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Sample records for previous studies dealing

  1. Dealing with downstream customers : an exploratory study

    NARCIS (Netherlands)

    Hillebrand, Bas; Biemans, Wim G.

    2011-01-01

    Purpose - In B2B markets, the demand for a supplier's products is derived from demand further down the supply chain. This complexity poses several challenges for B2B firms, especially when they are located near the beginning of a supply chain. This study aims to investigate to what extent firms near

  2. On the Tengiz petroleum deposit previous study

    International Nuclear Information System (INIS)

    Nysangaliev, A.N.; Kuspangaliev, T.K.

    1997-01-01

    Tengiz petroleum deposit previous study is described. Some consideration about structure of productive formation, specific characteristic properties of petroleum-bearing collectors are presented. Recommendation on their detail study and using of experience on exploration and development of petroleum deposit which have analogy on most important geological and industrial parameters are given. (author)

  3. Personality disorders in previously detained adolescent females: a prospective study

    NARCIS (Netherlands)

    Krabbendam, A.; Colins, O.F.; Doreleijers, T.A.H.; van der Molen, E.; Beekman, A.T.F.; Vermeiren, R.R.J.M.

    2015-01-01

    This longitudinal study investigated the predictive value of trauma and mental health problems for the development of antisocial personality disorder (ASPD) and borderline personality disorder (BPD) in previously detained women. The participants were 229 detained adolescent females who were assessed

  4. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer

    NARCIS (Netherlands)

    Coolbrandt, A.; Dierckx de Casterle, B.; Wildiers, H.; Aertgeerts, B.; Elst, E. Van der; Achterberg, T. van; Milisen, K.

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with

  5. Ransomware: A Research and a Personal Case Study of Dealing with this Nasty Malware

    OpenAIRE

    Azad Ali

    2017-01-01

    Aim/Purpose : Share research finding about ransomware, depict the ransomware work in a format that commonly used by researchers and practitioners and illustrate personal case experience in dealing with ransomware. Background: Author was hit with Ransomware, suffered a lot from it, and did a lot of research about this topic. Author wants to share findings in his research and his experience in dealing with the aftermath of being hit with ransomware. Methodology: Case study. Applying th...

  6. Radon anomalies prior to earthquakes (1). Review of previous studies

    International Nuclear Information System (INIS)

    Ishikawa, Tetsuo; Tokonami, Shinji; Yasuoka, Yumi; Shinogi, Masaki; Nagahama, Hiroyuki; Omori, Yasutaka; Kawada, Yusuke

    2008-01-01

    The relationship between radon anomalies and earthquakes has been studied for more than 30 years. However, most of the studies dealt with radon in soil gas or in groundwater. Before the 1995 Hyogoken-Nanbu earthquake, an anomalous increase of atmospheric radon was observed at Kobe Pharmaceutical University. The increase was well fitted with a mathematical model related to earthquake fault dynamics. This paper reports the significance of this observation, reviewing previous studies on radon anomaly before earthquakes. Groundwater/soil radon measurements for earthquake prediction began in 1970's in Japan as well as foreign countries. One of the most famous studies in Japan is groundwater radon anomaly before the 1978 Izu-Oshima-kinkai earthquake. We have recognized the significance of radon in earthquake prediction research, but recently its limitation was also pointed out. Some researchers are looking for a better indicator for precursors; simultaneous measurements of radon and other gases are new trials in recent studies. Contrary to soil/groundwater radon, we have not paid much attention to atmospheric radon before earthquakes. However, it might be possible to detect precursors in atmospheric radon before a large earthquake. In the next issues, we will discuss the details of the anomalous atmospheric radon data observed before the Hyogoken-Nanbu earthquake. (author)

  7. Copyright Law in Australia--Fair Dealing for Research or Study Purposes.

    Science.gov (United States)

    Khan, Anwar (Andy); Hancock, Philip

    2001-01-01

    Explores several issues involving provisions of the Australian copyright law that allow for "fair dealing for the purpose of research and study" in the use of copyrighted materials. Discusses liability of libraries for improper oversight of illegal photocopying of books and other copyrighted materials. Reviews recent efforts to improve…

  8. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer.

    Science.gov (United States)

    Coolbrandt, A; Dierckx de Casterlé, B; Wildiers, H; Aertgeerts, B; Van der Elst, E; van Achterberg, T; Milisen, K

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with chemotherapy-related symptoms in their home, which factors and ideas influence their self-management and what role professional caregivers play. One-off, semi-structured interviews were held with 28 adult patients with cancer being treated with chemotherapy. Using a Grounded Theory approach, we cyclically collected and analysed data to come to a thorough understanding of the major conceptual themes and their interconnections. Dealing with chemotherapy-related symptoms involves a process of experiencing and learning how side effects unfold over time and how to deal with them. Patients express very personal symptom experiences and symptom-management styles, which are shaped by personal factors (e.g. coping with cancer and cancer treatment, perceived level of control) and environmental factors (e.g. professionals' attitude, information resources). Improving symptom self-management support requires active exploration of the personal symptom experience and symptom-management style. Professional care should be tailored to the patient's perspective and should address personal and environmental determinants of their behaviour. © 2015 John Wiley & Sons Ltd.

  9. Screen dealing

    International Nuclear Information System (INIS)

    Barlow, J.W.

    1991-01-01

    The screen dealing system provides a facility whereby buyers and sellers of spot thermal coal can make bids and offers via the medium of the Reuters screen. A sale results when a market participant notifies his acceptance of a price to a central dealing desk. Use of the system is available to all genuine participants in the coal trade. This paper reports that it provides a focus for information and for the visible making of coal prices. For years screen trading has been used successfully to trade other commodities. At last coal is being traded electronically. It makes sense. It works. Users like it

  10. Ransomware: A Research and a Personal Case Study of Dealing with this Nasty Malware

    Directory of Open Access Journals (Sweden)

    Azad Ali

    2017-04-01

    Full Text Available Aim/Purpose\t: Share research finding about ransomware, depict the ransomware work in a format that commonly used by researchers and practitioners and illustrate personal case experience in dealing with ransomware. Background: Author was hit with Ransomware, suffered a lot from it, and did a lot of research about this topic. Author wants to share findings in his research and his experience in dealing with the aftermath of being hit with ransomware. Methodology: Case study. Applying the literature review for a personal case study. Contribution: More knowledge and awareness about ransomware, how it attacks peoples’ computers, and how well informed users can be hit with this malware. Findings: Even advanced computer users can be hit and suffer from Ransomware attacks. Awareness is very helpful. In addition, this study drew in chart format what is termed “The Ransomware Process”, depicting in chart format the steps that ransomware hits users and collects ransom. Recommendations for Practitioners\t: Study reiterates other recommendations made for dealing with ransomware attacks but puts them in personal context for more effective awareness about this malware. Recommendation for Researchers: This study lays the foundation for additional research to find solutions to the ransomware problem. IT researchers are aware of chart representations to depict cycles (like SDLC. This paper puts the problem in similar representation to show the work of ransomware. Impact on Society: Society will be better informed about ransomware. Through combining research, illustrating personal experience, and graphically representing the work of ransomware, society at large will be better informed about the risk of this malware. Future Research: Research into solutions for this problem and how to apply them to personal cases.

  11. Dealing with Coronary Artery Disease in Early Encountering: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Mohammad Mojalli

    2014-12-01

    Full Text Available Background: The prevalence of cardiovascular diseases is rising in industrial and developing countries. Coronary Artery Disease (CAD is the most common cardiovascular disease. Thus, understanding the signs and risk factors of CAD from the patients’ perspective and their ways of dealing with this disease is of vital importance. Objectives: This qualitative study aimed to explore the Iranian patients’ viewpoints about CAD and how they dealt with it in their first encounter. Patients and Methods: This study was a qualitative content analysis conducted on 18 patients with CAD. The data were collected through semi-structured interviews. Initially, purposeful sampling was performed followed by maximum variety. Sampling continued until data saturation. Then, all the interviews were recorded and transcribed verbatim. After all, the data were analyzed by constant comparative analysis using MAXQUDA2010 software. Results: The themes manifested in this study included “invasion of disease” with subthemes of “warning signs” and “risk factors” and “confrontation strategies” with subthemes of “seeking for information”, “follow-up”, and “control measures”. Conclusions:: The results of this study described the patients’ perceptions of CAD and how they dealt with this disorder in early encountering. Based on the results, physicians and nurses should focus on empowerment of patients by facilitating this process as well as by educating them with regards to dealing with CAD.

  12. On dealing with the pollution costs in agriculture: A case study of paddy fields

    Energy Technology Data Exchange (ETDEWEB)

    Yaqubi, Morteza, E-mail: yaqubi@pgs.usb.ac.ir [Faculty of Management and Economics, Department of Agricultural Economics, University of Sistan and Baluchestan Zahedan (Iran, Islamic Republic of); Shahraki, Javad, E-mail: j.shahraki@eco.usb.ac.ir [Faculty of Management and Economics, Department of Agricultural Economics, University of Sistan and Baluchestan Zahedan (Iran, Islamic Republic of); Sabouhi Sabouni, Mahmood, E-mail: sabouhi@ferdowsi.um.ac.ir [Department of Agricultural Economics, Ferdowsi University of Mashhad, Azadi Square, Mashhad (Iran, Islamic Republic of)

    2016-06-15

    The main purpose of this study is to evaluate marginal abatement cost of the main agricultural pollutants. In this sense, we construct three indices including Net Global Warming Potential (NGWP) and Nitrogen Surplus (NS), simulated by a biogeochemistry model, and also an Environmental Impact Quotient (EQI) for paddy fields. Then, using a Data Envelopment Analysis (DEA) model, we evaluate environmental inefficiencies and shadow values of these indices. The results show that there is still room for improvement at no extra cost just through a better input management. Besides, enormous potential for pollution reduction in the region is feasible. Moreover, in paddy cultivation, marginal abatement cost of pesticides and herbicides are much bigger than nitrogen surplus and greenhouse gasses. In addition, in the status quo, the mitigation costs are irrelevant to production decisions. Finally, to deal with the private pollution costs, market-based instruments are proved to be better than command-and-control regulation. - Highlights: • To evaluate agricultural pollution costs, a combination of two DNDC and DEA models was introduced. • The shadow values of three main agricultural pollutants in paddy fields were evaluated. • In the study area, a high potential for pollution reduction is feasible. • The pollution cost of pesticides are much bigger than nitrogen surplus and greenhouse gases. • From the farmers' viewpoint, a positive shadow value of undesirable outputs also is feasible. • To deal with the pollution costs, market-based instruments are preferred to command-and-control regulation.

  13. On dealing with the pollution costs in agriculture: A case study of paddy fields

    International Nuclear Information System (INIS)

    Yaqubi, Morteza; Shahraki, Javad; Sabouhi Sabouni, Mahmood

    2016-01-01

    The main purpose of this study is to evaluate marginal abatement cost of the main agricultural pollutants. In this sense, we construct three indices including Net Global Warming Potential (NGWP) and Nitrogen Surplus (NS), simulated by a biogeochemistry model, and also an Environmental Impact Quotient (EQI) for paddy fields. Then, using a Data Envelopment Analysis (DEA) model, we evaluate environmental inefficiencies and shadow values of these indices. The results show that there is still room for improvement at no extra cost just through a better input management. Besides, enormous potential for pollution reduction in the region is feasible. Moreover, in paddy cultivation, marginal abatement cost of pesticides and herbicides are much bigger than nitrogen surplus and greenhouse gasses. In addition, in the status quo, the mitigation costs are irrelevant to production decisions. Finally, to deal with the private pollution costs, market-based instruments are proved to be better than command-and-control regulation. - Highlights: • To evaluate agricultural pollution costs, a combination of two DNDC and DEA models was introduced. • The shadow values of three main agricultural pollutants in paddy fields were evaluated. • In the study area, a high potential for pollution reduction is feasible. • The pollution cost of pesticides are much bigger than nitrogen surplus and greenhouse gases. • From the farmers' viewpoint, a positive shadow value of undesirable outputs also is feasible. • To deal with the pollution costs, market-based instruments are preferred to command-and-control regulation.

  14. Dealing with aggressive methadone patients in community pharmacy: a critical incident study.

    Science.gov (United States)

    Irwin, Amy; Laing, Christianne; Mearns, Kathryn

    2012-01-01

    Community pharmacists are an important link between methadone patients and the health service in the United Kingdom. However, many pharmacists feel ill prepared to deal with methadone patients, with aggressive behavior a particular concern. To assess the perceived impact of methadone patient aggression on pharmacy practice. Sixteen registered pharmacists with a minimum of 3 years' work experience were recruited from within 3 Scottish health boards. Critical incident interviews were conducted to assess pharmacist behavior during an interaction with an aggressive methadone patient. Factors considered by pharmacists to have a negative impact on an interaction with an aggressive methadone patient included intoxication of the patient, the presence of a new or an inexperienced pharmacist, and a restricted time frame for dispensing methadone. Positive factors when dealing with aggressive patients were authoritative behavior by the pharmacist, a separate dispensing area for methadone patients, or a solid counter and a positive relationship between pharmacist and patient. Aggression from methadone patients is a risk when dispensing methadone. However, action can be taken by the pharmacist to minimize the impact of that aggression on pharmacy practice. The provision of further training and support, particularly to inexperienced pharmacists, could further reduce the negative impact of patient aggression. The present study indicates that such training could be based on nontechnical skills to strengthen current leadership and teamwork behaviors. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Dealing with taste and smell alterations-A qualitative interview study of people treated for lung cancer.

    Directory of Open Access Journals (Sweden)

    Kerstin Belqaid

    Full Text Available Taste and smell alterations have been recognized as common symptoms in relation to various cancers. However, previous research suggests that patients do not receive sufficient support in managing taste and smell alterations. Therefore, the objective of this study is to investigate how persons with experience from lung cancer-related taste and smell alterations reason about resources and strategies offered and used to manage these symptoms. Data from semi-structured individual interviews with 13 women and four men were analyzed with qualitative content analysis. We used Kleinman's now classic medical anthropological model of local health care systems, consisting of the personal, professional, and folk sector, to interpret and understand how people respond to sickness experiences in their daily lives. By presenting the findings using this model, we demonstrate that most strategies for dealing with taste and smell alterations were undertaken in the personal sector, i.e. in participants' daily lives, on an individual level and in interaction with family, social networks and communities. Taste and smell alterations implied two overarching challenges: 1 adjusting to no longer being able to trust information provided by one's own senses of taste and/or smell, and 2 coming to terms with taste and smell alterations as a part of having lung cancer. Health care professionals' involvement was described as limited, but appeared to fulfil most participants' expectations. However, through provision of normalizing information, practical advice, and to some extent, emotional support, health care professionals had potential to influence strategies and resources used for dealing with taste and smell alterations. With this study, we further the understanding of how people deal with lung cancer-related taste and smell alterations and discuss the role of health care professionals for this process.

  16. Dealing with taste and smell alterations-A qualitative interview study of people treated for lung cancer.

    Science.gov (United States)

    Belqaid, Kerstin; Tishelman, Carol; Orrevall, Ylva; Månsson-Brahme, Eva; Bernhardson, Britt-Marie

    2018-01-01

    Taste and smell alterations have been recognized as common symptoms in relation to various cancers. However, previous research suggests that patients do not receive sufficient support in managing taste and smell alterations. Therefore, the objective of this study is to investigate how persons with experience from lung cancer-related taste and smell alterations reason about resources and strategies offered and used to manage these symptoms. Data from semi-structured individual interviews with 13 women and four men were analyzed with qualitative content analysis. We used Kleinman's now classic medical anthropological model of local health care systems, consisting of the personal, professional, and folk sector, to interpret and understand how people respond to sickness experiences in their daily lives. By presenting the findings using this model, we demonstrate that most strategies for dealing with taste and smell alterations were undertaken in the personal sector, i.e. in participants' daily lives, on an individual level and in interaction with family, social networks and communities. Taste and smell alterations implied two overarching challenges: 1) adjusting to no longer being able to trust information provided by one's own senses of taste and/or smell, and 2) coming to terms with taste and smell alterations as a part of having lung cancer. Health care professionals' involvement was described as limited, but appeared to fulfil most participants' expectations. However, through provision of normalizing information, practical advice, and to some extent, emotional support, health care professionals had potential to influence strategies and resources used for dealing with taste and smell alterations. With this study, we further the understanding of how people deal with lung cancer-related taste and smell alterations and discuss the role of health care professionals for this process.

  17. Dealing with requests for euthanasia: a qualitative study investigating the experience of general practitioners.

    Science.gov (United States)

    Georges, J-J; The, A M; Onwuteaka-Philipsen, B D; van der Wal, G

    2008-03-01

    Caring for terminally ill patients is a meaningful task, however the patient's suffering can be a considerable burden and cause of frustration. The aim of this study is to describe the experiences of general practitioners (GPs) in The Netherlands in dealing with a request for euthanasia from a terminally ill patient. The data, collected through in-depth interviews, were analysed according to the constant comparative method. Having to face a request for euthanasia when attempting to relieve a patient's suffering was described as a very demanding experience that GPs generally would like to avoid. Nearly half of the GPs (14/30) strive to avoid euthanasia or physician assisted suicide because it was against their own personal values or because it was emotional burdening to be confronted with this issue. They explained that by being directed on promoting a peaceful dying process, or the quality of end-of-life of a patient by caring and supporting the patient and the relatives it was mainly possible to shorten patient's suffering without "intentionally hastening a patient's death on his request". The other GPs (16/30) explained that as sometimes the suffering of a patient could not be lessened they were open to consider a patient's request for euthanasia or physician assisted suicide. They underlined the importance of a careful decision-making process, based on finding a balance between the necessity to shorten the patient's suffering through euthanasia and their personal values. Dealing with requests for euthanasia is very challenging for GPs, although they feel committed to alleviate a patient's suffering and to promote a peaceful death.

  18. Pre and Post Merger Valuation- A Study of Tata Corus Merger Deal

    OpenAIRE

    Sumeet Gupta

    2009-01-01

    Indian Economy being characterized as Global Economy leading to inorganic growth through Mergers, Acquisitions, Takeovers and Joint Ventures. Mergers would affect the company’s inflow and outflow of various variables like sales, expenses and cash position etc. It becomes imperative to evaluate the pre merger and post merger conditions of the firms so that successful deal can be carried out. The deal would also affect the shareholders wealth. The prediction of future forecasted sales and other...

  19. Comparison of statistical approaches dealing with time-dependent confounding in drug effectiveness studies.

    Science.gov (United States)

    Karim, Mohammad Ehsanul; Petkau, John; Gustafson, Paul; Platt, Robert W; Tremlett, Helen

    2018-06-01

    In longitudinal studies, if the time-dependent covariates are affected by the past treatment, time-dependent confounding may be present. For a time-to-event response, marginal structural Cox models are frequently used to deal with such confounding. To avoid some of the problems of fitting marginal structural Cox model, the sequential Cox approach has been suggested as an alternative. Although the estimation mechanisms are different, both approaches claim to estimate the causal effect of treatment by appropriately adjusting for time-dependent confounding. We carry out simulation studies to assess the suitability of the sequential Cox approach for analyzing time-to-event data in the presence of a time-dependent covariate that may or may not be a time-dependent confounder. Results from these simulations revealed that the sequential Cox approach is not as effective as marginal structural Cox model in addressing the time-dependent confounding. The sequential Cox approach was also found to be inadequate in the presence of a time-dependent covariate. We propose a modified version of the sequential Cox approach that correctly estimates the treatment effect in both of the above scenarios. All approaches are applied to investigate the impact of beta-interferon treatment in delaying disability progression in the British Columbia Multiple Sclerosis cohort (1995-2008).

