broader socio-economic context? In the paper we look back on eight...... as slum clearence and urban renewal. To a certain extent parallels are drawn to international experiences, especially where these are of such a nature that they can be assumed transferred to Danish connctions. Conclusively, the strategies are discussed in the light of the turn of Danish urban planning...

  8. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres. (United States)

    Breck, Andrew; Dixon, L Beth; Kettel Khan, Laura


    The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Child-care centres were located in low-income neighbourhoods in NYC. Overall, 87 % of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by >60 %. Sweets and water had lower match percentages (40 and 32 %, respectively), but water was served 68 % of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day.

  9. Long-term functional outcomes after radical cystectomy with ileal bladder substitute: does the definition of continence matter? (United States)

    Liedberg, Fredrik; Ahlgren, Göran; Baseckas, Gediminas; Gudjonsson, Sigurdur; Håkansson, Ulf; Lindquist, Sara; Löfgren, Annica; Patschan, Oliver; Siller, Carina; Sjödahl, Gottfrid


    Functional outcomes after ileal bladder substitution reflect the expectations of future patients at a particular centre. The aim of this study was to use validated questionnaires and a pad-weighing test to investigate functional outcomes after neobladder reconstruction at long-term follow-up in patients at a single centre. During 2005 - 2015, 75 patients received a Studer ileal bladder substitute at the Department of Urology, Malmö. Forty-six of these patients were alive for follow-up and were evaluated using the pad-weighing test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Five of 37 evaluable patients (14%) were considered fully continent, reporting a pad-weighing test result of 0 g and an ICIQ-UI-SF score of 0. The median ICIQ-UI-SF score was 8 [interquartile range (IQR) 3-11], and seven patients (17%) were continent according to the ICIQ-UI-SF score only. In the pad-weighing test, 28 out of 37 patients (76%) reported 0 g day-time leakage whereas only 12 out of 37 patients (32%) reported 0 g night-time leakage. At follow-up, nine out of 39 (23%) of evaluable male patients were potent. The median ICIQ-UI-SF score was significantly lower during the second half of the study period [4 (IQR 0-8) vs 10 (IQR 6-14); p = .003]. The inverse applied to the median IIEF score [5 (IQR 3-12) vs 2 (IQR 1-4); p = .02]. Functional outcomes at long-term follow-up after radical cystectomy and Studer ileal bladder substitute were at best modest in this series. Better outcomes during the second half of the study period might be explained by improved patient selection and a refined surgical technique, but possibly also by longer follow-up of patients during the first half of the period resulting in a more pronounced time-dependent decline in functional outcomes.

  10. The dual influences of age and obstetric history on fecal continence in parous women.

    LENUS (Irish Health Repository)

    Eogan, Maeve


    To assess whether women who underwent forceps delivery were more likely than those who delivered either normally (spontaneous vaginal delivery [SVD]) or by cesarean to experience deterioration in fecal continence as they aged.

  11. Bibliography of sandy beaches and sandy beach organisms on the African continent

    CSIR Research Space (South Africa)

    Bally, R


    Full Text Available This bibliography covers the literature relating to sandy beaches on the African continent and outlying islands. The bibliography lists biological, chemical, geographical and geological references and covers shallow marine sediments, surf zones off...

  12. The Aristotelian continence: channeling of righteous actions in the scientist´s experiments with animals

    Directory of Open Access Journals (Sweden)

    Luis Fernando Garcés Giraldo


    Full Text Available In Aristotelian ethics, the virtue of continence is responsible for mastering the soul and direct it towards the right reason; thus the continent, knowing that passions are bad does not follow them because of the reason; this virtuous is the one who subdues the passions, since both, reason and passions, oppose each other. For Aristotle the desire is the beginning of the action, followed by the discussion leading to choose the best and the most perfect virtuous action. It is important for bioethics that the virtue of continence applies to the actions of scientists who use animals for experimentation and that all their actions are mediated by the good actions. This article will deal with the virtue of continence as the channeling of actions mediated by right reason in the scientist who is experimenting with animals.

  13. Mochovce waste treatment centre

    International Nuclear Information System (INIS)

    Sedliak, D.; Endrody, J.


    The first unit of the Mochovce NPP (WWER 440 MW) was put in a test operation in October 1998. The second unit with the same power output was put in the test operation in March 2000. The Nuclear Regulatory Authority of the Slovak Republic in its Decision No. 318/98 of 28 October 1998, by which an agreement with the operation of the Unit 1 of the Mochovce. Nuclear Power Plant was issued, requires to start the construction of the Liquid Radioactive Waste Treatment Centre until January 2004. The subject of this presentation is a system description of the Liquid Radioactive Waste (LRW) management in the Mochovce NPP. The initial part is dedicated to a short description of the radioactive waste management legislation requirements. Then the presentation continues with an information about the LRW production in the Mochovce NPP, LRW sources, chemical and radiochemical attributes, description of storage. The presentation also provides real values of its production in a comparison with the design data. The LRW production minimization principles are also mentioned there. Another part deals with the basic requirements for the technology proposal of the liquid RW treatment, especially concerning the acceptance criteria at the Republic RW Repository Mochovce. The final part is devoted to a short description of the investment procedure principles - design preparation levels and a proposed construction schedule of the centre. (authors)

  14. Impact of metabolic syndrome on early recovery of continence after robot-assisted radical prostatectomy. (United States)

    Nishikawa, Masatomo; Watanabe, Hiromitsu; Kurahashi, Toshifumi


    To evaluate the impact of metabolic syndrome on the early recovery of urinary continence after robot-assisted radical prostatectomy. The present study included a total of 302 consecutive Japanese patients with clinically localized prostate cancer who underwent robot-assisted radical prostatectomy. In this study, postoperative urinary continence was defined as no leak or the use of a security pad. The continence status was assessed by interviews before and 1 and 3 months after robot-assisted radical prostatectomy. Metabolic syndrome was defined as follows: body mass index ≥25 kg/m 2 and two or more of the following: hypertension, diabetes mellitus and dyslipidemia. The effect of the presence of metabolic syndrome on the continence status of these patients was retrospectively examined. A total of 116 (38.4%) and 203 (67.2%) of the 302 patients were continent at 1 and 3 months after robot-assisted radical prostatectomy, respectively. A total of 31 (10.3%) patients were judged to have metabolic syndrome. Despite the operative time being longer in patients with metabolic syndrome, no significant differences were observed in the remaining preoperative, intraoperative or postoperative variables between patients with or without metabolic syndrome. On multivariate logistic regression analysis, metabolic syndrome and the duration of hospitalization were significantly correlated with the 1-month continence status. Similarly, metabolic syndrome and estimated blood loss during surgery were independent predictors of continence rates at 3 months after robot-assisted radical prostatectomy. These findings suggest that the presence of metabolic syndrome could have a significant impact on the early recovery of urinary continence after robot-assisted radical prostatectomy. © 2017 The Japanese Urological Association.

  15. Effect of Nerve-Sparing Radical Prostatectomy on Urinary Continence in Patients With Preoperative Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Yong Hyun Park


    Full Text Available Purpose: We aimed to assess whether nerve-sparing radical prostatectomy (nsRP is associated with improved recovery of urinary continence compared to non–nerve-sparing radical prostatectomy (nnsRP in patients with localized prostate cancer and preoperative erectile dysfunction. Methods: A total of 360 patients with organ-confined prostate cancer and an International Index of Erectile Function score of less than 17 were treated with nsRP or nnsRP in Seoul St. Mary’s Hospital. Patients who received neoadjuvant or adjuvant androgen deprivation therapy or had a history of prostate-related surgery were excluded. Recovery of urinary continence was assessed at 0, 1, 3, 6, and 12 months. Postoperative recovery of continence was defined as zero pad usage. The association between nerve-sparing status and urinary continence was assessed by using univariate and multivariate Cox regression analyses after controlling for known predictive factors. Results: Urinary continence recovered in 279 patients (77.5% within the mean follow-up period of 22.5 months (range, 6–123 months. Recovery of urinary continence was reported in 74.6% and 86.4% of patients after nnsRP and nsRP, respectively, at 12 months (P=0.022. All groups had comparable perioperative criteria and had no significant preoperative morbidities. Age, American Society of Anesthesiologists score, and nerve-sparing status were significantly associated with recovery of urinary continence on univariate analysis. On multivariate analysis, age (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.002–1.478; P=0.026 and nerve-sparing status (HR, 0.713; 95% CI, 0.548–0.929; P=0.012 were independently associated with recovery of urinary continence. Conclusions: nsRP, as compared to nnsRP, improves recovery rates of urinary incontinence and decreases surgical morbidity without compromising pathologic outcomes.

  16. Free-volume distributions of polymers by positron annihilation spectroscopy: further experiences in using CONTIN for continuous lifetime distributions

    International Nuclear Information System (INIS)

    Dai, G.H.; Jean, Y.C.


    Thorough examinations of the CONTIN program were carried out by using the simulated positron lifetime spectra, to reveal the capability of CONTIN in the reconstruction of the positron lifetime distributions. It is shown that: 1. very high statistics is strongly desired by CONTIN to reproduce reliable lifetime distributions; 2. improving the time resolution of the measurement system, to the level of 0.030 ns full width at half maximum, does not significantly improve the resolving power of CONTIN; and 3. reducing the time width per channel is a practical way of improving the reconstruction of the lifetime probability density functions by CONTIN. (orig.)

  17. Learning Resource Centre in a Company

    Directory of Open Access Journals (Sweden)

    Aleksander Pokovec


    Full Text Available In the conditions of growing competition people are becoming the essential competitive advantage. Because of too much work, stress, too many responsibilities and other factors, employees are often unmotivated. Everyday self-study is the best way that leads to excellence. In order to enable self-study for all employees, the organisation should organise their own learning resource centre that includes: educational videoprogrammes, audio tapes, books and e-learning programmes. All educational programmes should cover business and personal topics.

  18. Reducing cooling energy consumption in data centres and critical facilities (United States)

    Cross, Gareth

    Given the rise of our everyday reliance on computers in all walks of life, from checking the train times to paying our credit card bills online, the need for computational power is ever increasing. Other than the ever-increasing performance of home Personal Computers (PC's) this reliance has given rise to a new phenomenon in the last 10 years ago. The data centre. Data centres contain vast arrays of IT cabinets loaded with servers that perform millions of computational equations every second. It is these data centres that allow us to continue with our reliance on the internet and the PC. As more and more data centres become necessary due to the increase in computing processing power required for the everyday activities we all take for granted so the energy consumed by these data centres rises. Not only are more and more data centres being constructed daily, but operators are also looking at ways to squeeze more processing from their existing data centres. This in turn leads to greater heat outputs and therefore requires more cooling. Cooling data centres requires a sizeable energy input, indeed to many megawatts per data centre site. Given the large amounts of money dependant on the successful operation of data centres, in particular for data centres operated by financial institutions, the onus is predominantly on ensuring the data centres operate with no technical glitches rather than in an energy conscious fashion. This report aims to investigate the ways and means of reducing energy consumption within data centres without compromising the technology the data centres are designed to house. As well as discussing the individual merits of the technologies and their implementation technical calculations will be undertaken where necessary to determine the levels of energy saving, if any, from each proposal. To enable comparison between each proposal any design calculations within this report will be undertaken against a notional data facility. This data facility will

  19. Call Centre- Computer Telephone Integration

    Directory of Open Access Journals (Sweden)

    Dražen Kovačević


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

  20. A unified model of avian species richness on islands and continents. (United States)

    Kalmar, Attila; Currie, David J


    How many species in a given taxon should be found in a delimited area in a specified place in the world? Some recent literature suggests that the answer to this question depends strongly on the geographical, evolutionary, and ecological context. For example, current theory suggests that species accumulate as a function of area differently on continents and islands. Species richness-climate relationships have been examined separately on continents and on islands. This study tests the hypotheses that (1) the functional relationship between richness and climate is the same on continents and islands; (2) the species-area slope depends on distance-based isolation; (3) species-area relationships differ among land bridge islands, oceanic islands, and continents; (4) richness differs among biogeographic regions independently of climate and isolation. We related bird species numbers in a worldwide sample of 240 continental parcels and 346 islands to several environmental variables. We found that breeding bird richness varies similarly on islands and on continents as a function of mean annual temperature, an area x precipitation interaction, and the distance separating insular samples from the nearest continent (R2 = 0.86). Most studies to date have postulated that the slope of the species-area relationship depends upon isolation. In contrast, we found no such interaction. A richness-environment relationship derived using Old World sites accurately predicts patterns of richness in the New World and vice versa (R2 = 0.85). Our results suggest that most of the global variation in richness is not strongly context-specific; rather, it reflects a small number of general environmental constraints operating on both continents and islands.

  1. Representations of OxyContin in North American newspapers and medical journals (United States)

    Whelan, Emma; Asbridge, Mark; Haydt, Susan


    BACKGROUND: There are public concerns regarding OxyContin (Purdue Pharma, Canada) and charges within the pain medicine community that media coverage of the drug has been biased. OBJECTIVE: To analyze and compare representations of OxyContin in medical journals and North American newspapers in an attempt to shed light on how each contributes to the ‘social problem’ associated with OxyContin. METHODS: Using searches of newspaper and medical literature databases, two samples were drawn: 924 stories published between 1995 and 2005 in 27 North American newspapers, and 197 articles published between 1995 and 2007 in 33 medical journals in the fields of addiction/substance abuse, pain/anesthesiology and general/internal medicine. The foci, themes, perspectives represented and evaluations of OxyContin presented in these texts were analyzed statistically. RESULTS: Newspaper coverage of OxyContin emphasized negative evaluations of the drug, focusing on abuse, addiction, crime and death rather than the use of OxyContin for the legitimate treatment of pain. Newspaper stories most often conveyed the perspectives of law enforcement and courts, and much less often represented the perspectives of physicians. However, analysis of physician perspectives represented in newspaper stories and in medical journals revealed a high degree of inconsistency, especially across the fields of pain medicine and addiction medicine. CONCLUSION: The prevalence of negative representations of OxyContin is often blamed on biased media coverage and an ignorant public. However, the proliferation of inconsistent messages regarding the drug from physicians plays a role in the drug’s persistent status as a social problem. PMID:22059195


    Directory of Open Access Journals (Sweden)

    Janez Zidar


    Full Text Available Main functions of a neuromuscular (NM centre are making diagnosis, treatment and counselling. Some other functions, e. g. forming a register and epidemiological endeavours, could be added. All these activities are expected to be achieved by multidisciplinary approach with the idea that members use the same guidelines and share the same knowledge.NM diseases affect lower levels of the nervous system that is motor units (motor cells in the brainstem and spinal cord, nerve roots, cranial and peripheral nerves, neuromuscular junction, and muscles. There are many such diseases; a few are more common others are rare.Rational approach in making a diagnosis can be divided into several steps. The process begins with a person with clinical symptoms and signs which raise the suspicion of NM disease. The first step is the description of the predominant pattern of muscular wasting and weakness (e. g. limb-girdle, distal, ocular, facio-scapulo-humeral. Each of these syndromes require a differential diagnosis within the motor unit territory what is achieved by means of EMG and muscle biopsy. The latter is even more important to define the nature of the abnormality. Disease nature can also be determined biochemically and, as NM disorders are commonly genetically determined, at the molecular genetic level. Treatment modalities include drugs (causative and symptomatic and other measures such as promoting and maintaining good general health, preventing skeletal deformities, physiotherapy, orthoses, surgery, and prevention of respiratory and cardiac functions. Counselling is mainly by social workers that focus on the practical aspects of coping with illness and disability and by genetic counsellors who gave advise on family planning.

  3. Does Europe have a centre? Reflections on the history of Western and Central Europe (United States)

    Mout, Nicolette


    Any definition of Central Europe based on geographical and/or historical facts causes difficulties. The line dividing Europe during the Cold War has a very limited use because it does not take into account Central Europe as a special part of the continent. Historians such as Geoffrey Barraclough, Hugh Seton-Watson and Oskar Halecki discussed the idea of a separate identity of Central Europe during the Cold War. Especially after the fall of the Berlin Wall, this discussion was re-opened. From a historian's point of view, the most important contributions came from Piotr Wandycz and Jeno Szucs. An imaginary centre of Europe can only be found in the continent's common history.

  4. ALICE opens its new nerve centre

    CERN Multimedia

    Antonella Del Rosso


    Twenty-nine fully equipped and ergonomic workstations, one meeting area and 11 large format screens in a completely refurbished room: the ALICE Run Control Centre (ARC) implements the best and newest solutions for its shift workers and expert operators, including access for persons with reduced mobility and very soon a magic window for Point 2 visitors.   The ALICE Run Control Centre. “Our initial intention was just to optimise the old layout,” says Federico Ronchetti from Laboratori Nazionali di Frascati (Italy), a CERN scientific associate currently appointed as ALICE Run Coordinator and person in charge of the ALICE Consolidation Task Force. “However, during the review process, we carried out a study of all the existing control rooms at CERN and became aware we needed a radical change. Hence we started planning a complete redesign of the workspace.” Designed and equipped over many years, the old ALICE control room did not have enough space to fit al...

  5. Council celebrates CERN Control Centre

    CERN Multimedia


    With the unveiling of its new sign, the CERN Control Centre was officially inaugurated on Thursday 16 March. To celebrate its startup, CERN Council members visited the sleek centre, a futuristic-looking room filled with a multitude of monitoring screens.

  6. The Aube centre. 1997 statement

    International Nuclear Information System (INIS)


    Since January 1992 the Aube centre ensures the storage of 90% of the short life radioactive wastes produced in France. This educational booklet describes the organization of the activities in the centre from the storage of wastes to the radioactivity surveillance of the environment (air, surface and ground waters, river sediments, plants and milk). (J.S.)

  7. CANDU 9 Control Centre Mockup

    International Nuclear Information System (INIS)

    Webster, A.; Macbeth, M.J.


    This paper provides a summary of the design process being followed, the benefits of applying a systematic design using human factors engineering, presents an overview of the CANDU 9 control centre mockup facility, illustrates the control centre mockup with photographs of the 3D CADD model and the full scale mockup, and provides an update on the current status of the project. (author)

  8. Report on workshop"Structure and evolution of Eurasia (super- continent"

    Directory of Open Access Journals (Sweden)

    Masaki Kanao


    Full Text Available A workshop on Structure and evolution of Eurasia (super- continent" was held on 23rd February 2004, at the National Institute of Polar Research with 29 participants. This provided an opportunity to review the history of amalgamation and breakup of past super-continents in the Earth's evolution, and speculate on the possibility of future super-continent formation. The largest continent on the present Earth, Eurasia, has been formed from an assembly of several sub-continental blocks including Asia, India and Europe, etc: it is also considered to be the nucleus of a future super-continent expected to form 250 m.y. after the present. In this workshop, several interesting topics were presented regarding the formation process, structure and dynamics of Eurasia, in particular in the deep crust and upper mantle. The first half of the workshop covered structural geology, shallow and deep seismic structure, and a simulation model of the Himalaya-Tibet region, known as a typical ongoing continent-continent collision zone. Inner crustal deformation of Eurasia was demonstrated by a newly developed Discrete Element method. In the latter half of the workshop, the possibility of formation of a future super-continent in the Western Pacific Triangular Zone was introduced with geological interpretation associated with an origin of the hot super-plumes. Seismic tomographic studies, particularly in China, which have revealed interesting features such as low velocity anomalies beneath the volcanic area, together with the presence of subducting Indian plates beneath the Tibet region were introduced. In the northwest Pacific region, remnant subducted slabs of the Kula plate have been found by local seismic tomography. Finally, a review of continental dynamics from gravity studies, and broadband seismic observations in the Baikal rift zones, were presented associated with the tectonics and evolution of central Eurasia. The formation mechanism of a hot super-plume in the

  9. The OxyContin crisis: problematisation and responsibilisation strategies in addiction, pain, and general medicine journals. (United States)

    Whelan, Emma; Asbridge, Mark


    OxyContin(®) (Purdue Pharma, L.P., Stamford, CT) is now widely regarded as a drug of abuse fueling a larger opioid health crisis. While coverage in the North American press about OxyContin overwhelmingly focused upon the problems of related crime and addiction/misuse and the perspectives of law enforcement officials and police, coverage in those fields of medicine most intimately concerned with OxyContin-pain medicine and addiction medicine-was more nuanced. In this article, we draw upon the constructivist social problems tradition and Hunt's theory of moral regulation in a qualitative analysis of 24 medical journal articles. We compare and contrast pain medicine and addiction medicine representations of the OxyContin problem, the agents responsible for it, and proposed solutions. While there are some significant differences, particularly concerning the nature of the problem and the agents responsible for it, both pain medicine and addiction medicine authors 'take responsibility' in ways that attempt to mitigate the potential appropriation of the issue by law enforcement and regulatory agencies. The responses of pain medicine and addiction medicine journal articles represent strategic moves to recapture lost credibility, to retain client populations and tools necessary to their jobs, and to claim a seat at the table in responding to the OxyContin crisis. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. The AP diameter of the pelvis: a new criterion for continence in the exstrophy complex?

    International Nuclear Information System (INIS)

    Ait-Ameur, A.; Kalifa, G.; Adamsbaum, C.; Wakim, A.; Dubousset, J.


    Reconstructive surgery of bladder exstrophy remains a challenge. By using CT of the pelvis, we suggest a new pre- and post-operative investigative procedure to define the AP diameter (APD) as a predictive criterion for continence in this anomaly. Patients and methods: Three axial CT slices were selected in nine children with exstrophy who had undergone neonatal reconstructive surgery. The three levels selected were the first sacral plate, the mid acetabular plane and the superior pubic spine. We used combined slices to measure: circle APD = distance between the first sacral vertebra and the pubic symphysis. circle Pubic diastasis (PD) circle Three angles defined on the transverse plane of the first sacral vertebra - iliac wing angle, sacropubic angle and acetabular version. In exstrophy, the angles demonstrate opening of the iliac wings and the pubic ramus, and acetabular retroversion compared to controls. Comparisons between controls, continent and incontinent patients reveal that in continent patients, APD increases with growth and seems to be a predictive criterion for continence, independent of diastasis of the pubic symphysis. We believe that CT of the pelvis with measurements of the APD should be performed in all neonates with bladder exstrophy before reconstructive surgery and for better understanding of the malformation. The APD seems to be predictive and may be a major criterion for continence, independent of PD. (orig.)

  11. Quality audit--a review of the literature concerning delivery of continence care. (United States)

    Swaffield, J


    This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

  12. RTEMS CENTRE- RTEMS Improvement (United States)

    Silva, Helder; Constantino, Alexandre; Freitas, Daniel; Coutinho, Manuel; Faustino, Sergio; Sousa, Jose; Dias, Luis; Zulianello, Marco


    During the last two years, EDISOFT's RTEMS CENTRE team [1], jointly with the European Space Agency and with the support of the worldwide RTEMS community [2], have been developing an activity to facilitate the qualification of the real-time operating system RTEMS (Real-Time Operating System for Multiprocessor Systems). This paper intends to give a high level visibility of the progress and the results obtained in the RTEMS Improvement [3] activity. The primary objective [4] of the project is to improve the RTEMS product, its documentation and to facilitate the qualification of RTEMS for future space missions, taking into consideration the specific operational requirements. The sections below provide a brief overview of the RTEMS operating system and the activities performed in the RTEMS Improvement project, which includes the selection of API managers to be qualified, the tailoring process, the requirements analysis, the reverse engineering and design of the RTEMS, the quality assurance process, the ISVV activities, the test campaign, the results obtained, the criticality analysis and the facilitation of qualification process.

  13. Thailand's nuclear research centre

    International Nuclear Information System (INIS)

    Yamkate, P.


    The Office of Atomic Energy for Peace, Thailand, is charged with three main tasks, namely, Nuclear Energy development Plan, Utilization of Nuclear Based technology Plan and Science and Technology Plan. Its activities are centred around the research reactor TRR-1/M1. The main areas of contribution include improvement in agricultural production, nuclear medicine and nuclear oncology, health care and nutrition, increasing industrial productivity and efficiency and, development of cadre competent in nuclear science and technology. The office also has the responsibility of ensuring nuclear safety, radiation safety and nuclear waste management. The office has started a new project in 1997 under which a 10 MWt research reactor, an isotope production facility and a waste processing and storage facility would be set up by General Atomic of USA. OAEP has a strong linkage with the IAEA and has been an active participant in RCA programmes. In the future OAEP will enhance its present capabilities in the use of radioisotopes and radiation and look into the possibility of using nuclear energy as an alternative energy resource. (author)

  14. Cecal rupture after continent ileocecal urinary diversion during total pelvic exenteration

    International Nuclear Information System (INIS)

    Brand, E.


    Continent ureteral diversion at the time of pelvic exenteration avoids an external appliance and allows patients to retain bladder reservoir function. The technical difficulty of this procedure requires meticulous attention to operative and perioperative care, particularly after pelvic irradiation. A patient with recurrent stage IIIB carcinoma of the cervix underwent total pelvic exenteration with reconstructive procedures including low rectal anastomosis, neovagina formation, and ileocecal (Indiana) continent diversion. Early catheterization of the reservoir began 2 weeks postoperatively. One week later cecal rupture occurred, not related to suture line (technical) failure. Because of the high wall tension and reduced compliance in the irradiated cecum, the authors do not recommend catheterization of the urinary reservoir before 4-6 weeks. In order for continent diversion to become the standard diversion in exenteration patients, the major complication rate must remain comparable to that of noncontinent diversion

  15. Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Thomsen, Frederik Birkebæk; Hvarness, Helle


    OBJECTIVE: The aim of this study was to describe recovery of urinary continence and potency and report oncological and functional outcomes using the survival, continence and potency (SCP) system for patients undergoing robot-assisted radical prostatectomy (RARP). MATERIAL AND METHODS: From 2009...... with preoperative ESI, 77.6% (67.9-86.1) and 34.4% (24.1-47.5) maintained ESI 12 months postoperatively after bilateral and unilateral nerve-sparing surgery (NS), respectively. NS (p .... Using the SCP system and defining potency as ESI, functional and oncological success 12 months after surgery was achieved in 69 out of 135 (51.1%) preoperative continent and potent patients who underwent unilateral or bilateral NS, and did not require adjuvant treatment; when defining potency as IIEF...

  16. Presentación: La Historia continúa

    Directory of Open Access Journals (Sweden)

    Julio Perez Serrano


    Full Text Available Por fortuna para quienes humildemente cultivamos este conocimiento, la Historia continúa. Las utopías finalistas que hace sólo una década inundaron el mercado de la letra impresa han sido borradas de un plumazo por la tozudez de los hechos. Aunque parezca increíble, en muchos aspectos nuestro futuro es hoy más incierto de lo que lo era hace veinte, treinta o cincuenta años. En lógica correspondencia con ello, el presente ha recobrado un impetuoso protagonismo. Siempre cambiante, punta de flecha del tiempo, el presente no puede dejar de ser visto en nuestros días sino como una angosta ventana hacia el futuro. Por esta ventana se han asomado ya desde antiguo, en tiempos de crisis, literatos y filósofos, y más recientemente lo han hecho periodistas, sociólogos, demógrafos, politólogos, economistas, físicos, bioquímicos, ecólogos y muchos otros científicos. También el ciudadano de la calle vive y entiende su presente como producto del pasado e indicio de lo que habrá de depararle el porvenir. No es más que el reflejo de hasta qué punto carece de sentido fijar fronteras impenetrables en el ámbito temporal.Son todavía pocos, sin embargo, los historiadores que han osado acercarse al presente con esta perspectiva. Algunos más lo han hecho buscando el anclaje con el pasado más próximo, quizá como forma de asegurar una continuidad con lo que hasta hace poco, y aun actualmente, se ha considerado propio de este oficio: el estudio del pasado. La Historia del Tiempo Presente ha ido tomando cuerpo así como un campo específico de la Historia centrado en el análisis del pretérito inmediato, un tiempo que subsiste en la memoria de las generaciones vivas y que, por influencia de éstas, es considerado propio (presente por el conjunto de la sociedad[1]. Ciertamente en este terreno los avances teóricos no son desdeñables, y superan con creces a las realizaciones prácticas, aunque quizá éste no sea el principal obstáculo que se

  17. Co-designing person-centred mental health care

    DEFF Research Database (Denmark)


    Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions.......Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions....

  18. Fear and overprotection in Australian residential aged-care facilities: The inadvertent impact of regulation on quality continence care. (United States)

    Ostaszkiewicz, Joan; O'Connell, Beverly; Dunning, Trisha


    Most residents in residential aged-care facilities are incontinent. This study explored how continence care was provided in residential aged-care facilities, and describes a subset of data about staffs' beliefs and experiences of the quality framework and the funding model on residents' continence care. Using grounded theory methodology, 18 residential aged-care staff members were interviewed and 88 hours of field observations conducted in two facilities. Data were analysed using a combination of inductive and deductive analytic procedures. Staffs' beliefs and experiences about the requirements of the quality framework and the funding model fostered a climate of fear and risk adversity that had multiple unintended effects on residents' continence care, incentivising dependence on continence management, and equating effective continence care with effective pad use. There is a need to rethink the quality of continence care and its measurement in Australian residential aged-care facilities. © 2015 AJA Inc.