  20. Assessing methods for dealing with treatment switching in randomised controlled trials: a simulation study

    Directory of Open Access Journals (Sweden)

    Latimer Nicholas

    2011-01-01

    Full Text Available Abstract Background We investigate methods used to analyse the results of clinical trials with survival outcomes in which some patients switch from their allocated treatment to another trial treatment. These included simple methods which are commonly used in medical literature and may be subject to selection bias if patients switching are not typical of the population as a whole. Methods which attempt to adjust the estimated treatment effect, either through adjustment to the hazard ratio or via accelerated failure time models, were also considered. A simulation study was conducted to assess the performance of each method in a number of different scenarios. Results 16 different scenarios were identified which differed by the proportion of patients switching, underlying prognosis of switchers and the size of true treatment effect. 1000 datasets were simulated for each of these and all methods applied. Selection bias was observed in simple methods when the difference in survival between switchers and non-switchers were large. A number of methods, particularly the AFT method of Branson and Whitehead were found to give less biased estimates of the true treatment effect in these situations. Conclusions Simple methods are often not appropriate to deal with treatment switching. Alternative approaches such as the Branson & Whitehead method to adjust for switching should be considered.

  1. Motivating employees to work beyond retirement: A multi-level study of the role of I-deals and unit climate

    NARCIS (Netherlands)

    Bal, P.M.; de Jong, S.; Jansen, P.G.W.; Bakker, A.B.

    2012-01-01

    The present study investigates what role I-deals (i.e. the idiosyncratic deals made between employees and their organization) play in the motivation of employees to continue working after retirement. We hypothesized two types of I-deals (i.e. development and flexibility I-deals) to be positively

  2. Dealing with Daily Challenges in Dementia (Deal-id Study): An Experience Sampling Study to Assess Caregivers' Sense of Competence and Experienced Positive Affect in Daily Life.

    Science.gov (United States)

    van Knippenberg, Rosalia J M; de Vugt, Marjolein E; Ponds, Rudolf W; Myin-Germeys, Inez; Verhey, Frans R J

    2017-08-01

    Positive emotions and feelings of competence seem to play an important role in the well-being of caregivers of people with dementia. Both are likely to fluctuate constantly throughout the caretaking process. Unlike standard retrospective methods, momentary assessments in daily life can provide insight into these moment-to-moment fluctuations. Therefore, in this study both retrospective and momentary assessments were used to examine the relationship between caregivers' sense of competence and their experienced positive affect (PA) in daily life. Thirty Dutch caregivers provided momentary data on PA and daily sense of competence ratings for 6 consecutive days using the experience sampling methodology. Additionally, they reported retrospectively on their sense of competence with a traditional questionnaire. A positive association was found between retrospective and daily measured sense of competence. Caregivers reported corresponding levels of sense of competence on both measures. Both daily and retrospective sense of competence were positively associated with the experienced levels of PA. However, daily sense of competence appeared to be the strongest predictor. Regarding the variability in PA, only daily sense of competence showed a significant association, with a higher daily sense of competence predicting a more stable PA pattern. This study provides support for redirecting caregiver support interventions toward enhancement of positive rather than negative experiences and focusing more on caregivers' momentary emotional experiences. Momentary assessments are a valuable addition to standard retrospective measures and provide a more comprehensive and dynamic view of caregiver functioning. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Dealing with ambiguity: Israeli physician's attitudes and practices regarding pre-exercise certificates: a questionnaire study.

    Science.gov (United States)

    Hoffman, Robert D; Golan, Ron; Vinker, Shlomo

    2016-01-01

    It has become clear in recent years that a healthy lifestyle, including physical exercise is crucial for health maintenance. Nevertheless, most people do not exercise regularly. Physician intervention is beneficial in increasing patient exercise. In Israel, the 1994 "Sports Law" regarding exercising in a gymnasium requires a physician's written authorization, but does not direct the physicians what they should ascertain before issuing the certificate. This pre-exercise certificate has been widely discussed in Israel over the last year as the law is to be revised to enable using a modification of the PAR-Q+ (Physical Activity Readiness questionnaire) patient questionnaire as a screening tool. This will leave the requirement for a pre-exercise certificate for a less healthy population, yet without clear instructions to the primary care physician on criteria for ascertaining fitness. Our aim was to evaluate how primary care physicians deal with the ambiguity of defining health criteria for issuing exercise authorization/certificate. We used an anonymous ten-item attitude/knowledge multiple choice questionnaire with an additional 13 personal/education and employment questions. We assessed each potential predictor of physician attitude and knowledge in univariate models. 135 useable questionnaires were collected. Of these, 43.7 % of the doctors will provide the pre-exercise certificate to all their patients; 63 % were aware of their HMO/employers guidelines for issuing certificates; 62 % stated they complied with these guidelines, and 16 % stated they did not follow them. In addition, 70 % of the physicians reported regular exercise themselves, an average of 4.12 h/week. These physicians tended to provide the pre-exercise certificate to all patients unconditionally, as compared to physicians that did not exercise regularly. (46 % vs. 14.5 %, p exercise in the gym. There is a wide variation as to what physicians check before providing the certificate. The

  4. 40 CFR 152.93 - Citation of a previously submitted valid study.

    Science.gov (United States)

    2010-07-01

    ... Data Submitters' Rights § 152.93 Citation of a previously submitted valid study. An applicant may demonstrate compliance for a data requirement by citing a valid study previously submitted to the Agency. The... the original data submitter, the applicant may cite the study only in accordance with paragraphs (b...

  5. A Small-Scale Study on Student Teachers' Perceptions of Classroom Management and Methods for Dealing with Misbehaviour

    Science.gov (United States)

    Atici, Meral

    2007-01-01

    The purpose of this study is to identify student teachers' perceptions of classroom management and methods for dealing with misbehaviour. In-depth interviews with nine student teachers at Cukurova University (CU) in Turkey have been conducted twice, prior to and at the end of their teaching practice. Instructional management, behaviour management,…

  6. A pilot study to test an intervention for dealing with verbal aggression.

    Science.gov (United States)

    McLaughlin, Sue; Bonner, Gwen; Mboche, Catherine; Fairlie, Trish

    Verbal aggression has been defined as communication with an intention to harm an individual through words, tone or manner, regardless of whether harm occurs. It includes verbal threat to harm, ridicule, openly hostile remarks, unjust persistent criticism, shouting or yelling insults, as well as more covert actions such as spreading hurtful rumours (Cox, 1987; Farrell et al, 2006). Receiving verbal aggression from a patient has been closely associated with psychological distress which may negatively affect work performance. A verbal aggression work book was developed to help nursing staff to deal with verbal aggression from patients in clinical practice. This was piloted over a six-week period with 18 nurses working on one acute psychiatric inpatient ward. Findings revealed that the intervention had some promising effects. However, much more attention needs to be paid to changing attitudes towards verbal aggression.

  7. Summary of Previous Chamber or Controlled Anthrax Studies and Recommendations for Possible Additional Studies

    Energy Technology Data Exchange (ETDEWEB)

    Piepel, Gregory F.; Amidan, Brett G.; Morrow, Jayne B.

    2010-12-29

    This report and an associated Excel file(a) summarizes the investigations and results of previous chamber and controlled studies(b) to characterize the performance of methods for collecting, storing and/or transporting, extracting, and analyzing samples from surfaces contaminated by Bacillus anthracis (BA) or related simulants. This report and the Excel are the joint work of the Pacific Northwest National Laboratory (PNNL) and the National Institute of Standards and Technology (NIST) for the Department of Homeland Security, Science and Technology Directorate. The report was originally released as PNNL-SA-69338, Rev. 0 in November 2009 with limited distribution, but was subsequently cleared for release with unlimited distribution in this Rev. 1. Only minor changes were made to Rev. 0 to yield Rev. 1. A more substantial update (including summarizing data from other studies and more condensed summary tables of data) is underway

  8. Matched cohort study of external cephalic version in women with previous cesarean delivery.

    Science.gov (United States)

    Keepanasseril, Anish; Anand, Keerthana; Soundara Raghavan, Subrahmanian

    2017-07-01

    To evaluate the efficacy and safety of external cephalic version (ECV) among women with previous cesarean delivery. A retrospective study was conducted using data for women with previous cesarean delivery and breech presentation who underwent ECV at or after 36 weeks of pregnancy during 2011-2016. For every case, two multiparous women without previous cesarean delivery who underwent ECV and were matched for age and pregnancy duration were included. Characteristics and outcomes were compared between groups. ECV was successful for 32 (84.2%) of 38 women with previous cesarean delivery and 62 (81.6%) in the control group (P=0.728). Multivariate regression analysis confirmed that previous cesarean was not associated with ECV success (odds ratio 1.89, 95% confidence interval 0.19-18.47; P=0.244). Successful vaginal delivery after successful ECV was reported for 19 (59.4%) women in the previous cesarean delivery group and 52 (83.9%) in the control group (P<0.001). No ECV-associated complications occurred in women with previous cesarean delivery. To avoid a repeat cesarean delivery, ECV can be offered to women with breech presentation and previous cesarean delivery who are otherwise eligible for a trial of labor. © 2017 International Federation of Gynecology and Obstetrics.

  9. Assessing methods for dealing with treatment crossover in clinical trials: A follow-up simulation study

    OpenAIRE

    Latimer, N.R.; Abrams, K.R.; Lambert, P.C.; Crowther, M.J.; Morden, J.P.

    2014-01-01

    Background: Treatment switching commonly occurs in clinical trials of novel interventions, particularly in the advanced or metastatic cancer setting, which causes important problems for health technology assessment. Previous research has demonstrated which adjustment methods are suitable in specific scenarios, but scenarios considered have been limited. \\ud Objectives: We aimed to assess statistical approaches for adjusting survival estimates in the presence of treatment switching in order to...

  10. Shareholder preferences of Merger Deals and Industry Choices: A Case Study of UK Companies

    OpenAIRE

    Reimoo, Maleka

    2007-01-01

    Abstract Mergers and acquisitions have gained enormous popularity in the recent past. There have been five trends in the previous century alone. There is however, a conflict in the literature regarding the impacts of such financial activities. While some researchers support mergers due to the financial profits associated with them, others argue against them as not being very favourable for the shareholders of the companies. This research therefore aims at calculating any abnormal returns ...

  11. In experimental studies how can we deal with chunk productions by learners?

    OpenAIRE

    道本,祐子

    2018-01-01

    Pienmann (1998; 2011) has proposed an L2 developmental schedule known as his “Processability Theory” or PT. The theory has been assumed in many empirical studies using not only speaking tasks (production) but reception tasks. However, writing studies for PT have not yet been developed. In this study, Mihimoto’s two empirical studies (Michimoto, 2015a; 2015b) are used in order to examine PT through writing tasks and to establish a suitable method for designing writing tasks. Important technica...

  12. Study of some physical aspects previous to design of an exponential experiment

    International Nuclear Information System (INIS)

    Caro, R.; Francisco, J. L. de

    1961-01-01

    This report presents the theoretical study of some physical aspects previous to the design of an exponential facility. The are: Fast and slow flux distribution in the multiplicative medium and in the thermal column, slowing down in the thermal column, geometrical distribution and minimum needed intensity of sources access channels and perturbations produced by possible variations in its position and intensity. (Author) 4 refs

  13. Adolescent Students and Their Experiences of Dealing with Pregnancy: A Mexican Mixed-Method Study

    Science.gov (United States)

    Atienzo, Erika E.; Campero, Lourdes; Marín, Eréndira; González, Guillermo

    2017-01-01

    In impoverished communities in Mexico, most adolescent mothers do not attend school; but typically, they become pregnant once they dropped out. Understanding the experiences of adolescents who have had a pregnancy and continue in school is complicated since few manage to do it. The goal of this study is to describe experiences within the family…

  14. Creating philanthropic foundations to deal with grief: case studies of bereaved parents.

    Science.gov (United States)

    Rossetto, Kelly R

    2014-01-01

    The current study involves the analysis of six bereaved parents' stories and argues that the development of philanthropic foundations helped these parents make meaning of their children's deaths and find purpose in the midst of their grief. Furthermore, philanthropy, as a way of making meaning and finding purpose, is a mutually beneficial process because it helps both the bereaved founders and the communities the organizations reach. Connections between these narratives and the bereavement literature help us better understand the individual/family grief process and meaning making, as well as how internal grief states intersect with communities.

  15. Study of functional-performance deficits in athletes with previous ankle sprains

    Directory of Open Access Journals (Sweden)

    hamid Babaee

    2008-04-01

    Full Text Available Abstract Background: Despite the importance of functional-performance deficits in athletes with history of ankle sprain few, studies have been carried out in this area. The aim of this research was to study relationship between previous ankle sprains and functional-performance deficits in athletes. Materials and methods: The subjects were 40 professional athletes selected through random sampling among volunteer participants in soccer, basketball, volleyball and handball teams of Lorestan province. The subjects were divided into 2 groups: Injured group (athletes with previous ankle sprains and healthy group (athletes without previous ankle sprains. In this descriptive study we used Functional-performance tests (figure 8 hop test and side hop test to determine ankle deficits and limitations. They participated in figure 8 hop test including hopping in 8 shape course with the length of 5 meters and side hop test including 10 side hop repetitions in course with the length of 30 centimeters. Time were recorded via stopwatch. Results: After data gathering and assessing information distributions, Pearson correlation was used to assess relationships, and independent T test to assess differences between variables. Finally the results showed that there is a significant relationship between previous ankle sprains and functional-performance deficits in the athletes. Conclusion: The athletes who had previous ankle sprains indicated functional-performance deficits more than healthy athletes in completion of mentioned functional-performance tests. The functional-performance tests (figure 8 hop test and side hop test are sensitive and suitable to assess and detect functional-performance deficits in athletes. Therefore we can use the figure 8 hop and side hop tests for goals such as prevention, assessment and rehabilitation of ankle sprains without spending too much money and time.

  16. Dealing with suicidal patients – a challenging task: a qualitative study of young physicians' experiences

    Directory of Open Access Journals (Sweden)

    Talseth Anne-Grethe

    2006-08-01

    Full Text Available Abstract Background Suicide is a major public health problem and treating suicidal patients represents one of the most challenging and complex clinical situations for young physicians. Education of physicians is considered an important strategy in suicide prevention. Young physicians often meet suicidal patients early in their career. Limited information is available about how newly educated physicians experience treating suicidal patients. The aim of the study was to shed light on the meaning of newly educated physicians' lived experiences in treating patients at risk of committing suicide. Methods Thirteen newly educated physicians narrated their experiences with suicidal patients. The interview text was transcribed and interpreted using a phenomenological-hermeneutical method inspired by Ricoeur's philosophy. Results Three main themes and ten themes were noted: Striving for relatedness: relating with the patient; not being able to relate with the patient; Intervening competently: having adequate professional knowledge; performing professionally; having professional values; evaluating one's own competence; and Being emotionally involved: accepting one's own vulnerability; feeling morally indignant; feeling powerless and accepting one's own fallibility. The recently educated physicians clearly described the variety of emotional and ethical dilemmas that arose in meeting suicidal patients and the professional challenge facing this clinical situation. The findings were interpreted in the perspective of communication, clinical decision-making and attention to the professional's emotional reactions. Conclusion An examination of the experiences of young physicians treating suicidal patients reveals three main themes that were a professional challenge for them: Striving for relatedness, Intervening competently and Being emotionally involved. Support for young practitioners that are treating these patients is likely important both to facilitate

  17. Mangrove Cultivation For Dealing With Coastal Abrasion Case Study Of Karangsong

    Science.gov (United States)

    Fatimatuzzahroh, Feti; Hadi, Sudharto P.; Purnaweni, Hartuti

    2018-02-01

    Coastal abrasion is consequence from destructive waves and sea current. One of cause is human intervention. The effort to solve of abrasion is by mangrove cultivation. Mangroves are halophyte plant that can restrain the sea wave. Mangrove cultivation required participation community that give awareness the importance of mangrove in coastal sustainability. Mangroves in coastal Karangsong, Indramayu west java, in 2007 was through abrasion approximately 127.30 ha. Mangrove cultivation in Karangsong has been replanting since 1998 to 2003, but there was no maintenance and management. In 2007 until 2015 Karangsong replanting mangroves and has been succeed. Karangsong became the center of mangrove study for west java area in 2015. This achievement is result of cooperation between community, NGO, and local government. In addition, this effort made not only overcome the abrasion problem but also give community awareness about the importance of mangrove cultivation in preventing coastal abrasion throughout community development. This paper reviews abrasion in Karangsong and the impact for local community and empowerment in mangrove cultivation. To achieve the success mangrove cultivation required community development approach from planning process, planting, maintenance and management.

  18. How Do Children Deal With Conflict? A Developmental Study of Sequential Conflict Modulation

    Science.gov (United States)

    Smulders, Silvan F. A.; Soetens, Eric L. L.; van der Molen, Maurits W.

    2018-01-01

    This study examined age-related differences in sequential conflict modulation (SCM), elicited in three tasks requiring the inhibition of pre-potent responses; a Simon task, an S-R compatibility (SRC) task and a hybrid Choice-reaction/NoGo task. The primary focus was on age-related changes in performance changes following a conflict trial. A secondary aim was to assess whether SCM follows different developmental trajectories depending on the type of conflict elicited by the tasks. The tasks were presented to three different groups of participants with an age range between 7- to 25-years—one group of participants for each task. For each task, the response-to-stimulus interval (RSI) was manipulated (50 vs. 500 ms) across trial blocks to assess time-dependent changes in conflict modulation. The results showed SCM for all three tasks, although the specific patterns differed between tasks and RSIs. Importantly, the magnitude of SCM decreased with advancing age, but this developmental trend did not survive when considering age-group differences in basic response speed. The current results contribute to the emerging evidence suggesting that patterns of SCM are task specific and were interpreted in terms of multiple bottom-up control mechanisms. PMID:29875718

  19. How Do Children Deal With Conflict? A Developmental Study of Sequential Conflict Modulation

    Directory of Open Access Journals (Sweden)

    Silvan F. A. Smulders

    2018-05-01

    Full Text Available This study examined age-related differences in sequential conflict modulation (SCM, elicited in three tasks requiring the inhibition of pre-potent responses; a Simon task, an S-R compatibility (SRC task and a hybrid Choice-reaction/NoGo task. The primary focus was on age-related changes in performance changes following a conflict trial. A secondary aim was to assess whether SCM follows different developmental trajectories depending on the type of conflict elicited by the tasks. The tasks were presented to three different groups of participants with an age range between 7- to 25-years—one group of participants for each task. For each task, the response-to-stimulus interval (RSI was manipulated (50 vs. 500 ms across trial blocks to assess time-dependent changes in conflict modulation. The results showed SCM for all three tasks, although the specific patterns differed between tasks and RSIs. Importantly, the magnitude of SCM decreased with advancing age, but this developmental trend did not survive when considering age-group differences in basic response speed. The current results contribute to the emerging evidence suggesting that patterns of SCM are task specific and were interpreted in terms of multiple bottom-up control mechanisms.