  19. Posterior and anterior fixation of the urethra during robotic prostatectomy improves early continence rates. (United States)

    Koliakos, Nikolaos; Mottrie, Alexandre; Buffi, Nicolo; De Naeyer, Geert; Willemsen, Pieter; Fonteyne, Etienne


    To investigate whether posterior and anterior fixation of the vesicourethral anastomosis during robotic radical prostatectomy (RRP) helps to establish continence earlier. Forty-seven consecutive patients undergoing RRP were randomized into two groups. The first group received a typical Van Velthoven vesicourethral anastomosis and the second group a modified anastomosis with posterior and anterior fixation. In this group the posterior fibrous tissues of the sphincter were sutured to the residual Denonvilliers' fascia. The anastomosis with two running sutures started at the 6 o'clock position on the bladder neck and continued upwards. Two-step stitching was done on the upper half of the anastomosis to ensure good stabilization of the bladder: a small portion of urethral stump followed by a deep haemostatic stitch on the plexus. Continence, as measured by patient self-reporting of the number of pads used per 24 h, was assessed 7 weeks after catheter removal, by telephone interview. The use of no pads or one pad was defined as "continent", two pads as "moderate incontinence" and more than two pads as "severe incontinence". At catheter removal, more patients in the fixation group were continent than in the Van Velthoven group [9/23 (39%) vs 3/24 (12.5%), p = 0.036]. At 7 weeks, continence was even better in the fixation group [15/23 (65%) vs 8/24 (33%), p = 0. 029]. The mean pad usage was less in the fixation group (1.43 vs 2.25, p = 0.032). The posterior and anterior fixation of the vesicourethral anastomosis during RRP results in an intact sphincteric mechanism, because no stretch is applied to the urethra, resulting in earlier continence.

  20. Preoperative predictive model of recovery of urinary continence after radical prostatectomy (United States)

    Matsushita, Kazuhito; Kent, Matthew T.; Vickers, Andrew J.; von Bodman, Christian; Bernstein, Melanie; Touijer, Karim A.; Coleman, Jonathan; Laudone, Vincent; Scardino, Peter T.; Eastham, James A.; Akin, Oguz; Sandhu, Jaspreet S.


    Objective ● To build a predictive model of urinary continence recovery following radical prostatectomy that incorporates magnetic resonance imaging parameters and clinical data. Patients and Methods ● We conducted a retrospective review of data from 2,849 patients who underwent pelvic staging magnetic resonance imaging prior to radical prostatectomy from November 2001 to June 2010. ● We used logistic regression to evaluate the association between each MRI variable and continence at 6 or 12 months, adjusting for age, body mass index (BMI), and American Society of Anesthesiologists (ASA) score and then used multivariable logistic regression to create our model. ● A nomogram was constructed using the multivariable logistic regression models. Results ● In total, 68% (n=1,742/2,559) and 82% (n=2,205/2,689) regained function at 6 and 12 months, respectively. ● In the base model, age, BMI, and ASA score were significant predictors of continence at 6 or 12 months on univariate analysis (p <0.005). ● Among the preoperative magnetic resonance imaging measurements, membranous urethral length, which showed great significance, was incorporated into the base model to create the full model. ● For continence recovery at 6 months, the addition of membranous urethral length increased the AUC to 0.664 for the validation set, an increase of 0.064 over the base model. For continence recovery at 12 months, the AUC was 0.674, an increase of 0.085 over the base model. Conclusions ● Using our model, the likelihood of continence recovery increases with membranous urethral length and decreases with age, body mass index, and ASA score. ● This model could be used for patient counseling and for the identification of patients at high risk for urinary incontinence in whom to study changes in operative technique that improve urinary function after radical prostatectomy. PMID:25682782

  1. Empowerment, patient centred care and self-management. (United States)

    Pulvirenti, Mariastella; McMillan, John; Lawn, Sharon


    Patient or person centred care is widely accepted as the philosophy and practice that underpins quality care. An examination of the Australian National Chronic Disease Strategy and literature in the field highlights assumptions about the self-manager as patient and a focus on clinical settings. This paper considers patient or person centred care in the light of empowerment as it is understood in the health promotion charters first established in Alma Ata in 1977. We argue that patient or person centred care can be reconfigured within a social justice and rights framework and that doing so supports the creation of conditions for well-being in the broader context, one that impacts strongly on individuals. These arguments have broader implications for the practice of patient centred care as it occurs between patient and health professional and for creating shared responsibility for management of the self. It also has implications for those who manage their health outside of the health sector. © 2011 John Wiley & Sons Ltd.

  2. The research of modern He discharge in volcanic and tectonically active areas of China's continent

    International Nuclear Information System (INIS)

    Shangguan, Z.G.


    The realising features of modern helium in volcanic and tectonically active areas of China's continent are here discussed, presenting that the current escaped He in volcanic areas are mainly the mantle-derived He. The 3 He/ 4 He ratios of crustal gases in Eastern China are relatively higher than those gases in Middle-Western China. The author considers difficult to interpret this phenomenon by means of the differences of tectonic activity in those areas: it may be related to the variation of crustal thickness of China's continent from East to West

  3. CONTIN XPCS: Software for Inverse Transform Analysis of X-Ray Photon Correlation Spectroscopy Dynamics. (United States)

    Andrews, Ross N; Narayanan, Suresh; Zhang, Fan; Kuzmenko, Ivan; Ilavsky, Jan


    X-ray photon correlation spectroscopy (XPCS) and dynamic light scattering (DLS) both reveal dynamics using coherent scattering, but X-rays permit investigating of dynamics in a much more diverse array of materials. Heterogeneous dynamics occur in many such materials, and we showed how classic tools employed in analysis of heterogeneous DLS dynamics extend to XPCS, revealing additional information that conventional Kohlrausch exponential fitting obscures. This work presents the software implementation of inverse transform analysis of XPCS data called CONTIN XPCS, an extension of traditional CONTIN that accommodates dynamics encountered in equilibrium XPCS measurements.

  4. Regulatory Changes and Productivity of the Banking Sector in the Indian Sub-Continent


    Shabbar Jaffry; Yaseen Ghulam; Sean Pascoe; Joe Cox


    This study seeks to measure changes in technical efficiency levels within the banking sectors of the Indian sub-continent: specifically India, Pakistan, and Bangladesh, over the period 1993–2002. This study is done in the context of a number of sweeping deregulations across the sub-continent in the early 1990s, and the possible effect these may have had upon efficiency levels. A Malmquist Index of TFP change over the time-period in question is employed, along with a Tobit regression, in order...

  5. A study on the birth and globalization of sports originated from each continent


    Lee, Byung Jin; Kim, Tae Young


    The purpose of this research is to see how continent specific sports rose to its modern-day status through globalization. This research focuses on the historical background of how England?s football, America?s national pastime, baseball, Japan?s Judo, and Korea?s Taekwondo developed into sports in addition to the reasoning behind its globalization. Promoted by England and the rest of the European continent, Soccer is considered to be one of the world?s most popular sports and has served its f...

  6. The Aube centre; Le Centre de l`Aube

    Energy Technology Data Exchange (ETDEWEB)



    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

  7. Introducing the PET Centre Prague

    International Nuclear Information System (INIS)

    Belohlavek, O.


    The PET Centre Prague ( was established in 1999 as the outcome of a joint project of the public Na Homolce Hospital and the Nuclear Research Institute Rez, plc, the Czech radiopharmaceutical producer. Technical and financial assistance was provided by the International Atomic Energy Agency, which perceived the Centre as its model project that could serve as a guide for the development of PET centres in countries sharing a comparable level of development with the Czech Republic. The article maps the history of the project, its design, workplace lay-out and equipment, radiation protection arrangements and spectrum of the first approx. 3000 investigations. (author)

  8. Impact of posterior rhabdosphincter reconstruction during robot-assisted radical prostatectomy: retrospective analysis of time to continence. (United States)

    Woo, Jason R; Shikanov, Sergey; Zorn, Kevin C; Shalhav, Arieh L; Zagaja, Gregory P


    Posterior rhabdosphincter (PR) reconstruction during robot-assisted radical prostatectomy (RARP) was introduced in an attempt to improve postoperative continence. In the present study, we evaluate time to achieve continence in patients who are undergoing RARP with and without PR reconstruction. A prospective RARP database was searched for most recent cases that were accomplished with PR reconstruction (group 1, n = 69) or with standard technique (group 2, n = 63). We performed the analysis applying two definitions of continence: 0 pads per day or 0-1 security pad per day. Patients were evaluated by telephone interview. Statistical analysis was carried out using the Kaplan-Meier method and log-rank test. With PR reconstruction, continence was improved when defined as 0-1 security pad per day (median time of 90 vs 150 days; P = 0.01). This difference did not achieve statistical significance when continence was defined as 0 pads per day (P = 0.12). A statistically significant improvement in continence rate and time to achieve continence is seen in patients who are undergoing PR reconstruction during RARP, with continence defined as 0-1 security/safety pad per day. A larger, prospective and randomized study is needed to better understand the impact of this technique on postoperative continence.

  9. Ageing and mental health resources for older persons in the African ...

    African Journals Online (AJOL)

    To better understand the organisation of care for older persons, data are being collected to reduce the imbalance between 'disease information\\' and 'resource information\\' – information that addresses older persons\\' needs in terms of mental health care. This review presents some results from the continent. Mental health ...

  10. The Earth Is Flat when Personally Significant Experiences with the Sphericity of the Earth Are Absent (United States)

    Carbon, Claus-Christian


    Participants with personal and without personal experiences with the Earth as a sphere estimated large-scale distances between six cities located on different continents. Cognitive distances were submitted to a specific multidimensional scaling algorithm in the 3D Euclidean space with the constraint that all cities had to lie on the same sphere. A…

  11. Programme of Indian Centre for Space Physics using Very Low Frequency Radio Waves (United States)

    Chakrabarti, Sandip Kumar; Sasmal, Sudipta; Pal, Sujay; Kanta Maji, Surya; Ray, Suman

    Indian Centre for Space Physics conducted two major VLF campaigns all over Indian Sub-continent to study the propagation effects of VLF radio waves. It made multi-receiver observations during solar eclipse. ICSP not only recorded multitudes of solar flares, it also reproduced VLF observation from ab initio calculation. ICSP extended its study to the field of earthquake predictions using signal anomalies and using case by case studies as well as statistical analysis, showed that anomalies are real and more studies are required to understand them. Using earth as a gigantic detector, it detected ionospheric perturbations due to soft gamma-ray repeaters and gamma-ray bursts.

  12. The centre of the action

    CERN Multimedia


    The CERN Control Centre (CCC) has all the ingredients of an action movie control room: hundreds of screens, technicians buzzing in and out, huge floor-to-ceiling windows revealing the looming vista of a mountain range, flashing lights, microphones… This is the place where not just the LHC, but the whole of CERN’s accelerator complex and technical support is based - truly the centre of the action at CERN.

  13. Sublatitudinal Isotope Heterogeneity of The Atlantic and Adjacent Continents: A Relation To The Litospheric Plates and Superplums (United States)

    Mironov, Yu. V.; Ryakhovsky, V. M.; Pustovoy, A. A.; Lapidus, I. V.

    Four Sr-Nd-Pb isotope sublatitudinal provinces are chosen in the Atlantic and on ad- jacent continents. They include mid-ocean ridges, oceanic rises and islands, as well as Late Mesozoic - Cenozoic continental rifts and traps. A modified Zindler-Hart "man- tle tetrahedron" (1986) have been used for rock systematics. Its major classification element alongside with known end-members (DM, HIMU, EM1, EM2) is any in- tratetrahedron component F ("focal") (Mironov et al., 2000; Rundquist et al., 2000; Ryakhovsky, 2000). It represents average characteristic of all known intratetrahedron components (FOZO, C, PREMA etc.), updated by methods of multidimensional statis- tics. Northern province includes Mid-Atlantic Ridge from a southern part of Reykjanes ridge up to 24S, numerous islands and rises, located at the same latitudes, Cameroon Line, African and European rifts, Aden and Red sea spreading centres, and also Co- mores in Indian ocean. The main composition dispersion of volcanics from withinplate oceanic and continental structures is determined by mixture of F and HIMU (rarely with admixture EM2). MORB within this area are characterized by stable admixture HIMU. Similar composition have the rocks in Bouvet-Antarctic province, within the limits of which the rises Spiss and Shona, the most southern part of Mid-Atlantic ridge, island Bouvet, an adjacent part of Southwest-Indian Ridge, and also traps and rifts on northern coast of Antarctic Continent are located. The Southern province lies in outlines of known Southern hemisphere DUPAL-anomaly (Hart, 1984). The with- inplate oceanic rocks (Gough, Tristan-da-Kunha, Walvis ridge, Rio Grande Plateau, Discovery) correspond to a mixture F + EM1 (sometimes F + EM1 + EM2) and are similar with traps of Southern America and Africa. Further to east this province is traced on islands and mid-ocean ridges in Indian ocean. MORB of Southern Atlantic and Indian ocean are enriched EM1. The Arctic province includes spreading ridges of

  14. Training centres - organization and management

    International Nuclear Information System (INIS)

    Kovar, P.


    In the lecture 'Training centres - organization and management' some principles and requirements which influence the organization, management and activity pattern of nuclear training centres, are briefly introduced. It is demonstrated, step by step, how these general principles are implemented in the development of the Czechoslovak nuclear power programme, it means, how the training of the NPP personnel proceeds in Czechoslovak nuclear training centres. General principles which are selected: a connection between the capacity of the training centre and the scope and needs of the nuclear power programme, a position of the training center within the institutional set-up, a structure and organization of the training system which complies with the system of NPP construction, reflect the pattern and the activity of the nuclear training centre and nuclear power technical level, a research group of workers in the nuclear training centre, main tasks and technical facilities, management of the training process and a transfer of knowledge and research results into the training process. The lecture is supplemented by pictures and slides. (orig.)

  15. RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System (United States)

    Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.


    RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (, to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

  16. Feldspar basalts in lunar soil and the nature of the lunar continents (United States)

    Reid, A. M.; Ridley, W. I.; Harmon, R. S.; Warner, J.; Brett, R.; Jakes, P.; Brown, R. W.


    It is found that 25% on the Apollo-14 glasses have the same composition as the glasses in two samples taken from the Luna-16 column. The compositions are equivalent to feldspar basalt and anorthosite gabbro, and are similar to the feldspar basalts identified from Surveyor-7 analysis for lunar continents.

  17. Papers presented to the Conference on Heat and Detachment in Crustal Extension on Continents and Planets (United States)


    Several topics relative to heat and detachment in crustal extension on continents and planets are discussed. Rifting on Venus, heat flow and continental breakup, magnetism, the mountains and tectonic processes of Io, and the ductile extension of planetary lithospheres are among the topics covered.

  18. The African nuclear-weapon-free zone and sustainable development on the continent

    International Nuclear Information System (INIS)

    Selassie, T.W.


    This article looks at the concept of safeguards and nuclear non-proliferation in the context of the Treaty, and discusses the relevance and potential of nuclear science and technology for contributing to the solution of the continent's numerous and urgent problems

  19. Examination of 2015 Human Development Index in Terms of Education: Comparison of the Continents and Turkey (United States)

    Nartgün, Senay Sezgin; Sezen-Gültekin, Gözde; Limon, Ibrahim


    This study aims to compare Turkey to the first three countries from each continent in terms of educational indicators in 2015 Human Development Report. In line with this aim, it is a case study utilizing document review method. Analysis of the data has been carried out on a single document which is United Nations Development Report (2015). To…

  20. Normalized difference vegetation index for the South American continent used as a climatic variability indicator

    International Nuclear Information System (INIS)

    Liu, W.T.; Massambani, O.; Festa, M.


    The NOAA AVHRR GAC data set was used to produce Normalized Difference Vegetation Index (NDVI) maps for the South American Continent covering the period from August 1, 1981 to June 30, 1987. A 15-day maximum value composite procedure was used to partially eliminate the cloud contamination and atmospheric attenuation. Monthly evolution of NDVI for a dry and a wet year within the period studied was used to estimate the area covered by NDVI value less than 0.223, This value was used as an indicator of the drought area and the delineation of the Low rainfall areas in the continent. It was observed a well defined regional dependence of the drought area variability for the Northeast, Southwest and Northwest continent and also for the Amazon region. It is shown a relative estimation of the area coverage with NDVI less than 0.223 for the years 1982/83 and 1984/85. The dynamics of the drought area evolution in the continent is discussed. It is also presented a diagnosis of regional variability of the continental distribution of drought area from 1981 to 1987 for the months of May and September. This information is also used to discuss its relationship with the EL-Nino-Southern Oscillation (ENSO) and the South American Precipitation patterns during this period. It is suggested that the use of NDVI image to identify the dynamics of the drought induced by low rainfall may provide us valuable information to study the large scale climatic variation

  1. Long Aftershock Sequences within Continents and Implications for Earthquake Hazard Assessment (United States)

    Stein, S. A.; Liu, M.


    Recent seismicity in the Tangshan region in North China has prompted concern about a repetition of the 1976 M7.8 earthquake that destroyed the city, killing more than 242,000 people. However, the decay of seismicity there implies that the recent earthquakes are probably aftershocks of the 1976 event. This 37-year sequence is an example of the phenomenon that aftershock sequences within continents are often significantly longer than the typical 10 years at plate boundaries. The long sequence of aftershocks in continents is consistent with a simple friction-based model predicting that the length of aftershock sequences varies inversely with the rate at which faults are loaded. Hence the slowly-deforming continents tend to have aftershock sequences significantly longer than at rapidly-loaded plate boundaries. This effect has two consequences for hazard assessment. First, within the heavily populated continents that are typically within plate interiors, assessments of earthquake hazards rely significantly on the assumption that the locations of small earthquakes shown by the short historical record reflect continuing deformation that will cause future large earthquakes. This assumption would lead to overestimation of the hazard in presently active areas and underestimation elsewhere, if some of these small events are aftershocks. Second, successful attempts to remove aftershocks from catalogs used for hazard assessment would underestimate the hazard, because much of the hazard is due to the aftershocks, and the declustering algorithms implicitly assume short aftershock sequences and thus do not remove long-duration ones.

  2. High resolution magnetic resonance imaging of urethral anatomy in continent nulliparous pregnant women

    International Nuclear Information System (INIS)

    Preyer, Oliver; Brugger, Peter C.; Laml, Thomas; Hanzal, Engelbert; Prayer, Daniela; Umek, Wolfgang


    Introduction: To quantify the distribution of morphologic appearances of urethral anatomy and measure variables of urethral sphincter anatomy in continent, nulliparous, pregnant women by high resolution magnetic resonance imaging (MRI). Materials and methods: We studied fifteen women during their first pregnancy. We defined and quantified bladder neck and urethral morphology on axial and sagittal MR images from healthy, continent women. Results: The mean (±standard deviation) total transverse urethral diameter, anterior–posterior diameter, unilateral striated sphincter muscle thickness, and striated sphincter length were 15 ± 2 mm (range: 12–19 mm), 15 ± 2 mm (range: 11–20 mm), 2 ± 1 mm (range: 1–4 mm), and 13 ± 3 mm (range: 9–18 mm) respectively. The mean (±standard deviation) total urethral length on sagittal scans was 22 ± 3 mm (range: 17.6–26.4 mm). Discussion: Advances in MR technique combined with anatomical and histological findings will provide an insight to understand how changes in urethral anatomy might affect the continence mechanisms in pregnant and non-pregnant, continent or incontinent individuals.

  3. Runes around the North Sea and on the Continent AD 150-700; texts & contexts

    NARCIS (Netherlands)

    Looijenga, Jantina Helena


    Het onderzoek naar de oudste runeninscripties van het Europese continent, Engeland en Denemarken voerde onderzoekster van Liverpool aan de Ierse Zee naar Constanza aan de Zwarte Zee; van Zürich naar Bergen; van Parijs naar Stockholm. In dit enorme gebied kende men reeds bij het begin van de vroege

  4. Obesity and stress urinary incontinence in women: compromised continence mechanism or excess bladder pressure during cough? (United States)

    Swenson, Carolyn W; Kolenic, Giselle E; Trowbridge, Elisa R; Berger, Mitchell B; Lewicky-Gaupp, Christina; Margulies, Rebecca U; Morgan, Daniel M; Fenner, Dee E; DeLancey, John O


    We compared two hypotheses as to why obesity is associated with stress urinary incontinence (SUI): (1) obesity increases demand on the continence system (e.g. higher cough pressure) and (2) obesity compromises urethral function and urethrovaginal support. A secondary analysis was performed using data from a case-control study of SUI in women. Measurements of urethrovaginal support (POP-Q point Aa, urethral axis), urethral function (maximal urethral closure pressure, MUCP), and measures of continence system demand (intravesical pressures at rest and during maximal cough) were analyzed. Cases and controls were divided into three body mass index (BMI) groups: normal (18.5-24.9 kg/m 2 ); overweight (25.0-29.9 kg/m 2 ); and obese (≥30 kg/m 2 ). Logistic regression models where created to investigate variables related to SUI for each BMI group. Structural equation modeling was used to test the direct and indirect relationships among BMI, SUI, maximal cough pressure, MUCP, and POP-Q point Aa. The study included 108 continent controls and 103 women with SUI. MUCP was the factor most strongly associated with SUI in all BMI groups. Maximal cough pressure was significantly associated with SUI in obese women (OR 3.191, 95% CI 1.326, 7.683; p continence mechanism.

  5. Measurement of Dynamic Urethral Pressures with a High Resolution Manometry System in Continent and Incontinent Women (United States)

    Kirby, Anna C; Tan-Kim, Jasmine; Nager, Charles W.


    Objectives Female stress urinary incontinence (SUI) is caused by urethral dysfunction during dynamic conditions, but current technology has limitations in measuring urethral pressures under dynamic conditions. An 8-French high resolution manometry catheter (HRM) currently in clinical use in gastroenterology may accurately measure urethral pressures under dynamic conditions because it has a 25ms response rate and circumferential pressure sensors along the length of the catheter (ManoScan® ESO, Given Imaging). We evaluated the concordance, repeatability, and tolerability of this catheter. Methods We measured resting, cough, and strain maximum urethral closure pressures (MUCPs) using HRM and measured resting MUCPs with water perfusion side-hole catheter urethral pressure profilometry (UPP) in 37 continent and 28 stress incontinent subjects. Maneuvers were repeated after moving the HRM catheter along the urethral length to evaluate whether results depend on catheter positioning. Visual analog pain scores evaluated the comfort of HRM compared to UPP. Results The correlation coefficient for resting MUCPs measured by HRM vs. UPP was high (r = 0.79, prest, cough, and strain with HRM: r= 0.92, 0.89, and 0.89. Mean MUCPs (rest, cough, strain) were higher in continent than incontinent subjects (all p continent subjects during cough and strain maneuvers compared to rest. Conclusions This preliminary study shows that HRM is concordant with standard technology, repeatable, and well tolerated in the urethra. Incontinent women have more impairment of their urethral closure pressures during cough and strain than continent women. PMID:25185595

  6. Self-reported urinary continence outcomes for repeat midurethral synthetic sling placement

    Directory of Open Access Journals (Sweden)

    Jonathan A. Eandi


    Full Text Available OBJECTIVE: To evaluate our experience with tension-free transvaginal tape (TVT placement for the management of stress urinary incontinence (SUI in women who had previously undergone a failed midurethral synthetic sling (MUS procedure. MATERIALS AND METHODS: Ten women underwent retropubic TVT insertion for continued or recurrent SUI following a prior MUS procedure. No attempt was made to remove the previously placed sling at the time of surgery. A retrospective chart review was performed to obtain perioperative and follow-up patient information. Post-operatively, each patient completed a mailed incontinence questionnaire to assess self-reported urinary continence outcomes. RESULTS: All 10 women were available for follow-up at a mean period of 16 months (range 6 to 33. Four of the 10 patients achieved complete continence, and another three patients reported significantly improved continence and quality of life. Three women stated that their continence did not improve. CONCLUSIONS: TVT placement may be a viable option for the management of women with persistent or recurrent SUI following an initial MUS procedure.

  7. Rotational inertia of continents: A proposed link between polar wandering and plate tectonics (United States)

    Kane, M.F.


    A mechanism is proposed whereby displacement between continents and the earth's pole of rotation (polar wandering) gives rise to latitudinal transport of continental plates (continental drift) because of their relatively greater rotational inertia. When extended to short-term polar wobble, the hypothesis predicts an energy change nearly equivalent to the seismic energy rate.

  8. Is continence status associated with quality of life in young children with spina bifida? (United States)

    Freeman, Kurt A; Smith, Kathryn; Adams, Elizabeth; Mizokawa, Stacey; Neville-Jan, Ann


    To evaluate the relationship between child- and parent-reported quality of life (QOL) and bowel and bladder continence among young children with spina bifida (SB). 104 children ages 5-12 years and one of their parents/guardians completed the Pediatric Quality of Life Inventory - Generic Form (PedsQL; parent and child) and the Quality of Life in Spina Bifida Questionnaire (QOLSBQ, parent only). Data on continence, child age, and condition-specific variables were obtained by chart review. Parent and child QOL scores (on all measures of QOL) were positively correlated; parents rated child QOL lower than children's self report. QOL scores did not differ based on continence status. Total PedsQL scores were associated with age and mobility based on child report and with mobility based on parent report. QOL may not be affected by continence status among young children with SB, though demographic (i.e., age) and condition-specific (i.e., functional mobility status) variables appear relevant. Additional research is needed to further evaluate condition-specific variables, other protective variables, and possible measurement issues that influence QOL in young children with SB.

  9. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres (United States)

    Breck, Andrew; Dixon, L Beth; Khan, Laura Kettel


    Objective The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Design Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Setting Child-care centres were located in low-income neighbourhoods in NYC. Results Overall, 87% of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by > 60%. Sweets and water had lower match percentages (40 and 32%, respectively), but water was served 68% of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. Conclusions In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day. PMID:27280341

  10. Optimizing revenue at a cosmetic surgery centre. (United States)

    Funk, Joanna M; Verheyden, Charles N; Mahabir, Raman C


    The demand for cosmetic surgery and services has diminished with recent fluctuations in the economy. To stay ahead, surgeons must appreciate and attend to the fiscal challenges of private practice. A key component of practice economics is knowledge of the common methods of payment. To review methods of payment in a five-surgeon group practice in central Texas, USA. A retrospective chart review of the financial records of a cosmetic surgery centre in Texas was conducted. Data were collected for the five-year period from 2003 to 2008, and included the method of payment, the item purchased (product, service or surgery) and the dollar amount. More than 11,000 transactions were reviewed. The most common method of payment used for products and services was credit card, followed by check and cash. For procedures, the most common form of payment was personal check, followed by credit card and financing. Of the credit card purchases for both products and procedures, an overwhelming majority of patients (more than 75%) used either Visa (Visa Inc, USA) or MasterCard (MasterCard Worldwide, USA). If the amount of the individual transaction surpassed US$1,000, the most common method of payment transitioned from credit card to personal check. In an effort to maximize revenue, surgeons should consider limiting the credit cards accepted by the practice and encourage payment through personal check.

  11. Human-centred approaches in slipperiness measurement (United States)

    Grönqvist, Raoul; Abeysekera, John; Gard, Gunvor; Hsiang, Simon M.; Leamon, Tom B.; Newman, Dava J.; Gielo-Perczak, Krystyna; Lockhart, Thurmon E.; Pai, Clive Y.-C.


    A number of human-centred methodologies—subjective, objective, and combined—are used for slipperiness measurement. They comprise a variety of approaches from biomechanically-oriented experiments to psychophysical tests and subjective evaluations. The objective of this paper is to review some of the research done in the field, including such topics as awareness and perception of slipperiness, postural and balance control, rating scales for balance, adaptation to slippery conditions, measurement of unexpected movements, kinematics of slipping, and protective movements during falling. The role of human factors in slips and falls will be discussed. Strengths and weaknesses of human-centred approaches in relation to mechanical slip test methodologies are considered. Current friction-based criteria and thresholds for walking without slipping are reviewed for a number of work tasks. These include activities such as walking on a level or an inclined surface, running, stopping and jumping, as well as stair ascent and descent, manual exertion (pushing and pulling, load carrying, lifting) and particular concerns of the elderly and mobility disabled persons. Some future directions for slipperiness measurement and research in the field of slips and falls are outlined. Human-centred approaches for slipperiness measurement do have many applications. First, they are utilized to develop research hypotheses and models to predict workplace risks caused by slipping. Second, they are important alternatives to apparatus-based friction measurements and are used to validate such methodologies. Third, they are used as practical tools for evaluating and monitoring slip resistance properties of foot wear, anti-skid devices and floor surfaces. PMID:11794763

  12. Mental, physical and social health problems of call centre workers

    Directory of Open Access Journals (Sweden)

    P Bhuyar


    Full Text Available Background: Call centre workers in BPO face unique occupational hazards - mental, physical and psychosocial. Material & Method: A sample 100 call centre workers of both sexes and from two cities Pune and Mumbai were surveyed by both qualitative and quantitative methods for the above health problems. Results: A high proportion of workers faced sleep disturbances and associated mental stress and anxiety. Sleep disturbance and anxiety was significantly more in international call centres compared to domestic. There was also disturbance in circadian rhythms due to night shift. Physical problems such as musculoskeletal disorders, obesity, eye, and hearing problems were also present. Psychosocial problems included disruption in family life, use of tobacco and alcohol, and faulty eating habits. Conclusion: Better personal management, health education and more research is indicated to study the health problems in this emerging occupation.

  13. Analysis of the Environmental Management System based on ISO 14001 on the American continent. (United States)

    Neves, Fábio de Oliveira; Salgado, Eduardo G; Beijo, Luiz A


    The American continent is in broad economic and industrial development. Consequently, a more detailed discussion of the impacts generated by such development is needed. Moreover, there is an increase in the number of ISO 14001 certificates issued to this continent. Given the above, no studies were found that bridge the gap to identify the influence of different factors on ISO 14001 in the Americas. Thus, this article has as its main aim to check which economic, environmental and cultural factors have influence on ISO 14001 Certification in the American Continent. The data were collected in the ISO Survey, World Bank, United Nations Development Programme and International Energy Agency. Among the countries of that continent, thirteen were analyzed and only two did not show the economic factors as the influence factor in the multiple regression models fitted with Brazil and the United State. In these models, all presented environmental factors as influencing factors. Only in Brazil the index HDI presented as cultural factor in multiple regression model fitted. The economic factors: Gross Domestic Product and exports of goods and services and environmental: Carbon Dioxide (CO 2 ) and fossil fuel consumption were the most influential in ISO 14001 certification. Venezuela, Uruguay, Colombia and the United States were countries that had factors dependent on each other, featuring the environmental marketing. Briefly, this study brings up several implications: to the academy, with the proposal of new concepts and guidance on the factors that assist in ISO 14001 certification in the American Continent. Additionally, taking into account the industry, the factors serve as efficiency parameters for the implementation of ISO 14001 standard, and for the Government to improve through factors that do not fit in multiple regression models. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Maritime Continent seasonal climate biases in AMIP experiments of the CMIP5 multimodel ensemble (United States)

    Toh, Ying Ying; Turner, Andrew G.; Johnson, Stephanie J.; Holloway, Christopher E.


    The fidelity of 28 Coupled Model Intercomparison Project phase 5 (CMIP5) models in simulating mean climate over the Maritime Continent in the Atmospheric Model Intercomparison Project (AMIP) experiment is evaluated in this study. The performance of AMIP models varies greatly in reproducing seasonal mean climate and the seasonal cycle. The multi-model mean has better skill at reproducing the observed mean climate than the individual models. The spatial pattern of 850 hPa wind is better simulated than the precipitation in all four seasons. We found that model horizontal resolution is not a good indicator of model performance. Instead, a model's local Maritime Continent biases are somewhat related to its biases in the local Hadley circulation and global monsoon. The comparison with coupled models in CMIP5 shows that AMIP models generally performed better than coupled models in the simulation of the global monsoon and local Hadley circulation but less well at simulating the Maritime Continent annual cycle of precipitation. To characterize model systematic biases in the AMIP runs, we performed cluster analysis on Maritime Continent annual cycle precipitation. Our analysis resulted in two distinct clusters. Cluster I models are able to capture both the winter monsoon and summer monsoon shift, but they overestimate the precipitation; especially during the JJA and SON seasons. Cluster II models simulate weaker seasonal migration than observed, and the maximum rainfall position stays closer to the equator throughout the year. The tropics-wide properties of these clusters suggest a connection between the skill of simulating global properties of the monsoon circulation and the skill of simulating the regional scale of Maritime Continent precipitation.

  15. Is there any difference in pelvic floor muscles performance between continent and incontinent women? (United States)

    Burti, Juliana Schulze; Hacad, Claudia R; Zambon, João Paulo; Polessi, Emily Assis; Almeida, Fernando G


    To compare pelvic floor muscles (PFMs) performance in women with and without stress urinary incontinence (SUI) during endurance test. It is a prospective case-control clinical trial. After determining PFM maximal voluntary contraction (MVC) by electromyography (EMG), women underwent endurance test, which consisted of consecutively PFM 1-sec fast contractions reaching MVC amplitude followed by 1-sec rest. Training time guided by Borg perceived exertion scale was noted. Heart rate (HR) behavior and EMG variables were assessed before and after training making a physiological analysis in both groups. A total of 56 women, mean age 52.19 years old, were evaluated (26 continent and 30 incontinent women). The time that SUI and continent women took to reach fatigue (Borg 10) was 9.1 ± 4.7 and 14.19 ± 8.32 min, respectively (P = 0.006). Confirming that all women performed similar effort during the test, analysis of variance with repeated measures showed that during the endurance test both groups presented similar increase in HR, showing detectable and significant increase from resting time to Borg 10 (P continent and SUI women, with a decrease from the baseline resting amplitude (P = 0.003 for SUI women and P = 0.006 for continent women). Women with SUI showed worse performance during an endurance test than continent women. It suggests that women have different capacity to perform PFM training. An initial evaluation based on PFM performance would help to define the best individualized PFM training. © 2014 Wiley Periodicals, Inc.

  16. Oceans and continents: Similarities and differences in the mechanisms of heat loss

    International Nuclear Information System (INIS)

    Sclater, J.G.; Parsons, B.; Jaupart, C.


    The principal objective of this paper is to present a simple and self-consistent review of the basic physical processes controlling heat loss from the earth. To accomplish this objective, we give a short summary of the oceanic and continental data and compare and contrast the respective mechanisms of heat loss . In the oceans we concentrate on the effect of hydrothermal circulation, and on the continents we consider in some detail a model relating surface heat flow to varying depth scales for the distribution of potassium, thorium, and uranium. From this comparison we conclude that the range in possible geotherms at depths below 100 to 150 km under continents and oceans overlaps and the thermal structure beneath an old stable continent is indistinguishable from that beneath an ocean were it at equilibrium. Oceans and continents are part of the same thermal system. Both have an upper rigid mechanical layer where heat loss is by conduction and a lower thermal boundary layer where convection is dominant. The simple conductive definition of the plate thickness is an oversimplification. The observed distribution of area versus age in the ocean allows us to investigate the dominant mechanism of heat loss which is plate creation. This distribution and an understanding of the heat flow through oceans and continents can be used to calculate the heat loss of the earth. This heat loss is 10 13 cal/s (4.2 x 10 13 W) of which more than 60% results from the creation of oceanic plate. The relation between area and age of the oceans is coupled to the ridge and subducting slab forces that contribute to the driving mechanism for plate motions. These forces are self-regulating and maintain the rate of plate generation required to achieve a balance between heat loss and heat generation

  17. Seminal vesicle sparing laparoscopic radical prostatectomy using a low-energy source: Better continence and potency

    Directory of Open Access Journals (Sweden)

    Shrenik J Shah


    Full Text Available Objectives: Ongoing with the newer developments in laparoscopic radical prostatectomy (LRP, we report our experience in a consecutive series of 42 patients with a mean 18-month follow-up. We also studied the use of a low-energy source, especially in the region of the prostatic apex and the neurovascular bundle and evaluated its outcome on continence and potency. Materials and Methods: Between November 2003 and December 2008, 50 patients aged 50-80 yrs underwent LRP with vesicourethral anastomosis and of these, 42 patients who had a minimum follow-up of 3 months were selected for the study. Of these, the initial 16 patients were operated by the routine method and the 26 patients operated in the later part of our experience were operated upon using a minimal energy source. Results: The mean follow-up was 18 months (range 3-60. Continence was evaluated at 1, 3, 6, and 12 months. Eleven of the 16 patients in Group I were continent as compared with 21 of 26 patients in Group II. The difference in continence rates was mainly due to less use of electrocautery and harmonic scalpel at the bladder neck. Of the eight patients who were potent pre-operatively in Group I, four remained potent 3 months after LRP. In Group II, 20 of the 26 patients were potent pre-operatively and 16 remained potent 3 months after LRP. Conclusions: Use of a low-energy source at the bladder neck and neurovascular bundle, sparing of seminal vesicle, and leaving behind a long, healthy stump of the urethra during apical dissection, is associated with better continence and potency without compromising oncological outcome.

  18. Achieving competences in patient-centred care

    DEFF Research Database (Denmark)

    Lomborg, Kirsten; Nielsen, Else Skånning; Jensen, Annesofie Lunde


    Aim: To document the efficacy of a training programme in patient-centred care in which the nursing staff was trained to involve chronic obstructive pulmonary patients in assisted personal body care (APBC). The objectives were to describe the programme and uncover the outcomes. Background: Chronic....... In order to achieve such competences in nursing staff, we developed, implemented and evaluated a training programme. Design: A qualitative outcome analysis was conducted in order to explore the dynamics of the training programme process and the outcome. patients to be more active, as was common practice...... prior to the training. According to the staff, there was no actual change in the patients’ level of activity. The training was time-consuming. Methods: Seven nurses and six nursing assistants from three hospital units were divided into two groups in which training and evaluation took place. The content...

  19. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

    Mas, R [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires


    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [French] L'auteur propose une base de reflexions a tous ceux qui doivent concevoir, realiser et faire vivre un Centre d'Etudes Nucleaires. Un grand nombre des idees exprimees peut d'ailleurs s'appliquer a un Centre d'Etudes Scientifiques non nucleaires. Dans son ouvrage, l'auteur passe en revue les differents problemes qui se posent au constructeur: plan, masse, infrastructure, batiments et grands appareils du Centre, et ceux qu'a a resoudre le directeur: entretien, fabrication, approvisionnements, securite. L'auteur insiste sur l'aspect des rapports qui doivent exister entre les chercheurs et ceux qui les administrent. Il propose a cette fin la creation d'une Ecole Nationale d'Administration de la Recherche qui formerait des cadres administratifs pour les organismes publics ou prives, specialises dans la Recherche fondamentale ou appliquee. (auteur)

  20. Personality Disorders (United States)

    Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and ...

  1. Personality Disorders (United States)

    ... Disorders in Adults Data Sources Share Personality Disorders Definitions Personality disorders represent “an enduring pattern of inner ... MSC 9663 Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS ...

  2. Personality Traits and Shame to Entrepreneurship

    Institute of Scientific and Technical Information of China (English)

    Elifas; Gongalves; Junior


    The failure of the parent's company has psychological, social, and economic repercussions for the children of theseentrepreneurs. Research has identified that the personality traits of conscientiousness and neuroticism are the majorinfluencers of the shame of parental failure among personality traits. The dimensions of openness, extraversion, andagreeableness were not significant. The research is quantitative and cross-sectional. The sample is non-probabilistic andconvenient, consisting of literate people from five continents and 33 countries, with a greater predominance of responsesfrom Brazil and Portugal. Data collection on-line was carried out by average social workers, allied to 19 institutions of highereducation. The metric used is called the five dimensions of personality--short version. A multiple linear regression wasperformed to assess the intensity of the five dimensions of personality. Conscientiousness and neuroticism were significantpredictors of shame. The results are important to help characterize the children of entrepreneurs who have failed and fill agap in the literature on entrepreneurship.

  3. The Belgian nuclear research centre

    International Nuclear Information System (INIS)

    Moons, F.


    The Belgian Nuclear Research Centre is almost exclusively devoted to nuclear R and D and services and is able to generate 50% of its resources (out of 75 million Euro) by contract work and services. The main areas of research include nuclear reactor safety, radioactive waste management, radiation protection and safeguards. The high flux reactor BR2 is extensively used to test fuel and structural materials. PWR-plant BR3 is devoted to the scientific analysis of decommissioning problems. The Centre has a strong programme on the applications of radioisotopes and radiation in medicine and industry. The centre has plans to develop an accelerator driven spallation neutron source for various applications. It has initiated programmes to disseminate correct information on issues of nuclear energy production and non-energy nuclear applications to different target groups. It has strong linkages with the IAEA, OECD-NEA and the Euratom. (author)

  4. Presentation of TVO's visitor's centre

    International Nuclear Information System (INIS)

    Aemmaelae, V.M.


    There are four nuclear power plant units in Finland, two of which are PWR's owned by Imatran Voima Oy. The two BWR units are located at Olkiluoto and owned by Teollisuuden Voima Oy. This presentation tells about TVO's concept of informing the visitors at Olkiluoto. At the site there are located, in addition to the two nuclear power plant units, the intermediate storage for spent fuel, the repository for low and medium-active waste as well as the training centre. At the Olkiluoto Visitor's Centre all the activities of the company are presented using varied audio-visual aids. The centre has several exhibits and there are also different installations to show how the plant works. (author)

  5. International Development Research Centre Act Loi sur le Centre de ...

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

    1 juin 2009 ... research includes any scientific or technical inquiry or experimentation that is .... data centres and facilities for research and other activ- ities;. (b) initiate and ..... Loi sur la pension de la fonction publique ne s'applique pas aux ...

  6. Training centres in Latin America

    Energy Technology Data Exchange (ETDEWEB)



    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  7. Training centres in Latin America

    International Nuclear Information System (INIS)


    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  8. Logistics centres development in Latvia

    Directory of Open Access Journals (Sweden)

    I. Kabashkin


    Full Text Available In the situation where a large increase in trade and freight transport volumes in the Baltic Sea region (BSR is expected and in which the BSR is facing a major economic restructuring, eff orts to achieve more integrated and sustainable transport and communication links within the BSR are needed. One of these eff orts is the development of logistics centres (LCs and their networking, which will continue to have an impact on improving communication links, spatial planning practices and approaches, logistics chain development and the promotion of sustainable transport modes. These factors will refl ect on logistics processes both in major gateway cities and in remote BSR areas. The importance of logistics systems as a whole is not seen clearly enough. Logistics actors see that logistics operations are not appreciated as much as other fi elds of activity. In addition, logistics centres and the importance of logistics activities to the business life of areas and the employment rate should be brought up better. In the paper main goal and tasks of national approach to LCs development are discussed. Strategic focus of new activities in this area is on the integration of various networks within and between logistics centres in order to improve and develop the quality of logistics networks as well as to spatially widen the networking activities. The key objectives are to integrate the links between logistics centres, ports and other logistics operators in a functional and sustainable way, to promote spatial integration by creating sustainable and integrated approaches to spatial planning of logistics centres and transport infrastructure, to improve ICT-based networking and communication practices of the fi elds of transport and logistics and to increase the competence of logistics centres and associated actors by organising educational and training events. The current activities include, for example, the creation of measures for transport networking and

  9. Personal Branding


    Climent i Martí, Jordi


    Proyecto Fin de Grado leído en la Universidad Rey Juan Carlos en el curso académico 2013/2014. Director: Cristina Ayala del Pino Con este Trabajo Fin de Grado he querido aproximar el concepto del Personal Branding y de marca personal como la herramienta para diferenciarse en el entorno profesional. Partiendo con la definición del concepto, su construcción, el panorama actual, compaginar empleo con marca personal y acabando con la visión personal de un gurú de la Marca Person...

  10. Personality and personal network type

    NARCIS (Netherlands)

    Doeven-Eggens, Lilian; De Fruyt, Filip; Hendriks, A. A. Jolijn; Bosker, Roel J.; Van der Werf, Margaretha P. C.


    The association between personality and personal relationships is mostly studied within dyadic relationships. We examined these variables within the context of personal network types. We used Latent Class Analysis to identify groups Of Students with similar role relationships with three focal

  11. Towards Human-Centred Design (United States)

    Bannon, Liam J.

    The field of HCI has evolved and expanded dramatically since its origin in the early 1980’s. The HCI community embraces a large community of researchers and practitioners around the world, from a variety of disciplinary backgrounds in the human and social sciences, engineering and informatics, and more recently, the arts and design disciplines. This kaleidoscope of cultures and disciplines as seen at INTERACT Conferences provides a rich pool of resources for examining our field. Applications are increasingly exploring our full range of sensory modalities, and merging the digital and physical worlds. WiFi has opened up a huge design space for mobile applications. A focus on usability of products and services has been complemented by an emphasis on engagement, enjoyment and experience. With the advent of ubiquitous computing, and the emergence of “The Internet of Things”, new kinds of more open infrastructures make possible radically new kinds of applications. The sources of innovation have also broadened, to include human and social actors outside of the computing and design organizations. The question is to what extent is our mainstream thinking in the HCI field ready for the challenges of this Brave New World? Do the technological and social innovations that we see emerging require us to re-shape, or even, re-create, our field, or is it a case of a more gradual evolution and development of that which we already know? In this closing Keynote, I will provide a perspective on the evolution and development of the HCI field, looking backwards as well as forwards, in order to determine what are some of the changes of significance in the field. This “broad-brush” approach to what I term “ human-centred design” will be complemented by the examination of specific projects and applications, to help anchor some of the discussion. Areas such as user-centred design, participatory design, computer-supported cooperative work and learning, and interaction design, in

  12. Indiana pouch continent urinary reservoir in patients with previous pelvic irradiation

    International Nuclear Information System (INIS)

    Mannel, R.S.; Braly, P.S.; Buller, R.E.


    Little information exists on the use of continent urinary reservoirs in patients with previous pelvic irradiation. We report the use of the Indiana pouch urinary reservoir in ten women with a history of pelvic irradiation for cervical cancer, of whom eight underwent a total pelvic exenteration for recurrent pelvic tumor and two had diversion for radiation-induced vesicovaginal fistula. All ten women achieved daytime continence, with a median time between catheterizations of 4.5 hours and a median pouch capacity of 500 mL. There was no evidence of leakage from the reservoir or significant ureteral reflux or obstruction on postoperative radiographic evaluation. No patient has required reoperation or had significant postoperative complications with the technique described

  13. Variation of atmospheric 210Pb concentration in the inland area of Chinese continent

    International Nuclear Information System (INIS)

    Doi, Taeko; Sato, Jun.


    Atmospheric concentrations of 210 Pb and their variations over Urumqi, Lanzhou and Baotou, cities located in inland area of Chinese continent, were observed for a period of 1 year in 1992. The monthly average concentrations ranged from 0.27 to 4.57 mBq/m 3 . The concentrations over these cities in winter were several times higher than that observed at Tsukuba Science City, Japan, and the range of variation was also larger. The variations in concentration over the 3 localities were similar to each other, showing the same seasonal variation pattern: low concentration appeared in summer and high in winter. This variation pattern was different from that observed at Tsukuba Science City. The variations in concentration over Chinese continent, where precipitation is much lower than that in Japan, correlated quite well with the variation in precipitation. (author)

  14. Checking of seismic and tsunami hazard for coastal NPP of Chinese continent after Fukushima nuclear accident

    Institute of Scientific and Technical Information of China (English)

    Chang Xiangdong; Zhou Bengang; Zhao Lianda


    A checking on seismic and tsunami hazard for coastal nuclear power plant (NPP) of Chinese continent has been made after Japanese Fukushima nuclear accident caused by earthquake tsunami.The results of the checking are introduced briefly in this paper,including the evaluations of seismic and tsunami hazard in NPP siting period,checking results on seismic and tsunami hazard.Because Chinese coastal area belongs to the continental shelf and far from the boundary of plate collision,the tsunami hazard is not significant for coastal area of Chinese continent.However,the effect from tsunami still can' t be excluded absolutely since calculated result of Manila trench tsunami source although the tsunami wave is lower than water level from storm surge.The research about earthquake tsunami will continue in future.The tsunami warning system and emergency program of NPP will be established based on principle of defense in depth in China.

  15. Responses of Mean and Extreme Precipitation to Deforestation in the Maritime Continent (United States)

    Chen, C. C.; Lo, M. H.; Yu, J. Y.


    Anthropogenic land use and land cover change, including tropical deforestation, could have substantial effects on local surface energy and water budgets, and thus on the atmospheric stability which may result in changes in precipitation. Maritime Continent has undergone severe deforestation in recent decades but has received less attention than Amazon or Congo rainforests. Therefore, this study is to decipher the precipitation response to deforestation in the Maritime Continent. We conduct deforestation experiments using Community Earth System Model (CESM) and through converting the tropical rainforest into grassland. The results show that deforestation in Maritime Continent leads to an increase in both mean temperature and mean precipitation. Moisture budget analysis indicates that the increase in precipitation is associated with the vertically integrated vertical moisture advection, especially the dynamic component (changes in convection). In addition, through moist static energy (MSE) budget analysis, we find the atmosphere among deforested areas become unstable owing to the combined effects of positive specific humidity anomalies at around 850 hPa and anomalous warming extended from the surface to 750 hPa. This instability will induce anomalous ascending motion, which could enhance the low-level moisture convergence, providing water vapor from the surrounding warm ocean. To further evaluate the precipitation response to deforestation, we examine the precipitation changes under La Niña events and global warming scenario using CESM Atmospheric Model Intercomparison Project (AMIP) simulations and Representative Concentration Pathway (RCP) 8.5 simulations. We find that the precipitation increase caused by deforestation in Maritime Continent is comparable in magnitude to that generated by either natural variability or global warming forcing. Besides the changes in mean precipitation, preliminary results show the extreme precipitation also increases. We will further

  16. Globalization in Urology: A Bibliographical Analysis of Cross-Continent Publication between 2002 and 2012. (United States)

    Mani, Jens; Juengel, Eva; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A


    Asian scientists have now increasingly begun to contribute to globalization; yet it is not clear whether publishing in the field of urology is paralleled by elevated cross-continental scientific publishing. An exemplary bibliometric analysis of urologic journals from 3 different continents was conducted between 2002 and 2012. Based on the ISI Web of Knowledge Journal Citation Reports, 2 urologic journals with similar impact factors (IFs) in 2013 were selected from Europe ('British Journal of Urology International', 'World Journal of Urology'), Asia ('International Journal of Urology', 'Asian Journal of Andrology') and North America ('Urologic Oncology-Seminars and Original Investigations', 'Urology'). The home continent of the journal, the workplace continental affiliation of the last author, article type (clinical, experimental or review) as well as the IF were documented. Most authors published their manuscripts in journals from the same continent in which they worked. However, a significant increase in cross-continental publishing was apparent from 2002 to 2012. Asians publishing in North America increased from 17% in 2002 to 35% in 2012. Europeans also increased the number of articles they published in North American journals, while publications from North American authors were shifted towards both European and Asian journals. Experimental and clinical articles showed significant increases in cross-continental publishing, while review publishing showed no significant change. The average IF for authors from all 3 continents increased from 2002 to 2012 (p < 0.001). The largest increase in the IF was found for Asian authors (0.11 per year). Cross-continental publication significantly increased during the period from 2002 to 2012. The impact that the Asian authors have experienced was found to be gradually impacting the North American and European colleagues. © 2015 S. Karger AG, Basel.

  17. Isotopic evidence of boron in precipitation originating from coal burning in Asian continent

    International Nuclear Information System (INIS)

    Sakata, Masahiro; Natsumi, Masahiro; Tani, Yukinori


    The boron concentration and isotopic composition (δ 11 B) of precipitation collected from December 2002 to March 2006 at three sites on the Japan Sea coast were measured. Those sites have been considerably affected by the long-range transport of air pollutants from the Asian continent during winter and spring when the airflows from the Asian continent are predominant. The boron concentration in the precipitation increased primarily during winter whereas the δ 11 B decreased during winter or spring. It is assumed that this decrease in δ 11 B is not associated with a Rayleigh distillation process, because the previous δD values of the precipitation collected at a site on the Japan Sea coast did not decrease in the same manner. A weak correlation (r 2 =0.13-0.24, P 11 B and the nonsea-salt sulfate (nss-SO 4 2- )/B ratio at each site, suggesting that boron in the precipitation originate primarily from two sources. The first source, which is characterized by high δ 11 B and nss-SO 4 2- /B=0, is seawater. At the northern site, the enrichment factor for boron in the precipitation relative to seawater approached unity during winter. This implies that much of the boron in the precipitation is derived from unfractionated sea salts rather than gaseous boron evaporated from seawater. The second source is characterized by low δ 11 B and high nss-SO 4 2- /B ratio. Most of the nss-SO 4 2- in the precipitation originates from anthropogenic combustion activities in the Asian continent based on the previous model calculations. Coal accounts for a major portion of the total primary energy supply in China. Moreover, coal enriches boron and represents generally negative δ 11 B values. Hence, we propose that the emission of boron from coal burning is the most likely second source. Thus, boron isotopes may be useful as tracers of coal-burning plumes from the Asian continent. (author)

  18. Runes around the North Sea and on the Continent AD 150-700; texts & contexts


    Looijenga, Jantina Helena


    Het onderzoek naar de oudste runeninscripties van het Europese continent, Engeland en Denemarken voerde onderzoekster van Liverpool aan de Ierse Zee naar Constanza aan de Zwarte Zee; van Zürich naar Bergen; van Parijs naar Stockholm. In dit enorme gebied kende men reeds bij het begin van de vroege middeleeuwen het runenschrift (rond 500 AD). Ergens in dit gebied moet een kern gelegen hebben, waar het begon - vermoedelijk in de eerste eeuw AD. Het localiseren van dat oorsprongsgebied begon me ...

  19. Hybrid metaheuristic optimization algorithm for strategic planning of {4D} aircraft trajectories at the continent scale


    Chaimatanan , Supatcha; Delahaye , Daniel; Mongeau , Marcel


    International audience; Global air-traffic demand is continuously increasing. To handle such a tremendous traffic volume while maintaining at least the same level of safety, a more efficient strategic trajectory planning is necessary. In this work, we present a strategic trajectory planning methodology which aims to minimize interaction between aircraft at the European-continent scale. In addition, we propose a preliminary study that takes into account uncertainties of aircraft positions in t...

  20. On the determination of the carbon balance of continents (Vladimir Ivanovich Vernadsky Medal Lecture) (United States)

    Dolman, Albertus J. Han


    The carbon balance of regions, the size of continents, can be determined, albeit with significant uncertainty, by combining several bottom up and top down methods. The bottom up methods use eddy covariance techniques, biometric inventory measurements and modeling, while the top down methods use atmospheric observations and inverse models. There has been considerable progress in the last few years in determining these balances through more or less standard protocols, as highlighted for instance by studies of the REgional Carbon Cycle Assessment and Processes (RECAPP) project of the Global Carbon Project. Important areas where uncertainty creeps in are the scaling of point measurements in the bottom up methods, the sparseness of the observation network and the role of model and other errors in the inversion methods. Typically these balances hold for periods of several years. They therefore do not resolve the impact of anomalies in weather and climate directly. The role of management in these balances also differs for different continents. For instance in Europe management plays a strong role in the carbon balance, whereas for the Russian continent this is less important. Management in the European carbon balance may potentially override climatically driven variability. In contrast, for Russia, the importance of the role of forest is paramount, but there the vulnerability of the Arctic regions and permafrost is a key uncertainty for future behaviour. I hope to show the importance of these different aspects of the terrestrial carbon balance by comparing the two continents, and also discuss the significant uncertainty we still face in determining the carbon budgets of large areas. I will argue that we need to get a clearer picture of the role of management in these budgets, but also of the time variability of the budgets to be able to determine the impact of anomalous weather and the vulnerability in a future climate.

  1. Formaldehyde in the Galactic Centre

    International Nuclear Information System (INIS)

    Cohen, R.J.; Few, R.W.


    Formaldehyde 6-cm absorption in the direction of the Galactic Centre has been surveyed using the Jodrell Bank MK II radio telescope (beam-width 10 x 9 arcmin). The observations sample the region - 2 0 = 0 and - 0 0 .5 = 0 .5, with a velocity range of 620 km s -1 , a velocity resolution of 2.1 km s -1 and an rms noise level of approximately 0.03 K. The data are presented as contour maps showing line temperature as a function of latitude and velocity (b-V maps) and as a function of longitude and velocity (l-V maps). Similar maps of the line-to-continuum ratio are also presented. The radial distribution of formaldehyde (H 2 CO) in the Galactic Centre region is derived using two different kinematic models which give similar results. Formaldehyde is strongly concentrated in the Galactic Centre in a layer of latitude extent approximately 0 0 .5 and longitude extent approximately 4 0 which contains one quarter of all the H 2 CO in the Galaxy. The distribution is centred on l approximately 1 0 . The individual H 2 CO features are described in detail. (author)

  2. The DEMETER Science Mission Centre

    Czech Academy of Sciences Publication Activity Database

    Lagoutte, D.; Brochot, J.; Y.; de Carvalho, D.; Elie, F.; Harivelo, F.; Hobara, Y.; Madrias, L.; Parrot, M.; Pincon, J. L.; Berthelier, J. J.; Peschard, D.; Seran, E.; Gangloff, M.; Sauvaud, J. A.; Lebreton, J. P.; Štverák, Štěpán; Trávníček, Pavel M.; Grygorczuk, J.; Slominski, J.; Wronowski, R.; Barbier, S.; Bernard, P.; Gaboriaud, A.; Wallut, J. M.