  20. Adolescents dealing with sexuality issues: a cross-sectional study in Greece.

    Science.gov (United States)

    Tsitsika, Artemis; Greydanus, Donald; Konstantoulaki, Eleftheria; Bountziouka, Vasiliki; Deligiannis, Ioannis; Dimitrakopoulou, Vasiliki; Critselis, Elena; Tounissidou, Despoina; Tsolia, Marisa; Papaevagelou, Vana; Constantopoulos, Andreas; Kafetzis, Dimitrios

    2010-10-01

    To evaluate the prevalence of sexual activity and contraception methods used by Greek adolescents. To assess the effect of various factors in the decision making on sexual activity. A cross-sectional study design was applied. SETTING-PARTICIPANTS: The population (N = 1538) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece. Anonymous self-completed questionnaires were used to assess sexual practices, contraception methods, and factors affecting sexual activity choices. Spearman association calculations and chi-square were used, while regression analysis models were also applied. We examined the sexual practices among Greek adolescents, and indicated the psychosocial factors that may influence adolescents' sexual behavior. 16% of the adolescents have had sexual intercourse, while the boy/girl ratio was 3/1 (P divorce, recent death, not living with mother) or sexually experienced peers, as well as those that seek sexual education from siblings or friends have higher possibilities of being sexually active. Greek adolescents can be sexually active at a young age and they need sexual education on safe sex practices. Copyright © 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  1. Dealing with Dependent Uncertainty in Modelling: A Comparative Study Case through the Airy Equation

    Directory of Open Access Journals (Sweden)

    J.-C. Cortés

    2013-01-01

    Full Text Available The consideration of uncertainty in differential equations leads to the emergent area of random differential equations. Under this approach, inputs become random variables and/or stochastic processes. Often one assumes that inputs are independent, a hypothesis that simplifies the mathematical treatment although it could not be met in applications. In this paper, we analyse, through the Airy equation, the influence of statistical dependence of inputs on the output, computing its expectation and standard deviation by Fröbenius and Polynomial Chaos methods. The results are compared with Monte Carlo sampling. The analysis is conducted by the Airy equation since, as in the deterministic scenario its solutions are highly oscillatory, it is expected that differences will be better highlighted. To illustrate our study, and motivated by the ubiquity of Gaussian random variables in numerous practical problems, we assume that inputs follow a multivariate Gaussian distribution throughout the paper. The application of Fröbenius method to solve Airy equation is based on an extension of the method to the case where inputs are dependent. The numerical results show that the existence of statistical dependence among the inputs and its magnitude entails changes on the variability of the output.

  2. Google Glass for Residents Dealing With Pediatric Cardiopulmonary Arrest: A Randomized, Controlled, Simulation-Based Study.

    Science.gov (United States)

    Drummond, David; Arnaud, Cécile; Guedj, Romain; Duguet, Alexandre; de Suremain, Nathalie; Petit, Arnaud

    2017-02-01

    To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team. Randomized controlled study. Children's hospital at a tertiary care academic medical center. Forty-two first-year pediatric residents. Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin. During the second evaluation, the residents in the Google Glass group were allowed to seek help from a remote intensivist at any time by activating real-time video communication. The residents in the control group were asked to provide usual care. The main outcome measures were the proportion of time for which the manikin received no ventilation (no-blow fraction) or no compression (no-flow fraction). In the first evaluation, overall no-blow and no-flow fractions were 74% and 95%, respectively. During the second evaluation, no-blow and no-flow fractions were similar between the two groups. Insufflations were more effective (p = 0.04), and the technique (p = 0.02) and rate (p Google Glass group than in the control group. Real-time video communication between the first responder and a remote intensivist through Google Glass did not decrease no-blow and no-flow fractions during the first 5 minutes of a simulated pediatric cardiopulmonary arrest but improved the quality of the insufflations and chest compressions provided.

  3. Data from studies of previous radioactive waste disposal in Massachusetts Bay

    International Nuclear Information System (INIS)

    Curtis, W.R.; Mardis, H.M.

    1984-12-01

    This report presents the results of studies conducted in Massachusetts Bay during 1981 and 1982. Included are data from: (1) a side scan sonar survey of disposal areas in the Bay that was carried out by the National Oceanic and Atmospheric Administration (NOAA) for EPA; (2) Collections of sediment and biota by NOAA for radiochemical analysis by EPA; (3) collections of marketplace seafood samples by the Food and Drug Administration (FDA) for radioanalysis by both FDA and EPA; and (4) a radiological monitoring survey of LLW disposal areas by EPA to determine whether there should be any concern for public health resulting from previous LLW disposals in the Bay

  4. Satisfaction with sex life in sexually active heterosexual couples dealing with breast cancer: a nationwide longitudinal study.

    Science.gov (United States)

    Rottmann, Nina; Gilså Hansen, Dorte; dePont Christensen, René; Hagedoorn, Mariët; Frisch, Morten; Nicolaisen, Anne; Kroman, Niels; Flyger, Henrik; Johansen, Christoffer

    2017-02-01

    A breast cancer (BC) diagnosis can profoundly affect the sex life of patient and partner within a couple. The purpose of the present study is to examine whether individual and partner sexual functioning, affectionate behavior, emotional closeness and depressive symptoms are associated with change over time in satisfaction with sex life of sexually active heterosexual couples dealing with BC and to explore whether the associations differ between patients and partners after adjustment for basic sociodemographic characteristics, comorbidity and BC treatment. Women with BC and their male partners participated in a longitudinal study (Time 1, ≤4 months after surgery; Time 2, 5 months later). Participants completed items from the PROMIS ® Sexual Function and Satisfaction measure (version 1.0), two items measuring affectionate behavior, a single item measuring emotional closeness and the Center for Epidemiologic Studies-Depression Scale. Registers provided sociodemographic and medical information. Multilevel models were used, which take the interdependency of couples' scores into account. A total of 287 sexually active couples were included in the analyses. Less vaginal discomfort and more vaginal lubrication were associated with increases in patients' satisfaction with sex life. Patients' and partners' satisfaction increased with higher ratings of their own orgasm ability and of partners' timing of ejaculation. Patients' reports of affectionate behavior were positively associated with their partners' satisfaction, and vice versa for partners. Patients' satisfaction increased the more emotional closeness their partner experienced. Partners' depressive symptoms were negatively associated with their satisfaction. Sociodemographic factors and BC treatment were not significantly associated with change in satisfaction. Satisfaction with sex life in sexually active couples dealing with BC needs to be seen as a couple issue. Health professionals should take the partner into

  5. Dealing with Sports Injuries

    Science.gov (United States)

    ... Videos for Educators Search English Español Dealing With Sports Injuries KidsHealth / For Teens / Dealing With Sports Injuries ... a long way toward preventing injuries. Types of Sports Injuries Common reasons why teens get injured playing ...

  6. A longitudinal study of plasma insulin and glucagon in women with previous gestational diabetes

    DEFF Research Database (Denmark)

    Damm, P; Kühl, C; Hornnes, P

    1995-01-01

    OBJECTIVE: To investigate whether plasma insulin or glucagon predicts later development of diabetes in women with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: The subjects studied were 91 women with diet-treated GDM and 33 healthy women. Plasma insulin and glucagon during a 50...... at follow-up (2 had insulin-dependent diabetes mellitus, 13 had non-insulin-dependent diabetes mellitus, and 12 had impaired glucose tolerance). Compared with the control subjects, women with previous GDM had relatively impaired insulin secretion (decreased insulinogenic index and delayed peak insulin...... for subsequent development of overt diabetes (logistic regression analysis). CONCLUSIONS: Women who develop GDM have a relative insulin secretion deficiency, the severity of which is predictive for later development of diabetes. Furthermore, our data indicate that their relatively reduced beta-cell function may...

  7. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    Directory of Open Access Journals (Sweden)

    Moreno Victor

    2011-08-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. Methods CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. Results None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive, rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive, rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant, and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive. In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1

  8. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    International Nuclear Information System (INIS)

    Abulí, Anna; Morillas, Juan D; Rigau, Joaquim; Latorre, Mercedes; Fernández-Bañares, Fernando; Peña, Elena; Riestra, Sabino; Payá, Artemio; Jover, Rodrigo; Xicola, Rosa M; Llor, Xavier; Fernández-Rozadilla, Ceres; Carvajal-Carmona, Luis; Villanueva, Cristina M; Moreno, Victor; Piqué, Josep M; Carracedo, Angel; Castells, Antoni; Andreu, Montserrat; Ruiz-Ponte, Clara; Castellví-Bel, Sergi; Alonso-Espinaco, Virginia; Muñoz, Jenifer; Gonzalo, Victoria; Bessa, Xavier; González, Dolors; Clofent, Joan; Cubiella, Joaquin

    2011-01-01

    Colorectal cancer (CRC) is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase) are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category) and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value < 0.05 in EPICOLON stage 1 [rs698 in ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive), rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive), rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant), and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive). In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1.12, 95% CI = 1

  9. A Questionnaire Study on the Attitudes and Previous Experience of Croatian Family Physicians toward their Preparedness for Disaster Management.

    Science.gov (United States)

    Pekez-Pavliško, Tanja; Račić, Maja; Jurišić, Dinka

    2018-04-01

    To explore family physicians' attitudes, previous experience and self-assessed preparedness to respond or to assist in mass casualty incidents in Croatia. The cross-sectional survey was carried out during January 2017. Study participants were recruited through a Facebook group that brings together family physicians from Croatia. They were asked to complete the questionnaire, which was distributed via google.docs. Knowledge and attitudes toward disaster preparedness were evaluated by 18 questions. Analysis of variance, Student t test and Kruskal-Wallis test t were used for statistical analysis. Risk awareness of disasters was high among respondents (M = 4.89, SD=0.450). Only 16.4 of respondents have participated in the management of disaster at the scene. The majority (73.8%) of physicians have not been participating in any educational activity dealing with disaster over the past two years. Family physicians believed they are not well prepared to participate in national (M = 3.02, SD=0.856) and local community emergency response system for disaster (M = 3.16, SD=1.119). Male physicians scored higher preparedness to participate in national emergency response system for disaster ( p =0.012), to carry out accepted triage principles used in the disaster situation ( p =0.003) and recognize differences in health assessments indicating potential exposure to specific agents ( p =0,001) compared to their female colleagues. Croatian primary healthcare system attracts many young physicians, who can be an important part of disaster and emergency management. However, the lack of experience despite a high motivation indicates a need for inclusion of disaster medicine training during undergraduate studies and annual educational activities.

  10. A study about the interest and previous contact of high school students with Astronomy

    Science.gov (United States)

    Carvalho, C. L.; Zanitti, M. H. R.; Felicidade, B. L.; Gomes, A. D. T.; Dias, E. W.; Coelho, F. O.

    2016-04-01

    The currently problems in Astronomy teaching in Brazilian Basic Education contrast with the space, and the popularity that astronomical themes have in various media in the country. In this work, we present the results of a study about the interest, and previous contact of high school students from a public school in the city of "São João del-Rei"/MG with topics related to Astronomy. The study and the pedagogical intervention were carried out by students of the PIBID/CAPES/UFSJ. The intervention was performed through an oral exposition with the students' participation, followed by the use of the Stellarium program. The results suggest the majority of students surveyed are interested in Astronomy, and have had some contact with the area. However, some inconsistencies in their responses were identified and examined. The implications for research and for Astronomy Education are discussed. We also make some considerations about relationship between the lack of specific knowledge and the misinformation as one possible reason for the little interest of students in various areas of Science.

  11. Fire Risk Scoping Study: Investigation of nuclear power plant fire risk, including previously unaddressed issues

    International Nuclear Information System (INIS)

    Lambright, J.A.; Nowlen, S.P.; Nicolette, V.F.; Bohn, M.P.

    1989-01-01

    An investigation of nuclear power plant fire risk issues raised as a result of the USNRC sponsored Fire Protection Research Program at Sandia National Laboratories has been performed. The specific objectives of this study were (1) to review and requantify fire risk scenarios from four fire probabilistic risk assessments (PRAs) in light of updated data bases made available as a result of USNRC sponsored Fire Protection Research Program and updated computer fire modeling capabilities, (2) to identify potentially significant fire risk issues that have not been previously addressed in a fire risk context and to quantify the potential impact of those identified fire risk issues where possible, and (3) to review current fire regulations and plant implementation practices for relevance to the identified unaddressed fire risk issues. In performance of the fire risk scenario requantifications several important insights were gained. It was found that utilization of a more extensive operational experience base resulted in both fire occurrence frequencies and fire duration times (i.e., time required for fire suppression) increasing significantly over those assumed in the original works. Additionally, some thermal damage threshold limits assumed in the original works were identified as being nonconservative based on more recent experimental data. Finally, application of the COMPBRN III fire growth model resulted in calculation of considerably longer fire damage times than those calculated in the original works using COMPBRN I. 14 refs., 2 figs., 16 tabs

  12. Dealing with incidents of serious disciplinary problems amongst learners: A comparative study between South Africa and selected countries

    Directory of Open Access Journals (Sweden)

    Charl C. Wolhuter

    2013-11-01

    Full Text Available Teachers in South African schools battle with problems in learner discipline. Research indicates that teachers are at a loss as to handling these situations. The aim of this article is to survey incidents of serious learner misconduct in a representative selection of education systems abroad to extract any guidelines that might be applicable to South African schools. Eight education systems were surveyed: Brazil, England, Turkey, Singapore, Malaysia, China, Australia and New Zealand. The international systems surveyed in this article developed promising models, namely the National Safe Schools Framework (NSSF in Australia, the Response Early Intervention and Assessment Community Health (REACH programme in Singapore, the National Education Plan in the state of São Paolo, Brazil, and the two models in the category of positive disciplinary approaches in New Zealand, namely the Respectful Schools: Restorative Practices in Education and the New Zealand Minister of Education’s Positive Behaviour for [a] Learning Action Plan. A study of these international practices and underlying principles for dealing with discipline in pedagogical situations (Christian or secular could provide guidelines for South African teachers and education authorities.

  13. Communication difficulties and the experience of loneliness in patients with cancer dealing with fertility issues: a qualitative study.

    Science.gov (United States)

    Goossens, Joline; Delbaere, Ilse; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann

    2015-01-01

    To explore communication difficulties and the experience of loneliness among patients with cancer dealing with fertility issues. Qualitative study based on grounded theory principles. One university hospital and two general hospitals in Flanders, Belgium. 21 female and 7 male patients with cancer with potential fertility problems as a result of treatment. Grounded theory approach using the constant comparison method; data collection (semistructured face-to-face interviews) and analysis occurred simultaneously. Loneliness was a central theme in the experience of potential fertility loss among patients with cancer. Feelings of loneliness resulted from communication difficulties between the patient and members of his or her social environment or healthcare professionals because of several underlying processes and influencing factors. Loneliness was a strong and common feeling among patients with cancer. Patients, members of their social environment, and healthcare professionals experienced difficulties in communicating about fertility in the context of cancer, leading to patients' feelings of loneliness. Healthcare professionals must be attentive to signs indicating loneliness regarding fertility concerns, and they should provide adequate information and appropriate guidance to support patients. Professionals need further training to improve knowledge and skills.

  14. Are we failing to prepare nursing and midwifery students to deal with domestic abuse? Findings from a qualitative study.

    Science.gov (United States)

    Bradbury-Jones, Caroline; Broadhurst, Karen

    2015-09-01

    To investigate student nurses' and midwives' knowledge, confidence and educational needs regarding recognition and responses to domestic abuse. Domestic abuse is a serious global problem and has greater, negative effects on long-term health than more obvious diseases, such as diabetes. Nurses and midwives are well-placed to recognize and respond to domestic abuse but many lack confidence in this area. There is firm evidence that training can increase the confidence of Registered Nurses and midwives in responding to domestic abuse. But the issue of undergraduate preparation is significantly under-investigated. A qualitative study. Nursing and midwifery students were recruited using purposive sampling. We facilitated eight focus groups with a total of 55 students (student midwives N = 32; student nurses n = 23). Data were collected between May-November 2014. Students in the study viewed the issue of domestic abuse as important and they possessed sound theoretical knowledge of its nature and consequences. However, they lacked confidence in recognizing and responding to abuse and were concerned about the implications of this for their future practice as registered practitioners. Interactive learning opportunities that engaged with service users and involved experts from practice were viewed as important educational requirements. Most students in the study felt insufficiently prepared to deal with the issue of domestic abuse. They perceived this as a cyclical state of disempowerment that would impact negatively on their practice and on their own ability to support nursing and midwifery students of the future. © 2015 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

  15. The biomechanics of running in athletes with previous hamstring injury: A case-control study.

    Science.gov (United States)

    Daly, C; Persson, U McCarthy; Twycross-Lewis, R; Woledge, R C; Morrissey, D

    2016-04-01

    Hamstring injury is prevalent with persistently high reinjury rates. We aim to inform hamstring rehabilitation by exploring the electromyographic and kinematic characteristics of running in athletes with previous hamstring injury. Nine elite male Gaelic games athletes who had returned to sport after hamstring injury and eight closely matched controls sprinted while lower limb kinematics and muscle activity of the previously injured biceps femoris, bilateral gluteus maximus, lumbar erector spinae, rectus femoris, and external oblique were recorded. Intergroup comparisons of muscle activation ratios and kinematics were performed. Previously injured athletes demonstrated significantly reduced biceps femoris muscle activation ratios with respect to ipsilateral gluteus maximus (maximum difference -12.5%, P = 0.03), ipsilateral erector spinae (maximum difference -12.5%, P = 0.01), ipsilateral external oblique (maximum difference -23%, P = 0.01), and contralateral rectus femoris (maximum difference -22%, P = 0.02) in the late swing phase. We also detected sagittal asymmetry in hip flexion (maximum 8°, P = 0.01), pelvic tilt (maximum 4°, P = 0.02), and medial rotation of the knee (maximum 6°, P = 0.03) effectively putting the hamstrings in a lengthened position just before heel strike. Previous hamstring injury is associated with altered biceps femoris associated muscle activity and potentially injurious kinematics. These deficits should be considered and addressed during rehabilitation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Collective Innovation : A new approach for dealing with society induced challenges: A case study in the Dutch Bakery Sector

    NARCIS (Netherlands)

    De Graaf, R.; Van der Duin, P.M.

    2013-01-01

    Since many of today's problems are becoming ever more complex, the way we look for and manage innovations to solve these problems should also be innovated. We introduce the ‘Collective Innovation’ approach to deal with these kind of ‘wicked problems’ that require the input of many different parties.

  17. Rancidity inhibition study in frozen whole mackerel (scomber scombrus by a previous plant extract treatment.

    Directory of Open Access Journals (Sweden)

    Aubourg, Santiago P.