    Roč. 54, č. 5 (2006), s. 428-440 ISSN 0032-0633 Institutional research plan: CEZ:AV0Z30420517 Keywords : Mission Centre * Data processing Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 1.509, year: 2006


    Directory of Open Access Journals (Sweden)



    Full Text Available The centre of the main interests of the debtor is a legal tool meant to settle conflicts that can arise between jurisdictions in cross-border insolvencies, based on the principles of mutual recognition and co-operation.

  4. Longitudinal Study of Intestinal Symptoms and Fecal Continence in Patients With Conformal Radiotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Geinitz, Hans; Thamm, Reinhard; Keller, Monika; Astner, Sabrina T.; Heinrich, Christine; Scholz, Christian; Pehl, Christian; Kerndl, Simone; Prause, Nina; Busch, Raymonde; Molls, Michael; Zimmermann, Frank B.


    Purpose: To prospectively assess the intestinal symptoms and fecal continence in patients who had undergone conformal radiotherapy (CRT) for prostate cancer. Methods and Materials: A total of 78 men who had undergone definitive CRT for prostate cancer were evaluated. The patients were assessed before, during (treatment Weeks 4 and 6), and 2, 12, and 24 months after CRT completion. The intestinal symptoms and fecal continence were evaluated with comprehensive standardized questionnaires. Results: The intestinal symptoms were mostly intermittent, with only a small minority of patients affected daily. Defecation pain, fecal urge, and rectal mucous discharge increased significantly during therapy. Defecation pain and rectal mucous discharge had returned to baseline levels within 8 weeks and 1 year after CRT, respectively. However, fecal urge remained significantly elevated for ≤1 year and then returned toward the pretreatment values. The prevalence of rectal bleeding was significantly elevated 2 years after CRT. Fecal continence deteriorated during CRT and remained impaired at 1 year after treatment. Incontinence was mostly minor, occurring less than once per week and predominantly affecting incontinence for gas. Conclusion: Intestinal symptoms and fecal incontinence increased during prostate CRT. Except for rectal bleeding, the intestinal symptoms, including fecal incontinence, returned to baseline levels within 1-2 years after CRT. Thus, the rate of long-term late radiation-related intestinal toxicity was low.

  5. Pattern recognition receptor-mediated cytokine response in infants across 4 continents. (United States)

    Smolen, Kinga K; Ruck, Candice E; Fortuno, Edgardo S; Ho, Kevin; Dimitriu, Pedro; Mohn, William W; Speert, David P; Cooper, Philip J; Esser, Monika; Goetghebuer, Tessa; Marchant, Arnaud; Kollmann, Tobias R


    Susceptibility to infection as well as response to vaccination varies among populations. To date, the underlying mechanisms responsible for these clinical observations have not been fully delineated. Because innate immunity instructs adaptive immunity, we hypothesized that differences between populations in innate immune responses may represent a mechanistic link to variation in susceptibility to infection or response to vaccination. Determine whether differences in innate immune responses exist among infants from different continents of the world. We determined the innate cytokine response following pattern recognition receptor (PRR) stimulation of whole blood from 2-year-old infants across 4 continents (Africa, North America, South America, and Europe). We found that despite the many possible genetic and environmental exposure differences in infants across 4 continents, innate cytokine responses were similar for infants from North America, South America, and Europe. However, cells from South African infants secreted significantly lower levels of cytokines than did cells from infants from the 3 other sites, and did so following stimulation of extracellular and endosomal but not cytosolic PRRs. Substantial differences in innate cytokine responses to PRR stimulation exist among different populations of infants that could not have been predicted. Delineating the underlying mechanism(s) for these differences will not only aid in improving vaccine-mediated protection but possibly also provide clues for the susceptibility to infection in different regions of the world. Copyright © 2013 The Authors. Published by Mosby, Inc. All rights reserved.

  6. Left-colon antegrade continence enema (LACE) procedure for fecal incontinence. (United States)

    Churchill, Bernard M; De Ugarte, Daniel A; Atkinson, James B


    Antegrade continence enemas (ACE) are an efficacious therapeutic option for patients with fecal incontinence. The authors review their institution's experience with a variation of the Monti-Malone ACE procedure using the left colon as a source of an intestinal conduit and enema reservoir. From 2000 to 2002, 18 patients with fecal incontinence or intractable constipation underwent left-colon ACE (LACE) procedure. Concomitant Mitrofanoff appendicovesicostomy was performed in 15 patients and bladder augmentation in 9. The majority of patients had neural tube defects. A segment of left colon was tubularized, tunneled into the muscular wall of the distal colon, and exteriorized through the left upper quadrant or midabdomen. Stomal catherization and enema installation were started one month postoperatively. Fifteen patients (83%) achieved fecal continence, 2 remain incontinent of stool, and 1 experienced stomal closure (mean follow-up was 24 +/- 9 months). Two patients had stomal stenosis that required revision. The mean enema volume in patient's achieving continence was 360 +/- 216 mL, and the mean transit time was 18 +/- 12 minutes. LACE is an efficacious procedure for fecal incontinence that can be performed safely at the time of major urologic reconstruction. Administration of enemas into the left colon has several physiologic advantages that result in predictable bowel evacuation.

  7. Striking Seasonality in the Secular Warming of the Northern Continents: Structure and Mechanisms (United States)

    Nigam, S.; Thomas, N. P.


    The linear trend in twentieth-century surface air temperature (SAT)—a key secular warming signal— exhibits striking seasonal variations over Northern Hemisphere continents; SAT trends are pronounced in winter and spring but notably weaker in summer and fall. The SAT trends in historical twentieth-century climate simulations informing the Intergovernmental Panel for Climate Change's Fifth Assessment show varied (and often unrealistic) strength and structure, and markedly weaker seasonal variation. The large intra-ensemble spread of winter SAT trends in some historical simulations was surprising, especially in the context of century-long linear trends, with implications for the detection of the secular warming signal. The striking seasonality of observed secular warming over northern continents warrants an explanation and the representation of related processes in climate models. Here, the seasonality of SAT trends over North America is shown to result from land surface-hydroclimate interactions and, to an extent, also from the secular change in low-level atmospheric circulation and related thermal advection. It is argued that the winter dormancy and summer vigor of the hydrologic cycle over middle- to high-latitude continents permit different responses to the additional incident radiative energy from increasing greenhouse gas concentrations. The seasonal cycle of climate, despite its monotony, provides an expanded phase space for the exposition of the dynamical and thermodynamical processes generating secular warming, and an exceptional cost-effective opportunity for benchmarking climate projection models.

  8. Clinical application of continent anal plug in bedridden patients with intractable diarrhea. (United States)

    Kim, J; Shim, M C; Choi, B Y; Ahn, S H; Jang, S H; Shin, H J


    Some patients bedridden from various causes such as stroke or spinal cord injury experience poor control of bowel movement. This causes fecal leakage and diarrhea, increases the risk of perianal excoriation and bed sores, and is a burden on caregivers. To evaluate the efficacy of fecal evacuation and the prevention and treatment of skin complications in intractable diarrhea patients using a new device. A continent anal plug (US Patent No. 5 569 216) comprises an inner balloon surrounded by an outer balloon, both of which are mounted on a silicone tube containing a pair of air passages and an enema fluid inlet. The tube is secured in place in the rectum by the inflatable outer balloon and is designed to drain fecal matter through a thin collapsible hose situated in the anal canal. Thirty-two patients (21 male; median age 61 (range, 28-76) years) were evaluated after fully informed consent. Median duration was 12 (range, 3-37) days. The continent anal plug evacuated efficiently in those patients with loose or watery stools who only required irrigation once daily or not at all. Skin excoriations improved in three to seven days. Minimal leakage was seen around the anus. There was no anorectal mucosal injury noted over 37 days. The continent anal plug is an efficient method of treating patients with loss of bowel control and incontinence because it enables controlled fecal evacuation and helps reduce skin complications without causing anorectal mucosal injury.

  9. Sn-wave velocity structure of the uppermost mantle beneath the Australian continent (United States)

    Wei, Zhi; Kennett, Brian L. N.; Sun, Weijia


    We have extracted a data set of more than 5000 Sn traveltimes for source-station pairs within continental Australia, with 3-D source relocation using Pn arrivals to improve data consistency. We conduct tomographic inversion for S-wave-speed structure down to 100 km using the Fast Marching Tomography (FMTOMO) method for the whole Australian continent. We obtain a 3-D model with potential resolution of 3.0° × 3.0°. The new S-wave-speed model provides strong constraints on structure in a zone that was previously poorly characterized. The S velocities in the uppermost mantle are rather fast, with patterns of variation generally corresponding to those for Pn. We find strong heterogeneities of Swave speed in the uppermost mantle across the entire continent of Australia with a close relation to crustal geological features. For instance, the cratons in the western Australia usually have high S velocities (>4.70 km s-1), while the volcanic regions on the eastern margin of Australia are characterized by low S velocities (<4.40 km s-1). Exploiting an equivalent Pn inversion, we also determine the Vp/Vs ratios across the whole continent. We find that most of the uppermost mantle has Vp/Vs between 1.65 and 1.85, but with patches in central Australia and in the east with much higher Vp/Vs ratios. Distinctive local anomalies on the eastern margin may indicate the positions of remnants of mantle plumes.

  10. A study on the birth and globalization of sports originated from each continent. (United States)

    Lee, Byung Jin; Kim, Tae Young


    The purpose of this research is to see how continent specific sports rose to its modern-day status through globalization. This research focuses on the historical background of how England's football, America's national pastime, baseball, Japan's Judo, and Korea's Taekwondo developed into sports in addition to the reasoning behind its globalization. Promoted by England and the rest of the European continent, Soccer is considered to be one of the world's most popular sports and has served its function as a form of cultural imperialism. It has also advanced alongside commerce, missionary work and other types of cultural clashes. In America, baseball was used to integrate its multicultural society and developed so that the team captain leads the rest of his team. The sports of Oriental countries were reborn through modernization that was influenced by the modern rationality, education etc. of its Western counterparts. Judo and Taekwondo were introduced globally through the Olympic Games. As mentioned above the birth of sporting events has a close connection to a nation's cultural background and globalization has taken different forms depending on which continent it originated from.

  11. A study on the birth and globalization of sports originated from each continent (United States)

    Lee, Byung Jin; Kim, Tae Young


    The purpose of this research is to see how continent specific sports rose to its modern-day status through globalization. This research focuses on the historical background of how England’s football, America’s national pastime, baseball, Japan’s Judo, and Korea’s Taekwondo developed into sports in addition to the reasoning behind its globalization. Promoted by England and the rest of the European continent, Soccer is considered to be one of the world’s most popular sports and has served its function as a form of cultural imperialism. It has also advanced alongside commerce, missionary work and other types of cultural clashes. In America, baseball was used to integrate its multicultural society and developed so that the team captain leads the rest of his team. The sports of Oriental countries were reborn through modernization that was influenced by the modern rationality, education etc. of its Western counterparts. Judo and Taekwondo were introduced globally through the Olympic Games. As mentioned above the birth of sporting events has a close connection to a nation’s cultural background and globalization has taken different forms depending on which continent it originated from. PMID:26933653

  12. Integrated Mid-Continent Carbon Capture, Sequestration & Enhanced Oil Recovery Project

    Energy Technology Data Exchange (ETDEWEB)

    Brian McPherson


    A consortium of research partners led by the Southwest Regional Partnership on Carbon Sequestration and industry partners, including CAP CO2 LLC, Blue Source LLC, Coffeyville Resources, Nitrogen Fertilizers LLC, Ash Grove Cement Company, Kansas Ethanol LLC, Headwaters Clean Carbon Services, Black & Veatch, and Schlumberger Carbon Services, conducted a feasibility study of a large-scale CCS commercialization project that included large-scale CO{sub 2} sources. The overall objective of this project, entitled the 'Integrated Mid-Continent Carbon Capture, Sequestration and Enhanced Oil Recovery Project' was to design an integrated system of US mid-continent industrial CO{sub 2} sources with CO{sub 2} capture, and geologic sequestration in deep saline formations and in oil field reservoirs with concomitant EOR. Findings of this project suggest that deep saline sequestration in the mid-continent region is not feasible without major financial incentives, such as tax credits or otherwise, that do not exist at this time. However, results of the analysis suggest that enhanced oil recovery with carbon sequestration is indeed feasible and practical for specific types of geologic settings in the Midwestern U.S.

  13. Parallel Evolution of Copy-Number Variation across Continents in Drosophila melanogaster (United States)

    Schrider, Daniel R.; Hahn, Matthew W.; Begun, David J.


    Genetic differentiation across populations that is maintained in the presence of gene flow is a hallmark of spatially varying selection. In Drosophila melanogaster, the latitudinal clines across the eastern coasts of Australia and North America appear to be examples of this type of selection, with recent studies showing that a substantial portion of the D. melanogaster genome exhibits allele frequency differentiation with respect to latitude on both continents. As of yet there has been no genome-wide examination of differentiated copy-number variants (CNVs) in these geographic regions, despite their potential importance for phenotypic variation in Drosophila and other taxa. Here, we present an analysis of geographic variation in CNVs in D. melanogaster. We also present the first genomic analysis of geographic variation for copy-number variation in the sister species, D. simulans, in order to investigate patterns of parallel evolution in these close relatives. In D. melanogaster we find hundreds of CNVs, many of which show parallel patterns of geographic variation on both continents, lending support to the idea that they are influenced by spatially varying selection. These findings support the idea that polymorphic CNVs contribute to local adaptation in D. melanogaster. In contrast, we find very few CNVs in D. simulans that are geographically differentiated in parallel on both continents, consistent with earlier work suggesting that clinal patterns are weaker in this species. PMID:26809315

  14. [Physics of materials and female stress urinary continence: New concepts: I) Elasticity under bladder]. (United States)

    Guerquin, B


    Improving the understanding of the adaptation to stress of urinary continence. A transversal analysis between physics of materials and the female anatomy. Laws of physics of the materials and of their viscoelastic behavior are applied to the anatomy of the anterior vaginal wall. The anterior vaginal wall may be divided into two segments of different viscoelastic behavior, the vertical segment below the urethra and the horizontal segment below the bladder. If the urethra gets crushed on the first segment according to the hammock theory, the crushing of the bladder on the second segment is, on the other hand, damped by its important elasticity. The importance of this elasticity evokes an unknown function: damping under the bladder that moderates and delays the increase of intravesical pressure. This damping function below the bladder is increased in the cystocele, which is therefore a continence factor; on the other hand, it is impaired in obesity, which is therefore a factor of SUI. It is necessary to include in the theory of stress continence, the notion of a damping function below the bladder. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Security and privacy issues of personal health. (United States)

    Blobel, Bernd; Pharow, Peter


    While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

  16. Personality Development

    Directory of Open Access Journals (Sweden)

    Osman Ozdemir


    Full Text Available Personality is the integration of characteristics acquired or brought by birth which separate the individual from others. Personality involves aspects of the individual's mental, emotional, social, and physical features in continuum. Several theories were suggested to explain developmental processes of personality. Each theory concentrates on one feature of human development as the focal point, then integrates with other areas of development in general. Most theories assume that childhood, especially up to 5-6 years, has essential influence on development of personality. The interaction between genetic and environmental factors reveals a unique personality along growth and developmental process. It could be said that individual who does not have any conflict between his/her basic needs and society's, has well-developed and psychologically healthy personality.

  17. Left behind and left out: The impact of the school environment on young people with continence problems. (United States)

    Whale, Katie; Cramer, Helen; Joinson, Carol


    To explore the impact of the secondary school environment on young people with continence problems. In-depth qualitative semi-structured interviews. We interviewed 20 young people aged 11-19 years (11 female and nine male) with continence problems (daytime wetting, bedwetting, and/or soiling). Interviews were conducted by Skype (n = 11) and telephone (n = 9). Transcripts were analysed using inductive thematic analysis. We generated five main themes: (1) Boundaries of disclosure: friends and teachers; (2) Social consequences of avoidance and deceit; (3) Strict and oblivious gatekeepers; (4) Intimate actions in public spaces; and (5) Interrupted learning. Disclosure of continence problems at school to both friends and teachers was rare, due to the perceived stigma and fears of bullying and social isolation. The lack of disclosure to teachers and other school staff, such as pastoral care staff, creates challenges in how best to support these young people. Young people with continence problems require unrestricted access to private and adequate toilet facilities during the school day. There is a need for inclusive toilet access policies and improved toilet standards in schools. Addressing the challenges faced by young people with continence problems at school could help to remove the barriers to successful self-management of their symptoms. It is particularly concerning that young people with continence problems are at higher risk of academic underachievement. Increased support at school is needed to enable young people with continence problems to achieve their academic potential. Statement of Contribution What is already known on this subject? Continence problems are among the most common paediatric health problems Self-management of continence problems requires a structured schedule of fluid intake and bladder emptying Inadequate toilet facilities and restricted access make it difficult for young people to manage their incontinence What does this study add

  18. University career centres – venues of non-formal learning for students

    Directory of Open Access Journals (Sweden)

    Sabina Žnidaršič Žagar


    Full Text Available Incorporation of young people, including tertiary graduates, into the labour market is facing stagnation in Slovenia. Besides external factors that are beyond the control of an individual, good employability also depends on personal characteristics of the employment seeker. Awareness of the importance of good employability means empowering and strengthening individuals through process of lifelong learning, thus enabling them to find and retain sustainable employment within the labour market. This consequently enables them to fulfil their career goals and creatively contribute to their own personal satisfaction and success, as well as that of society as a whole. Universities in Slovenia have established careers centres. The University of Ljubljana opened its first careers centre years ago (in 2008, and we are now beginning to see the results, which are similar to those achieved by careers centres of other European universities. This confirms that promotion and facilitation of good employability is more effective when careers centres are closely involved in the study process.

  19. Seismotectonic features of the African plate: the possible dislocation of a continent (United States)

    Meghraoui, Mustapha


    The African continent is made of seismically active structures with active deformation in between main substratum shields considered as stable continental interiors. Seismically active regions are primarily located along rift zones, thrust and fold mountain belts, transform faults and volcanic fields. The active tectonic structures generated large and destructive earthquakes in the past with significant damage and economic losses in Africa. Although some regions of the continent show a low-level of seismic activity, several large earthquakes (with M > 7) have occurred in the past. The presence of major active faults that generate destructive earthquakes is among the most important geological and geophysical hazards for the continent. National and International scientific projects dealing with the seismic hazards assessment are increasing in seismically active regions in Africa. The UNESCO-SIDA/IGCP (Project 601 support the preparation and implementation of the "Seismotectonic Map of Africa". Therefore, new seismotectonic data with the regional analysis of earthquake hazards became necessary as a basis for a mitigation of the earthquake damage. A database in historical and instrumental seismicity, active tectonics, stress tensor distribution, earthquake geology and paleoseismology, active deformation, earthquake geodesy (GPS) and gravity, crustal structure studies, magnetic and structural segmentation, volcanic fields, collision tectonics and rifting processes is prepared to constrain the geodynamic evolution of the continent. Taking into account the geological, tectonic and geophysical characteristics, we define six seismotectonic provinces that characterize the crustal deformation. With the previously identified Somalia tectonic block, the seismotectonic and geophysical framework of the continent reveal the existence of the Cameroon volcanic line, the South African tectonic block with transform faulting and Cape folding system

  20. Evolution of the Adria-Europe plate boundary in the northern Dinarides: From continent-continent collision to back-arc extension (United States)

    Ustaszewski, Kamil; Kounov, Alexandre; Schmid, Stefan M.; Schaltegger, Urs; Krenn, Erwin; Frank, Wolfgang; Fügenschuh, Bernhard


    The Sava Zone of the northern Dinarides is part of the Cenozoic Adria-Europe plate boundary. Here Late Cretaceous subduction of remnants of Meliata-Vardar oceanic lithosphere led to the formation of a suture, across which upper plate European-derived units of Tisza-Dacia were juxtaposed with Adria-derived units of the Dinarides. Late Cretaceous siliciclastic sediments, deposited on the Adriatic plate, were incorporated into an accretionary wedge that evolved during the initial stages of continent-continent collision. Structurally deeper parts of the exposed accretionary wedge underwent amphibolite-grade metamorphism. Grt-Pl-Ms-Bt thermobarometry and multiphase equilibria indicate temperatures between 550°C and 630°C and pressures between 5 and 7 kbar for this event. Peak metamorphic conditions were reached at around 65 Ma. Relatively slow cooling from peak metamorphic conditions throughout most of the Paleogene was possibly induced by hanging wall erosion in conjunction with southwest directed propagation of thrusting in the Dinarides. Accelerated cooling took place in Miocene times, when the Sava Zone underwent substantial extension that led to the exhumation of the metamorphosed units along a low-angle detachment. Footwall exhumation started under greenschist facies conditions and was associated with top-to-the-north tectonic transport, indicating exhumation from below European plate units. Extension postdates the emplacement of a 27 Ma old granitoid that underwent solid-state deformation under greenschist facies conditions. The 40Ar/39Ar sericite and zircon and apatite fission track ages from the footwall allow bracketing this extensional unroofing between 25 and 14 Ma. This extension is hence linked to Miocene rift-related subsidence in the Pannonian basin, which represents a back-arc basin formed due to subduction rollback in the Carpathians.

  1. The Centre of High-Performance Scientific Computing, Geoverbund, ABC/J - Geosciences enabled by HPSC (United States)

    Kollet, Stefan; Görgen, Klaus; Vereecken, Harry; Gasper, Fabian; Hendricks-Franssen, Harrie-Jan; Keune, Jessica; Kulkarni, Ketan; Kurtz, Wolfgang; Sharples, Wendy; Shrestha, Prabhakar; Simmer, Clemens; Sulis, Mauro; Vanderborght, Jan


    The Centre of High-Performance Scientific Computing (HPSC TerrSys) was founded 2011 to establish a centre of competence in high-performance scientific computing in terrestrial systems and the geosciences enabling fundamental and applied geoscientific research in the Geoverbund ABC/J (geoscientfic research alliance of the Universities of Aachen, Cologne, Bonn and the Research Centre Jülich, Germany). The specific goals of HPSC TerrSys are to achieve relevance at the national and international level in (i) the development and application of HPSC technologies in the geoscientific community; (ii) student education; (iii) HPSC services and support also to the wider geoscientific community; and in (iv) the industry and public sectors via e.g., useful applications and data products. A key feature of HPSC TerrSys is the Simulation Laboratory Terrestrial Systems, which is located at the Jülich Supercomputing Centre (JSC) and provides extensive capabilities with respect to porting, profiling, tuning and performance monitoring of geoscientific software in JSC's supercomputing environment. We will present a summary of success stories of HPSC applications including integrated terrestrial model development, parallel profiling and its application from watersheds to the continent; massively parallel data assimilation using physics-based models and ensemble methods; quasi-operational terrestrial water and energy monitoring; and convection permitting climate simulations over Europe. The success stories stress the need for a formalized education of students in the application of HPSC technologies in future.

  2. Gestion du Centre | CRDI - Centre de recherches pour le ...

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

    Le Comité de gestion du Centre (CGC) est composé des membres de la haute direction du CRDI, notamment les directeurs de nos quatre bureaux régionaux et de nos principaux secteurs de programme. Le CGC travaille en collaboration avec le président afin de soutenir la recherche pour le développement, lui fournissant ...

  3. RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System (United States)

    Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.


    RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

  4. Double breasting of bladder neck and posterior urethra for continence in isolated peno-pubic epispadias. (United States)

    Bhat, Amilal; Upadhayay, Ravi; Bhat, Mahakshit; Kumar, Rajiv; Kumar, Vinay


    The objectives of surgical repair of epispadias include the achievement of urinary continence, cosmetically acceptable genitalia with correction of curvature and normal genital function. To achieve all the aforementioned objectives, patients usually undergo two- or multiple-stage surgeries. Traditionally, the patients undergo epispadias repair in the first stage through modified Cantwell-Ransley or Mitchell-Bagli procedure. Subsequently, in the second stage, bladder neck repair is performed to achieve continence, the most common procedure being modified Young-Dees-Leadbetter. There is no reported single-stage technique of epispadias repair achieving both cosmesis and continence in isolated incontinent epispadias. The objectives of the study were to assess continence and cosmesis with partial penile disassemble and double breasting of bladder neck and posterior urethra in isolated peno-pubic epispadias. A retrospective analysis of surgical outcome of seven cases of primary isolated incontinent peno-pubic epispadias repair from July 2008 to July 2012 was carried out. Patients' age varied from 10 months to 16 years. Penile de-gloving is done with mobilization of urethral plate from ventrum to dorsum, distally till mid-glans and proximally up to pubic symphysis with preservation of blood supply at both ends. Partial mobilization of corporal bodies from its attachment and division of peno-pubic ligament are done to lengthen the penis. A mucosal strip of 5-7 mm is excised to denude the mucosa for double breasting. Tubularization of urethral plate with double breasting from the region of bladder neck to posterior urethra is done to increase the outlet resistance and then tubularization of distal urethral plate. Approximation of mobilized pelvic floor muscles is done to complete sphincteroplasty. Spongioplasty along the entire length and corporoplasty with medial rotation of corporeal bodies is done. Glanuloplasty with meatoplasty is done to bring the meatus ventrally and

  5. Personal Reflections

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education. Personal Reflections. Articles in Resonance – Journal of Science Education. Volume 6 Issue 3 March 2001 pp 90-93 Personal Reflections. Why did I opt for Career in Science? Jayant V Narlikar · More Details Fulltext PDF. Volume 9 Issue 8 August 2004 pp 89-89 ...

  6. Institutional Support : Centre for Research and Technology ...

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

    year-old science and technology research centre at Maseno University in western Kenya. The Centre focuses on science and technology research to influence both national policies and development practices at the community level. Currently ...

  7. Japanese maintenance centres strive for greater realism

    International Nuclear Information System (INIS)

    Nedderman, J.


    Japanese utilities have devoted considerable efforts to ensuring that realistic plant conditions are simulated at their maintenance centres. In some centres, eg that of Kansai Electric Power Co, realism extends to difficult access, limited lighting and restricted ventilation. (author)

  8. About the Mid-Continent Ecology Division (MED) of EPA's National Health and Environmental Effects Research Laboratory (United States)

    The Mid-Continent Ecology Division (MED) conducts innovative research and predictive modeling to document and forecast the effects of pollutants on the integrity of watersheds and freshwater ecosystems.

  9. Report: Cultural Research Centre (CRC)


    Cross-Cultural Foundation of Uganda


    This report arises from research carried out in Iganga and Namutumba districts in late 2006/early 2007 by the Cultural Research Centre (CRC), based in Jinja. Our research focus was to gauge the impact of using Lusoga as a medium of instruction (since 2005 in "pilot" lower primary classes) within and outside the classroom. This initiative was in response to a new set of circumstances in the education sector in Uganda, especially the introduction by Government of teaching in local languages in ...