    2005-09-01

    Full Text Available The effect of flaxseeds (Linum usitatissimum on rancidity development in frozen whole mackerel (Scomber scombrus was studied. For it, fresh mackerel were dipped in flaxseeds aqueous extract during 60 min, frozen at –80 ºC during 24 hours and kept frozen (–20 ºC up to 12 months. Sampling was carried out on the initial material and at months 1, 3, 5, 7, 9 and 12 of frozen storage at –20 ºC. A parallel experiment with non treated fish was carried out in the same conditions. Rancidity development was measured by several biochemical indices (free fatty acids, peroxides, conjugated dienes and trienes, secondary oxidation products and lipoxygenase activity and complemented by the sensory analysis (skin, flesh odour, consistency and flesh appearance. As a result of the previous antioxidant treatment, peroxides showed to breakdown faster (pSe ha estudiado el efecto del lino (Linum usitatissimum en el desarrollo de rancidez en caballa entera congelada (Scomber scombrus. Para ello, caballas frescas fueron sumergidas en extractos acuosos de semillas de lino durante 60 min, congeladas a -80 ºC durante 24 h y mantenidas congeladas ( -20 ºC durante 12 meses. Se tomaron muestras del material inicial y tras 1, 3, 5, 7, 9 y 12 meses de congelación a -20 ºC . Un experimento paralelo con pescado no tratado fue llevado acabo en las mismas condiciones. El desarrollo de la rancidez fue medido por varios índices bioquímicos (ácidos grasos libres, peróxidos, dienos y trienos conjugados, productos secundarios de oxidación y actividad lipoxigenasa y completado con análisis sensorial (piel, olor de la carne, consistencia y apariencia de la carne. Como resultado del tratamiento antioxidante, los peróxidos se degradaron más rápidos (p < 0.05 después del mes 7, y por tanto, contenidos mayores (p < 0.05 de dienos y trienos conjugados pudieron ser detectados en el pescado tratado. El tratamiento antioxidante también condujo a un

  18. Exclusive Dealing and Entry

    OpenAIRE

    João Leão

    2008-01-01

    This paper examines the use of exclusive dealing agreements to prevent the entry of rival firms. An exclusive dealing agreement is a contract between a buyer and a seller where the buyer commits to buy a good exclusively from the seller. One main concern of the literature is to explain how an incumbent seller is able to persuade the buyers to sign an exclusive dealing agreement that deters the entry of a more efficient rival seller. We propose a new explanation when the buyers are downstream ...

  19. Effect of Previous Irradiation on Vascular Thrombosis of Microsurgical Anastomosis: A Preclinical Study in Rats

    Science.gov (United States)

    Gallardo-Calero, Irene; López-Fernández, Alba; Romagosa, Cleofe; Vergés, Ramona; Aguirre-Canyadell, Marius; Soldado, Francisco; Velez, Roberto

    2016-01-01

    Background: The objective of the present investigation was to compare the effect of neoadjuvant irradiation on the microvascular anastomosis in cervical bundle using an experimental model in rats. Methods: One hundred forty male Sprague–Dawley rats were allocated into 4 groups: group I, control, arterial microanastomosis; group II, control, venous microanastomosis; group III, arterial microanastomosis with previous irradiation (20 Gy); and group IV, venous microanastomosis with previous irradiation (20 Gy). Clinical parameters, technical values of anastomosis, patency, and histopathological parameters were evaluated. Results: Irradiated groups (III and IV) and vein anastomosis groups (II and IV) showed significantly increased technical difficulties. Group IV showed significantly reduced patency rates (7/35) when compared with the control group (0/35). Radiotherapy significantly decreased the patency rates of the vein (7/35) when compared with the artery (1/35). Groups III and IV showed significantly reduced number of endothelial cells and also showed the presence of intimal thickening and adventitial fibrosis as compared with the control group. Conclusion: Neoadjuvant radiotherapy reduces the viability of the venous anastomosis in a preclinical rat model with a significant increase in the incidence of vein thrombosis. PMID:27975009

  20. Late preterm birth and previous cesarean section: a population-based cohort study.

    Science.gov (United States)

    Yasseen Iii, Abdool S; Bassil, Kate; Sprague, Ann; Urquia, Marcelo; Maguire, Jonathon L

    2018-02-21

    Late preterm birth (LPB) is increasingly common and associated with higher morbidity and mortality than term birth. Yet, little is known about the influence of previous cesarean section (PCS) and the occurrence of LPB in subsequent pregnancies. We aim to evaluate this association along with the potential mediation by cesarean sections in the current pregnancy. We use population-based birth registry data (2005-2012) to establish a cohort of live born singleton infants born between 34 and 41 gestational weeks to multiparous mothers. PCS was the primary exposure, LPB (34-36 weeks) was the primary outcome, and an unplanned or emergency cesarean section in the current pregnancy was the potential mediator. Associations were quantified using propensity weighted multivariable Poisson regression, and mediating associations were explored using the Baron-Kenny approach. The cohort included 481,531 births, 21,893 (4.5%) were LPB, and 119,983 (24.9%) were predated by at least one PCS. Among mothers with at least one PCS, 6307 (5.26%) were LPB. There was increased risk of LPB among women with at least one PCS (adjusted Relative Risk (aRR): 1.20 (95%CI [1.16, 1.23]). Unplanned or emergency cesarean section in the current pregnancy was identified as a strong mediator to this relationship (mediation ratio = 97%). PCS was associated with higher risk of LPB in subsequent pregnancies. This may be due to an increased risk of subsequent unplanned or emergency preterm cesarean sections. Efforts to minimize index cesarean sections may reduce the risk of LPB in subsequent pregnancies.

  1. Phase III Study of Cabozantinib in Previously Treated Metastatic Castration-Resistant Prostate Cancer: COMET-1.

    Science.gov (United States)

    Smith, Matthew; De Bono, Johann; Sternberg, Cora; Le Moulec, Sylvestre; Oudard, Stéphane; De Giorgi, Ugo; Krainer, Michael; Bergman, Andries; Hoelzer, Wolfgang; De Wit, Ronald; Bögemann, Martin; Saad, Fred; Cruciani, Giorgio; Thiery-Vuillemin, Antoine; Feyerabend, Susan; Miller, Kurt; Houédé, Nadine; Hussain, Syed; Lam, Elaine; Polikoff, Jonathan; Stenzl, Arnulf; Mainwaring, Paul; Ramies, David; Hessel, Colin; Weitzman, Aaron; Fizazi, Karim

    2016-09-01

    Cabozantinib is an inhibitor of kinases, including MET and vascular endothelial growth factor receptors, and has shown activity in men with previously treated metastatic castration-resistant prostate cancer (mCRPC). This blinded phase III trial compared cabozantinib with prednisone in patients with mCRPC. Men with progressive mCRPC after docetaxel and abiraterone and/or enzalutamide were randomly assigned at a two-to-one ratio to cabozantinib 60 mg once per day or prednisone 5 mg twice per day. The primary end point was overall survival (OS). Bone scan response (BSR) at week 12 as assessed by independent review committee was the secondary end point; radiographic progression-free survival (rPFS) and effects on circulating tumor cells (CTCs), bone biomarkers, serum prostate-specific antigen (PSA), and symptomatic skeletal events (SSEs) were exploratory assessments. A total of 1,028 patients were randomly assigned to cabozantinib (n = 682) or prednisone (n = 346). Median OS was 11.0 months with cabozantinib and 9.8 months with prednisone (hazard ratio, 0.90; 95% CI, 0.76 to 1.06; stratified log-rank P = .213). BSR at week 12 favored cabozantinib (42% v 3%; stratified Cochran-Mantel-Haenszel P < .001). rPFS was improved in the cabozantinib group (median, 5.6 v 2.8 months; hazard ratio, 0.48; 95% CI, 0.40 to 0.57; stratified log-rank P < .001). Cabozantinib was associated with improvements in CTC conversion, bone biomarkers, and post-random assignment incidence of SSEs but not PSA outcomes. Grade 3 to 4 adverse events and discontinuations because of adverse events were higher with cabozantinib than with prednisone (71% v 56% and 33% v 12%, respectively). Cabozantinib did not significantly improve OS compared with prednisone in heavily treated patients with mCRPC and progressive disease after docetaxel and abiraterone and/or enzalutamide. Cabozantinib had some activity in improving BSR, rPFS, SSEs, CTC conversions, and bone biomarkers but not PSA outcomes. © 2016 by

  2. Dealing with uncertainties in impact studies of climate change on hydrometeorological series over Segura River Basin (Spain)

    Science.gov (United States)

    Garcia Galiano, S. G.; Garcia Cardenas, R.; Tetay Botia, C.; Giraldo Osorio, J.; Erena Arrabal, M.; Baille, A.

    2011-12-01

    The Segura River Basin (SRB) located in the South East of Spain, is affected by recurrent drought and water scarcity episodes. This basin presents the lowest percentage of renewable water resources of all the Spanish basins. Intensive reforestation has been carried out in the region, to halt desertification and erosion, which added to climate change and variability, do not allow the default assumption of stationarity in the water resources systems. Therefore, the study of effects in hydrometeorological series should be addressed by nonstationary probabilistic models that allow describing the time evolution of their probability distribution functions (PDFs). In the present work, the GAMLSS (Generalized Additive Models for Location, Scale and Shaper) approach is applied to identify of spatio-temporal trends in observed precipitation (P) and potential evapotranspiration (PET), at basin scale. Several previous studies have addressed the potential impacts of climate change in water supply systems, focusing on the sensitivity analysis of runoff to climate. Considering the use of a conceptual hydrological model with few parameters, the impacts on runoff and its trend from historical data, are assessed. The conclusions of this study represent a breakthrough in the development of methodologies to understand and anticipate the impacts on water resources systems, in the light of current and future climate conditions, considering hydroclimatic non-stationarity. These findings are expected to contribute to the management of conditions of water resources scarcity and droughts, such as the observed in the SRB, as support to decision-making process by stakeholders.

  3. Radon diffusion coefficients for soils. Previous studies and their application to uranium-bearing wastes

    International Nuclear Information System (INIS)

    Sasaki, Tomozo; Gunji, Yasuyoshi; Iida, Takao

    2008-01-01

    Radon diffusion in soils has been studied over the years by many researchers. The application of such studies to the evaluation of radiation exposure caused by radon from uranium-bearing wastes disposed in a shallow land site is very important. The present paper surveyed closely relevant studies and elucidated the inherent nature of radon diffusion in terms of the definition of radon diffusion coefficients. Then, basic features of measurement methods for determining radon diffusion coefficients in soils were explained. Furthermore, theoretical aspects of radon diffusion in soils were discussed in terms of microscopic radon diffusion in soils and large-scale radon diffusion through cover soil defects for uranium mill tailings. Finally, in order to apply the radon diffusion studies to uranium-bearing waste disposal in shallow land sites, new challenges were presented: elucidation of radon diffusion in uranium-bearing wastes and cover-soil cracks, and demonstration of the validity of applying only radon diffusion in the evaluation of radiation exposure caused by radon, which would come through Japanese cover soils for uranium-bearing waste disposal. (author)

  4. Dealing with data

    CERN Document Server

    Lyon, Arthur L

    1970-01-01

    Dealing with Data is an introductory course to problems and techniques dealing with data analysis, with emphasis on the physical and engineering sciences. The book starts with the basics of data analysis through non-statistical and non-mathematical assessments of error and uncertainty conditions. Experimental and maximum errors and the use of simple graphical methods are briefly described. Applying quick methods on data analysis such as frequency distributions, determination of standard errors, and applications of significance tests are explained. Special attention is given to the statistical

  5. Interbirth interval and history of previous preeclampsia: a case–control study among multiparous women

    OpenAIRE

    Harutyunyan, Arusyak; Armenian, Haroutune; Petrosyan, Varduhi

    2013-01-01

    Abstract Background Preeclampsia is a disorder with a reported incidence of 2%-8% among all pregnancies, accounting for more than 50,000 deaths worldwide each year. In low- and middle- income countries maternal/perinatal morbidity and mortality associated with preeclampsia are high due to the lack of proper prenatal and hospital care and limited access to neonatal intensive care. The objectives of our study were to determine the association of long in...

  6. A Review of Previous Studies on Information Processing in Career Decision Making among University Students

    OpenAIRE

    池田, 智子; Satoko, Ikeda

    2018-01-01

    This review of the researches of career choice of Japanese university students focused the studies on decision-making theory conducted in Japan. The present review suggested the necessity of examination of the effect of self-efficacy about career information search on the process of career choice. It is also needed to examine the relationship between specific self-efficacy about career information search and career decision-making self-efficacy, moreover, general self-efficacy.

  7. A Comment Upon Previous Studies on 3-D Boundary Layer Transition

    OpenAIRE

    ÇARPINLIOĞLU, Melda Özdinç

    2014-01-01

    The common feature of the experimental studies upon 3-D boundary layer development on swept flat plates cited in the available literature is the application of streamwise and/or spanwise pressure gradients. In fact; presence of the pressure gradients was suggested to be vital for having crossflow effective in 3-D boundary layer transition. In the presented paper here, this idea is questioned evaluating the results of an experimental investigation conducted on swept flat plates under the ab...

  8. Neuropsychiatric and cardiometabolic comorbidities in patients with previously diagnosed Cushing's disease: a longitudinal observational study

    OpenAIRE

    Dimopoulou, C; Geraedts, V; Stalla, G K; Sievers, C

    2015-01-01

    INTRODUCTION: Only few studies have systematically investigated neuropsychiatric aspects in patients with Cushing's disease (CD). Pain syndromes have been described in patients with pituitary adenomas, but so far no systematical investigation has been conducted in patients with CD. Additionally, CD has an association with cardiometabolic comorbidities which ultimately leads to increased morbidity and mortality. Long-term treatment of the hypercortisolic state cannot prevent the persistence of...

  9. A New Zealand based cohort study of anaesthetic trainees' career outcomes compared with previously expressed intentions.

    Science.gov (United States)

    Moran, E M L; French, R A; Kennedy, R R

    2011-09-01

    Predicting workforce requirements is a difficult but necessary part of health resource planning. A 'snapshot' workforce survey undertaken in 2002 examined issues that New Zealand anaesthesia trainees expected would influence their choice of future workplace. We have restudied the same cohort to see if that workforce survey was a good predictor of outcome. Seventy (51%) of 138 surveys were completed in 2009 compared with 100 (80%) of 138 in the 2002 survey. Eighty percent of the 2002 respondents planned consultant positions in New Zealand. We found 64% of respondents were working in New Zealand (P New Zealand based respondents but only 40% of those living outside New Zealand agreed or strongly agreed with this statement (P New Zealand but was important for only 2% of those resident in New Zealand (P New Zealand were predominantly between NZ$150,000 and $200,000 while those overseas received between NZ$300,000 and $400,000. Of those that are resident in New Zealand, 84% had studied in a New Zealand medical school compared with 52% of those currently working overseas (P < 0.01). Our study shows that stated career intentions in a group do not predict the actual group outcomes. We suggest that 'snapshot' studies examining workforce intentions are of little value for workforce planning. However we believe an ongoing program matching career aspirations against career outcomes would be a useful tool in workforce planning.

  10. Life cycle impact assessment of ammonia production in Algeria: A comparison with previous studies

    Energy Technology Data Exchange (ETDEWEB)

    Makhlouf, Ali, E-mail: almakhsme@gmail.com; Serradj, Tayeb; Cheniti, Hamza

    2015-01-15

    In this paper, a Life Cycle Analysis (LCA) from “cradle to gate” of one anhydrous ton of ammonia with a purity of 99% was achieved. Particularly, the energy and environmental performance of the product (ammonia) were evaluated. The eco-profile of the product and the share of each stage of the Life Cycle on the whole environmental impacts have been evaluated. The flows of material and energy for each phase of the life cycle were counted and the associated environmental problems were identified. Evaluation of the impact was achieved using GEMIS 4.7 software. The primary data collection was executed at the production installations located in Algeria (Annaba locality). The analysis was conducted according to the LCA standards ISO 14040 series. The results show that Cumulative Energy Requirement (CER) is of 51.945 × 10{sup 3} MJ/t of ammonia, which is higher than the global average. Global Warming Potential (GWP) is of 1.44 t CO{sub 2} eq/t of ammonia; this value is lower than the world average. Tropospheric ozone precursor and Acidification are also studied in this article, their values are: 549.3 × 10{sup −6} t NMVOC eq and 259.3 × 10{sup −6} t SO{sub 2} eq respectively.

  11. Life cycle impact assessment of ammonia production in Algeria: A comparison with previous studies

    International Nuclear Information System (INIS)

    Makhlouf, Ali; Serradj, Tayeb; Cheniti, Hamza

    2015-01-01

    In this paper, a Life Cycle Analysis (LCA) from “cradle to gate” of one anhydrous ton of ammonia with a purity of 99% was achieved. Particularly, the energy and environmental performance of the product (ammonia) were evaluated. The eco-profile of the product and the share of each stage of the Life Cycle on the whole environmental impacts have been evaluated. The flows of material and energy for each phase of the life cycle were counted and the associated environmental problems were identified. Evaluation of the impact was achieved using GEMIS 4.7 software. The primary data collection was executed at the production installations located in Algeria (Annaba locality). The analysis was conducted according to the LCA standards ISO 14040 series. The results show that Cumulative Energy Requirement (CER) is of 51.945 × 10 3 MJ/t of ammonia, which is higher than the global average. Global Warming Potential (GWP) is of 1.44 t CO 2 eq/t of ammonia; this value is lower than the world average. Tropospheric ozone precursor and Acidification are also studied in this article, their values are: 549.3 × 10 −6 t NMVOC eq and 259.3 × 10 −6 t SO 2 eq respectively

  12. Dealing with Dwindling Resources.

    Science.gov (United States)

    Martorana, S. V.

    Factors contributing to the struggle for survival faced by postsecondary institutions and ways to deal with dwindling resources, in particular by regionalism and regionalization, are considered. Among the contributing factors are the leveling off of the college-age population (18-21-year-olds), the declining status of advanced learning in American…

  13. Dealing with dualities

    NARCIS (Netherlands)

    Dittrich, K.; Jaspers, F.P.H.; Valk, van der W.; Wynstra, J.Y.F.

    2006-01-01

    This paper introduces the topic of dealing with dualities, which is the theme of this special issue. We first give a short review of the notion of paradox and duality in management research. After this, we discuss the relevance of dualities for the IMP approach of analyzing industrial networks.

  14. Dealing with Sexual Harassment.

    Science.gov (United States)

    Rowe, Mary P.

    1981-01-01

    Advice is presented for managers who encounter sexual harassment problems. Three recommendations are offered: complainants can be helped to help themselves, such conflicts can be resolved through procedures designed to deal with all kinds of complaints, and the issue of power differences should be confronted. (MLW)

  15. Creating flexible work arrangements through idiosyncratic deals.

    Science.gov (United States)

    Hornung, Severin; Rousseau, Denise M; Glaser, Jürgen

    2008-05-01

    A survey of 887 employees in a German government agency assessed the antecedents and consequences of idiosyncratic arrangements individual workers negotiated with their supervisors. Work arrangements promoting the individualization of employment conditions, such as part-time work and telecommuting, were positively related to the negotiation of idiosyncratic deals ("i-deals"). Worker personal initiative also had a positive effect on i-deal negotiation. Two types of i-deals were studied: flexibility in hours of work and developmental opportunities. Flexibility i-deals were negatively related and developmental i-deals positively related to work-family conflict and working unpaid overtime. Developmental i-deals were also positively related to increased performance expectations and affective organizational commitment, while flexibility i-deals were unrelated to either. PsycINFO Database Record (c) 2008 APA, all rights reserved.

  16. School Nurses' Experiences in Dealing with Bullying Situations among Students

    Science.gov (United States)

    Pigozi, Pamela Lamarca; Jones Bartoli, Alice

    2016-01-01

    School nurses have an important role in helping students to deal with bullying. However, most of the previously undertaken studies do not have nurses as the subjects, considering their experiences around this theme. This study used a qualitative approach through in-depth interviews with 12 school nurses (SNs). The thematic analysis was employed…

  17. A comparative study of the models dealing with localized and semi-localized transitions in thermally stimulated luminescence

    International Nuclear Information System (INIS)

    Kumar, Munish; Kher, R K; Bhatt, B C; Sunta, C M

    2007-01-01

    Different models dealing with localized and semi-localized transitions, namely Chen-Halperin, Mandowski and the model based on the Braunlich-Scharmann (BS) approach are compared. It has been found that for recombination dominant situations (r > 1, the three models differ. This implies that for localized transitions under recombination dominant situations, the Chen-Halperin model is the best representative of the thermally stimulated luminescence (TSL) process. It has also been found that for the TSL glow curves arising from delocalized recombination in Mandowski's semi-localized transitions model, the double peak structure of the TSL glow curve is a function of the radiation dose as well as of the heating rate. Further, the double peak structure of the TSL glow curves arising from delocalized recombination disappears at low doses as well as at higher heating rates. It has also been found that the TSL glow curves arising from delocalized recombination in the semi-localized transitions model based on the BS approach do not exhibit double peak structure as observed in the Mandowski semi-localized transitions model

  18. Building deals on bedrock.

    Science.gov (United States)

    Harding, David; Rovit, Sam

    2004-09-01

    The headlines are filled with the sorry tales of companies like Vivendi and AOL Time Warner that tried to use mergers and acquisitions to grow big fast or transform fundamentally weak business models. But, drawing on extensive data and experience, the authors conclude that major deals make sense in only two circumstances: when they reinforce a company's existing basis of competition or when they help a company make the shift, as the industry's competitive base changes. In most stable industries, the authors contend, only one basis--superior cost position, brand power, consumer loyalty, real-asset advantage, or government protection--leads to industry leadership, and companies should do only those deals that bolster a strategy to capitalize on that competitive base. That's what Kellogg did when it acquired Keebler. Rather than bow to price pressures from lesser players, Kellogg sought to strengthen its existing basis of competition--its brand--through Keebler's innovative distribution system. A company coping with a changing industry should embark on a series of acquisitions (most likely coupled with divestitures) aimed at moving the firm to the new competitive basis. That's what Comcast did when changes in government regulations fundamentally altered the broadcast industry. In such cases, speed is essential, the investments required are huge, and half-measures can be worse than nothing at all. Still, the research shows, successful acquirers are not those that try to swallow a single, large, supposedly transformative deal but those that go to the M&A table often and take small bites. Deals can fuel growth--as long as they're anchored in the fundamental way money is made in your industry. Fail to understand that and no amount of integration planning will keep you and your shareholders from bearing the high cost of your mistakes.

  19. DEAL annual report.

    Energy Technology Data Exchange (ETDEWEB)

    Misra, Shashank [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-11-01

    The digital electronics at the atomic limit (DEAL) project seeks to leverage Sandia's atomic-precision fabrication capability to realize the theorized orders-of-magnitude improvement in operating voltage for tunnel field effect transistors (TFETs) compared to CMOS. Not only are low-power digital circuits a critical element of many national security systems (e.g. satellites), TFETs can perform circuit functions inaccessible to CMOS (e.g. polymorphism).

  20. 1985 : new energy deal

    International Nuclear Information System (INIS)

    Anon.

    2008-01-01

    The 540-mile Norman Wells pipeline was completed by Interprovincial Pipe Line in 1985, allowing 25,000 barrels per day of commercial crude deliveries from Esso Resources. A new energy deal was also announced by the federal energy minister, ending 11 years of administered oil prices. The new energy deal also marked the demise of the National Energy Program. The Western Accord deregulated oil prices and eliminated oil export charges. It also provided for the phasing out of the petroleum and gas revenue tax and frontier exploration grants under the Petroleum Incentive Program (PIP). However, grandfathering provisions in the energy deal extended the PIP until 1987. The agreement was viewed by industry as a measure for national economic recovery from the recession of the early 1980s. In 1985, the Newfoundland Accord provided a $300 million offshore development fund and co-management of resources. Safety regulations were also overhauled following the sinking of the Ocean Ranger. The first 100,000 barrel shipment of crude oil from the Bent Horn Field was sent to Montreal after nearly 2 decades of work in the Arctic. 1 tab., 1 fig

  1. Ifosfamide in previously untreated disseminated neuroblastoma. Results of Study 3A of the European Neuroblastoma Study Group.

    Science.gov (United States)

    Kellie, S J; De Kraker, J; Lilleyman, J S; Bowman, A; Pritchard, J

    1988-05-01

    A prospective study of the effectiveness of ifosfamide as a single agent in the management of previously untreated patients with Evans stage IV neuroblastoma was undertaken. Eighteen children aged more than 1 year were treated with ifosfamide (IFX) 3 g/m2 daily for 2 days immediately after diagnosis and 3 weeks later. Treatment was continued with combination chemotherapy using vincristine, cyclophosphamide, cisplatinum and etoposide (OPEC) or a variant. Mesna (2-mercaptoethane sulphonate) was given to all patients during IFX treatment to prevent urotoxicity. Eight of the 18 patients (44%) responded to IFX. Nine had greater than 66% reduction in baseline tumor volume. Of 15 evaluable patients with raised pre-treatment urinary catecholamine excretion, six (40%) achieved greater than 50% reduction in pretreatment levels. Two of 10 patients evaluable for bone marrow response had complete clearance. Toxicity was mild in all patients. Upon completing 'first line' therapy, only four patients (22%) achieved a good partial remission (GPR) or complete response (CR). Median survival was 11 months. There was a lower rate of attaining GPR and shortened median survival in patients receiving phase II IFX before OPEC or variant, compared to patients with similar pre-treatment characteristics treated with OPEC from diagnosis in an earlier study.

  2. Estimating the effect of current, previous and never use of drugs in studies based on prescription registries

    DEFF Research Database (Denmark)

    Nielsen, Lars Hougaard; Løkkegaard, Ellen; Andreasen, Anne Helms

    2009-01-01

    of this misclassification for analysing the risk of breast cancer. MATERIALS AND METHODS: Prescription data were obtained from Danish Registry of Medicinal Products Statistics and we applied various methods to approximate treatment episodes. We analysed the duration of HT episodes to study the ability to identify......PURPOSE: Many studies which investigate the effect of drugs categorize the exposure variable into never, current, and previous use of the study drug. When prescription registries are used to make this categorization, the exposure variable possibly gets misclassified since the registries do...... not carry any information on the time of discontinuation of treatment.In this study, we investigated the amount of misclassification of exposure (never, current, previous use) to hormone therapy (HT) when the exposure variable was based on prescription data. Furthermore, we evaluated the significance...

  3. An fMRI study of neuronal activation in schizophrenia patients with and without previous cannabis use

    Directory of Open Access Journals (Sweden)

    Else-Marie eLøberg

    2012-10-01

    Full Text Available Previous studies have mostly shown positive effects of cannabis use on cognition in patients with schizophrenia, which could reflect lower neurocognitive vulnerability. There are however no studies comparing whether such cognitive differences have neuronal correlates. Thus, the aim of the present study was to compare whether patients with previous cannabis use differ in brain activation from patients who has never used cannabis. The patients groups were compared on the ability to up-regulate an effort mode network during a cognitive task and down-regulate activation in the same network during a task-absent condition. Task-present and task-absent brain activation was measured by functional magnetic resonance neuroimaging (fMRI. Twenty-six patients with a DSM-IV and ICD-10 diagnosis of schizophrenia were grouped into a previous cannabis user group and a no-cannabis group. An auditory dichotic listening task with instructions of attention focus on either the right or left ear stimulus was used to tap verbal processing, attention and cognitive control, calculated as an aggregate score. When comparing the two groups, there were remaining activations in the task-present condition for the cannabis group, not seen in the no-cannabis group, while there was remaining activation in the task-absent condition for the no-cannabis group, not seen in the cannabis group. Thus, the patients with previous cannabis use showed increased activation in an effort mode network and decreased activation in the default mode network as compared to the no-cannabis group. It is concluded that the present study show some differences in brain activation to a cognitively challenging task between previous cannabis and no-cannabis schizophrenia patients.

  4. Dealing with media distractions: An observational study of computer-based multitasking among children and adults in the Netherlands

    NARCIS (Netherlands)

    Baumgartner, S.E.; Sumter, S.R.

    2017-01-01

    The aim of this observational study was to investigate differences in computer-based multitasking among children and adults. Moreover, the study investigated how attention problems are related to computer-based multitasking and how these individual differences interact with age. Computer-based

  5. Dealing with variability in food production chains: a tool to enhance the sensitivity of epidemiological studies of phytochemicals

    NARCIS (Netherlands)

    Dekker, M.; Verkerk, R.

    2003-01-01

    Background Many epidemiological studies have tried to associate the intake of certain food products with a reduced risk for certain diseases. Results of these studies are often ambiguous, conflicting, or show very large deviations of trends. Nevertheless, a clear and often reproduced inverse

  6. Satisfaction with sex life in sexually active heterosexual couples dealing with breast cancer : a nationwide longitudinal study

    NARCIS (Netherlands)

    Rottmann, Nina; Hansen, Dorte Gilsa; Christensen, Rene dePont; Hagedoorn, Mariet; Frisch, Morten; Nicolaisen, Anne; Kroman, Niels; Flyger, Henrik; Johansen, Christoffer

    2017-01-01

    Background: A breast cancer (BC) diagnosis can profoundly affect the sex life of patient and partner within a couple. The purpose of the present study is to examine whether individual and partner sexual functioning, affectionate behavior, emotional closeness and depressive symptoms are associated

  7. [Health workers' experiences in dealing with the neoliberal logic: a study of primary care in Colombia and Brazil].

    Science.gov (United States)

    Garrido-Pinzón, Johanna; Bernardo, Marcia Hespanhol

    2017-09-28

    : The aim of this study was to analyze the experiences of primary healthcare workers in the public health systems in Colombia and Brazil in relation to the neoliberal logic. These two cases are relevant to public health research, as examples of health systems that emerged from opposing guidelines: the Colombian system was created at the government level with a marked private-sector influence, while the Brazilian system was an important conquest by social movements. Based on the Social Psychology of Work, this was a qualitative and empirical study. In-depth reflexive interviews were conducted with two groups of primary healthcare and administrative workers: one in Bucaramanga, Colombia, and the other in Campinas (São Paulo State), Brazil. Content analysis was used in the analytical process. According to the study, in both countries the main experiences of healthcare workers involve the changes in working conditions, relations, and organization. In the Colombian context, we identified the central problems in the transition induced by the reform that established the country's current health system. These problems are expressed in the deterioration of relations with health system users, as well as in the configuration of healthcare teams, marked by conflicting employment arrangements in the healthcare staff. The latter condition also appears in the Brazilian context, as a result of outsourcing, which appears to have become an effective mechanism for undermining the Brazilian Unified National Health System (SUS), facilitating its dismantlement and pointing it in the same direction as the Colombian system.

  8. Consumers' multifaceted deal knowledge in a grocery retail setting

    DEFF Research Database (Denmark)

    Jensen, Birger Boutrup; Bech-Larsen, Tino

    2017-01-01

    of deal price status, typical deal price knowledge, and deal-spotting ability. Results show reasonably stable knowledge of typical deal prices, while knowledge of deal price status and deal-spotting ability improves significantly during grocery shopping. Surprisingly, consumers’ deal knowledge...... typical deal price knowledge. Furthermore, the findings suggest that consumers store internal reference deal prices. Retailers are therefore well advised to consider mixed depth and creative discount patterns to prevent ‘perfect’ perceptions of typical deal prices.......Despite its relevance to retailers, studies of consumers’ deal knowledge have been few. This study explores consumers’ deal knowledge before, during, and after the store visit applying a between-subjects field-study design with 1204 respondents. In particular, the authors investigate perception...

  9. Dexamethasone intravitreal implant in previously treated patients with diabetic macular edema : Subgroup analysis of the MEAD study

    OpenAIRE

    Augustin, A.J.; Kuppermann, B.D.; Lanzetta, P.; Loewenstein, A.; Li, X.; Cui, H.; Hashad, Y.; Whitcup, S.M.; Abujamra, S.; Acton, J.; Ali, F.; Antoszyk, A.; Awh, C.C.; Barak, A.; Bartz-Schmidt, K.U.

    2015-01-01

    Background Dexamethasone intravitreal implant 0.7?mg (DEX 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy and safety in the MEAD registration trials. We performed subgroup analysis of MEAD study results to evaluate the efficacy and safety of DEX 0.7 treatment in patients with previously treated DME. Methods Three-year, randomized, sham-controlled phase 3 study in patients with DME, best-corrected visual acuity (BCVA) of 34?68 Early Treatment...

  10. Progress report on Green Deals 2013; Voortgangsrapportage Green Deals 2013

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-11-15

    In the Dutch governmental coalition agreement the Green Deal approach was announced in the autumn of 2010. The focus of the Green Deals is for people and companies to develop sustainable initiatives that contribute to economic growth. The Green Deal approach started with the theme energy, but has been extended with the themes biobased economy, climate, resources, buildings, food, mobility, water and biological diversity. This progress report provides an overview of the deals that this bottom-up approach has yielded. The report also provides information on the progress of the deals and the interim results of the approach and the individual deals. Also attention is paid to how the 146 Green Deals score on innovation and entrepreneurship [Dutch] In het regeerakkoord van het kabinet is in het najaar van 2010 de Green Deal-aanpak aangekondigd. Centraal in de aanpak staat dat mensen en bedrijven zoveel mogelijk ruimte krijgen voor eigen duurzame initiatieven die bijdragen aan economische groei. De aanpak is gestart vanuit het thema energie, maar beslaat inmiddels ook de thema's biobased economy, klimaat, grondstoffen, bouw, voedsel, mobiliteit, water en biodiversiteit. Deze voortgangsrapportage geeft een overzicht van de deals die deze bottom-up aanpak heeft opgeleverd. De rapportage informeert bovendien over de voortgang van de deals en over de tussentijdse resultaten van zowel de aanpak als de afzonderlijke deals. Ook wordt gekeken hoe de 146 Green Deals scoren op innovatief vermogen en ondernemerschap.

  11. Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study

    Directory of Open Access Journals (Sweden)

    van Spaendonck Karel P

    2009-09-01

    Full Text Available Abstract Background Persistent presentation of medically unexplained symptoms (MUS is troublesome for general practitioners (GPs and causes pressure on the doctor-patient relationship. As a consequence, GPs face the problem of establishing an ongoing, preferably effective relationship with these patients. This study aims at exploring GPs' perceptions about explaining MUS to patients and about how relationships with these patients evolve over time in daily practice. Methods A qualitative approach, interviewing a purposive sample of twenty-two Dutch GPs within five focus groups. Data were analyzed according to the principles of constant comparative analysis. Results GPs recognise the importance of an adequate explanation of the diagnosis of MUS but often feel incapable of being able to explain it clearly to their patients. GPs therefore indicate that they try to reassure patients in non-specific ways, for example by telling patients that there is no disease, by using metaphors and by normalizing the symptoms. When patients keep returning with MUS, GPs report the importance of maintaining the doctor-patient relationship. GPs describe three different models to do this; mutual alliance characterized by ritual care (e.g. regular physical examination, regular doctor visits with approval of the patient and the doctor, ambivalent alliance characterized by ritual care without approval of the doctor and non-alliance characterized by cutting off all reasons for encounter in which symptoms are not of somatic origin. Conclusion GPs feel difficulties in explaining the symptoms. GPs report that, when patients keep presenting with MUS, they focus on maintaining the doctor-patient relationship by using ritual care. In this care they meticulously balance between maintaining a good doctor-patient relationship and the prevention of unintended consequences of unnecessary interventions.

  12. How to Deal with Hemophilia

    Science.gov (United States)

    ... Educators Search English Español How to Deal With Hemophilia KidsHealth / For Kids / How to Deal With Hemophilia ... mild case of hemophilia. Why Do Kids Get Hemophilia? Hemophilia almost always affects boys. Why? Because the ...

  13. Progress report on Green Deals 2012; Voortgangsrapportage Green Deals 2012

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-10-15

    In the Dutch governmental coalition agreement the Green Deal approach was announced in the autumn of 2010. The focus of the Green Deals is for people and companies to develop sustainable initiatives that contribute to economic growth. This progress report provides an overview of the deals that this bottom-up approach has yielded. The report also provides information on the progress of the deals and the interim results of the approach and the individual deals. Also attention is paid to how the 131 Green Deals score on innovation and entrepreneurship [Dutch] In het regeerakkoord van het kabinet is in het najaar van 2010 de Green Deal-aanpak aangekondigd. Centraal in de aanpak staat dat mensen en bedrijven zoveel mogelijk ruimte krijgen voor eigen duurzame initiatieven die bijdragen aan economische groei. Deze voortgangsrapportage geeft een overzicht van de deals die deze bottom-up aanpak heeft opgeleverd. De rapportage informeert bovendien over de voortgang van de deals en over de tussentijdse resultaten van zowel de aanpak als de afzonderlijke deals. Ook wordt gekeken hoe de 131 Green Deals scoren op innovatief vermogen en ondernemerschap.

  14. Youth suicide: an insight into previous hospitalisation for injury and sociodemographic conditions from a nationwide cohort study.

    Science.gov (United States)

    Zambon, Francesco; Laflamme, Lucie; Spolaore, Paolo; Visentin, Cristiana; Hasselberg, Marie

    2011-06-01

    This study investigates the degree to which a previous hospitalisation for injury of any intent is a risk of subsequent youth suicide and whether this association is influenced by family socioeconomic status or economic stress. A nationwide register-based cohort study was conducted covering all Swedish subjects born between January 1977 and December 1991 (N=1,616,342, male/female ratio=1.05). The cohort subjects were followed-up from January 1998 to December 2003, when aged 7-26 years. Poisson regression and the likelihood ratio test (95% CI) were used to assess the age-adjusted effect of hospitalisation for injuries of various intent on youth suicide and its effect once adjusted for family sociodemographic and social circumstances. Each set of exposures was associated independently and significantly with suicide mortality. Being hospitalised for self-inflicted injuries or injuries of undetermined intent was associated with a risk of suicide 36 to 47 times, respectively, that of subjects never hospitalised in the period under study (95% CI 28.36 to 45.58 and 26.67 to 83.87 for self-inflicted injuries and for events of undetermined intent, respectively; overall psuicide (RR 3.08; 95% CI 2.26 to 4.19). These effects were solid and not substantially altered after adjustment for family demographic and socioeconomic circumstances. A strong association exists between previous hospitalisation for injury of any intent and youth suicide. The association is robust and unaltered by family socioeconomic circumstances.

  15. Previous Fractures at Multiple Sites Increase the Risk for Subsequent Fractures: The Global Longitudinal Study of Osteoporosis in Women

    Science.gov (United States)

    Gehlbach, Stephen; Saag, Kenneth G.; Adachi, Jonathan D.; Hooven, Fred H.; Flahive, Julie; Boonen, Steven; Chapurlat, Roland D.; Compston, Juliet E.; Cooper, Cyrus; Díez-Perez, Adolfo; Greenspan, Susan L.; LaCroix, Andrea Z.; Netelenbos, J. Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Sambrook, Philip N.; Silverman, Stuart; Siris, Ethel S.; Watts, Nelson B.; Lindsay, Robert

    2016-01-01

    Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women ≥ 55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ≥3 fractures since age 45. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no prior fractures, women with 1, 2, or ≥ 3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ≥3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio 7.3) and hip (hazard ratio 3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture; women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development. PMID:22113888

  16. Previous experiences and emotional baggage as barriers to lifestyle change - a qualitative study of Norwegian Healthy Life Centre participants.