  10. Radwaste Treatment Centre Jaslovske Bohunice

    International Nuclear Information System (INIS)


    In this leaflet the Bohunice Radwaste Treatment Centre (BSC RAO) is presented. BSC RAO is designed to process and treat liquid and solid radwaste, arising from the NPP A-1 decommissioning, from NPPs V-1, V-2, and Mochovce operations, as well as institutional radwaste of diverse institutional (hospitals, research institutes) in the Slovak Republic. Transport, sorting, incineration, compacting, concentration and cementation of radwaste as well as monitoring of emission are described

  11. Monitoring of internet forums to evaluate reactions to the introduction of reformulated OxyContin to deter abuse. (United States)

    McNaughton, Emily C; Coplan, Paul M; Black, Ryan A; Weber, Sarah E; Chilcoat, Howard D; Butler, Stephen F


    Reformulating opioid analgesics to deter abuse is one approach toward improving their benefit-risk balance. To assess sentiment and attempts to defeat these products among difficult-to-reach populations of prescription drug abusers, evaluation of posts on Internet forums regarding reformulated products may be useful. A reformulated version of OxyContin (extended-release oxycodone) with physicochemical properties to deter abuse presented an opportunity to evaluate posts about the reformulation in online discussions. The objective of this study was to use messages on Internet forums to evaluate reactions to the introduction of reformulated OxyContin and to identify methods aimed to defeat the abuse-deterrent properties of the product. Posts collected from 7 forums between January 1, 2008 and September 30, 2013 were evaluated before and after the introduction of reformulated OxyContin on August 9, 2010. A quantitative evaluation of discussion levels across the study period and a qualitative coding of post content for OxyContin and 2 comparators for the 26 month period before and after OxyContin reformulation were conducted. Product endorsement was estimated for each product before and after reformulation as the ratio of endorsing-to-discouraging posts (ERo). Post-to-preintroduction period changes in ERos (ie, ratio of ERos) for each product were also calculated. Additionally, post content related to recipes for defeating reformulated OxyContin were evaluated from August 9, 2010 through September 2013. Over the study period, 45,936 posts related to OxyContin, 18,685 to Vicodin (hydrocodone), and 23,863 to Dilaudid (hydromorphone) were identified. The proportion of OxyContin-related posts fluctuated between 6.35 and 8.25 posts per 1000 posts before the reformulation, increased to 10.76 in Q3 2010 when reformulated OxyContin was introduced, and decreased from 9.14 in Q4 2010 to 3.46 in Q3 2013 in the period following the reformulation. The sentiment profile for OxyContin

  12. Family-centred care delivery (United States)

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone


    Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

  13. The Aube storage centre: Annual report 2010

    International Nuclear Information System (INIS)


    After a presentation of the Aube storage centre, a storage centre for low and intermediate activity nuclear wastes, this report gives an overview of measures related to nuclear security, to radioprotection and to nuclear safety. It indicates the incidents and accidents which occurred in 2010, describes how the centre's wastes are managed, and indicates the actions performed in terms of public information

  14. North America Wound, Ostomy, and Continence and Enterostomal Therapy Nurses Current Ostomy Care Practice Related to Peristomal Skin Issues. (United States)

    Colwell, Janice C; McNichol, Laurie; Boarini, Joy

    The purpose of this study was to describe the practice of 796 ostomy nurses in North America in 2014 related to peristomal skin issues. Descriptive study. Participants were 796 wound, ostomy, and continence (WOC) and enterostomal therapy (ET) nurses currently practicing in the United States or Canada and caring for patients with ostomies. The collection of data occurred in conjunction with an educational program on peristomal skin complications and practice issues and solicited the participant's perception on the incidence and frequency of peristomal skin issues as well as on practice patterns. Participants attended an educational program. They were also asked to anonymously respond to multiple-choice questions on ostomy care management via an audience response system followed by discussion of each item and their responses. This descriptive study reports on the answers to the questions as well as the pertinent discussion points. Participants estimated that approximately 77.70% of their patients developed peristomal skin issues. The most commonly encountered problem was irritant contact dermatitis (peristomal moisture-associated skin damage). Contributing factors were inappropriate use of a pouching system owing to lack of follow-up after hospital discharge. Reported interventions for the prevention and management of peristomal skin issues included preoperative stoma site marking, use of a convex pouching system, and barrier rings. However, subsequent discussion revealed that the frequency of use of these products varied considerably. Participants identified shortened hospital stays, absence of preoperative stoma marking, and limited outpatient follow-up as contributing to development of peristomal skin problems. WOC and ET nurses estimate that more than three-quarters of persons living with an ostomy develop peristomal skin problems. Multiple interventions for managing these problems were identified, but some variability in management approaches emerged.

  15. Codon usage and expression level of human mitochondrial 13 protein coding genes across six continents. (United States)

    Chakraborty, Supriyo; Uddin, Arif; Mazumder, Tarikul Huda; Choudhury, Monisha Nath; Malakar, Arup Kumar; Paul, Prosenjit; Halder, Binata; Deka, Himangshu; Mazumder, Gulshana Akthar; Barbhuiya, Riazul Ahmed; Barbhuiya, Masuk Ahmed; Devi, Warepam Jesmi


    The study of codon usage coupled with phylogenetic analysis is an important tool to understand the genetic and evolutionary relationship of a gene. The 13 protein coding genes of human mitochondria are involved in electron transport chain for the generation of energy currency (ATP). However, no work has yet been reported on the codon usage of the mitochondrial protein coding genes across six continents. To understand the patterns of codon usage in mitochondrial genes across six different continents, we used bioinformatic analyses to analyze the protein coding genes. The codon usage bias was low as revealed from high ENC value. Correlation between codon usage and GC3 suggested that all the codons ending with G/C were positively correlated with GC3 but vice versa for A/T ending codons with the exception of ND4L and ND5 genes. Neutrality plot revealed that for the genes ATP6, COI, COIII, CYB, ND4 and ND4L, natural selection might have played a major role while mutation pressure might have played a dominant role in the codon usage bias of ATP8, COII, ND1, ND2, ND3, ND5 and ND6 genes. Phylogenetic analysis indicated that evolutionary relationships in each of 13 protein coding genes of human mitochondria were different across six continents and further suggested that geographical distance was an important factor for the origin and evolution of 13 protein coding genes of human mitochondria. Copyright © 2017 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

  16. Parallel Evolution of Copy-Number Variation across Continents in Drosophila melanogaster. (United States)

    Schrider, Daniel R; Hahn, Matthew W; Begun, David J


    Genetic differentiation across populations that is maintained in the presence of gene flow is a hallmark of spatially varying selection. In Drosophila melanogaster, the latitudinal clines across the eastern coasts of Australia and North America appear to be examples of this type of selection, with recent studies showing that a substantial portion of the D. melanogaster genome exhibits allele frequency differentiation with respect to latitude on both continents. As of yet there has been no genome-wide examination of differentiated copy-number variants (CNVs) in these geographic regions, despite their potential importance for phenotypic variation in Drosophila and other taxa. Here, we present an analysis of geographic variation in CNVs in D. melanogaster. We also present the first genomic analysis of geographic variation for copy-number variation in the sister species, D. simulans, in order to investigate patterns of parallel evolution in these close relatives. In D. melanogaster we find hundreds of CNVs, many of which show parallel patterns of geographic variation on both continents, lending support to the idea that they are influenced by spatially varying selection. These findings support the idea that polymorphic CNVs contribute to local adaptation in D. melanogaster In contrast, we find very few CNVs in D. simulans that are geographically differentiated in parallel on both continents, consistent with earlier work suggesting that clinal patterns are weaker in this species. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail:

  17. Tracing Males From Different Continents by Genotyping JC Polyomavirus in DNA From Semen Samples. (United States)

    Rotondo, John Charles; Candian, Tommaso; Selvatici, Rita; Mazzoni, Elisa; Bonaccorsi, Gloria; Greco, Pantaleo; Tognon, Mauro; Martini, Fernanda


    The human JC polyomavirus (JCPyV) is an ubiquitous viral agent infecting approximately 60% of humans. Recently, JCPyV sequences have been detected in semen samples. The aim of this investigation was to test whether semen JCPyV genotyping can be employed to trace the origin continent of males. Semen DNA samples (n = 170) from males of different Continents were investigated by PCR for the polymorphic JCPyV viral capsid protein 1 (VP1) sequences, followed by DNA sequencing. JCPyV sequences were detected with an overall prevalence of 27.6% (47/170). DNA sequencing revealed that European males carried JCPyV types 1A (71.4%), 4 (11.4%), 2B (2.9%), 2D1 (2.9%), and 3A (2.9%). Asians JCPyV type 2D1 (66.7%) and Africans JCPyV types 3A (33.3%) and 1A (33.3%). In 10.6% of males, two different JCPyV genotypes were detected, suggesting that the second JCPyV genotype was acquired in the destination country. This study indicates that the majority of semen samples found to be JCPyV-positive, were infected with the JCPyV genotype found in the geographic area of male origin. Therefore, semen JCPyV genotyping could be employed to trace the origin continent of males. Our findings could be applied to forensic investigations, in case of for instance sexual crimes. Indeed, JCPyV genotyping should enable investigators to make additional detailed profiling of the offender. J. Cell. Physiol. 232: 982-985, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Regional climate projection of the Maritime Continent using the MIT Regional Climate Model (United States)

    IM, E. S.; Eltahir, E. A. B.


    Given that warming of the climate system is unequivocal (IPCC AR5), accurate assessment of future climate is essential to understand the impact of climate change due to global warming. Modelling the climate change of the Maritime Continent is particularly challenge, showing a high degree of uncertainty. Compared to other regions, model agreement of future projections in response to anthropogenic emission forcings is much less. Furthermore, the spatial and temporal behaviors of climate projections seem to vary significantly due to a complex geographical condition and a wide range of scale interactions. For the fine-scale climate information (27 km) suitable for representing the complexity of climate change over the Maritime Continent, dynamical downscaling is performed using the MIT regional climate model (MRCM) during two thirty-year period for reference (1970-1999) and future (2070-2099) climate. Initial and boundary conditions are provided by Community Earth System Model (CESM) simulations under the emission scenarios projected by MIT Integrated Global System Model (IGSM). Changes in mean climate as well as the frequency and intensity of extreme climate events are investigated at various temporal and spatial scales. Our analysis is primarily centered on the different behavior of changes in convective and large-scale precipitation over land vs. ocean during dry vs. wet season. In addition, we attempt to find the added value to downscaled results over the Maritime Continent through the comparison between MRCM and CESM projection. Acknowledgements.This research was supported by the National Research Foundation Singapore through the Singapore MIT Alliance for Research and Technology's Center for Environmental Sensing and Modeling interdisciplinary research program.

  19. Future climate change enhances rainfall seasonality in a regional model of western Maritime Continent (United States)

    Kang, Suchul; Im, Eun-Soon; Eltahir, Elfatih A. B.


    In this study, future changes in rainfall due to global climate change are investigated over the western Maritime Continent based on dynamically downscaled climate projections using the MIT Regional Climate Model (MRCM) with 12 km horizontal resolution. A total of nine 30-year regional climate projections driven by multi-GCMs projections (CCSM4, MPI-ESM-MR and ACCESS1.0) under multi-scenarios of greenhouse gases emissions (Historical: 1976-2005, RCP4.5 and RCP8.5: 2071-2100) from phase 5 of the Coupled Model Inter-comparison Project (CMIP5) are analyzed. Focusing on dynamically downscaled rainfall fields, the associated systematic biases originating from GCM and MRCM are removed based on observations using Parametric Quantile Mapping method in order to enhance the reliability of future projections. The MRCM simulations with bias correction capture the spatial patterns of seasonal rainfall as well as the frequency distribution of daily rainfall. Based on projected rainfall changes under both RCP4.5 and RCP8.5 scenarios, the ensemble of MRCM simulations project a significant decrease in rainfall over the western Maritime Continent during the inter-monsoon periods while the change in rainfall is not relevant during wet season. The main mechanism behind the simulated decrease in rainfall is rooted in asymmetries of the projected changes in seasonal dynamics of the meridional circulation along different latitudes. The sinking motion, which is marginally positioned in the reference simulation, is enhanced and expanded under global climate change, particularly in RCP8.5 scenario during boreal fall season. The projected enhancement of rainfall seasonality over the western Maritime Continent suggests increased risk of water stress for natural ecosystems as well as man-made water resources reservoirs.

  20. Urinary continence following repair of intermediate and high urogenital sinus in CAH. Experience with 55 cases.

    Directory of Open Access Journals (Sweden)

    Maria Marcela Bailez


    Full Text Available Aim :Evaluate postoperative urinary continence in patients withcongenital adrenal hyperplasia(CAHwith intermediate (ITand high urogenital sinus (UGS who underwent a UGS mobilization maneuver .Methods: We called IT to those that although needing an aggressive dissection to get to the vagina, still have enough urethra proximal to the vaginal confluence. Very low variants are excluded from this analysis. Dissection always started in the posterior wall of the UGS with an aggressive separation from the anterior rectal wall. If the wide portion of the vagina was reached dissection stopped and the UGS opened ventrally widening to the introitus. Nineteen patients were treated using this maneuver (Group1. When more dissection was required the anterior wall of the UGS was dissected and carefully freed from the low retropubic space. Then the UGS was opened either ventrally or dorsally. Thirty three patients required this approach (Group 2 .Combined procedures were used in 3 patients with high UGS (Group 3. Results : Mean age at the time of the repair and length of the UGS were 12.2 years (4 months to 18 years and 3.75 cm (3 -8 cmfor G 1; 8 years (5 months to 17 years and 6.34 cm ( 4-12 cm in G2 and 8,3 years (2 -14 y and 11.5cm (11-12cm in G3. All patients had been regularly followed. Mean age at last follow up of 14.3y, 17y and 9.9y for groups 1, 2 and 3 respectively. All patients continue to void normally and are continent. All patients have 2 separate visible orifices in the vulva. Only 3 are sexually active.Conclusion: UGS mobilization for vaginoplasty in girls with CAH does not compromise voiding function or urinary continence,

  1. Clinical Evaluation of a Prototype Underwear Designed to Detect Urine Leakage From Continence Pads. (United States)

    Long, Adele; Edwards, Julia; Worthington, Joanna; Cotterill, Nikki; Weir, Iain; Drake, Marcus J; van den Heuvel, Eleanor


    We evaluated the performance of prototype underwear designed to detect urine leakage from continence pads, their acceptability to users, and their effect on health-related quality of life and psychosocial factors. Prototype product evaluation. Participants were 81 women with an average age of 67 years (range, 32-98 years) recruited between October 2010 and February 2012 from outpatient clinics, general practice surgeries, community continence services, and through charities and networks. The TACT3 project developed and manufactured a prototype undergarment designed to alert the wearer to a pad leak before it reaches outer clothing or furniture. The study was conducted in 2 stages: a pilot/feasibility study to assess general performance and a larger study to measure performance, acceptability to users, health-related quality of life, and psychosocial impact. Participants were asked to wear the prototype underwear for a period of 2 weeks, keeping a daily diary of leakage events for the first 7 days. They also completed validated instruments measuring lower urinary tract symptoms, health-related quality of life, and psychosocial impact. On average, 86% of the time participants were alerted to pad leakage events. More than 90% thought the prototype underwear was "good" or "OK" and that it would or could give them more confidence. Mean scores for the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form indicated no change in the level of symptoms reported before or after the intervention, and no significant changes in health-related quality of life status occurred, except improvement in for travel restrictions. Evaluation via the Psychosocial Impact of Assistive Devices Scale also indicated a positive impact. The prototype underwear evaluated in this study was effective and acceptable for 5 out of every 10 wearers. Findings also suggest that the prototype underwear is suitable for women of all ages, dress sizes, and continence

  2. Strain-specific and pooled genome sequences for populations of Drosophila melanogaster from three continents. (United States)

    Bergman, Casey M; Haddrill, Penelope R


    To contribute to our general understanding of the evolutionary forces that shape variation in genome sequences in nature, we have sequenced genomes from 50 isofemale lines and six pooled samples from populations of Drosophila melanogaster on three continents. Analysis of raw and reference-mapped reads indicates the quality of these genomic sequence data is very high. Comparison of the predicted and experimentally-determined Wolbachia infection status of these samples suggests that strain or sample swaps are unlikely to have occurred in the generation of these data. Genome sequences are freely available in the European Nucleotide Archive under accession ERP009059. Isofemale lines can be obtained from the Drosophila Species Stock Center.

  3. Radiation protection monitoring for #betta#-radiation at the Juelich Nuclear Research Centre

    International Nuclear Information System (INIS)

    Keller, M.; Heinzelmann, M.


    A complete system for radiation protection monitoring also includes #betta#-radiation monitoring. This requires suitable dose rate meters, personal dosemeters and last but not least detailed information about possible radiation exposure due to #betta#-radiation. Since there are at present no suitable #betta#-dosemeters available on the market yet, a large nuclear research centre such as the KFA Juelich, where radioactive substances are being handled by more than 1600 persons, has the task of developing and deploying suitable dosemeters. The centre's accomplishments in this area are described

  4. The role of science centres and museums in the dialogue between science and society

    Directory of Open Access Journals (Sweden)

    Paola Rodari


    Full Text Available In a meta-analysis carried out in 2002, the two main associations of science centres and museums (ASTC, mainly US-centered, and ECSITE, mainly European gathered all studies analysing the impact of science centres and museums on their local communities1. Four types of impact were identified: personal, social, political and economical. It was noticed that the vast majority of studies concentrated on the personal impact (that is, learning outcome, visitor satisfaction, etc., while the latter three were largely neglected. The very fact of pointing this out, and many recent experiences - some of which are included in this commentary - show that there is now a shift of attention.

  5. Personal Computers. (United States)

    Toong, Hoo-min D.; Gupta, Amar


    Describes the hardware, software, applications, and current proliferation of personal computers (microcomputers). Includes discussions of microprocessors, memory, output (including printers), application programs, the microcomputer industry, and major microcomputer manufacturers (Apple, Radio Shack, Commodore, and IBM). (JN)

  6. Healthcare Practitioners' Personal and Professional Values (United States)

    Moyo, Mpatisi; Goodyear-Smith, Felicity A.; Weller, Jennifer; Robb, Gillian; Shulruf, Boaz


    Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them…

  7. Personality and motivation for body donation

    NARCIS (Netherlands)

    Bolt, S.H.; Eisinga, R.N.; Venbrux, H.J.M.; Kuks, J.B.M.; Gerrits, P.O.


    Background This study examines the relationship between motivation for body donation to science and personality characteristics using a body donor survey (N = 759) conducted by the University Medical Centre Groningen (UMCG) in The Netherlands. The survey expands on anthropological studies that

  8. Personality and motivation for body donation

    NARCIS (Netherlands)

    Bolt, Sophie; Eisinga, Rob; Venbrux, Eric; Kuks, Jan B. M.; Gerrits, Peter O.


    Background: This study examines the relationship between motivation for body donation to science and personality characteristics using a body donor survey (N = 759) conducted by the University Medical Centre Groningen (UMCG) in The Netherlands. The survey expands on anthropological studies that

  9. Discussion on 'Centres of excellence' in Africa

    International Nuclear Information System (INIS)

    Riad, S.


    In Africa, Centres of Excellence should be oriented to build up scientific and technological capacity in the four topics of international Monitoring System related technologies, namely, seismic monitoring, hydro acoustic monitoring, infrasound monitoring and radionuclides monitoring. Training programs on these topics should be a major objective. A network of such centres should be established in a number of African countries. Centres should be equipped with means and materials for on-line course dispatch to interested training centres or research institutions. African centres should develop strong relationship among themselves through information and data exchange and sharing, harmonization of training programs. National data centres may be established as a component of the African Centre of Excellence. States Signatories may authorize the establishment of a specific fund to support the activities of the African center

  10. The emergence of urban centres

    DEFF Research Database (Denmark)

    Lazaro, Evelyn; Agergaard, Jytte; Larsen, Marianne Nylandsted

    by Tanzanian market liberalizations and its long term effects on private enterprise. The paper is based on a study of four EUCs in Tanzania (Ilula, Igowole, Madizini and Kibaigwa) and seeks to answer three research questions: 1) What economic and spatial trends, including national policies, have formed...... the pathway for rural transformation and early densification towards the emergence of urban centres in Tanzania? 2) What characterize the relationship between value chain dynamics and rural densification? 3) How do migration and investments contribute to the consolidation of EUCs as places of attraction...


    Directory of Open Access Journals (Sweden)

    Ljiljana Stošić Mihajlović


    Full Text Available The company "Simpo" – Vranje, is the largest exporter of Serbian furniture and more than four decades has been present on the international market, in almost every continent. And today in about 30 countries worldwide exports 65% of production. Its main advantages are a business emphasis on modern design, the constant innovation of products and materials, and personalization.

  12. Integrating personality structure, personality process, and personality development

    NARCIS (Netherlands)

    Baumert, Anna; Schmitt, Manfred; Perugini, Marco; Johnson, Wendy; Blum, Gabriela; Borkenau, Peter; Costantini, Giulio; Denissen, J.J.A.; Fleeson, William; Grafton, Ben; Jayawickreme, Eranda; Kurzius, Elena; MacLeod, Colin; Miller, Lynn C.; Read, Stephen J.; Robinson, Michael D.; Wood, Dustin; Wrzus, Cornelia


    In this target article, we argue that personality processes, personality structure, and personality development have to be understood and investigated in integrated ways in order to provide comprehensive responses to the key questions of personality psychology. The psychological processes and

  13. Comparison of the functional profile of elderly women with urinary continence and incontinence

    Directory of Open Access Journals (Sweden)

    Gabriele Regiane Winter


    Full Text Available Urinary incontinence (UI, more prevalent in women and influencing their functional decline, increases with age. Current longitudinal study with two data collection in 2005-2006 and 2011 compares the functional profile of urinary continence and incontinence in elderly women. Sixty-eight women were divided into females with urinary continence (CG; n = 62 and females with urinary incontinence (IG; n = 6. Dependent variables measured were obesity and body adiposity indexes and functional fitness. Data were given in means with standard deviation (± and analyzed by the independent t-test (p < 0.05. There were six cases of UI. In the first evaluation group differences occurred for waist circumference (CG: 85.3±9.7 cm; IG: 91.2 ± 12.4cm; t=-2.267; p < 0.05 and cardiorespiratory fitness (CG: 517.9 ± 67.3 m; IG: 463.0±85.9 m; t = 2.571; p < 0.05. CG had a better functional profile, excepting flexibility and lower limbs strength, in the second evaluation. Women with UI had higher waist circumference and lower cardiorespiratory fitness. This may be due to the relationship between the variables and greater abdominal compression and functional decline. Results show that future public health strategies should focus on these factors to decrease the risk of people developing UI and to improve physical-functional and psycho-social benefits to elderly women.

  14. Phylogeography of the Microcoleus vaginatus (Cyanobacteria from three continents--a spatial and temporal characterization.

    Directory of Open Access Journals (Sweden)

    Petr Dvořák

    Full Text Available It has long been assumed that cyanobacteria have, as with other free-living microorganisms, a ubiquitous occurrence. Neither the geographical dispersal barriers nor allopatric speciation has been taken into account. We endeavoured to examine the spatial and temporal patterns of global distribution within populations of the cyanobacterium Microcoleus vaginatus, originated from three continents, and to evaluate the role of dispersal barriers in the evolution of free-living cyanobacteria. Complex phylogeographical approach was applied to assess the dispersal and evolutionary patterns in the cyanobacterium Microcoleus vaginatus (Oscillatoriales. We compared the 16S rRNA and 16S-23S ITS sequences of strains which had originated from three continents (North America, Europe, and Asia. The spatial distribution was investigated using a phylogenetic tree, network, as well as principal coordinate analysis (PCoA. A temporal characterization was inferred using molecular clocks, calibrated from fossil DNA. Data analysis revealed broad genetic diversity within M. vaginatus. Based on the phylogenetic tree, network, and PCoA analysis, the strains isolated in Europe were spatially separated from those which originated from Asia and North America. A chronogram showed a temporal limitation of dispersal barriers on the continental scale. Dispersal barriers and allopatric speciation had an important role in the evolution of M. vaginatus. However, these dispersal barriers did not have a permanent character; therefore, the genetic flow among populations on a continental scale was only temporarily present. Furthermore, M. vaginatus is a recently evolved species, which has been going through substantial evolutionary changes.

  15. Convergence across a continent: adaptive diversification in a recent radiation of Australian lizards. (United States)

    Blom, Mozes P K; Horner, Paul; Moritz, Craig


    Recent radiations are important to evolutionary biologists, because they provide an opportunity to study the mechanisms that link micro- and macroevolution. The role of ecological speciation during adaptive radiation has been intensively studied, but radiations can arise from a diversity of evolutionary processes; in particular, on large continental landmasses where allopatric speciation might frequently precede ecological differentiation. It is therefore important to establish a phylogenetic and ecological framework for recent continental-scale radiations that are species-rich and ecologically diverse. Here, we use a genomic (approx. 1 200 loci, exon capture) approach to fit branch lengths on a summary-coalescent species tree and generate a time-calibrated phylogeny for a recent and ecologically diverse radiation of Australian scincid lizards; the genus Cryptoblepharus We then combine the phylogeny with a comprehensive phenotypic dataset for over 800 individuals across the 26 species, and use comparative methods to test whether habitat specialization can explain current patterns of phenotypic variation in ecologically relevant traits. We find significant differences in morphology between species that occur in distinct environments and convergence in ecomorphology with repeated habitat shifts across the continent. These results suggest that isolated analogous habitats have provided parallel ecological opportunity and have repeatedly promoted adaptive diversification. By contrast, speciation processes within the same habitat have resulted in distinct lineages with relatively limited morphological variation. Overall, our study illustrates how alternative diversification processes might have jointly stimulated species proliferation across the continent and generated a remarkably diverse group of Australian lizards. © 2016 The Author(s).

  16. The Influence of a Substellar Continent on the Climate of a Tidally Locked Exoplanet (United States)

    Lewis, Neil T.; Lambert, F. Hugo; Boutle, Ian A.; Mayne, Nathan J.; Manners, James; Acreman, David M.


    Previous studies have demonstrated that continental carbon-silicate weathering is important to the continued habitability of a terrestrial planet. Despite this, few studies have considered the influence of land on the climate of a tidally locked planet. In this work we use the Met Office Unified Model, coupled to a land-surface model, to investigate the climate effects of a continent located at the substellar point. We choose to use the orbital and planetary parameters of Proxima Centauri B as a template, to allow comparison with the work of others. A region of the surface where T s > 273.15 K is always retained, and previous conclusions on the habitability of Proxima Centauri B remain intact. We find that substellar land causes global cooling and increases day–night temperature contrasts by limiting heat redistribution. Furthermore, we find that substellar land is able to introduce a regime change in the atmospheric circulation. Specifically, when a continent offset to the east of the substellar point is introduced, we observe the formation of two mid-latitude counterrotating jets, and a substantially weakened equatorial superrotating jet.

  17. Does structural complexity determine the morphology of assemblages? An experimental test on three continents. (United States)

    Gibb, Heloise; Parr, Catherine L


    Understanding how species will respond to global change depends on our ability to distinguish generalities from idiosyncrasies. For diverse, but poorly known taxa, such as insects, species traits may provide a short-cut to predicting species turnover. We tested whether ant traits respond consistently to habitat complexity across geographically independent ant assemblages, using an experimental approach and baits. We repeated our study in six paired simple and complex habitats on three continents with distinct ant faunas. We also compared traits amongst ants with different foraging strategies. We hypothesised that ants would be larger, broader, have longer legs and more dorsally positioned eyes in simpler habitats. In agreement with predictions, ants had longer femurs and dorsally positioned eyes in simple habitats. This pattern was most pronounced for ants that discovered resources. Body size and pronotum width responded as predicted for experimental treatments, but were inconsistent across continents. Monopolising ants were smaller, with shorter femurs than those that occupied or discovered resources. Consistent responses for several traits suggest that many, but not all, aspects of morphology respond predictably to habitat complexity, and that foraging strategy is linked with morphology. Some traits thus have the potential to be used to predict the direction of species turnover, changes in foraging strategy and, potentially, evolution in response to changes in habitat structure.

  18. Comparing determinants of alien bird impacts across two continents: implications for risk assessment and management. (United States)

    Evans, Thomas; Kumschick, Sabrina; Dyer, Ellie; Blackburn, Tim


    Invasive alien species can have serious adverse impacts on both the environment and the economy. Being able to predict the impacts of an alien species could assist in preventing or reducing these impacts. This study aimed to establish whether there are any life history traits consistently correlated with the impacts of alien birds across two continents, Europe and Australia, as a first step toward identifying life history traits that may have the potential to be adopted as predictors of alien bird impacts. A recently established impact scoring system was used in combination with a literature review to allocate impact scores to alien bird species with self-sustaining populations in Australia. These scores were then tested for correlation with a series of life history traits. The results were compared to data from a previous study in Europe, undertaken using the same methodology, in order to establish whether there are any life history traits consistently correlated with impact across both continents. Habitat generalism was the only life history trait found to be consistently correlated with impact in both Europe and Australia. This trait shows promise as a potential predictor of alien bird impacts. The results support the findings of previous studies in this field, and could be used to inform decisions regarding the prevention and management of future invasions.

  19. Polychlorinated terphenyl patterns and levels in selected marine mammals and a river fish from different continents. (United States)

    Rosenfelder, Natalie; Vetter, Walter


    Polychlorinated terphenyls (PCTs) are a class of persistent organic pollutants which have been used from the 1920s to the 1980s for similar purposes as polychlorinated biphenyls (PCBs). Comparably little data was available on the PCT distribution in the environment mainly due to analytical difficulties in their determination. By means of a calculation algorithm recently developed we now studied the PCT pattern in individual marine mammal samples and one fish sample from different continents. Altogether, 97 PCTs were detected in eight samples and twelve to 66 tetra- to nonachloroterphenyl (tetra- to nonaCT) congeners were detected in individual samples. PCTs were present in all marine mammal samples which originated from four continents, but the PCT pattern was varied. TetraCTs were dominant in the sample from Africa, Australia, Spitsbergen (European Arctic) and in a sample from the Baltic Sea, heptaCTs in samples from the North Sea and octaCTs in a sample from Iceland. The abundance of sumPCTs relative to PCB 153, estimated from the GC/ECNI-MS response corrected for the degree of chlorination, ranged from 0.9 to 8.8%, corresponding with ~0.22-2.2% of the total PCB content. The highest PCT level detected was 980 mg/kg lipid in a harbour seal from the North Sea, Germany. The results from this study indicated that samples from certain areas, e.g. the North Sea may still be polluted with PCTs. © 2013.