    Science.gov (United States)

    Følling, Ingrid S; Solbjør, Marit; Helvik, Anne-S

    2015-06-23

    Changing lifestyle is challenging and difficult. The Norwegian Directorate of Health recommends that all municipalities establish Healthy Life Centres targeted to people with lifestyle issues. Little is known about the background, experiences and reflections of participants. More information is needed about participants to shape effective lifestyle interventions with lasting effect. This study explores how participants in a lifestyle intervention programme describe previous life experiences in relation to changing lifestyle. Semi-structured qualitative in-depth interviews were performed with 23 participants (16 women and 7 men) aged 18 - 70 years. The data were analysed using systematic text condensation searching for issues describing participants' responses, and looking for the essence, aiming to share the basis of life-world experiences as valid knowledge. Participants identified two main themes: being stuck in old habits, and being burdened with emotional baggage from their previous negative experiences. Participants expressed a wish to change their lifestyles, but were unable to act in accordance with the health knowledge they possessed. Previous experiences with lifestyle change kept them from initiating attempts without professional assistance. Participants also described being burdened by an emotional baggage with problems from childhood and/or with family, work and social life issues. Respondents said that they felt that emotional baggage was an important explanation for why they were stuck in old habits and that conversely, being stuck in old habits added load to their already emotional baggage and made it heavier. Behavioural change can be hard to perform as psychological distress from life baggage can influence the ability to change. The study participants' experience of being stuck in old habits and having substantial emotional baggage raises questions as to whether or not Healthy Life Centres are able to help participants who need to make a lifestyle

  17. Everolimus for Previously Treated Advanced Gastric Cancer: Results of the Randomized, Double-Blind, Phase III GRANITE-1 Study

    Science.gov (United States)

    Ohtsu, Atsushi; Ajani, Jaffer A.; Bai, Yu-Xian; Bang, Yung-Jue; Chung, Hyun-Cheol; Pan, Hong-Ming; Sahmoud, Tarek; Shen, Lin; Yeh, Kun-Huei; Chin, Keisho; Muro, Kei; Kim, Yeul Hong; Ferry, David; Tebbutt, Niall C.; Al-Batran, Salah-Eddin; Smith, Heind; Costantini, Chiara; Rizvi, Syed; Lebwohl, David; Van Cutsem, Eric

    2013-01-01

    Purpose The oral mammalian target of rapamycin inhibitor everolimus demonstrated promising efficacy in a phase II study of pretreated advanced gastric cancer. This international, double-blind, phase III study compared everolimus efficacy and safety with that of best supportive care (BSC) in previously treated advanced gastric cancer. Patients and Methods Patients with advanced gastric cancer that progressed after one or two lines of systemic chemotherapy were randomly assigned to everolimus 10 mg/d (assignment schedule: 2:1) or matching placebo, both given with BSC. Randomization was stratified by previous chemotherapy lines (one v two) and region (Asia v rest of the world [ROW]). Treatment continued until disease progression or intolerable toxicity. Primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), overall response rate, and safety. Results Six hundred fifty-six patients (median age, 62.0 years; 73.6% male) were enrolled. Median OS was 5.4 months with everolimus and 4.3 months with placebo (hazard ratio, 0.90; 95% CI, 0.75 to 1.08; P = .124). Median PFS was 1.7 months and 1.4 months in the everolimus and placebo arms, respectively (hazard ratio, 0.66; 95% CI, 0.56 to 0.78). Common grade 3/4 adverse events included anemia, decreased appetite, and fatigue. The safety profile was similar in patients enrolled in Asia versus ROW. Conclusion Compared with BSC, everolimus did not significantly improve overall survival for advanced gastric cancer that progressed after one or two lines of previous systemic chemotherapy. The safety profile observed for everolimus was consistent with that observed for everolimus in other cancers. PMID:24043745

  18. Coupons from Deal Sites as Gifts

    DEFF Research Database (Denmark)

    Pavlicek, Antonin; Sudzina, Frantisek

    2017-01-01

    There already exist studies on what influences use of deal sites. But there is a gap in literature when it comes to purchasing coupons from deal sites and then using them as gifts. The paper analyzes whether gender, age and personality traits influence such behavior. Big Five Inventory traits...

  19. The New Deal: A Global History

    NARCIS (Netherlands)

    Patel, Kiran Klaus

    2016-01-01

    The New Deal: A Global History provides a radically new interpretation of a pivotal period in US history. The first comprehensive study of the New Deal in a global context, the book compares American responses to the international crisis of capitalism and democracy during the 1930s to responses by

  20. Doxorubicin and ifosfamide combination chemotherapy in previously treated acute leukemia in adults: a Southwest Oncology Group pilot study.

    Science.gov (United States)

    Ryan, D H; Bickers, J N; Vial, R H; Hussein, K; Bottomley, R; Hewlett, J S; Wilson, H E; Stuckey, W J

    1980-01-01

    The Southwest Oncology Group did a limited institutional pilot study of the combination of doxorubicin and ifosfamide in the treatment of previously treated adult patients with acute leukemia. Thirty-four patients received one or two courses of the combination. All patients had received prior chemotherapy and 32 had received prior anthracycline chemotherapy. Three patients died before their responses could be fully evaluated. Fourteen patients achieved complete remission (41%) and one patient achieved partial remission. The complete remission rate was 27% for patients with acute myeloblastic leukemia (myelomonoblastic leukemia, monoblastic leukemia, and erythroleukemia) and 89% for patients with acute lymphocytic and undifferentiated leukemia (ALL). Toxic effects included severe hematologic reactions in 33 of 34 patients, hematuria in six patients, altered sensorium in one patient, and congestive heart failure in one patient. The safety of the combination was established and toxic side effects of this therapy were tolerable. The 89% complete remission rate for previously treated patients with ALL suggests that the combination of doxorubicin and ifosfamide may be particularly effective in ALL.

  1. The suitability of XRF analysis for compositional classification of archaeological ceramic fabric: A comparison with a previous NAA study

    International Nuclear Information System (INIS)

    Padilla, R.; Espen, P. van; Torres, P.P. Godo

    2006-01-01

    The main drawbacks of EDXRF techniques, restricting its more frequent use for the specific purpose of compositional analysis of archaeological ceramic fabric, have been the insufficient sensitivity to determine some important elements (like Cr, REE, among others), a somewhat worse precision and the inability to perform standard-less quantitative procedures in the absence of suitable certified reference materials (CRM) for ceramic fabric. This paper presents the advantages of combining two energy dispersive X-ray fluorescence methods for fast and non-destructive analysis of ceramic fabric with increased sensitivity. Selective polarized excitation using secondary targets (EDPXRF) and radioisotope excitation (R-XRF) using a 241 Am source. The analytical performance of the methods was evaluated by analyzing several CRM of sediment type, and the fitness for the purpose of compositional classification was compared with that obtained by using Instrumental Neutron Activation Analysis in a previous study of Cuban aborigine pottery

  2. The suitability of XRF analysis for compositional classification of archaeological ceramic fabric: A comparison with a previous NAA study

    Energy Technology Data Exchange (ETDEWEB)

    Padilla, R. [Centro de Aplicaciones Tecnologicas y Desarrollo Nuclear (CEADEN), Laboratorio de Analisis Quimico, Calle 30 no. 502, Playa, Ciudad Habana (Cuba)]. E-mail: roman.padilla@infomed.sld.cu; Espen, P. van [University of Antwerp (Belgium); Torres, P.P. Godo [Centro de Antropologia, Havana (Cuba)

    2006-02-03

    The main drawbacks of EDXRF techniques, restricting its more frequent use for the specific purpose of compositional analysis of archaeological ceramic fabric, have been the insufficient sensitivity to determine some important elements (like Cr, REE, among others), a somewhat worse precision and the inability to perform standard-less quantitative procedures in the absence of suitable certified reference materials (CRM) for ceramic fabric. This paper presents the advantages of combining two energy dispersive X-ray fluorescence methods for fast and non-destructive analysis of ceramic fabric with increased sensitivity. Selective polarized excitation using secondary targets (EDPXRF) and radioisotope excitation (R-XRF) using a {sup 241}Am source. The analytical performance of the methods was evaluated by analyzing several CRM of sediment type, and the fitness for the purpose of compositional classification was compared with that obtained by using Instrumental Neutron Activation Analysis in a previous study of Cuban aborigine pottery.

  3. Treatment satisfaction with paliperidone extended-release tablets: open-label study in schizophrenia patients dissatisfied with previous antipsychotic medication

    Directory of Open Access Journals (Sweden)

    Yang FD

    2017-04-01

    Full Text Available Fu De Yang,1 Juan Li,1 Yun Long Tan,1 Wei Ye Liang,1 Rongzhen Zhang,1 Ning Wang,1 Wei Feng,1 Shangli Cai,2 Jian Min Zhuo,2 Li Li Zhang2 1Beijing Hui-Long-Guan Hospital, 2Department of Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People’s Republic of China Objective: The aim of this study was to evaluate the changes in treatment satisfaction after switching to paliperidone extended-release (ER in Chinese schizophrenia patients dissatisfied with their previous antipsychotic treatment.Methods: In this 8-week, open-label, single-arm, multicenter, prospective study, 1,693 patients dissatisfied with previous antipsychotic medication were enrolled and switched to paliperidone ER tablets (3–12 mg/d based on clinical judgment. The primary efficacy end point was change in Medication Satisfaction Questionnaire (MSQ score from baseline to week 8. The secondary end points included percentage of patients with MSQ score ≥4, as well as changes in Clinical Global Improvement-Severity (CGI-S and Personal and Social Performance (PSP scores.Results: MSQ scores increased significantly from baseline (mean [standard deviation {SD}]: 2.48 [0.55] to week 8 (5.47 [0.89], P<0.0001; primary end point, full analysis set. The percentage of patients with MSQ score ≥4 was 95.9% at week 8, indicating that most of the patients were satisfied with their treatment. Significant (P<0.0001 improvements from baseline to week 8 were noted in CGI-S score (2.37 [1.20] and PSP score (25.5 [15.0]. A total of 174 (10.28% patients experienced adverse events (AEs. The most common (>10 patients events were extrapyramidal disorder (n=84, 4.96%, poor quality sleep (n=18, 1.06% and akathisia (n=13, 0.77%. The majority of AEs were mild to moderate in severity. No deaths occurred.Conclusion: Treatment satisfaction improved after switching to paliperidone ER from the previous antipsychotic in Chinese patients with schizophrenia. Keywords: atypical antipsychotics, open label

  4. Learning to deal constructively with troubled conscience related to care providers' perceptions of deficient teamwork in residential care of older people--a participatory action research study.

    Science.gov (United States)

    Ericson-Lidman, Eva; Strandberg, Gunilla

    2015-06-01

    Conscience can be perceived as an asset that helps care providers to provide good care, but it can also be a burden that generates stress of conscience (stress related to a troubled conscience). Participatory action research (PAR) has been shown to be successful in supporting care providers in residential care of older people to learn to deal with their troubled conscience in challenging and demanding care situations. The aim of the study was to describe an intervention process to assist care providers in residential care of older people to constructively deal with their troubled conscience related to perceptions of deficient teamwork. The study design was grounded in PAR. Nine enrolled nurses (ENs), two nursing aids (NAs), one Registered Nurse (RN) and their manager participated in 12 PAR sessions. All sessions were tape-recorded, and a domain analysis of the transcriptions was performed. Findings show that a PAR-based intervention can support care providers to understand, handle and take measures against deficient teamwork. Using troubled conscience as a driving force can increase the opportunities to improve quality of care in residential care for older people. During the PAR process, participants raised their awareness of the need to view the team in a wider sense and that the manager and the Registered Nurse should also be members of the team to improve team outcome. To improve clinical practice, we suggest that teams in residential care of older people should be enabled to share and reflect on challenging situations that generate troubled conscience. However, as shown in this study, care providers might need support in order to facilitate and promote sharing and reflecting on what their conscience tells them. © 2014 Nordic College of Caring Science.

  5. Deal with Diets

    Science.gov (United States)

    ... Eat breakfast. Studies show that people who eat breakfast do better in school, tend to eat less throughout the day, and are less likely to be overweight. Choose smaller portions at fast-food restaurants. Avoid supersizing even if ...

  6. Value and reliability of findings from previous epidemiologic studies in the assessment of radiation-related cancer risks. Pt. 3

    International Nuclear Information System (INIS)

    Frasch, G.; Martignoni, K.

    1990-01-01

    The theories put forward here are predominantly based on pooled data from previous studies in a number of cohorts made up by mostly non-average individuals. These studies were carried out by various researchers and differed in procedures and aims. Factors of major importance to the validity and reliability of the conclusions drawn from this study are pointed out. In one chapter some light is thrown on factors known to bear a relation to the incidence of radiation-induced cancer of the breast, even though at present this can only very vaguely be described on a quantitative basis. These factors include fractionated dose regimens, pregnancies and parturitions, menarche, menopause, synergisms as well as secondary cancer of the breast. The available body of evidence suggests that exposure of each of 1 million women to a dose of 10 mGy (rad) can be linked with approx. 3 additional cases of mammary cancer reported on an average per year after the latency period. The fact that there is some statistical scatter around this value is chiefly attributable to age-related causes at the beginning of exposure. Differences in ethnic and cultural characteristics between the populations investigated appeared to be less important here. (orig./MG) [de

  7. Barriers to postpartum screening for type 2 diabetes: a qualitative study of women with previous gestational diabetes.

    Science.gov (United States)

    Rafii, Forough; Rahimparvar, Seyedeh Fatemeh Vasegh; Mehrdad, Neda; Keramat, Afsaneh

    2017-01-01

    Risk of developing type 2 diabetes is increased in women with previous gestational diabetes mellitus (GDM). Postpartum glycemic screening is recommended in women with recent GDM. But this screening rate is low and the reasons are unclear. The aim of this study was to explore the experiences of Iranian women with recent GDM on barriers of postpartum screening for diabetes. This qualitative study was conducted in Tehran, Iran in 2016. Semi-structured interview was used for data collection. 22 women with recent GDM were interviewed. These women gave birth in Tehran hospitals at a minimum of 6 months before interview. The missed screening defined as not attending to laboratory for Fasting Blood Sugar and/or Oral Glucose Tolerance Test, 6 week to 6 month after their child birthing. The data was analyzed by content analysis method. Themes and sub-themes that illustrated the barriers to postpartum diabetes screening were: inadequate education (about developing diabetes in the future, implementation of the screening, and glucometer validity in diagnosis of diabetes), perceiving the screening as difficult (feeling comfortable with the glucometer, poor laboratory conditions, issues related to the baby/babies, and financial problems), improper attitudes toward the screening (unwilling to get diagnosed, not giving priority to oneself, having false beliefs) and procrastination (gap to intention and action, self-deception and self-regulation failure). Women with recent GDM reported several barriers for postpartum diabetes screening. This study help to develop the evidence-based interventions for improving this screening rate.

  8. A Flexible-Dose Study of Paliperidone ER in Patients With Nonacute Schizophrenia Previously Treated Unsuccessfully With Oral Olanzapine.

    Science.gov (United States)

    Kotler, Moshe; Dilbaz, Nesrin; Rosa, Fernanda; Paterakis, Periklis; Milanova, Vihra; Smulevich, Anatoly B; Lahaye, Marjolein; Schreiner, Andreas

    2016-01-01

    The goal of this study was to explore the tolerability, safety, and treatment response of switching from oral olanzapine to paliperidone extended release (ER). Adult patients with nonacute schizophrenia who had been treated unsuccessfully with oral olanzapine were switched to flexible doses of paliperidone ER (3 to 12 mg/d). The primary efficacy outcome was a ≥ 20% improvement in Positive and Negative Syndrome Scale (PANSS) total scores from baseline to endpoint for patients who switched medications because of lack of efficacy with olanzapine and noninferiority versus previous olanzapine treatment (mean endpoint change in PANSS total scores vs. baseline of ≤ 5 points) for patients who switched for reasons other than lack of efficacy. Safety and tolerability were assessed by monitoring adverse events, extrapyramidal symptoms, and weight change. Of 396 patients, 65.2% were men, mean age was 40.0 ± 12.0 years, and 75.5% had paranoid schizophrenia. Among the patients whose main reason for switching was lack of efficacy, an improvement in the PANSS total score of ≥ 20% occurred in 57.4% of patients. Noninferiority was confirmed for each subgroup of patients whose main reason for switching was something other than lack of efficacy. Paliperidone ER was generally well tolerated. Extrapyramidal symptoms as measured by total Extrapyramidal Symptom Rating Scale scores showed statistically significant and clinically relevant improvements at endpoint, the average weight decreased by 0.8 ± 5.2 kg at endpoint, and a clinically relevant weight gain of ≥ 7% occurred in 8.0% of patients. Paliperidone ER flexibly-dosed over 6 months was well tolerated and associated with a meaningful clinical response in patients with nonacute schizophrenia who had previously been unsuccessfully treated with oral olanzapine.

  9. Dealing with Electricity Prices

    NARCIS (Netherlands)

    C. Huurman

    2007-01-01

    textabstractChristian Huurman was born in Dacca (Bangladesh) on 10 May 1977. From 1995 to 2001, Christian studied Business Administration at the Erasmus University. After obtaining his MSc degree in June 2001, he started his career as an assistant professor at the Strategic Management department of

  10. Surviving crack: a qualitative study of the strategies and tactics developed by Brazilian users to deal with the risks associated with the drug

    Directory of Open Access Journals (Sweden)

    Nappo Solange A

    2010-11-01

    Full Text Available Abstract Background Due to marginalization, trafficking violence, conflicts with the police and organic and social psychological problems associated with the drug, crack is one of the most devastating drugs currently in use. However, there is evidence that some users manage to stay alive and active while using crack cocaine for many years, despite the numerous adversities and risks involved with this behavior. In this context, the aim of the present study was to identify the strategies and tactics developed by crack users to deal with the risks associated with the culture of use by examining the survival strategies employed by long-term users. Method A qualitative research method was used involving semi-structured, in-depth interviews. Twenty-eight crack users fulfilling a pre-defined enrollment criterion were interviewed. This criterion was defined as the long-term use of crack (i.e., at least four years. The sample was selected using information provided by key informants and distributed across eight different supply chains. The interviews were literally transcribed and analyzed via content analysis techniques using NVivo-8 software. Results There was diversity in the sample with regard to economic and education levels. The average duration of crack use was 11.5 years. Respondents believed that the greatest risks of crack dependence were related to the drug's psychological effects (e.g., cravings and transient paranoid symptoms and those arising from its illegality (e.g., clashes with the police and trafficking. Protection strategies focused on the control of the psychological effects, primarily through the consumption of alcohol and marijuana. To address the illegality of the drug, strategies were developed to deal with dealers and the police; these strategies were considered crucial for survival. Conclusions The strategies developed by the respondents focused on trying to protect themselves. They proved generally effective, though they

  11. Petroleum: the new deal

    International Nuclear Information System (INIS)

    Magalhaes, St.; Kan, E.