  20. American Exceptionalism: Population Trends and Flight Initiation Distances in Birds from Three Continents (United States)

    Møller, Anders Pape; Samia, Diogo S. M.; Weston, Mike A.; Guay, Patrick-Jean; Blumstein, Daniel T.


    Background All organisms may be affected by humans' increasing impact on Earth, but there are many potential drivers of population trends and the relative importance of each remains largely unknown. The causes of spatial patterns in population trends and their relationship with animal responses to human proximity are even less known. Methodology/Principal Finding We investigated the relationship between population trends of 193 species of bird in North America, Australia and Europe and flight initiation distance (FID); the distance at which birds take flight when approached by a human. While there is an expected negative relationship between population trend and FID in Australia and Europe, we found the inverse relationship for North American birds; thus FID cannot be used as a universal predictor of vulnerability of birds. However, the analysis of the joint explanatory ability of multiple drivers (farmland breeding habitat, pole-most breeding latitude, migratory habit, FID) effects on population status replicated previously reported strong effects of farmland breeding habitat (an effect apparently driven mostly by European birds), as well as strong effects of FID, body size, migratory habit and continent. Farmland birds are generally declining. Conclusions/Significance Flight initiation distance is related to population trends in a way that differs among continents opening new research possibilities concerning the causes of geographic differences in patterns of anti-predator behavior. PMID:25226165

  1. Does structural complexity determine the morphology of assemblages? An experimental test on three continents.

    Directory of Open Access Journals (Sweden)

    Heloise Gibb

    Full Text Available Understanding how species will respond to global change depends on our ability to distinguish generalities from idiosyncrasies. For diverse, but poorly known taxa, such as insects, species traits may provide a short-cut to predicting species turnover. We tested whether ant traits respond consistently to habitat complexity across geographically independent ant assemblages, using an experimental approach and baits. We repeated our study in six paired simple and complex habitats on three continents with distinct ant faunas. We also compared traits amongst ants with different foraging strategies. We hypothesised that ants would be larger, broader, have longer legs and more dorsally positioned eyes in simpler habitats. In agreement with predictions, ants had longer femurs and dorsally positioned eyes in simple habitats. This pattern was most pronounced for ants that discovered resources. Body size and pronotum width responded as predicted for experimental treatments, but were inconsistent across continents. Monopolising ants were smaller, with shorter femurs than those that occupied or discovered resources. Consistent responses for several traits suggest that many, but not all, aspects of morphology respond predictably to habitat complexity, and that foraging strategy is linked with morphology. Some traits thus have the potential to be used to predict the direction of species turnover, changes in foraging strategy and, potentially, evolution in response to changes in habitat structure.

  2. Carbon cycle, chemical erosion of continents and transfers to the oceans

    International Nuclear Information System (INIS)

    Amiotte Suchet, P.


    This study tries to define the processes that control the CO 2 consumption due to the chemical erosion of continents, to appreciate the spatial-temporal fluxes of consumed CO 2 , and to estimate the transfers of dissolved mineral carbon from the continents to the oceans. Complementary approaches using different scales of time and space are necessary to study all these processes. Chemical alteration of minerals from continental rocks is due to the carbonic acid indirectly produced by atmospheric CO 2 via the photosynthesis and the degradation of organic matter in soils. The transfer of dissolved CO 2 towards the oceans is done by the drainage waters of the river basins. Continental erosion develops at the interfaces of the biosphere, atmosphere and ocean reservoirs and is controlled by numerous geological, hydro-climatical, biological and anthropic factors. Seasonal variations of CO 2 consumption has been studied for the Garonne (France), Congo and Ubangui basins to determine the mechanisms that control this consumption. A predictive model has been developed to simulate the consumed CO 2 fluxes on continental surfaces for which the spatial distribution of lithology and drainage is known. This model has been validated using available data from the Garonne (France), Congo and Amazone basins. (J.S.). 272 refs., 78 figs., 41 tabs., 1 annexe

  3. Characteristics of the oceanic MCC, continental MCC, and coastal MCC over the Indonesian maritime continent (United States)



    This study explains the comparison of mesoscale convective complexes (MCC) characteristics in the oceans, land and in the coast over Indonesian maritime continent (IMC). MCCs were identified and tracked during 15-years (2001-2015) over IMC by infrared satellite imagery using an algorithm that combines criteria of cloud coverage, eccentricity, and cloud lifetime. Infrared satellite imagery was obtained from Himawari generation satellite data. This study showed most of the continental MCC found near the mountains and the high elevation areas. The frequency of MCC occurrences was larger over the land than over the ocean. The oceanic MCCs, which lasted for more than 12 hours, were longer-lived than the continental MCCs. The MCCs with small size most frequently occurred in the continent, in contrast, the MCC with the medium and large size were most concentrated over the ocean. Generally, the continental and coastal MCC initiation occurs in the late afternoon and reach maximum size around midnight before decaying the next morning. In contrast, the oceanic MCC dominantly develops in midnight, and reach maximum size in the morning and then MCC decayed and dissipated from noon until afternoon. The evolution of MCC development in the ocean, land, and in the coast has almost the same stages and ways.

  4. Spatiotemporal variability of snow depth across the Eurasian continent from 1966 to 2012 (United States)

    Zhong, Xinyue; Zhang, Tingjun; Kang, Shichang; Wang, Kang; Zheng, Lei; Hu, Yuantao; Wang, Huijuan


    Snow depth is one of the key physical parameters for understanding land surface energy balance, soil thermal regime, water cycle, and assessing water resources from local community to regional industrial water supply. Previous studies by using in situ data are mostly site specific; data from satellite remote sensing may cover a large area or global scale, but uncertainties remain large. The primary objective of this study is to investigate spatial variability and temporal change in snow depth across the Eurasian continent. Data used include long-term (1966-2012) ground-based measurements from 1814 stations. Spatially, long-term (1971-2000) mean annual snow depths of >20 cm were recorded in northeastern European Russia, the Yenisei River basin, Kamchatka Peninsula, and Sakhalin. Annual mean and maximum snow depth increased by 0.2 and 0.6 cm decade-1 from 1966 through 2012. Seasonally, monthly mean snow depth decreased in autumn and increased in winter and spring over the study period. Regionally, snow depth significantly increased in areas north of 50° N. Compared with air temperature, snowfall had greater influence on snow depth during November through March across the former Soviet Union. This study provides a baseline for snow depth climatology and changes across the Eurasian continent, which would significantly help to better understanding climate system and climate changes on regional, hemispheric, or even global scales.

  5. Internal Delorme's Procedure for Treating ODS Associated With Impaired Anal Continence. (United States)

    Liu, Weicheng; Sturiale, Alessandro; Fabiani, Bernardina; Giani, Iacopo; Menconi, Claudia; Naldini, Gabriele


    The aim of this study was to evaluate the medium-term outcomes of internal Delorme's procedure for treating obstructed defecation syndrome (ODS) patients with impaired anal continence. In a retrospective study, 41 ODS patients who underwent internal Delorme's procedure between 2011 and 2015 were divided into 3 subgroups according to their associated symptoms of impaired continence, as urgency, passive fecal incontinence and both, before study. Then the patients' preoperative statuses, perioperative complications, and postoperative outcomes were investigated and collected from standardized questionnaires, including Altomare ODS score, Fecal Incontinence Severity Index (FISI), Patient Assessment of Constipation-Quality of Life Questionnaire (PAC-QoL), and Fecal Incontinence Quality of Life Scale (FIQLS). All results with a 2-tailed P ODS score, FISI, PAC-QoL, and FIQLS in all patients when comparing scores from before the operation with those at the final follow-up. Similar results were also observed in both the urgency subgroup and passive fecal incontinence subgroup, but there were no statistically significant improvements ( P > .05) in Altomare ODS score, FISI, PAC-QoL, or FIQLS in the urgency and passive fecal incontinence subgroups. Anorectal manometry showed the mean value of anal resting pressure increased 20%. Additionally, no major complications occurred. Internal Delorme's procedure is effective without major morbidity for treating ODS associated with urgency or passive fecal incontinence, but it may be less effective for treating ODS associated with both urgency and passive fecal incontinence.

  6. Continent-wide survey reveals massive decline in African savannah elephants. (United States)

    Chase, Michael J; Schlossberg, Scott; Griffin, Curtice R; Bouché, Philippe J C; Djene, Sintayehu W; Elkan, Paul W; Ferreira, Sam; Grossman, Falk; Kohi, Edward Mtarima; Landen, Kelly; Omondi, Patrick; Peltier, Alexis; Selier, S A Jeanetta; Sutcliffe, Robert


    African elephants (Loxodonta africana) are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC), the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants' downward trajectory by preventing poaching and protecting habitat.

  7. Continent-wide survey reveals massive decline in African savannah elephants

    Directory of Open Access Journals (Sweden)

    Michael J. Chase


    Full Text Available African elephants (Loxodonta africana are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC, the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants’ downward trajectory by preventing poaching and protecting habitat.

  8. Wound, Ostomy, and Continence Nursing: Scope and Standards of Practice, 2nd Edition: An Executive Summary. (United States)


    Wound, ostomy, and continence (WOC) nursing was recognized as a nursing specialty by the American Nurses Association in February 2010, and the Society published the original scope and standards of WOC nursing practice in May 2010. The Wound, Ostomy, and Continence Nursing: Scope and Standards of Practice, 2nd Edition is the definitive resource promoting excellence in professional practice, quality care, and improved patient outcomes in WOC specialty practice. It can be used to articulate the value of WOC nurses to administrators, legislators, payers, patients, and others. The second edition also provides an overview of the scope of WOC nursing practice including a description of the specialty, the history and evolution of WOC nursing, characteristics of WOC nursing practice, and description of the trispecialty. The document describes various WOC nurse roles, populations served, practice settings, care coordination, and collaboration. Educational preparation, levels of practice within WOC specialty nursing, certification, mandate for continuous professional development, ethics, current trends, future considerations and challenges, and standards of WOC nursing practice and professional performance with competencies for each standard are provided. The purpose of this Executive Summary is to describe the process for developing the scope and standards document, provide an overview of the scope of WOC nursing practice, and list the standards of practice and professional performance along with the competencies for each level of WOC nurse provider. The original document is available from the WOCN Society's online book store (

  9. The further development of the active urine collection device: a novel continence management system. (United States)

    Tinnion, E; Jowitt, F; Clarke-O'Neill, S; Cottenden, A M; Fader, M; Sutherland, I


    Continence difficulties affect the lives of a substantial minority of the population. Women are far more likely than men to be affected by urinary incontinence but the range of management options for them is limited. There has been considerable interest in developing an external urine collection system for women but without success to date. This paper describes the development and preliminary clinical testing of an active urine collection device (AUCD), which could provide a solution for sufferers. The device uses stored vacuum, protected by a high bubble point filter, to remove urine as quickly as it is produced. This allows a small battery-operated pump to provide the required vacuum, enabling the device to be portable. Two different types of non-invasive patient/device interface were developed, and tested by volunteers: urinal and small pad. The slimline urinal was popular with users although liquid noise was a problem. The pad interface was successful on occasions but further work is necessary to produce a reliable pad. This study has successfully demonstrated that a prototype AUCD liquid handling system can remove urine at clinically relevant flowrates. While further development is required, volunteer tests have shown that the AUCD could be a useful advance in continence management.

  10. Centre for nuclear engineering University of Toronto annual report 1984

    International Nuclear Information System (INIS)


    The annual report of the Centre for Nuclear Engineering, University of Toronto covers the following subjects: message from the Dean; Chairman's message; origins of the centre; formation of the centre; new nuclear appointments; and activities of the centre, 1984

  11. Poison centre network saves lives | IDRC - International ...

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


    Oct 27, 2010 ... ... all are potentially fatal if the correct antidote isn't identified and applied — fast. ... Organization ( WHO ) and other sources, and made all this available to ... has crossed two continents and a number of social science fiel.

  12. The new AMS control centre

    CERN Multimedia

    Anaïs Schaeffer


    Construction work for the future AMS control room began in November 2010 and should be finished this June. The new building, which will have been completed in record time thanks to the professionalism of the project team, will soon be ready to receive the initial data from the AMS experiment.     Luigi Scibile and Michael Poehler, from the GS department, at the AMS control centre construction site.   The Alpha Magnetic Spectrometer (AMS) is due to wing its way towards the International Space Station (ISS) on board the shuttle Discovery in April. Mainly intended for research on antimatter and dark matter, the data collected by AMS will be sent to Houston in the United States and then directly to CERN’s new Building 946. Construction work for the AMS control centre building on the Route Gentner at CERN’s Prévessin site started in November 2010 and must be completed in time to receive the first data from the spectrometer in June. “It normall...

  13. Personality disorder

    DEFF Research Database (Denmark)

    Tyrer, Peter; Mulder, Roger; Crawford, Mike


    and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting......Personality disorder is now being accepted as an important condition in mainstream psychiatry across the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services...... increasing evidence that some treatments, mainly psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task....

  14. Personality disorders

    DEFF Research Database (Denmark)

    Simonsen, Sebastian; Heinskou, Torben; Sørensen, Per


    BACKGROUND: In this naturalistic study, patients with personality disorders (N = 388) treated at Stolpegaard Psychotherapy Center, Mental Health Services, Capital Region of Denmark were allocated to two different kinds of treatment: a standardized treatment package with a preset number of treatment...... characteristics associated with clinicians' allocation of patients to the two different personality disorder services. METHODS: Patient characteristics across eight domains were collected in order to study whether there were systematic differences between patients allocated to the two different treatments....... Patient characteristics included measures of symptom severity, personality pathology, trauma and socio-demographic characteristics. Significance testing and binary regression analysis were applied to identify important predictors. RESULTS: Patient characteristics on fifteen variables differed...

  15. Evolutionary conservatism and convergence both lead to striking similarity in ecology, morphology and performance across continents in frogs. (United States)

    Moen, Daniel S; Irschick, Duncan J; Wiens, John J


    Many clades contain ecologically and phenotypically similar species across continents, yet the processes generating this similarity are largely unstudied, leaving fundamental questions unanswered. Is similarity in morphology and performance across assemblages caused by evolutionary convergence or by biogeographic dispersal of evolutionarily conserved ecotypes? Does convergence to new ecological conditions erase evidence of past adaptation? Here, we analyse ecology, morphology and performance in frog assemblages from three continents (Asia, Australia and South America), assessing the importance of dispersal and convergent evolution in explaining similarity across regions. We find three striking results. First, species using the same microhabitat type are highly similar in morphology and performance across both clades and continents. Second, some species on different continents owe their similarity to dispersal and evolutionary conservatism (rather than evolutionary convergence), even over vast temporal and spatial scales. Third, in one case, an ecologically specialized ancestor radiated into diverse ecotypes that have converged with those on other continents, largely erasing traces of past adaptation to their ancestral ecology. Overall, our study highlights the roles of both evolutionary conservatism and convergence in explaining similarity in species traits over large spatial and temporal scales and demonstrates a statistical framework for addressing these questions in other systems.

  16. Personalized ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor


    microenvironment. Furthermore, HVAC systems should be designed to protect occupants from airborne transmission of infectious agents that may be present in exhaled air. Personalized ventilation is a new development in the field of HVAC and has the potential to fulfill the above requirements. This paper reviews...... existing knowledge on performance of personalized ventilation (PV) and on human response to it. The airflow interaction in the vicinity of the human body is analyzed and its impact on thermal comfort and inhaled air quality is discussed together with control strategies and the application of PV in practice...

  17. One billion year-old Mid-continent Rift leaves virtually no clues in the mantle (United States)

    Bollmann, T. A.; Frederiksen, A. W.; van der Lee, S.; Wolin, E.; Revenaugh, J.; Wiens, D.; Darbyshire, F. A.; Aleqabi, G. I.; Wysession, M. E.; Stein, S.; Jurdy, D. M.


    We measured the relative arrival times of more than forty-six thousand teleseismic P waves recorded by seismic stations of Earthscope's Superior Province Rifting Earthscope Experiment (SPREE) and combined them with a similar amount of such measurements from other seismic stations in the larger region. SPREE recorded seismic waves for two and a half years around the prominent, one billion year-old Mid-continent Rift structure. The curvilinear Mid-continent Rift (MR) is distinguished by voluminous one billion year-old lava flows, which produce a prominent gravity high along the MR. As for other seismic waves, these lava flows along with their underplated counterpart, slightly slow down the measured teleseismic P waves, on average, compared to P waves that did not traverse structures beneath the Mid-continent Rift. However, the variance in the P wave arrival times in these two groups is nearly ten times higher than their average difference. In a seismic-tomographic inversion, we mapped all measured arrival times into structures deep beneath the crust, in the Earth's mantle. Beneath the crust we generally find relatively high P velocities, indicating relatively cool and undeformable mantle structures. However, the uppermost mantle beneath the MR shows several patches of slightly decreased P velocities. These patches are coincident with where the gravity anomalies peak, in Iowa and along the northern Minnesota/Wisconsin border. We will report on the likelihood that these anomalies are indeed a remaining mantle-lithospheric signature of the MR or whether these patches indirectly reflect the presence of the lava flows and their underplated counterparts at the crust-mantle interface. Other structures of interest and of varying depth extent in our tomographic image locate at 1) the intersection of the Superior Craton with the Penokean Province and the Marshfield Terrane west of the MR in southern Minnesota, 2) the intersection of the Penokean, Yavapai, and Mazatzal Terranes

  18. Rainfall over the African continent from the 19th through the 21st century (United States)

    Nicholson, Sharon E.; Funk, Chris; Fink, Andreas H.


    Most of the African continent is semi-arid and hence prone to extreme variations in rainfall from year to year. The extreme droughts that have plagued the Sahel and eastern Africa are particularly well known. This article uses a markedly expanded and updated rainfall data set to examine rainfall variability in 13 sectors that cover most of the continent. Annual rainfall is presented for each sector; the March-to-May and October-November seasons are also examined for equatorial sectors. In each case, the article includes the longest and most comprehensive precipitation gauge series ever published. All time series cover at least a century and most cover roughly one and one-half centuries or more. Although towards the end of the 20th century there was a widespread trend towards more arid conditions, few significant trends are evident over the entire period of record. The largest were downward trends in the Sahel and western sectors of North Africa. In those regions, an abrupt reduction in rainfall occurred around 1968, but a synchronous change occurred many other parts of Africa. A recovery did occur in the Sahel, but to varying degrees across the east-west expanse of the region. Noteworthy is that the west-to-east rainfall gradient across the region appears to have weakened in recent decades. For the continent as a whole, another change began in the 1980s decade, with more arid conditions persisting at the continental scale until early in the twenty-first century. No other such period of dry conditions occurred within the roughly one and one-half centuries evaluated here. A notable change also occurred at the seasonal level. During the period 1980 to 1998 rainfall during March-to-May was well below the long-term mean throughout most of the area from 20° N to 35° S. At the same time rainfall was above the long-term mean in most of eastern sectors within this latitude span, indicating a change in the seasonality of rainfall of a large part of Africa.

  19. Personality disorders

    NARCIS (Netherlands)

    van den Bosch, L.M.C.; Verheul, R.; Verster, J.C.; Brady, K.; Galanter, M.; Conrod, P.


    Subject of this chapter is the often found combination of personality disorders and ­substance abuse disorders. The serious nature of this comorbidity is shown through the discussion of prevalence and epidemiological data. Literature shows that the comorbidity, hampering the diagnostic process, is

  20. Personalized nanomedicine

    NARCIS (Netherlands)

    Lammers, Twan Gerardus Gertudis Maria; Rizzo, L.Y.; Storm, Gerrit; Kiessling, F.


    Abstract Personalized medicine aims to individualize chemotherapeutic interventions on the basis of ex vivo and in vivo information on patient- and disease-specific characteristics. By noninvasively visualizing how well image-guided nanomedicines-that is, submicrometer-sized drug delivery systems

  1. Smart work centres in rural areas

    DEFF Research Database (Denmark)

    Lorentzen, Anne Birte

    This paper discusses the establishment of telework centres as an element in local development strategies in rural areas, with a particular view to two new telework centres in region North Denmark. The paper argues that telework centres do not represent an easy solution to problems of local...... development and environmental sustainability, and further, that technology may not even be the most important feature needed to make them function as such....

  2. Elm Farm Organic Research Centre December 2006


    Sanders, Richard; Whiltley, Andrew; Haigh, Zoe; Clarke, Sarah; Hitchings, Roger; O'Brien, Josie


    The Organic Research Centre. Elm Farm Research Centre Bulletin with Technical Updates from The Organic Advisory Service is a regular publication from The Organic Research Centre. The current issue covers: Report from 2006 Cirencester Conference; Quest for more home produced organic food; in a world where bread matters; Improving wheat with plenty of parents; Unlocking the secrets of the ancient (cereal varieties); Brain food- a good read; Not to late to protect the future: The organic...

  3. Powering the Future Data Centre

    DEFF Research Database (Denmark)

    Zhang, Zhe


    of the characteristics of these two power sources: long warm-up stage and low dynamics for fuel cell, and variable terminal voltage for supercapacitors. The motivation for this project was to find ways which can overcome those limitations to integrate fuel cells and supercapcitors to the system with high efficiency......The extended run Uninterruptible Power Supply system (UPSs) which powered by fuel cells and supercapcitors, is a promising solution for future data centre to obtain environmentfriendly energy efficient and cost effective. There are many challenges in power electronic interface circuits, because......: • Optimized design method for dual active bridge (DAB) converter and its derived circuits; • A novel hybrid dc-dc converter and its corresponding optimal design method are proposed; • An improved dual input current-fed DC-DC converter with bidirectional power conversion ability is investigated; • Extend...

  4. Preparation of emergency care centre exercises

    International Nuclear Information System (INIS)

    Schnadt, H.; Miska, H.


    Setup and operation of emergency care centres (sometimes also addressed as emergency reception centres) are part of emergency response in the environs of nuclear power plants. The preparation of an exercise scenario for such a centre is very demanding on the responsible agency. Therefore, a computer code has been developed which helps to translate the exercise objectives into instructions for figurants which simulate the affected population. These instructions are intended to steer a determined flow of people through the emergency care centre by providing fictitious radiological readings and by injecting the demand for additional actions of response personnel by statements and questions. (orig.)

  5. The Influence of Preoperative Bladder Outlet Obstruction on Continence and Satisfaction in Patients with Stress Urinary Incontinence after Midurethral Sling

    Directory of Open Access Journals (Sweden)

    Su Jin Kim


    Full Text Available Purpose We studied the influence of preoperative bladder outlet obstruction (BOO on postoperative continence rates and patient satisfaction after the midurethral sling procedure. Methods A total of 159 women who underwent the midurethral sling procedure were evaluated. Using the Blaivas-Groutz nomogram, we assigned the patients were assigned to Group I (n=37, no obstruction, Group II (n=89, mild obstruction, or Group III (n=33, moderate to severe obstruction. Continence rates, patient satisfaction, urinary sensation scale and uroflowmetry were evaluated postoperatively. Results There were no significant differences in continence rates, satisfaction, or postoperative maximal flow rate between the 3 groups. Postoperative urgency was improved after surgery in Groups I and II (P<0.05 but not in Group III. Conclusions BOO does not seem to be a risk factor for failure after the midurethral sling procedure. However, BOO may be considered as a potential factor for persistent storage symptoms after the midurethral sling.

  6. Developing and testing the patient-centred innovation questionnaire for hospital nurses. (United States)

    Huang, Ching-Yuan; Weng, Rhay-Hung; Wu, Tsung-Chin; Lin, Tzu-En; Hsu, Ching-Tai; Hung, Chiu-Hsia; Tsai, Yu-Chen


    Develop the patient-centred innovation questionnaire for hospital nurses and establish its validity and reliability. Patient-centred care has been adopted by health care managers in their efforts to improve health care quality. It is regarded as a core concept for developing innovation. A cross-sectional study was employed to collect data from hospital nurses in Taiwan. This study was divided into two stages: pilot study and main study. In the main study, 596 valid responses were collected. This study adopted reliability analysis, exploratory factor analysis, confirmatory factor analysis and selected nurse innovation scale as a criterion to test criterion-related validity. Five-dimension patient-centred innovation questionnaire was proposed: access and practicability, co-ordination and communication, sharing power and responsibility, care continuity, family and person focus. Each dimension demonstrated a reliability of 0.89-0.98. All dimensions had acceptable convergent and discriminate validity. The patient-centred innovation questionnaire and nurse innovation scale exhibited a significantly positive correlation. Patient-centred innovation questionnaire not only had a good theoretical basis but also had sufficient reliability and construct validity, and criterion-related validity. Patient-centred innovation questionnaire could give a measure for evaluating the implementation of patient-centred care and could be used as a management tool during the process of nurse innovation. © 2017 John Wiley & Sons Ltd.

  7. The changing role of mammal life histories in Late Quaternary extinction vulnerability on continents and islands. (United States)

    Lyons, S Kathleen; Miller, Joshua H; Fraser, Danielle; Smith, Felisa A; Boyer, Alison; Lindsey, Emily; Mychajliw, Alexis M


    Understanding extinction drivers in a human-dominated world is necessary to preserve biodiversity. We provide an overview of Quaternary extinctions and compare mammalian extinction events on continents and islands after human arrival in system-specific prehistoric and historic contexts. We highlight the role of body size and life-history traits in these extinctions. We find a significant size-bias except for extinctions on small islands in historic times. Using phylogenetic regression and classification trees, we find that while life-history traits are poor predictors of historic extinctions, those associated with difficulty in responding quickly to perturbations, such as small litter size, are good predictors of prehistoric extinctions. Our results are consistent with the idea that prehistoric and historic extinctions form a single continuing event with the same likely primary driver, humans, but the diversity of impacts and affected faunas is much greater in historic extinctions. © 2016 The Author(s).

  8. Crustal volumes of the continents and of oceanic and continental submarine plateaus (United States)

    Schubert, G.; Sandwell, D.


    Using global topographic data and the assumption of Airy isostasy, it is estimated that the crustal volume of the continents is 7182 X 10 to the 6th cu km. The crustal volumes of the oceanic and continental submarine plateaus are calculated at 369 X 10 to the 6th cu km and 242 X 10 to the 6th cu km, respectively. The total continental crustal volume is found to be 7581 X 10 to the 6th cu km, 3.2 percent of which is comprised of continental submarine plateaus on the seafloor. An upper bound on the contintental crust addition rate by the accretion of oceanic plateaus is set at 3.7 cu km/yr. Subduction of continental submarine plateaus with the oceanic lithosphere on a 100 Myr time scale yields an upper bound to the continental crustal subtraction rate of 2.4 cu km/yr.


    Directory of Open Access Journals (Sweden)



    Full Text Available The paper analysed the total assets in 2016 achieved by the strongest 96 banks from 4 continents: Europe, America, Asia and Africa. It aims to evaluate the level of total assets provided by banks in 2016 and continental banking markets degree of differentiation to determine the overall conditions of the banks. Methodologies used in this study are based on cluster and descriptives analysis. Data set was built based on informations reported by banks on total assets. The results indicate that most of total banking assets are found in Asia and the fewest in Africa. At the end of 2016, the top 16 global banks owned total assets of $ 30.19 trillion according to the data set contains cluster 1 and the centroid was (2.25, 2.11, 3.06, 0.01.

  10. Consistent response of bird populations to climate change on two continents. (United States)

    Stephens, Philip A; Mason, Lucy R; Green, Rhys E; Gregory, Richard D; Sauer, John R; Alison, Jamie; Aunins, Ainars; Brotons, Lluís; Butchart, Stuart H M; Campedelli, Tommaso; Chodkiewicz, Tomasz; Chylarecki, Przemysław; Crowe, Olivia; Elts, Jaanus; Escandell, Virginia; Foppen, Ruud P B; Heldbjerg, Henning; Herrando, Sergi; Husby, Magne; Jiguet, Frédéric; Lehikoinen, Aleksi; Lindström, Åke; Noble, David G; Paquet, Jean-Yves; Reif, Jiri; Sattler, Thomas; Szép, Tibor; Teufelbauer, Norbert; Trautmann, Sven; van Strien, Arco J; van Turnhout, Chris A M; Vorisek, Petr; Willis, Stephen G


    Global climate change is a major threat to biodiversity. Large-scale analyses have generally focused on the impacts of climate change on the geographic ranges of species and on phenology, the timing of ecological phenomena. We used long-term monitoring of the abundance of breeding birds across Europe and the United States to produce, for both regions, composite population indices for two groups of species: those for which climate suitability has been either improving or declining since 1980. The ratio of these composite indices, the climate impact indicator (CII), reflects the divergent fates of species favored or disadvantaged by climate change. The trend in CII is positive and similar in the two regions. On both continents, interspecific and spatial variation in population abundance trends are well predicted by climate suitability trends. Copyright © 2016, American Association for the Advancement of Science.

  11. Integration of health and environment through health impact assessment: cases from three continents. (United States)

    Negev, Maya; Levine, Hagai; Davidovitch, Nadav; Bhatia, Rajiv; Mindell, Jennifer


    Despite the strong linkage between environment and health, institutions responsible for these fields operate in largely fragmented ways with limited interaction. As illustrated in the recent engagement between health and urban planning institutions, inter-institutional cooperation could support more effective and politically acceptable solutions for both local and global problems. Analysis of three case-studies, from three different continents, shows that HIA might serve to promote synergies among health and environmental disciplines in different local contexts, and could lead to institutional and procedural changes that promote health. Case examples provided supportive evidence for these effects, despite differences in approaches to HIA and governance levels. Obstacles to the use of HIA for inter-institutional integration also differed between countries. Lessons learned could support cooperation in other common interests of health and environment disciplines such as research, training and preparedness, and mitigation of public health emergencies related to the environment. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. The uranium geology and tectonic correlation between the African and Latin American continents

    International Nuclear Information System (INIS)

    Toens, P.D.; Le Roux, J.P.; Van Biljon, W.J.


    Subsequent to a meeting of the International Atomic Agency's Advisory Group on Uranium Geology in Latin America held in Lima, Peru in December 1978, it was decided that a project involving the correlation of uranium geology on either side of the Atlantic was called for. The representatives of the countries concerned were asked to meet in Vienna in July 1980 and present interim reports on progress made in their respective countries on this project. This paper represents an interim report by the South African Working Group. The aspects dealt with cover the matching of the two continents, the nature and distribution of the Gondwana and earlier sequences, as well as the nature and distribution of uraniferous alkaline complexes and granites [af

  13. The peopling of the African continent and the diaspora into the new world. (United States)

    Campbell, Michael C; Hirbo, Jibril B; Townsend, Jeffrey P; Tishkoff, Sarah A


    Africa is the birthplace of anatomically modern humans, and is the geographic origin of human migration across the globe within the last 100,000 years. The history of African populations has consisted of a number of demographic events that have influenced patterns of genetic and phenotypic variation across the continent. With the increasing amount of genomic data and corresponding developments in computational methods, researchers are able to explore long-standing evolutionary questions, expanding our understanding of human history within and outside of Africa. This review will summarize some of the recent findings regarding African demographic history, including the African Diaspora, and will briefly explore their implications for disease susceptibility in populations of African descent.

  14. Seismic site evaluation practice and seismic design guide for NPP in Continent of China

    Energy Technology Data Exchange (ETDEWEB)

    Yuxian, Hu [State Seismological Bureau, Beijing, BJ (China). Inst. of Geophysics


    Energy resources, seismicity, NPP and related regulations of the Continent of China are briefly introduced in the beginning and two codes related to the seismic design of NPP, one on siting and another on design, are discussed in some detail. The one on siting is an official code of the State Seismological Bureau, which specifies the seismic safety evaluation requirements of various kinds of structures, from the most critic and important structures such as NPP to ordinary buildings, and including also engineering works in big cities. The one on seismic design of NPP is a draft subjected to publication now, which will be an official national code. The first one is somewhat unique but the second one is quite similar to those in the world. (author)

  15. Seismic site evaluation practice and seismic design guide for NPP in Continent of China

    International Nuclear Information System (INIS)

    Hu Yuxian


    Energy resources, seismicity, NPP and related regulations of the Continent of China are briefly introduced in the beginning and two codes related to the seismic design of NPP, one on siting and another on design, are discussed in some detail. The one on siting is an official code of the State Seismological Bureau, which specifies the seismic safety evaluation requirements of various kinds of structures, from the most critic and important structures such as NPP to ordinary buildings, and including also engineering works in big cities. The one on seismic design of NPP is a draft subjected to publication now, which will be an official national code. The first one is somewhat unique but the second one is quite similar to those in the world. (author)

  16. Structure and frame conditions for power exchange agreements with the Continent

    International Nuclear Information System (INIS)

    Wiedswang, R.


    The conference paper relates to the obtained agreements between Norway and the Continent on the exchange of electric power. The paper discusses the structure and frame conditions for the ELSAM, PreussenElektra, SEP and EuroStrom agreements. ELSAM covers the agreement with Denmark which started on 27 July 1995. The PreussenElektra agreement includes the exchange of power with the German PreussenElektra AG which starts on 1 October 1998. SEP covers the agreement with the Netherlands which is planned to start on 1 October 2001, and the EuroStrom agreement with the German EST EuroStrom Trading GmbH in Hamburg which is planned to start on 1 January 2003. 8 figs

  17. Warming increases plant biomass and reduces diversity across continents, latitudes, and species migration scenarios in experimental wetland communities. (United States)

    Baldwin, Andrew H; Jensen, Kai; Schönfeldt, Marisa


    Atmospheric warming may influence plant productivity and diversity and induce poleward migration of species, altering communities across latitudes. Complicating the picture is that communities from different continents deviate in evolutionary histories, which may modify responses to warming and migration. We used experimental wetland plant communities grown from seed banks as model systems to determine whether effects of warming on biomass production and species richness are consistent across continents, latitudes, and migration scenarios. We collected soil samples from each of three tidal freshwater marshes in estuaries at three latitudes (north, middle, south) on the Atlantic coasts of Europe and North America. In one experiment, we exposed soil seed bank communities from each latitude and continent to ambient and elevated (+2.8 °C) temperatures in the greenhouse. In a second experiment, soil samples were mixed either within each estuary (limited migration) or among estuaries from different latitudes in each continent (complete migration). Seed bank communities of these migration scenarios were also exposed to ambient and elevated temperatures and contrasted with a no-migration treatment. In the first experiment, warming overall increased biomass (+16%) and decreased species richness (-14%) across latitudes in Europe and North America. Species richness and evenness of south-latitude communities were less affected by warming than those of middle and north latitudes. In the second experiment, warming also stimulated biomass and lowered species richness. In addition, complete migration led to increased species richness (+60% in North America, + 100% in Europe), but this higher diversity did not translate into increased biomass. Species responded idiosyncratically to warming, but Lythrum salicaria and Bidens sp. increased significantly in response to warming in both continents. These results reveal for the first time consistent impacts of warming on biomass and

  18. Suicidal behaviour across the African continent: a review of the literature. (United States)

    Mars, Becky; Burrows, Stephanie; Hjelmeland, Heidi; Gunnell, David


    Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world's second most populous continent, are limited. We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa's population; suicide attempt data were available for men are typically at least three times higher than in women. The most frequently used methods of suicide are hanging and pesticide poisoning. Reported risk factors are similar for suicide and suicide attempts and include interpersonal difficulties, mental and physical health problems, socioeconomic problems and drug and alcohol use/abuse. Qualitative studies are needed to identify additional culturally relevant risk factors and to understand how risk factors may be connected to suicidal behaviour in different socio-cultural contexts. Our estimate is somewhat lower than GBD, but still clearly indicates suicidal behaviour is an important public health problem in Africa. More regional studies, in both urban and rural areas, are needed to more accurately estimate the burden of suicidal behaviour across the continent. Qualitative studies are required in addition to quantitative studies.

  19. Hierarchical Genetic Analysis of German Cockroach (Blattella germanica) Populations from within Buildings to across Continents (United States)

    Vargo, Edward L.; Crissman, Jonathan R.; Booth, Warren; Santangelo, Richard G.; Mukha, Dmitry V.; Schal, Coby


    Understanding the population structure of species that disperse primarily by human transport is essential to predicting and controlling human-mediated spread of invasive species. The German cockroach (Blattella germanica) is a widespread urban invader that can actively disperse within buildings but is spread solely by human-mediated dispersal over longer distances; however, its population structure is poorly understood. Using microsatellite markers we investigated population structure at several spatial scales, from populations within single apartment buildings to populations from several cities across the U.S. and Eurasia. Both traditional measures of genetic differentiation and Bayesian clustering methods revealed increasing levels of genetic differentiation at greater geographic scales. Our results are consistent with active dispersal of cockroaches largely limited to movement within a building. Their low levels of genetic differentiation, yet limited active spread between buildings, suggests a greater likelihood of human-mediated dispersal at more local scales (within a city) than at larger spatial scales (within and between continents). About half the populations from across the U.S. clustered together with other U.S. populations, and isolation by distance was evident across the U.S. Levels of genetic differentiation among Eurasian cities were greater than those in the U.S. and greater than those between the U.S. and Eurasia, but no clear pattern of structure at the continent level was detected. MtDNA sequence variation was low and failed to reveal any geographical structure. The weak genetic structure detected here is likely due to a combination of historical admixture among populations and periodic population bottlenecks and founder events, but more extensive studies are needed to determine whether signatures of global movement may be present in this species. PMID:25020136

  20. Drought consistently alters the composition of soil fungal and bacterial communities in grasslands from two continents. (United States)

    Ochoa-Hueso, Raúl; Collins, Scott L; Delgado-Baquerizo, Manuel; Hamonts, Kelly; Pockman, William T; Sinsabaugh, Robert L; Smith, Melinda D; Knapp, Alan K; Power, Sally A


    The effects of short-term drought on soil microbial communities remain largely unexplored, particularly at large scales and under field conditions. We used seven experimental sites from two continents (North America and Australia) to evaluate the impacts of imposed extreme drought on the abundance, community composition, richness, and function of soil bacterial and fungal communities. The sites encompassed different grassland ecosystems spanning a wide range of climatic and soil properties. Drought significantly altered the community composition of soil bacteria and, to a lesser extent, fungi in grasslands from two continents. The magnitude of the fungal community change was directly proportional to the precipitation gradient. This greater fungal sensitivity to drought at more mesic sites contrasts with the generally observed pattern of greater drought sensitivity of plant communities in more arid grasslands, suggesting that plant and microbial communities may respond differently along precipitation gradients. Actinobateria, and Chloroflexi, bacterial phyla typically dominant in dry environments, increased their relative abundance in response to drought, whereas Glomeromycetes, a fungal class regarded as widely symbiotic, decreased in relative abundance. The response of Chlamydiae and Tenericutes, two phyla of mostly pathogenic species, decreased and increased along the precipitation gradient, respectively. Soil enzyme activity consistently increased under drought, a response that was attributed to drought-induced changes in microbial community structure rather than to changes in abundance and diversity. Our results provide evidence that drought has a widespread effect on the assembly of microbial communities, one of the major drivers of soil function in terrestrial ecosystems. Such responses may have important implications for the provision of key ecosystem services, including nutrient cycling, and may result in the weakening of plant-microbial interactions and a

  1. Um continente entortado (América Latina The lopsided continent (Latin America

    Directory of Open Access Journals (Sweden)

    Kelly Hoffman


    Full Text Available Em todo o mundo, a América Latina é a região que apresenta a mais desequilibrada distribuição de recursos. O artigo define um conjunto comum de elementos que caracterizam as estruturas sociais do continente, sugere algumas linhas de análise e teorização e defende a integração dos estudos regionais nas discussões mais amplas a respeito da estratificação. Na primeira parte, examina-se a situação do continente como um todo, com uma breve discussão sobre a relação entre pobreza e desigualdade, e sobre o problema da disponibilidade de dados. Em seguida, analisa-se classe, gênero e raça. A conclusão identifica três fatores críticos que explicam a desigualdade latino-americana: sua posição no interior do sistema econômico global, o colonialismo interno que mantém as categorias raciais e o subdesenvolvimento das estruturas estataisLatin America has the most unbalanced distribution of resources of all regions in the world. This review defines a set of common elements characterizing social structures on this continent, suggests some approaches for analysis and theorizing, and supports the integration of regional studies into broader discussions of stratification. An overview of the situation on the continent as a whole, including a short discussion of the relationship between poverty and inequality, allows to address some concerns with data availability. We then devote a section each to class, gender, and race, and conclude by identifying three critical factors that explain Latin American inequality: its position within a global economic system, internal colonialism with maintenance of racial categories, and the underdevelopment of state structures.

  2. Strike-slip faults offshore southern Taiwan: implications for the oblique arc-continent collision processes (United States)

    Fuh, Shi-Chie; Liu, Char-Shine; Lundberg, Neil; Reed, Donald L.


    Taiwan is the site of present-day oblique arc-continent collision between the Luzon arc of the Philippine Sea plate and the Chinese continental margin. The major structural pattern revealed from marine geophysical studies in the area offshore southern Taiwan is that of a doubly-vergent orogenic belt, bounded by significant zones of thrusting on the west and east of the submarine accretionary wedge. Due to the oblique collision process, strike-slip faults could play an important role in this convergent domain. Topographic lineaments revealed from new digital bathymetry data and seismic reflection profiles confirm the existence of three sets of strike-slip faults in the collision-subduction zone offshore southern Taiwan: the N-S-trending left-lateral strike-slip faults within the Luzon volcanic arc, the NE-SW-trending right-lateral strike-slip faults across the accretionary wedge, and the NNE-SSW-trending left-lateral strike-slip faults lie in the frontal portion of the accretionary wedge. These strike-slip faults overprint pre-existing folds and thrusts and may convert into oblique thrusts or thrusts as the forearc blocks accrete to the mountain belt. A bookshelf rotation model is used to explain the observed geometrical relationships of these strike-slip fault systems. Based on this model, the counter-clockwise rotation of the forearc blocks in the area offshore southern Taiwan could have caused extrusion of the accretionary wedge material into the forearc basin. The originally continuous forearc basin is thus deformed into several closed and separate proto-collisional basins such as the Southern Longitudinal Trough and Taitung Trough. A tectonic evolution model which emphasizes on the development of various structures at different stages of the oblique arc-continent collision for the Taiwan mountain belt is proposed.

  3. Seismic investigation of an ocean-continent transition zone in the northern South China Sea (United States)

    Zhu, J.; Qiu, X.; Xu, H.; Zhan, W.; Sun, Z.


    Rifted continental margins and basins are mainly formed by the lithospheric extension. Thined lithosphere of passive continental margins results in decompression melt of magma and created oceanic crust and thined ocean-continent transition (OCT) zone. Two refraction profiles used ocean bottom seismometers deployed in the broad continental shelf and three multi-channel seismic reflection lines in the northern South China Sea, acquired by the ship "Shiyan 2" of the South China Sea Institute of Oceanology, Chinese Academy of Sciences in 2010, are processed and interpreted in this study. Seismic reflection lines cut through the Dongsha rise, Zhu-1 and Zhu-2 depression within a Tertiary basin, Pear River Mouth basin (called as Zhujiangkou basin). These tectonic features are clear imaged in the seismic reflection records. Numerous normal faults, cutted through the basement and related to the stretch of the northern South China Sea margin, are imaged and interpreted. Reflection characteristics of the ocean-continent transition (OCT) zone are summaried and outlined. The COT zone is mainly divided into the northern syn-rift subsidence zone, central volcano or buried volcano uplift zone and tilt faulted block near the South Chia Sea basin. Compared to the previous seismic reflection data and refraction velocity models, the segmentation range of the OCT zone is outlined, from width of about 225 km in the northeastern South China Sea , of 160 km in the central to of 110 km in the north-central South China Sea. Based on the epicenter distribution of sporadic and large than 6 magnitude earthquakes, it suggests the OCT zone in the northern South China Sea at present is still an active seismic zone.

  4. Anisotropic tomography of the Indian continent and the geodynamic role of its keel (United States)

    Montagner, J. P.; Maurya, S.; Sibrant, A.; Davaille, A.; Stutzmann, E.; Kumar, R.; Jean, B.


    The Indian moved at an exceptional high rate (18-20cm/year) after the birth of La Réunion hotspot, ≈65Ma ago and the Deccan volcanic province before the collision with the Asian continent. Other older plumes Marion, Kerguelen located in the Indian ocean are also associated with very fast plate motion. We present a high-resolution 3D anisotropic model of the Indian plate region down to 300 km depth, obtained by inverting a new massive database of surface-wave observations. The Rayleigh and Love wave dispersion measurements along 14,000 paths are made in a broad frequency range (16-250s). Our estimates of the depth to the Lithosphere-Asthenosphere Boundary (LAB) derived from seismic velocity Vsv variations at depth reveal large variations (120-250 km) beneath the different cratonic blocks. A low velocity layer associated with the Mid-lithospheric discontinuity is present when the root of the lithosphere is deep. This extensive anisotropic tomographic investigation of the Indian continent displays an almost north-south keel, 600km long and 300km wide, down to 250km depth. The keel is characterized by fast velocities, smaller than average radial and azimuthal anisotropies. The distribution of azimuthal anisotropy defines the flow lines around the keel, and, at the LAB, coincides with the APM direction of the Indian plate. The fast axis azimuths at 250 km depth are also in accordance with the results from SK(K)S splitting. Such a keel could probably perturb plume-induced flow in the asthenosphere. To determine the influence of such a keel on the interaction of India with several mantle plumes (Marion, Crozet, Kerguelen, La Réunion), we used laboratory experiments. Some preliminary results will be presented on the comparison between the laboratory flowlines and the direction of seismic anisotropy.

  5. Geodynamic evolution of the Sabzevar zone, northern central Iranian micro-continent (United States)

    Omrani, Hadi; Moazzen, Mohssen; Oberhänsli, Roland


    The Northern Central Iranian Micro-continent (CIM) represents Neotethys-related oceanic crust remnants, emplaced due to convergence between CIM and Eurasia plates during Eocene. Mafic and ultramafic units are exposed along the northern part of the CIM in the Sabzevar area. The geology and field relation of Sabzevar ophiolite indicate northward subduction of the Sabzevar basin. The average whole rock chemistry of mafic (gabbros) and ultramafic samples (lherzolite, harzburgite and dunite) is characterized by a range of MgO of 11.16-31.88, CaO 5.22-11.53 and Al2O3 2.77-14.57, respectively. Low LREE/HREE ratio of ultramafic samples is accompanied by enrichment of large ion lithophile elements (LILE) such as Sr, Pb and K. Mafic samples show two distinct groups with low and high LREE/HREE ratios. The spider diagram of mafic samples indicates enrichment in Sr, Pb and K and depletion in REE. Petrological and geochemical evidence and field relations show that the mafic rocks formed in a supra-subduction zone setting. Petrological studies reveal the role of fractional crystallization and assimilation effect by released fluids during subduction related generation of the Sabzevar mafic rocks. We suggest that the studied mafic rocks likely represent the basement of an initial island arc, which was generated in a supra-subduction zone setting within the Neotethys branch of the Sabzevar Ocean at the north of CIM. Copper, gold and chromite mineralizations are studied in relation to island arc setting and supra-subduction environment. Similarities in lithology, ophiolite age and mineralization between Sabzevar ophiolite and Bardaskan-Torbat Heydariyeh ophiolites testify for their separation due to rotation (or faulting) of the Central Iranian Micro-continent.

  6. Establishment of a South African nuclear science exhibition centre

    Energy Technology Data Exchange (ETDEWEB)

    Lekwe, K.G.; Stander, G.; Faanhof, A. [South African Nuclear Energy Cooperation, P O Box 582, Pretoria (South Africa)


    After an initial survey undertaken by the South African Nuclear Energy Corporation (Necsa), one of the findings was that nuclear knowledge is virtually non-existent amongst the general public, including school children, throughout the country. The Department of Education (DoE) is currently in the process of introducing Nuclear as part of the school curriculum, which would require a collective effort between the schools and all the Nuclear Institutions in the country. Necsa as well as other nuclear industries have the responsibility to promote public awareness, appreciation and understanding of science and nuclear science in particular. Necsa is leading the national initiative to establish the nuclear science centre which would amongst others guide a person from the very basics of nuclear science to present and future applications thereof. The nuclear science centre will include information on the SAFARI-1 reactor, the Koeberg power reactor, the Pebble Bed Modular Reactor (PBMR), particle accelerators, food preservation, medical applications, etc. This paper will give the overview of the centre as well as its objectives thereof. (authors)

  7. Establishment of a South African nuclear science exhibition centre

    International Nuclear Information System (INIS)

    Lekwe, K.G.; Stander, G.; Faanhof, A.


    After an initial survey undertaken by the South African Nuclear Energy Corporation (Necsa), one of the findings was that nuclear knowledge is virtually non-existent amongst the general public, including school children, throughout the country. The Department of Education (DoE) is currently in the process of introducing Nuclear as part of the school curriculum, which would require a collective effort between the schools and all the Nuclear Institutions in the country. Necsa as well as other nuclear industries have the responsibility to promote public awareness, appreciation and understanding of science and nuclear science in particular. Necsa is leading the national initiative to establish the nuclear science centre which would amongst others guide a person from the very basics of nuclear science to present and future applications thereof. The nuclear science centre will include information on the SAFARI-1 reactor, the Koeberg power reactor, the Pebble Bed Modular Reactor (PBMR), particle accelerators, food preservation, medical applications, etc. This paper will give the overview of the centre as well as its objectives thereof. (authors)


    Directory of Open Access Journals (Sweden)

    A. V. Bobrov


    Full Text Available The evolution of the ‘mantle – moving deformable continents’ system has been studied by numerical experiments. The continents move self-consistently with the mantle flows of thermo-compositional convection. Our model (two-dimensional mantle convection, non-Newtonian rheology, the presence of deformable continents demonstrates the main features of global geodynamics: convergence and divergence of continents; appearance and disappearance of subduction zones; backrolling of subduction zones; restructuring of mantle flows; stretching, breakup and divergence of continents; opening and closing of oceans; oceanic crust recirculation in the mantle, and overriding of hot mantle plumes by continents. In our study, the continental crust is modeled by active markers which transfer additional viscosity and buoyancy, while the continental lithosphere is marked only by increased viscosity with neutral buoyancy. The oceanic crust, in its turn, is modeled by active markers that have only an additional buoyancy. The principal result of our modeling is a consistency between the numerical calculations and the bimodal dynamics of the real Earth: the oceanic crust, despite its positive buoyancy near the surface, submerges in subduction zones and sinks deep into the mantle. (Some part of the oceanic crust remains attached to the continental margins for a long time. In contrast to the oceanic crust, the continental crust does not sink in subduction zones. The continental lithosphere, despite its neutral buoyancy, also remains on the surface due to its viscosity and coupling with the continental crust. It should be noted that when a continent overrides a subduction zone, the subduction zone disappears, and the flows in the mantle are locally reorganized. The effect of basalt-eclogite transition in the oceanic crust on the mantle flow pattern and on the motion of continents has been studied. Our numerical experiments show that the inclusion of this effect in the

  9. Large-scale fuel cycle centres

    International Nuclear Information System (INIS)

    Smiley, S.H.; Black, K.M.


    The US Nuclear Regulatory Commission (NRC) has considered the nuclear energy centre concept for fuel cycle plants in the Nuclear Energy Centre Site Survey 1975 (NECSS-75) Rep. No. NUREG-0001, an important study mandated by the US Congress in the Energy Reorganization Act of 1974 which created the NRC. For this study, the NRC defined fuel cycle centres as consisting of fuel reprocessing and mixed-oxide fuel fabrication plants, and optional high-level waste and transuranic waste management facilities. A range of fuel cycle centre sizes corresponded to the fuel throughput of power plants with a total capacity of 50,000-300,000MW(e). The types of fuel cycle facilities located at the fuel cycle centre permit the assessment of the role of fuel cycle centres in enhancing the safeguard of strategic special nuclear materials - plutonium and mixed oxides. Siting fuel cycle centres presents a smaller problem than siting reactors. A single reprocessing plant of the scale projected for use in the USA (1500-2000t/a) can reprocess fuel from reactors producing 50,000-65,000MW(e). Only two or three fuel cycle centres of the upper limit size considered in the NECSS-75 would be required in the USA by the year 2000. The NECSS-75 fuel cycle centre evaluation showed that large-scale fuel cycle centres present no real technical siting difficulties from a radiological effluent and safety standpoint. Some construction economies may be achievable with fuel cycle centres, which offer opportunities to improve waste-management systems. Combined centres consisting of reactors and fuel reprocessing and mixed-oxide fuel fabrication plants were also studied in the NECSS. Such centres can eliminate shipment not only of Pu but also mixed-oxide fuel. Increased fuel cycle costs result from implementation of combined centres unless the fuel reprocessing plants are commercial-sized. Development of Pu-burning reactors could reduce any economic penalties of combined centres. The need for effective fissile

  10. Personal Beacon (United States)


    The MicroPLB (personal locator beacon) is a search and rescue satellite-aided tracking (SARSAT) transmitter. When activated it emits a distress signal to a constellation of internationally operated satellites. The endangered person's identity and location anywhere on Earth is automatically forwarded to central monitoring stations around the world. It is accurate to within just a few meters. The user uses the device to download navigation data from a global positioning satellite receiver. After the download is complete, the MicroPLB functions as a self-locating beacon. Also, it is the only PLB to use a safe battery. In the past, other PLB devices have used batteries that have enough volatility to explode with extreme force. It was developed by Microwave Monolithic, Inc. through SBIR funding from Glenn Research Center and Goddard Space Flight Center.

  11. Personalized Search

    CERN Document Server



    As the volume of electronically available information grows, relevant items become harder to find. This work presents an approach to personalizing search results in scientific publication databases. This work focuses on re-ranking search results from existing search engines like Solr or ElasticSearch. This work also includes the development of Obelix, a new recommendation system used to re-rank search results. The project was proposed and performed at CERN, using the scientific publications available on the CERN Document Server (CDS). This work experiments with re-ranking using offline and online evaluation of users and documents in CDS. The experiments conclude that the personalized search result outperform both latest first and word similarity in terms of click position in the search result for global search in CDS.

  12. Measurement of electromagnetic waves in ELF and VLF bands to monitor lightning activity in the Maritime Continent (United States)

    Yamashita, Kozo; Takahashi, Yukihiro; Ohya, Hiroyo; Tsuchiya, Fuminori; Sato, Mitsuteru; Matsumoto, Jun


    Data of lightning discharge has been focused on as an effective way for monitoring and nowcasting of thunderstorm activity which causes extreme weather. Spatial distribution of lightning discharge has been used as a proxy of the presence or absence of deep convection. Latest observation shows that there is extremely huge lightning whose scale is more than hundreds times bigger than that of averaged event. This result indicates that lightning observation should be carried out to estimate not only existence but also scale for quantitative evaluation of atmospheric convection. In this study, lightning observation network in the Maritime Continent is introduced. This network is consisted of the sensors which make possible to measure electromagnetic wave radiated from lightning discharges. Observation frequency is 0.1 - 40 kHz for the measurement of magnetic field and 1 - 40 kHz for that of electric field. Sampling frequency is 100 kHz. Waveform of electromagnetic wave is recorded by personal computer. We have already constructed observation stations at Tainan in Taiwan (23.1N, 121.1E), Saraburi in Thailand (14.5N, 101.0E), and Pontianak in Indonesia (0.0N, 109.4E). Furthermore, we plan to install the monitoring system at Los Banos in Philippines (14.18, 121.25E) and Hanoi in Viet Nam. Data obtained by multipoint observation is synchronized by GPS receiver installed at each station. By using data obtained by this network, location and scale of lightning discharge can be estimated. Location of lightning is determined based on time of arrival method. Accuracy of geolocation could be less than 10km. Furthermore, charge moment is evaluated as a scale of each lightning discharge. It is calculated from electromagnetic waveform in ELF range (3-30 kHz). At the presentation, we will show the initial result about geolocation for source of electromagnetic wave and derivation of charge moment value based on the measurement of ELF and VLF sferics.

  13. Hillary Clinton impressed by the Centre's work. (United States)


    In April 1994, US First Lady Hillary Rodham Clinton, her daughter Chelsea, the Bangladesh Minister for Women and Children's Affairs, and the US Ambassador to Bangladesh visited the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). The First Lady remarked that ICDDR,B's research programs on health and family planning have many important lessons for the developing and developed regions alike. She noted the development successes in Bangladesh that can be applied in the US and other countries: the Grameen Bank, oral rehydration solution (ORS), and the community outreach programs for health and family planning services. The First Lady was especially interested in ORS and its cost-effectiveness. Most of the 220,000 children hospitalized each year in the US for severe gastrointestinal illness are treated with expensive intravenous (IV) drips (average cost = $2300), while a few ORS packets would be a small fraction of the cost. The average cost of treatment per patient at ICDDR,B was only $12. Patients receive care free of charge. Less than 0.6% of the patients die. The previous year, a USAID administrator asked ICDDR,B for its expertise in fighting cholera at the Rwandan refugee camps in Goma, Zaire. ICDDR,B staff developed diagnostic antisera for the new cholera strain responsible for the epidemic in the Americas, described its pathophysiology, and established its mode of transmission in surface waters. ICDDR,B also provides technical support to the national family planning and maternal and child health programs. In the Matlab, ICDDR,B's work has contributed to a high contraceptive prevalence rate of more than 64% among poor and largely illiterate persons.