    2008-01-01

    The drop of oil prices imposes a revision of development and investment strategies of petroleum and para-petroleum companies, while technologies under study try to optimize the exploration and production costs. Following the financial and economical crises, the petroleum industry is preparing its restructuring: new profitability threshold of projects, slowing down of the activity, expected surge of mergers. Despite the crisis, the R and D for the exploitation of tar sands still goes on while on the offshore side, R and D has never been so active to take up the challenge of extreme deep sea conditions. (J.S.)

  12. Dealing with difficult pasts

    DEFF Research Database (Denmark)

    McAtackney, Laura

    2013-01-01

    develop. I argue that such politically loaded manifestations of difficult pasts are highly significant during post-conflict renegotiations of society. They act as reminders of what happened, a commentary on how far society has – or has not moved on – and the potential for future relations and directions....... Using Robben Island and Long Kesh / Maze as case-studies this paper will explore the physical manifestations of political imprisonment, their experiences in the post-conflict context and reveal contestations of meaning at these dark heritage sites....

  13. Dealing with Emotions

    DEFF Research Database (Denmark)

    Education is always evolving, consistently with a society in flux. So transformations in learning and pedagogy are necessary. These endless, rapid changes in pedagogy influence students and educators in a variety of ways and awake diverse emotions, from happiness to fear, from joy to anger....... Emotions are proven to influence the ways students interact with the world. In the present book, the authors reflect on emotions and education from multiple perspectives: the socio-cultural perspective that looks at interactions among individuals, the creation and recreation of the self and others......, the study of collaboration, change processes (transformative learning) and aesthetic and creative learning processes. The purpose of this volume is to reflect on students’ and educators’ emotional responses. The construction of a safe, stimulating learning climate is essential in innovative learning...

  14. Keeping the Deal

    Science.gov (United States)

    Hecht, Michael

    2002-01-01

    On the 4th of July 1997, I lay on a blanket with my family at a fireworks display near our home in Los Angeles, California. The pyrotechnics, they tell me, were dazzling. I wouldn't know. My attention was fixed on a tiny orange dot in the sky - Mars. A month earlier, NASA had released an Announcement of Opportunity for a supplementary payload on the Mars Surveyor Lander mission scheduled for launch in 2001. The Human Exploration and Development of Space (HEDS) organization had been authorized to make the most preliminary of investigations into the feasibility of sending humans to Mars. Among the requested investigations was an opportunity to study the dust and soil of the Red Planet, emphasizing possible hazards to human explorers. I spent that summer of '97 working on a proposal for the project I would eventually lead, the Mars Environmental Compatibility Assessment (MECA). MECA was selected in February of '98. We promised to deliver four new instruments by April 2000 with a modest budget of $5M. This is a story about some of the people who created MECA.

  15. Pilot Study of an Individualised Early Postpartum Intervention to Increase Physical Activity in Women with Previous Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Harold David McIntyre

    2012-01-01

    Full Text Available Optimal strategies to prevent progression towards overt diabetes in women with recent gestational diabetes remain ill defined. We report a pilot study of a convenient, home based exercise program with telephone support, suited to the early post-partum period. Twenty eight women with recent gestational diabetes were enrolled at six weeks post-partum into a 12 week randomised controlled trial of Usual Care (n=13 versus Supported Care (individualised exercise program with regular telephone support; n=15. Baseline characteristics (Mean ± SD were: Age  33±4  years; Weight 80 ± 20 kg and Body Mass Index (BMI 30.0±9.7 kg/m2. The primary outcome, planned physical activity {Median (Range}, increased by 60 (0–540 mins/week in the SC group versus 0 (0–580 mins/week in the UC group (P=0.234. Walking was the predominant physical activity. Body weight, BMI, waist circumference, % body fat, fasting glucose and insulin did not change significantly over time in either group. This intervention designed to increase physical activity in post-partum women with previous gestational diabetes proved feasible. However, no measurable improvement in metabolic or biometric parameters was observed over a three month period.

  16. Patterns and Determinants of Treatment Seeking among Previously Untreated Psychotic Patients in Aceh Province, Indonesia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Marthoenis Marthoenis

    2016-01-01

    Full Text Available Immediate treatment of first-episode psychosis is essential in order to achieve a positive outcome. However, Indonesian psychiatric patients often delay accessing health services, the reason for which is not yet fully understood. The current study aimed to understand patterns of treatment seeking and to reveal determinants of the delay in accessing psychiatric care among first-time user psychotic patients. Qualitative interviews were conducted with sixteen family members who accompanied the patients to a psychiatric hospital. Many families expressed beliefs that mental illness appertains to village sickness and not hospital sickness; therefore, they usually take the patients to traditional or religious healers before taking them to a health professional. They also identified various factors that potentially delay accessing psychiatric treatment: low literacy and beliefs about the cause of the illness, stigmatisation, the role of extended family, financial problems, and long distance to the psychiatric hospital. On the other hand, the family mentioned various factors related to timely help seeking, including being a well-educated family, living closer to health facilities, previous experience of successful psychotic therapy, and having more positive symptoms of psychosis. The findings call for mental health awareness campaigns in the community.

  17. Previous injuries and some training characteristics predict running-related injuries in recreational runners: a prospective cohort study.

    Science.gov (United States)

    Hespanhol Junior, Luiz Carlos; Pena Costa, Leonardo Oliveira; Lopes, Alexandre Dias

    2013-12-01

    What is the incidence of running-related injuries (RRIs) in recreational runners? Which personal and training characteristics predict RRIs in recreational runners? Prospective cohort study. A total of 200 recreational runners answered a fortnightly online survey containing questions about their running routine, races, and presence of RRI. These runners were followed-up for a period of 12 weeks. The primary outcome of this study was running-related injury. The incidence of injuries was calculated taking into account the exposure to running and was expressed by RRI/1000 hours. The association between potential predictive factors and RRIs was estimated using generalised estimating equation models. A total of 84 RRIs were registered in 60 (31%) of the 191 recreational runners who completed all follow-up surveys. Of the injured runners 30% (n=18/60) developed two or more RRIs, with 5/18 (28%) being recurrences. The incidence of RRI was 10 RRI/1000 hours of running exposure. The main type of RRI observed was muscle injuries (30%, n=25/84). The knee was the most commonly affected anatomical region (19%, n=16/84). The variables associated with RRI were: previous RRI (OR 1.88, 95% CI 1.01 to 3.51), duration of training although the effect was very small (OR 1.01, 95% CI 1.00 to 1.02), speed training (OR 1.46, 95% CI 1.02 to 2.10), and interval training (OR 0.61, 95% CI 0.43 to 0.88). Physiotherapists should be aware and advise runners that past RRI and speed training are associated with increased risk of further RRI, while interval training is associated with lower risk, although these associations may not be causative. Copyright © 2013 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  18. Thirteen Secrets of the Deal

    Science.gov (United States)

    Schaffhauser, Dian

    2011-01-01

    Whether one is on Wall Street, in Congress, or working in an IT shop on campus, negotiating a good deal is hard work. As higher education enters its purchasing season, "Campus Technology" talks to deal makers who have "been there and done that." This article presents their tips for getting the most value from vendors the next time one buys…

  19. Dealing with Bullies (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Search English Español Dealing With Bullies KidsHealth / For Kids / Dealing With Bullies What's in this article? Bullying ...

  20. Family Ownership and the Entrenchment Effect on Intellectual Capital Utilization: A Study of High-Technology Companies in Indonesia Dealing with the ASEAN Economic Community (AEC

    Directory of Open Access Journals (Sweden)

    Bima Cinintya Pratama

    2017-08-01

    Full Text Available At the end of 2015, the Association of Southeast Asian Nations (ASEAN brought into being the ASEAN Economic Community (AEC. Due to the AEC, the firms in ASEAN should utilize their resources more effectively and efficiently, so that the firms can survive and grow despite strong competition in the AEC. Indonesia, as the country with the largest economy in the region, needs to address this issue so that companies in Indonesia can face the challenges resulting from the AEC. This study aimed to examine the positive relationship between the intellectual capital (IC and the financial performance of high-technology (high-tech companies that are listed on the Indonesia Stock Exchange, and also to examine whether the entrenchment effect of family ownership exists. This study was conducted from 2008 to 2014. The final sample used in this study consisted of 31 companies with a total of 144 observations. This study used a panel data regression model analysis. The results showed that, for a company, IC has a positive impact on financial performance. This result indicated that the efficient and effective use of their IC will help the firms to achieve higher financial performance, and will be useful for dealing with the AEC. There was no evidence that the entrenchment effect exists in the family ownership of high-tech companies in Indonesia and hampers the utilization of IC.

  1. Family Ownership and the Entrenchment Effect on Intellectual Capital Utilization: A Study of High-Technology Companies in Indonesia Dealing with the ASEAN Economic Community (AEC

    Directory of Open Access Journals (Sweden)

    Bima Cinintya Pratama

    2017-07-01

    Full Text Available At the end of 2015, the Association of Southeast Asian Nations (ASEAN brought into being the ASEAN Economic Community (AEC. Due to the AEC, the firms in ASEAN should utilize their resources more effectively and efficiently, so that the firms can survive and grow despite strong competition in the AEC. Indonesia, as the country with the largest economy in the region, needs to address this issue so that companies in Indonesia can face the challenges resulting from the AEC. This study aimed to examine the positive relationship between the intellectual capital (IC and the financial performance of high-technology (high-tech companies that are listed on the Indonesia Stock Exchange, and also to examine whether the entrenchment effect of family ownership exists. This study was conducted from 2008 to 2014. The final sample used in this study consisted of 31 companies with a total of 144 observations. This study used a panel data regression model analysis. The results showed that, for a company, IC has a positive impact on financial performance. This result indicated that the efficient and effective use of their IC will help the firms to achieve higher financial performance, and will be useful for dealing with the AEC. There was no evidence that the entrenchment effect exists in the family ownership of high-tech companies in Indonesia and hampers the utilization of IC.

  2. Blood donations from previously transfused or pregnant donors: a multicenter study to determine the frequency of alloexposure.

    Science.gov (United States)

    Rios, Jorge A; Schlumpf, Karen S; Kakaiya, Ram M; Triulzi, Darrell J; Roback, John D; Kleinman, Steve H; Murphy, Edward L; Gottschall, Jerome L; Carey, Patricia M

    2011-06-01

    Transfusion-related acute lung injury (TRALI) mitigation strategies include the deferral of female donors from apheresis platelet (PLT) donations and the distribution of plasma for transfusion from male donors only. We studied the implications of these policies in terms of component loss at six blood centers in the United States. We collected data from allogeneic blood donors making whole blood and blood component donations during calendar years 2006 through 2008. We analyzed the distribution of donations in terms of the sex, transfusion and pregnancy histories, and blood type. A TRALI mitigation policy that would not allow plasma from female whole blood donors to be prepared into transfusable plasma components would result in nearly a 50% reduction in the units of whole blood available for plasma manufacturing and would decrease the number of type AB plasma units that could be made from whole blood donations by the same amount. Deferral of all female apheresis PLT donors, all female apheresis PLT donors with histories of prior pregnancies, or all female apheresis PLT donors with histories of prior pregnancies and positive screening test results for antibodies to human leukocyte antigens (HLAs) will result in a loss of 37.1, 22.5, and 5.4% of all apheresis PLT donations, respectively. A TRALI mitigation policy that only defers female apheresis PLT donors with previous pregnancies and HLAs would result in an approximately 5% decrease in the inventory of apheresis PLTs, but would eliminate a large proportion of components that are associated with TRALI. © 2010 American Association of Blood Banks.

  3. PCNL - a comparative study in nonoperated and in previously operated (open nephrolithotomy/pyelolithotomy patients - a single-surgeon experience

    Directory of Open Access Journals (Sweden)

    Rahul Gupta

    2011-12-01

    Full Text Available PURPOSE: Re-procedure in patients with history of open stone surgery is usually challenging due to the alteration in the retroperitoneal anatomy. The aim of this study was to determine the possible impact of open renal surgery on the efficacy and morbidity of subsequent percutaneous nephrolithotomy (PCNL. MATERIALS AND METHODS: From March 2009 until September 2010, 120 patients underwent PCNL. Of these, 20 patients were excluded (tubeless or bilateral simultaneous PCNL. Of the remaining 100, 55 primary patients were categorized as Group 1 and the remaining (previous open nephrolithotomy as Group 2. Standard preoperative evaluation was carried out prior to intervention, Statistical analysis was performed using SPSS v. 11 with the chi-square test, independent samples t-test, and Mann-Whitney U test. A p-value < 0.05 was taken as statistically significant. RESULTS: Both groups were similar in demographic profile and stone burden. Attempts to access the PCS was less in Group 1 compared to Group 2 (1.2 + 1 2 vs 3 + 1.3 respectively and this was statistically significant (p < 0.04. However, the mean operative time between the two groups was not statistically significant (p = 0.44. Blood transfusion rate was comparable in the two groups (p = 0.24. One patient in Group 2 developed hemothorax following a supra-11th puncture. Remaining complications were comparable in both groups. CONCLUSION: Patients with past history of renal stone surgery may need more attempts to access the pelvicaliceal system and have difficulty in tract dilation secondary to retroperitoneal scarring. But overall morbidity and efficacy is same in both groups.

  4. Sunburn and sun-protective behaviors among adults with and without previous nonmelanoma skin cancer: a population-based study

    Science.gov (United States)

    Fischer, Alexander H.; Wang, Timothy S.; Yenokyan, Gayane; Kang, Sewon; Chien, Anna L.

    2016-01-01

    Background Individuals with previous nonmelanoma skin cancer (NMSC) are at increased risk for subsequent skin cancer, and should therefore limit UV exposure. Objective To determine whether individuals with previous NMSC engage in better sun protection than those with no skin cancer history. Methods We pooled self-reported data (2005 and 2010 National Health Interview Surveys) from US non-Hispanic white adults (758 with and 34,161 without previous NMSC). We calculated adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (95% CI), taking into account the complex survey design. Results Individuals with previous NMSC versus no history of NMSC had higher rates of frequent use of shade (44.3% versus 27.0%; aPOR=1.41; 1.16–1.71), long sleeves (20.5% versus 7.7%; aPOR=1.55; 1.21–1.98), a wide-brimmed hat (26.1% versus 10.5%; aPOR=1.52; 1.24–1.87), and sunscreen (53.7% versus 33.1%; aPOR=2.11; 95% CI=1.73–2.59), but did not have significantly lower odds of recent sunburn (29.7% versus 40.7%; aPOR=0.95; 0.77–1.17). Among subjects with previous NMSC, recent sunburn was inversely associated with age, sun avoidance, and shade but not sunscreen. Limitations Self-reported cross-sectional data and unavailable information quantifying regular sun exposure. Conclusion Physicians should emphasize sunburn prevention when counseling patients with previous NMSC, especially younger adults, focusing on shade and sun avoidance over sunscreen. PMID:27198078

  5. Atlantic petroleum royalties : fair deal or raw deal

    International Nuclear Information System (INIS)

    Watkins, G.C.; Crowley, B.L.

    2001-01-01

    A study was conducted to address the controversy regarding the Newfoundland and Nova Scotia offshore royalty regimes and associated agreements. This study compared the regimes in Atlantic Canada with the best practices elsewhere and laid important groundwork for understanding the Atlantic offshore oil and gas industry. The main concern by the public is whether the distribution of returns from resource exploitation is fair. The report is divided into 6 sections which examine the nature of economic rent in the context of natural resources, and look at various instruments used to lay claim to it. A review of the resource rent royalty (RRR) instrument, dealing with a tax on net cash flow before outlining its approximation by the RRR was included along with a set of examples of such regimes in Australia, Canadian Frontier Lands, and the United Kingdom. An evaluation criteria was developed for the royalty regime and this criteria was applied to the current generic Nova Scotia and Newfoundland offshore petroleum tax regimes. It was concluded that there is room for improvement, but in general, the regimes stand up to rigorous experimentation and they provide a fair return to the provinces and citizens. The present regimes do not discourage further development of the industry. 17 refs., 1 tab., 2 figs

  6. Laparoscopy After Previous Laparotomy

    Directory of Open Access Journals (Sweden)

    Zulfo Godinjak

    2006-11-01

    Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

  7. Cancer treatment: dealing with pain

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000827.htm Cancer treatment - dealing with pain To use the sharing features ... test, can cause pain. Treatment. Many types of cancer treatments can cause pain, including chemotherapy , radiation , and surgery. ...

  8. Dealing with a Health Condition

    Science.gov (United States)

    ... own troubles as Melissa, who has Crohn's disease , discovered. Some of Melissa's medications made her look puffy, ... Palsy Juvenile Idiopathic Arthritis (JIA) Dealing With Cancer HIV and AIDS View more About Us Contact Us ...

  9. Show what you know and deal with stress yourself: a qualitative interview study of medical interns' perceptions of stress and gender.

    Science.gov (United States)

    Verdonk, Petra; Räntzsch, Viktoria; de Vries, Remko; Houkes, Inge

    2014-05-17

    Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians' perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns' perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress. In order to do this, we have performed a qualitative study. In 2010-2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically. First, stress mainly evolves from having to prove one's self and show off competencies and motivation ("Show What You Know…"). Second, interns seek own solutions for handling stress because it is not open for discussion (… "And Deal With Stress Yourself"). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as 'professional and self-confident', remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations. The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the 'masculine protest' may benefit from a culture that embraces more collaborative styles, such as having open conversation

  10. Radioimmunotherapy with Y-90-epratuzumab in patients with previously treated B-cell lymphoma. A fractionated dose-escalation study

    International Nuclear Information System (INIS)

    Linden, O.; Cavallin-Stahl, E.; Tennvall, J.; Hindorf, C.; Olsson, T.; Strand, S.E.; Stenberg, L.; Wingardh, K.

    2002-01-01

    Aim: Fractionated RIT may improve outcome by decreasing heterogeneity in absorbed dose and by increasing therapeutic window. The humanised anti-CD22 antibody, Epratuzumab, (Immunomedics, Inc., Morris Plains, NJ) can be given repeatedly with minimal risk of neutralising Ab (HAHA), making fractionated treatment with 90 Y-labelled epratuzumab possible. Materials and Methods: Patients with previously treated B-cell lymphoma received increasing number (2-4) of weekly infusions of 90 Y-epratuzumab. Patients received either 185 MBq/m 2 per infusion (group A), or, if they had a history of high-dose chemotherapy with stem-cell rescue, 92.5 MBq/m 2 per infusion (group B). The first infusion included 150 MBq of 111 Indium for scintigraphic verification of tumour targeting and dosimetry. 1.5 mg/kg epratuzumab was administered with each infusion. The treatment could be repeated once after 3 m. Results: Of 23 patients, 16 in group A and 6 in group B were evaluable for response. The RR in group A was 62% objective response (OR) and 25% CR/CRu. One patient in group B showed OR. OR was seen in aggressive and indolent lymphoma. Response was also long-lasting and event-free survival of patients showing CR/CRu was 14 to 25+ months. In group A all seven patient, receiving three infusions, showed less than grade 3 platelet and neutrophil toxicity, except for two patients suffering grade 3 neutropenia. Of five patients with 4 weekly infusions there were two patients with dose-limiting haematological toxicity (DLT), both recently treated with high dose cytosar before RIT. With criteria used the maximal tolerated dose was three infusions 185 MBq/m 2 . In group B no patient suffered DLT and one patient exhibited OR. Seven patients were retreated after 3 months with minor toxicity, but improvement in OR in two cases. No patient has developed HAHA. CD22 expression on tumour cells, as assessed by flow cytometry, is available in 18 of 22 patients. In group A, seven of eight patients with

  11. Vocational Studies, Lifelong Learning and Social Values: Investigating Education, Training and NVQs under the New Deal. Monitoring Change in Education [Series].