  14. Strategic management in company information centre

    International Nuclear Information System (INIS)

    Judita Kopacikova, J.


    The article deals with the necessity of strategic management in libraries and information centres, with the process of creation, realization and regulation of settlement of strategic objectives and plans. It analyzes two levels of strategic management - information support of strategic management towards the superior body, provider, top management of the enterprise and organisation and proper strategic management of the information workplace. Marginally it also interferes with the problems of the so-called functional strategies - personal, technical provision and marketing. The current political, economical, social and for librarians and informative workers even information environs are subject to review of continual changes and show the organisations, institutions, enterprises and libraries how to compete successfully in competition. Changes, which are typical for the current period, will continue constantly. Consequently we must try to get them under the control, respond to them elastically, to be ready for them and to expect and predict them. For their managing we keep the modern management tools and methods at disposal - strategic management, TQM, knowledge management, management of human sources, etc. Increasing intensity and change ranges in the environs around us effect exceeding of strategic management demand - strategy. The higher uncertainty of the future development and the more solution alternatives are, the more important demand for strategic thinking and strategic proceeding is. By the strategic management the strategic thinking is the supposition of success and increasing of the effectiveness, performance and quality of products and services are the target. The final outcome is a satisfied customer, reader, user and its purpose is a long-term success in the activity or in the business. (author)

  15. Strategic management in company information centre

    International Nuclear Information System (INIS)

    Judita Kopacikova, J.


    The presentation deals with the necessity of strategic management in libraries and information centres, with the process of creation, realization and regulation of settlement of strategic objectives and plans. It analyzes two levels of strategic management - information support of strategic management towards the superior body, provider, top management of the enterprise and organisation and proper strategic management of the information workplace. Marginally it also interferes with the problems of the so-called functional strategies - personal, technical provision and marketing. The current political, economical, social and for librarians and informative workers even information environs are subject to review of continual changes and show the organisations, institutions, enterprises and libraries how to compete successfully in competition. Changes, which are typical for the current period, will continue constantly. Consequently we must try to get them under the control, respond to them elastically, to be ready for them and to expect and predict them. For their managing we keep the modern management tools and methods at disposal - strategic management, TQM, knowledge management, management of human sources, etc. Increasing intensity and change ranges in the environs around us effect exceeding of strategic management demand - strategy. The higher uncertainty of the future development and the more solution alternatives are, the more important demand for strategic thinking and strategic proceeding is. By the strategic management the strategic thinking is the supposition of success and increasing of the effectiveness, performance and quality of products and services are the target. The final outcome is a satisfied customer, reader, user and its purpose is a long-term success in the activity or in the business. (author)

  16. Urinary Incontinence, Related Factors and Depression among 20 Aged and Over Women in Beylikova District Centre in Eskisehir

    Directory of Open Access Journals (Sweden)

    Alaettin Unsal


    Full Text Available Aim: To determination of prevalence of Urinary incontinence (UI, and to evaluation of relationship between UI and depression in women. Material and methods: This study is a cross-sectional type research, was realized between 05 July 2011 to 25 August 2011, among 20 and over aged women that living in Beylikova district centre. The study group was occurred 500 women. The presence of UI, its type and severity were evaluated according to criteria recommended by the International Continence Society. For the purpose of the questionnaire form prepared by the study, households were visited one by one, filled with face to face method. Beck Depression Inventory (BDI was used for evaluation of depression. Chi-square test and Logistic Regression Analyses were used in statistical analyses. For statistical significance, p<0.05 were approved. Results: The ages of women were between 20 to 81 years, and average age was 46.97±15.65 years. Prevalence of UI was found 41.4% (n=207. Of the UI cases were 35.7% stress incontinence, 15.5% urge incontinence, 48.8% mixed type. Of the cases were 95 (45.9% low severity, 60 (29.0% middle severity, 52 (25.1% high severity. In this study, UI was an important risk factor in illiterates (OR: 6.617, no smoking (OR: 1.868, obes (OR: 2.777, persons with anyone chronicle disease that diagnosed by doctor (OR: 4.711, enuresis nocturna hystory in childhood age (OR: 2.600, large baby history in women who had given birth (OR: 1.947, and menopause (OR: 2.497. Prevalence of depression was found 25.4% (n=127. Prevalence of depression was higher found in the women with UI, stress type UI, and high severity UI (for each one; p<0.05. Conclusion: In this study, it was determinate that UI an important health problem in the women, and depression prevalence was higher in the women with UI. [TAF Prev Med Bull 2013; 12(3.000: 231-242

  17. Austria: The INIS Austria Centre 1970-2015

    International Nuclear Information System (INIS)

    Rössner, Marcus


    This article spotlights Austrian people and institutions that have influenced the fortunes of INIS and the INIS Centre in Austria. The work of two Austrians had a lasting influence on INIS. The first person, Ms Elisabeth Ruckenbauer, was Head of the INIS Bibliographic Control Unit at the start of INIS. She was responsible for the development and implementation of the INIS bibliographic description rules (INIS Reference Series IAEA-INIS-01 and -02). The second person having a lasting influence on INIS was Mr Alexander Nevyjel. He was Austrian INIS Liaison Officer from 1983 –2002, and Head of the INIS Subject Control Unit until 2011. During his second term of office, he developed, together with the Swiss company Convera, the Computer Assisted Indexing Software (CAI). The aim of the project was to optimize indexing. The implementation of CAI in 2004 resulted in an increase of input to the INIS database; from around 60 000 records per year to over 100 000 records per year. We are proud that Mr Nevyjel is still an active member of the INIS Austria Center and that he continues to offer his experience and expertise. The Austrian INIS Centre has resided at two scientific institutions: Seibersdorf and the Austrian Central Library for Physics and Chemistry Library, each having a specific relationship with the IAEA and INIS


    African Journals Online (AJOL)

    centres in South Africa revealed that some field .... psychomotor goals suitable for each age group? * Did the officer have a proper ..... education centres, spending two to four weeks at a ... you must be willing to suspend judgement, to hold in ...

  19. Australian International Food Security Research Centre | IDRC ...

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

    Australian International Food Security Research Centre. Australian International Food Security Research Centre. Cultivate Africa's Future. The Cultivate Africa's Future research partnership is designed to support applied research to combat hunger in sub-Saharan Africa by harnessing the potential ...

  20. Communications strategy for the Chernobyl Centre

    International Nuclear Information System (INIS)

    Kurilchik, Mykola; Green, Len


    This Communications Strategy was developed for the International Chernobyl Centre (ICC) as part of a joint UK/Ukraine project, sponsored by the Department of Trade and Industry and NNC Limited. The Plan was developed during four weeks of workshop discussions in the UK between staff from the centre and experienced PR Professionals from NNC Limited. The requirements for a sustained communications activity at the ICC go much further than simply enhancing or promoting the Centre's scientific and technical activities. Raising sufficient awareness of the Centre among potential funding agents and commercial partners is critical to its future development as a major centre for international co-operation and research. It is only through establishing and developing effective communications that the Centre will become well enough known and understood both within the Ukraine, and internationally, to secure its long term future. However, as the workshop programme unfolded, it also became clear that communications was in itself a legitimate and necessary function of the Centre, and part of the foundations of its existence. The Centre has a fundamental role as an 'information exchange', collecting and communicating information from within the Ukraine to the rest of the world, and interpreting world interest and attitudes to the Ukraine Government and nuclear industry. As such compliments the efforts of individual power plant and corporate PR functions within the Ukraine nuclear energy sector

  1. The job demands-resources model of work engagement in South African call centres

    Directory of Open Access Journals (Sweden)

    Yolandi Janse van Rensburg


    Full Text Available Orientation: A ‘sacrificial human resource strategy’ is practised in call centres, resulting in poor employee occupational health. Consequently, questions are posed in terms of the consequences of call centre work and which salient antecedent variables impact the engagement and wellbeing of call centre representatives. Research purpose: Firstly, to gauge the level of employee engagement amongst a sample of call centre representatives in South Africa and, secondly, to track the paths through which salient personal and job resources affect this engagement. More specifically, the relationships between sense of coherence, leadership effectiveness, team effectiveness and engagement were investigated, thus testing the Job Demands-Resources model of work engagement. Motivation for the study: To present an application of the Job Demands-Resources model of work engagement in a call centre environment in order to diagnose current ills and consequently propose remedies. Research design: A cross-sectional survey design was used and a non-probability convenient sample of 217 call centre representatives was selected. The measuring instruments comprise the Utrecht Work Engagement Scale to measure engagement, the Team Diagnostic Survey to measure team effectiveness, the leadership practices inventory to gauge leadership effectiveness, and the Orientation to Life Questionnaire to measure sense of coherence. A series of structural equation modelling analyses were performed. Main findings: Contrary to the ‘electronic sweatshop’ image attached to call centre jobs depicted in the literature, results show a high level of employee engagement for call centre representatives in the sample. Also, personal resources such as sense of coherence and job resources such as team effectiveness related significantly to engagement. A non-significant relationship exists between leadership effectiveness and engagement. Practical/managerial implications: Both the content and

  2. The job demands-resources model of work engagement in South African call centres

    Directory of Open Access Journals (Sweden)

    Yolandi Janse van Rensburg


    Full Text Available Orientation: A ‘sacrificial human resource strategy’ is practised in call centres, resulting in poor employee occupational health. Consequently, questions are posed in terms of the consequences of call centre work and which salient antecedent variables impact the engagement and wellbeing of call centre representatives.Research purpose: Firstly, to gauge the level of employee engagement amongst a sample of call centre representatives in South Africa and, secondly, to track the paths through which salient personal and job resources affect this engagement. More specifically, the relationships between sense of coherence, leadership effectiveness, team effectiveness and engagement were investigated, thus testing the Job Demands-Resources model of work engagement.Motivation for the study: To present an application of the Job Demands-Resources model of work engagement in a call centre environment in order to diagnose current ills and consequently propose remedies.Research design: A cross-sectional survey design was used and a non-probability convenient sample of 217 call centre representatives was selected. The measuring instruments comprise the Utrecht Work Engagement Scale to measure engagement, the Team Diagnostic Survey to measure team effectiveness, the leadership practices inventory to gauge leadership effectiveness, and the Orientation to Life Questionnaire to measure sense of coherence. A series of structural equation modelling analyses were performed.Main findings: Contrary to the ‘electronic sweatshop’ image attached to call centre jobs depicted in the literature, results show a high level of employee engagement for call centre representatives in the sample. Also, personal resources such as sense of coherence and job resources such as team effectiveness related significantly to engagement. A non-significant relationship exists between leadership effectiveness and engagement.Practical/managerial implications: Both the content and

  3. Centre for urban ecotechnology in ``Oeksnehallen``

    Energy Technology Data Exchange (ETDEWEB)


    The Lord Mayor`s Department of the municipality of Copenhagen, Denmark, has with support from this project made a proposal for the establishment of the Centre for Urban Ecotechnology in ``Oeksnehallen``, located in the Vesterbro area of the city. The centre should contribute to the dissemination of knowledge on ecological techniques (regarding passive solar energy etc.) to the inhabitants of Vesterbro and other citizens of Copenhagen, and also serve as a centre in an European context. The ecological demonstration centre will cover an area of two thousand square meters and will also include a cafe, a room for showing coloured slides, facilities for exhibitions created by the center and interested firms etc. The centre should play an important role as part of the ecological concept of urban renewal in Vesterbro. (author).

  4. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve


    Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

  5. Laparoscopic adrenalectomy: Single centre experience.

    LENUS (Irish Health Repository)

    O'Farrell, N J


    BACKGROUND: Laparoscopic adrenalectomy is an attractive alternative to the traditional open approach in the surgical excision of an adrenal gland. It has replaced open adrenalectomy in our institution and we review our experience to date. METHODS: All cases of laparoscopic adrenalectomies in our hospital over eight years (from 2001 to May 2009) were retrospectively reviewed. Patient demographics, diagnosis, length of hospital stay, histology and all operative and post-operative details were evaluated. RESULTS: Fifty-five laparoscopic adrenalectomies (LA) were performed on 51 patients over eight years. The mean age was 48 years (Range 16-86 years) with the male: female ratio 1:2. Twenty-three cases had a right adrenalectomy, 24 had a left adrenalectomy and the remaining four patients had bilateral adrenalectomies. 91% were successfully completed laparoscopically with five converted to an open approach. Adenomas (functional and non functional) were the leading indication for LA, followed by phaeochromocytomas. Other indications for LA included Cushing\\'s disease, adrenal malignancies and rarer pathologies. There was one mortality from necrotising pancreatitis following a left adrenalectomy for severe Cushing\\'s disease, with subsequent death 10 days later. CONCLUSION: Laparoscopic adrenalectomy is effective for the treatment of adrenal tumours, fulfilling the criteria for the ideal minimally invasive procedure. It has replaced the traditional open approach in our centre and is a safe and effective alternative. However, in the case of severe Cushing\\'s disease, laparoscopic adrenalectomy has the potential for significant adverse outcomes and mortality.


    Directory of Open Access Journals (Sweden)

    C. Boulanger


    Full Text Available The Centre Block of Canada’s Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  7. Capturing Reality at Centre Block (United States)

    Boulanger, C.; Ouimet, C.; Yeomans, N.


    The Centre Block of Canada's Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS) of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  8. Family-centred care for families living with cystic fibrosis in a rural setting: A qualitative study. (United States)

    Jessup, Melanie; Smyth, Wendy; Abernethy, Gail; Shields, Linda; Douglas, Tonia


    To explore experiences of family-centred care among parents of children with cystic fibrosis living far from tertiary treatment centres and to understand what such distances mean to their care. Australia is a large continent. However, many families with a child with cystic fibrosis live in regional areas, often thousands of kilometres away from the primary treatment centres located in Australia's coastal capital cities. A qualitative, phenomenological design using a Van Manen () approach. Individual, semi-structured interviews were conducted with parents (n = 7) of a child with cystic fibrosis who lived in regional Australia. Thematic content data analysis was used. The essence of the participants' experience was their seeking certainty and continuity in the changeable realm of cystic fibrosis while negotiating a collaborative approach to their child's care. Five core themes and two subthemes were identified: "Daily care: a family affair," including the subtheme "Accessing expert care"; "Family-centred care: seeking inclusion"; "Control versus collaboration: seeking mutual trust," with the subtheme "The team who grows with you"; "Future projections"; and "The CF circle." Some concerns are not unlike those of their city counterparts, but can be intensified by their sense of distance and isolation. Insight into this unique milieu from the parents' perspective is requisite so that care is appropriate to such a challenging environment and incorporates the whole family. © 2017 John Wiley & Sons Ltd.

  9. Spatial and temporal variability of stable isotope composition of precipitation over the south american continent

    Directory of Open Access Journals (Sweden)


    Full Text Available VARIABILITE SPATIALE ET TEMPORELLE DE LA COMPOSITION EN ISOTOPES STABLES DE LA PRECIPITATION SUR LE CONTINENT SUDAMERICAIN. L’Agence Internationale de l’Energie Atomique, en coopération avec l’Organisation Météorologique Mondiale, exploite un réseau mondial de stations pour la prise d’échantillons mensuels de précipitation. Actuellement, à peu près 60 stations fournissent des informations sur la composition isotopique de la précipitation sur le continent sudaméricain. Ces dernières années plusieurs réseaux d’échantillonnage d’un caractère national (Argentine, Brésil, Chili, Equateur, Pérou ont été initiés. Les données apportées par ces réseaux contribuent au réseau mondial de l’AIEA/OMM. Ces travaux se concentrent sur l’étude de la variabilité spatiale et temporelle de la composition isotopique stable de la précipitation sur le continent. Dans cette étude, est examinée en détail la relation entre la composition isotopique de la précipitation dans la région et quelques paramètres climatiques, tels que la quantité de précipitation et la température de l’air. VARIABILIDAD ESPACIAL Y TEMPORAL DE LA COMPOSICIÓN DE ISÓTOPOS ESTABLES DE LA PRECIPITACIÓN EN EL CONTINENTE SUDAMERICANO. El Organismo Internacional de Energía Atómica (OIEA, en colaboración con la Organización Meteorológica Mundial (OMM, está llevando a cabo un estudio a escala global de la composición isotópica de la precipitación a partir de muestras mensuales de lluvia recogidas en estaciones meteorológicas. En la actualidad alrededor de 60 estaciones proporcionan información sobre la composición isotópica de la precipitación en el continente sudamericano. Durante los últimos años se han establecido en la región varias redes de control con carácter nacional (Argentina, Brasil, Chile, Ecuador, Perú. Los datos aportados por estas redes representan una valiosa contribución a la red mundial del OIEA/OMM. Este trabajo se

  10. Birth centre confinement at the Queen Victoria Medical Centre. I. Obstetric and neonatal outcome. (United States)

    Campbell, J; Hudson, H; Lumley, J; Morris, N; Rao, J; Spensley, J


    A review of hte first 175 confinements at the Queen Victoria Medical Centre Birth Centre is presented. The design, structure and function of hte Birth Centre is described and the safety of the programme demonstrated. Seventy-four pregnancies (42%) accepted for Birth Centre confinement required transfer because of antepartum or intrapartum complications. There were satisfactory obstetric and neonatal outcomes in all pregnancies. The first year's experience has allowed a reassessment of the risk factors, which will permit greater use of the Birth Centre without any increases risk to mothers or babies.

  11. Taking the pulse of a continent: Expanding site-based research infrastructure for regional- to continental-scale ecology (United States)

    Many of the most dramatic and surprising effects of global change on ecological systems will occur across large spatial extents, from regions to continents. Multiple ecosystem types will be impacted across a range of interacting spatial and temporal scales. The ability of ecologists to understand an...

  12. Emergence of silicic continents as the lower crust peels off on a hot plate-tectonic Earth (United States)

    Chowdhury, Priyadarshi; Gerya, Taras; Chakraborty, Sumit


    The rock record and geochemical evidence indicate that continental recycling has been occurring since the early history of the Earth. The stabilization of felsic continents in place of Earth's early mafic crust about 3.0 to 2.0 billion years ago, perhaps due to the initiation of plate tectonics, implies widespread destruction of mafic crust during this time interval. However, the physical mechanisms of such intense recycling on a hotter, (late) Archaean and presumably plate-tectonic Earth remain largely unknown. Here we use thermomechanical modelling to show that extensive recycling via lower crustal peeling-off (delamination but not eclogitic dripping) during continent-continent convergence was near ubiquitous during the late Archaean to early Proterozoic. We propose that such destruction of the early mafic crust, together with felsic magmatism, may have caused both the emergence of silicic continents and their subsequent isostatic rise, possibly above the sea level. Such changes in the continental character have been proposed to influence the Great Oxidation Event and, therefore, peeling-off plate tectonics could be the geodynamic trigger for this event. A transition to the slab break-off controlled syn-orogenic recycling occurred as the Earth aged and cooled, leading to reduced recycling and enhanced preservation of the continental crust of present-day composition.

  13. International Continence Society Good Urodynamic Practices and Terms 2016 : Urodynamics, uroflowmetry, cystometry, and pressure-flow study

    NARCIS (Netherlands)

    Rosier, Peter F W M; Schaefer, Werner; Lose, Gunnar; Goldman, Howard B.; Guralnick, Michael; Eustice, Sharon; Dickinson, Tamara; Hashim, Hashim

    AIMS: The working group initiated by the ICS Standardisation Steering Committee has updated the International Continence Society Standard "Good Urodynamic Practice" published in 2002. METHODS: On the basis of the manuscript: "ICS standard to develop evidence-based standards," a new ICS Standard was

  14. International children's continence society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children

    NARCIS (Netherlands)

    Rawashdeh, Y. F.; Austin, P.; Siggaard, C.; Bauer, S. B.; Franco, I.; de Jong, T. P.; Jorgensen, T. M.


    Purpose We present a consensus view of members of the International Children's Continence Society on the therapeutic intervention in congenital neuropatic bladder and bowel dysfunction in children. Material and Methods Discussions were held by a group of pediatric urologists and gastroenterologists

  15. Globalization and Multilingualism: Case Studies of Indigenous Culture-Based Education from the Indian Sub-Continent and Their Implications (United States)

    Singh, Navin Kumar


    This paper presents some of the major program initiatives honoring Indigenous knowledge, culture, heritage, arts, and skills through curricular reforms and culturally appropriate educational practices on the Indian sub-continent. It presents case studies of Indigenous culture-based education, with reference to mother tongue and multicultural…

  16. Measurement of dynamic urethral pressures with a high-resolution manometry system in continent and incontinent women. (United States)

    Kirby, Anna C; Tan-Kim, Jasmine; Nager, Charles W


    Female stress urinary incontinence is caused by urethral dysfunction during dynamic conditions, but current technology has limitations in measuring urethral pressures under these conditions. An 8-French high-resolution manometry (HRM) catheter currently in clinical use in gastroenterology may accurately measure urethral pressures under dynamic conditions because it has a 25-millisecond response rate and circumferential pressure sensors along the length of the catheter (ManoScan ESO; Given Imaging, Yoqneam, Israel). We evaluated the concordance, repeatability, and tolerability of this catheter. We measured resting, cough, and strain maximum urethral closure pressures (MUCPs) using HRM and measured resting MUCPs with water-perfusion side-hole catheter urethral pressure profilometry (UPP) in 37 continent and 28 stress-incontinent subjects. Maneuvers were repeated after moving the HRM catheter along the urethral length to evaluate whether results depend on catheter positioning. Visual analog pain scores evaluated the comfort of HRM compared to UPP. The correlation coefficient for resting MUCPs measured by HRM versus UPP was high (r = 0.79, P rest, cough, and strain with HRM: r = 0.92, 0.89, and 0.89. Mean MUCPs (rest, cough, and strain) were higher in continent than in incontinent subjects (all P continent subjects during cough and strain maneuvers compared to rest. This preliminary study shows that HRM is concordant with standard technology, repeatable, and well tolerated in the urethra. Incontinent women have more impairment of their urethral closure pressures during cough and strain than continent women.

  17. Arc-continent collision of the Coastal Range in Taiwan: Geochronological constraints from U-Pb ages of zircons (United States)

    Geng, Wei; Zhang, Xun-Hua; Huang, Long


    The oblique arc-continent collision between the Luzon arc and the southeastern margin of the Eurasian continent caused the uplift of Taiwan. The Coastal Range in eastern Taiwan is the northern section of the Luzon arc in the collision zone and thus records important information about the arc-continent collision. In this paper, we determine and analyze the U-Pb ages of magmatic zircons from the volcanic arc and clastic zircons from the fore-arc basin in the Coastal Range. For the volcanic arc in the Coastal Range, the eruption ages range from 16.8-5 Ma. Given that the initial subduction of the South China Sea oceanic crust (17 Ma) occurred before the Luzon arc formed, we conclude that the volcanic activity of the Coastal Range began at 16.8 ± 1.3 Ma; it was most active from 14 to 8 Ma and continued until approximately 5 Ma. The U-Pb chronology also indicates that the initial stage of arc-continent collision of the Coastal Range started at approximately 5 Ma, when the northern section of the Luzon arc moved away from the magmatic chamber because of the kinematics of the Philippine Sea Plate.

  18. Intermediate crust (IC); its construction at continent edges, distinctive epeirogenic behaviour and identification as sedimentary basins within continents: new light on pre-oceanic plate motions (United States)

    Osmaston, Miles F.


    Introduction. The plate tectonics paradigm currently posits that the Earth has only two kinds of crust - continental and oceanic - and that the former may be stretched to form sedimentary basins or the latter may be modified by arc or collision until it looks continental. But global analysis of the dynamics of actual plate motions for the past 150 Ma indicates [1 - 3] that continental tectospheres must be immensely thicker and rheologically stiffer than previously thought; almost certainly too thick to be stretched with the forces available. In the extreme case of cratons, these tectospheric keels evidently extend to 600 km or more [2, 3]. This thick-plate behaviour is attributable, not to cooling but to a petrological 'stiffening' effect, associated with a loss of water-weakening of the mineral crystals, which also applies to the hitherto supposedly mobile LVZ below MORs [4, 5]. The corresponding thick-plate version of the mid-ocean ridge (MOR) process [6 - 8], replacing the divergent mantle flow model, has a deep, narrow wall-accreting axial crack which not only provides the seismic anisotropy beneath the flanks but also brings two outstanding additional benefits:- (i) why, at medium to fast spreading rates, MOR axes become straight and orthogonally segmented [6], (ii) not being driven by body forces, it can achieve the sudden jumps of axis, spreading-rate and direction widely present in the ocean-floor record. Furthermore, as we will illustrate, the crack walls push themselves apart at depth by a thermodynamic mechanism, so the plates are not being pulled apart. So the presence of this process at a continental edge would not imply the application of extensional force to the margin. Intermediate Crust (IC). In seeking to resolve the paradox that superficially extensional structures are often seen at margins we will first consider how this MOR process would be affected by the heavy concurrent sedimentation to be expected when splitting a mature continent. I reason

  19. Les Cinq Continents, a antologia de Goll: apelo (poético cosmopolita

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Barbosa


    Full Text Available Este artigo trata de alguns trabalhos poéticos de Ivan Goll, publicados em alemão, francês e inglês, nos quais o diapasão cosmopolita e o apelo a uma poesia supranacional representaram um grito marginal de resistência frente às tendências totalizantes e às categorias nacionais da primeira metade do século XX. Busca-se compreender se o grito encontra respaldo nas reflexões atuais, pensando-o como um antecedente questionador de taxonomias de gênero literário e de forma artística, um transgender. Assinala que o modernista brasileiro Mário de Andrade não somente acompanhou a querela entre Goll e Breton sobre a herança do conceito Surréalisme legado por Apollinaire, como também se correspondeu e trocou livros com o poeta alsaciano, tendo recebido com entusiasmo a antologia Les Cinq continents. Ao final, este artigo apresenta a tradução de dois poemas afinados com a noção cosmopolita: "O Negro do Teatro de Variedades" e "A Canção de João Sem-Terra, O Duplo".Esta comunicación trata sobre algunos trabajos poéticos de Ivan Goll, publicados en alemán, francés e inglés, en los cuales el tono cosmopolita y el llamamiento a una poesía supranacional representaron un grito marginal de resistencia frente a las tendencias totalizantes y a las categorías nacionales de la primera mitad del siglo XX. El artículo busca comprender si el grito reverbera y encuentra respaldo en las reflexiones actuales, pensándolo como un antecedente cuestionador de taxonomías de género totalitario y, de forma artística, como un "transgender". El texto también incide en la relación establecida con el escritor modernista brasileño Mário de Andrade, que no sólo acompañó la querella entre Goll y Breton sobre la herencia del concepto "Surréalisme" legado por Apollinaire, sino que mantuvo contacto epistolar e intercambio de libros con el poeta alsaciano, y recibió con entusiasmo la antología Les Cinq continents. Finalmente, este art

  20. The urethral closure function in continent and stress urinary incontinent women assessed by urethral pressure reflectometry. (United States)

    Saaby, Marie-Louise


    Stress urinary incontinence (SUI) occurs when the bladder pressure exceeds the urethral pressure in connection with physical effort or exertion or when sneezing or coughing and depends both on the strength of the urethral closure function and the abdominal pressure to which it is subjected. The urethral closure function in continent women and the dysfunction causing SUI are not known in details. The currently accepted view is based on the concept of a sphincteric unit and a support system. Our incomplete knowledge relates to the complexity of the closure apparatus and to inadequate assessment methods which so far have not provided robust urodynamic diagnostic tools, severity measures, or parameters to assess outcome after intervention. Urethral Pressure Reflectometry (UPR) is a novel method that measures the urethral pressure and cross-sectional area (by use of sound waves) simultaneously. The technique involves insertion of only a small, light and flexible polyurethane bag in the urethra and therefore avoids the common artifacts encountered with conventional methods. The UPR parameters can be obtained at a specific site of the urethra, e.g. the high pressure zone, and during various circumstances, i.e. resting and squeezing. During the study period, we advanced the UPR technique to enable faster measurement (within 7 seconds by the continuous technique) which allowed assessment during increased intra-abdominal pressure induced by physical straining. We investigated the urethral closure function in continent and SUI women during resting and straining by the "fast" UPR technique. Thereby new promising urethral parameters were provided that allowed characterization of the closure function based on the permanent closure forces (primarily generated by the sphincteric unit, measured by the Po-rest) and the adjunctive closure forces (primarily generated by the support system, measured by the abdominal to urethral pressure impact ratio (APIR)). The new parameters enabled