    Science.gov (United States)

    Hyland, Terry

    This book examines the New Labour policy on lifelong learning in Great Britain. Special attention is paid to developments surrounding the University for Industry and the New Deal initiatives and the issue of upgrading the British vocational education and training (VET) system to match those of Britain's European competitors. The following are…

  12. "I didn't think we'd be dealing with stuff like this": A qualitative study of volunteer support for very disadvantaged pregnant women and new mothers.

    Science.gov (United States)

    McLeish, Jenny; Redshaw, Maggie

    2017-02-01

    to identify the particular issues associated with volunteer support for very disadvantaged mothers (who were young, had insecure immigration status, were recent migrants whose English was poor,misused drugs or alcohol, or were involved in crime), from the perspective of the volunteers. a qualitative descriptive study, informed by phenomenological social psychology. Semi-structured qualitative interviews were carried out between July 2013 and March 2015. Interview transcripts were analysed using inductive thematic analysis. nine volunteer support projects for pregnant women and new mothers, run by third sector organisations in England. 38 volunteer supporters. three key themes were identified: 'Meeting challenges', 'Needing support' and 'Identifying successes'. 'Meeting challenges' contained the subthemes 'making the relationship of trust','remaining non-judgemental', 'maintaining boundaries' and 'dealing with child protection'. 'Needing support' contained the subthemes 'feeling prepared', 'feeling supported' and 'staying safe'. 'Identifying successes' contained the subthemes 'celebrating the small wins', 'validation as a mother', and 'supporting access to services'. volunteers were able to build strong, empowering relationships with some very disadvantaged women during pregnancy and afterwards, including where the mothers did not readily engage with professionals. However, supporting women with complex needs is emotionally challenging and volunteers need to be carefully selected, realistically trained and robustly supervised and supported during their volunteering. third sector organisations offering volunteer support for pregnant women and new mothers can be valuable partners in reaching very disadvantaged women who may find it difficult to engage with services. Volunteers can build up a relationship of trust with vulnerable mothers over time, but need to be well supported to do this safely and effectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. PEG tubes: dealing with complications.

    Science.gov (United States)

    Malhi, Hardip; Thompson, Rosie

    A percutaneous endoscopic gastronomy tube can be used to deliver nutrition, hydration and medicines directly into the patient's stomach. Patients will require a tube if they are unable to swallow safely, putting them at risk of aspiration of food, drink and medicines into their lungs. It is vital that nurses are aware of the complications that may arise when caring for a patient with a PEG tube. It is equally important that nurses know how to deal with these complications or from where tc seek advice. This article provides a quick troubleshooting guide to help nurses deal with complications that can arise with PEG feeding.

  14. Show what you know and deal with stress yourself: a qualitative interview study of medical interns’ perceptions of stress and gender

    Science.gov (United States)

    2014-01-01

    Background Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians’ perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns’ perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress. Methods In order to do this, we have performed a qualitative study. In 2010–2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically. Results First, stress mainly evolves from having to prove one’s self and show off competencies and motivation (“Show What You Know…”). Second, interns seek own solutions for handling stress because it is not open for discussion (… “And Deal With Stress Yourself”). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as ‘professional and self-confident’, remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations. Conclusions The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the ‘masculine protest’ may benefit from a culture that

  15. A case study of IMRT planning (Plan B) subsequent to a previously treated IMRT plan (Plan A)

    International Nuclear Information System (INIS)

    2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" data-affiliation=" (Department of Medical Physics and 2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" >Cao, F; 2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" data-affiliation=" (Department of Medical Physics and 2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" >Leong, C; 2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" data-affiliation=" (Department of Medical Physics and 2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" >Schroeder, J; 2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" data-affiliation=" (Department of Medical Physics and 2Department of Radiation Oncology, Fraser Valley Centre, BC Cancer Agency, Surrey, British Columbia (Canada))" >Lee, B

    2014-01-01

    Background and purpose: Treatment of the contralateral neck after previous ipsilateral intensity modulated radiation therapy (IMRT) for head and neck cancer is a challenging problem. We have developed a technique that limits the cumulative dose to the spinal cord and brainstem while maximizing coverage of a planning target volume (PTV) in the contralateral neck. Our case involves a patient with right tonsil carcinoma who was given ipsilateral IMRT with 70Gy in 35 fractions (Plan A). A left neck recurrence was detected 14 months later. The patient underwent a neck dissection followed by postoperative left neck radiation to a dose of 66 Gy in 33 fractions (Plan B). Materials and Methods: The spinal cord-brainstem margin (SCBM) was defined as the spinal cord and brainstem with a 1.0 cm margin. Plan A was recalculated on the postoperative CT scan but the fluence outside of SCBM was deleted. A further modification of Plan A resulted in a base plan that was summed with Plan B to evaluate the cumulative dose received by the spinal cord and brainstem. Plan B alone was used to evaluate for coverage of the contralateral neck PTV. Results: The maximum cumulative doses to the spinal cord with 0.5cm margin and brainstem with 0.5cm margin were 51.96 Gy and 45.60 Gy respectively. For Plan B, 100% of the prescribed dose covered 95% of PTVb1. Conclusion: The use of a modified ipsilateral IMRT plan as a base plan is an effective way to limit the cumulative dose to the spinal cord and brainstem while enabling coverage of a PTV in the contralateral neck.

  16. Evaluation of a rapid dipstick (Crystal VC for the diagnosis of cholera in Zanzibar and a comparison with previous studies.

    Directory of Open Access Journals (Sweden)

    Benedikt Ley

    Full Text Available The gold standard for the diagnosis of cholera is stool culture, but this requires laboratory facilities and takes at least 24 hours. A rapid diagnostic test (RDT that can be used by minimally trained staff at treatment centers could potentially improve the reporting and management of cholera outbreaks.We evaluated the Crystal VC™ RDT under field conditions in Zanzibar in 2009. Patients presenting to treatment centers with watery diarrhea provided a stool sample for rapid diagnostic testing. Results were compared to stool culture performed in a reference laboratory. We assessed the overall performance of the RDT and evaluated whether previous intake of antibiotics, intravenous fluids, location of testing, and skill level of the technician affected the RDT results.We included stool samples from 624 patients. Compared to culture, the overall sensitivity of the RDT was 93.1% (95%CI: 88.7 to 96.2%, specificity was 49.2% (95%CI: 44.3 to 54.1%, the positive predictive value was 47.0% (95%CI: 42.1 to 52.0% and the negative predictive value was 93.6% (95%CI: 89.6 to 96.5%. The overall false positivity rate was 50.8% (213/419; fieldworkers frequently misread very faint test lines as positive.The observed sensitivity of the Crystal VC RDT evaluated was similar compared to earlier versions, while specificity was poorer. The current version of the RDT could potentially be used as a screening tool in the field. Because of the high proportion of false positive results when field workers test stool specimens, positive results will need to be confirmed with stool culture.

  17. Idiosyncratic Deals and Organizational Commitment

    Science.gov (United States)

    Ng, Thomas W. H.; Feldman, Daniel C.

    2010-01-01

    This article examines the relationship between idiosyncratic deals and organizational commitment. In particular, it examines how two individual differences which reflect self-worth (core self-evaluations and age) moderate that relationship. We predicted that employees with feelings of high self-worth will expect and will feel entitled to these…

  18. Dealing with Resistance to Change

    Science.gov (United States)

    Williamson, Ronald; Blackburn, Barbara R.

    2010-01-01

    One of the biggest roadblocks to addressing instructional rigor in schools is the resistance to change that is displayed by teachers, students, parents, and other building and district leaders. Every person deals differently with change. Some are more accepting, others more resistant. No change is successful if the people being asked to change…

  19. Studies in iodine metabolism: 33 year summary, 1948-1979 (as previously submitted) with appendix, 1979-1982

    International Nuclear Information System (INIS)

    Middlesworth, L.V.

    1982-01-01

    The results of research into iodine metabolism from 1948 to 1982 are summarized. Study areas included the monitoring of iodine 131 from fallout in the thyroid glands of cattle and humans, the biological functions and metabolism of thyroid hormones, and methods to reduce the retention of radioiodine in the thyroid

  20. CHRONOVAC VOYAGEUR: A study of the immune response to yellow fever vaccine among infants previously immunized against measles.

    Science.gov (United States)

    Goujon, Catherine; Gougeon, Marie-Lise; Tondeur, Laura; Poirier, Béatrice; Seffer, Valérie; Desprès, Philippe; Consigny, Paul-Henri; Vray, Muriel

    2017-10-27

    For administration of multiple live attenuated vaccines, the Advisory Committee on Immunization Practices recommends either simultaneous immunization or period of at least 28days between vaccines, due to a possible reduction in the immune response to either vaccine. The main objective of this study was to compare the immune response to measles (alone or combined with mumps and rubella) and yellow fever vaccines among infants aged 6-24months living in a yellow fever non-endemic country who had receivedmeasles and yellow fever vaccines before travelling to a yellow fever endemic area. A retrospective, multicenter case-control study was carried out in 7 travel clinics in the Paris area from February 1st 2011 to march 31, 2015. Cases were defined as infants immunized with the yellow fever vaccine and with the measles vaccine, either alone or in combination with mumps and rubella vaccine, with a period of 1-27days between each immunization. For each case, two controls were matched based on sex and age: a first control group (control 1) was defined as infants having received the measles vaccine and the yellow fever vaccine simultaneously; a second control group (control 2) was defined as infants who had a period of more than 27days between receiving the measles vaccine and yellow fever vaccine. The primary endpoint of the study was the percentage of infants with protective immunity against yellow fever, measured by the titer of neutralizing antibodies in a venous blood sample. One hundred and thirty-one infants were included in the study (62 cases, 50 infants in control 1 and 19 infants in control 2). Of these, 127 (96%) were shown to have a protective titer of yellow fever antibodies. All 4 infants without a protective titer of yellow fever antibodies were part of control group 1. The measles vaccine, alone or combined with mumps and rubella vaccines, appears to have no influence on humoral immune response to the yellow fever vaccine when administered between 1 and 27

  1. Structural Study and Evaluation of Previous Restoration Work of Mohammad 'Ali Pasha Mosque at the Citadel in Cairo

    Directory of Open Access Journals (Sweden)

    dr.Yaser Yehya Amin Abdel-Aty

    2011-01-01

    Full Text Available Mohammad 'Ali Pasha Mosque at the Citadel in Cairo is considered one of the main landmarks in Egypt. It majestically stands at a northwestern bend of the Citadel and it is visible from numerous locations in Cairo. It has become the symbol of the Citadel, to the point that its name is given to the whole complex in the colloquial Egyptian parlance. This paper studies analytically the static and dynamic structural behavior of this great mosque using computer numerical modeling techniques, to reach the main reasons for past cracking and failures in its domed-roof and other structural elements, which occurred by the end of 19th Century. A number of 3D-models are analyzed to study the mosque, in both original and after restoration conditions, under static (i.e. dead and live loads and dynamic (i.e. Eigenvector modal analysis, response-spectrum and time-history cases of loading. Besides, structural evaluation of major restoration project, in 1930s, is conducted to determine the current structural safety status of the mosque

  2. Comparative study of a novel application of automated HR HPV assay and stability in a previously untested Preservative media.

    Science.gov (United States)

    Morel, Mike E; McBride, Simon E; Gomez, Maria P

    2017-12-01

    The suitability and stability of cervical cells in Novaprep media (NHQ) for certain HPV assays is unknown. We evaluated the accuracy of an automated HPV assay (Abbott RealTime HR HPV) for cervical cells prepared in NHQ and NHQ with a pre-treatment to mimic a worst case clinical use, compared to the assay manufacturers media; repeatability and reproducibility of HPV results and the stability of detectable HPV in NHQ over time compared to CE marked liquid based cytology preservatives. Cell lines were used to simulate patient samples. Cells stored in NHQ produced accurate, repeatable and reproducible results. Stability in NHQ was comparable to the best performing LBC, with at least 7 months' stability at 18-25°C, 2-8°C, -20°C and -80°C; and at least 3 months' stability at 40°C. Similar results were obtained for pre-treated NHQ except only 3.5 months' stability at 18-25°C. Cell line samples in all media and concentrations tested were detected appropriately by the assay. Based on this first stage validation analytical study, cervical cells stored in NHQ are suitable for the Realtime HPV assay. There should be no reservations for inclusion of NHQ in any further validation and clinical performance evaluation of this assay. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Comparative study of a novel application of automated HR HPV assay and stability in a previously untested Preservative media

    Directory of Open Access Journals (Sweden)

    Mike E. Morel

    2017-12-01

    Full Text Available Background: The suitability and stability of cervical cells in Novaprep media (NHQ for certain HPV assays is unknown. Methods: We evaluated the accuracy of an automated HPV assay (Abbott RealTime HR HPV for cervical cells prepared in NHQ and NHQ with a pre-treatment to mimic a worst case clinical use, compared to the assay manufacturers media; repeatability and reproducibility of HPV results and the stability of detectable HPV in NHQ over time compared to CE marked liquid based cytology preservatives. Cell lines were used to simulate patient samples. Results: Cells stored in NHQ produced accurate, repeatable and reproducible results. Stability in NHQ was comparable to the best performing LBC, with at least 7 months’ stability at 18–25 °C, 2–8 °C, −20 °C and −80 °C; and at least 3 months’ stability at 40 °C. Similar results were obtained for pre-treated NHQ except only 3.5 months’ stability at 18–25 °C. Cell line samples in all media and concentrations tested were detected appropriately by the assay. Conclusions: Based on this first stage validation analytical study, cervical cells stored in NHQ are suitable for the Realtime HPV assay. There should be no reservations for inclusion of NHQ in any further validation and clinical performance evaluation of this assay. Keywords: HPV, Preservative, Sample stability, Automated HR HPV assay

  4. German-Brazilian nuclear deal

    International Nuclear Information System (INIS)

    Krugmann, H.

    1981-01-01

    Examination of the arguments in favor of the nuclear deal with West Germany and the resulting program suggests that revisions of both are in order to make them more compatible with Brazil's national interests. The deficiencies of current policy appear to be too weighty and numerous to be ignored. Sooner or later the government will have to move toward adjusting its nuclear agreement with West Germany, if not for the reasons discussed here then for lack of capital. Current estimates of the nuclear package lie in the range of $25 to $30 billion, compared to an initial projection of about $5 billion. The deal has become so expensive that it would draw capital from the hydropower and alcohol programs essential for the short and medium-term energy needs of the country. Mr. Krugman feels the Brazilian government should hold off on further nuclear contracts. And it should thoroughly reassess what Brazil's nuclear energy and technology requirements are and how to meet them. There are indications that the reassessment process is already underway. As long as the German nuclear industry depends on the sale of technology to Brazil, the Brazilian government will have considerable bargaining power to enforce further changes in the deal. If this power is used wisely, the result could be cooperation between the two countries toward nuclear options that are consistent with Brazil's energy and development needs

  5. Emotions & Relationships: Dealing with the Tough Stuff

    Science.gov (United States)

    Emotions & Relationships: Dealing with the Tough Stuff; emotional health; emotional health; emotional health article; emotional health articles; best way to deal with emotions; best ways to deal with relationships; how to build relationships; how to strengthen relationships

  6. Dealing with ocular artifacts on lateralized ERPs in studies of visual-spatial attention and memory: ICA correction versus epoch rejection.

    Science.gov (United States)

    Drisdelle, Brandi Lee; Aubin, Sébrina; Jolicoeur, Pierre

    2017-01-01

    The objective of the present study was to assess the robustness and reliability of independent component analysis (ICA) as a method for ocular artifact correction in electrophysiological studies of visual-spatial attention and memory. The N2pc and sustained posterior contralateral negativity (SPCN), electrophysiological markers of visual-spatial attention and memory, respectively, are lateralized posterior ERPs typically observed following the presentation of lateral stimuli (targets and distractors) along with instructions to maintain fixation on the center of the visual search for the entire trial. Traditionally, trials in which subjects may have displaced their gaze are rejected based on a cutoff threshold, minimizing electrophysiological contamination by saccades. Given the loss of data resulting from rejection, we examined ocular correction by comparing results using standard fixation instructions against a condition where subjects were instructed to shift their gaze toward possible targets. Both conditions were analyzed using a rejection threshold and ICA correction for saccade activity management. Results demonstrate that ICA conserves data that would have otherwise been removed and leaves the underlying neural activity intact, as demonstrated by experimental manipulations previously shown to modulate the N2pc and the SPCN. Not only does ICA salvage and not distort data, but also large eye movements had only subtle effects. Overall, the findings provide convincing evidence for ICA correction for not only special cases (e.g., subjects did not follow fixation instruction) but also as a candidate for standard ocular artifact management in electrophysiological studies interested in visual-spatial attention and memory. © 2016 Society for Psychophysiological Research.

  7. The atomic deal with Brazil

    International Nuclear Information System (INIS)

    Mirow, K.R.

    1980-01-01

    The author deals with the German-Brazilian nuclear treaty using sources which are meanwhile official. A roaring trade - made in 1975 - had become a public nuisance in 1979. Grand plans of German and Brazilian politicians had changed into economic crisis, unemployment and uncompleted, dilapidating buildings. While even the new government adhered to the treaty, Brazilia had begun a national instigation campaign. This was, however, superseded by Brazil's high indebtedness, an economic crisis and social unrest so that it was impossible to realize the nuclear treaty. (HSCH) [de

  8. Dealing with the difficult utility

    International Nuclear Information System (INIS)

    Keats, D.E.; Sundquist, M.J.; Cross, J.P.

    1991-01-01

    STS HydroPower, Ltd. (STS) is an independent hydroelectric power developer involved in the full scope of hydroelectric activities. This includes the permitting, design, financing, turbine design and manufacturing, site construction and operation of small to mid-sized hydroelectric sites across the United States. At the present time, STS owns and operates nine sites in four states with a combined capacity of 20 megawatts. In dealing with the implementation of these sites, STS has dealt with five different utilities. In addition, in pursuing additional development opportunities throughout the United States, STS has had contact with numerous other utilities. During this time it would be fair to conclude that each of these utilities has exhibited its own personality with respect to dealing with independent developers. To the credit of the utility industry, the majority of these utilities have been helpful and supportive of independent projects, but a small number of utilities have approached projects from an initial and continuing adversarial position. The purpose of this paper is to examine those options and procedures available to the developer when a utility is encountered with a negative predisposition

  9. An inventory of the first round of Green Deals

    International Nuclear Information System (INIS)

    Wetzels, W.; Hekkenberg, M.; Daniels, B.W.; Ybema, J.R.

    2012-01-01

    By means of the Green Deal, the Dutch government aims to accelerate the sustainability of the economy by supporting initiatives in the field of energy, water, feedstocks and mobility. Businesses, organizations and authorities have submitted over 200 proposals, of which 59 have been selected and elaborated into Green Deals. A previous note has mapped the additional effects of the Green Deals on the share of renewable energy and the emission of non-ETS greenhouse gases. This note addressed questions such as: Which positive effects may occur?; Do the Green Deals lead to additional activities?; Can the results be scaled up?; Can the effects be measured?; Which effects can be observed for renewable energy and emissions in 2020? The note subsequently discusses in which ways the positive effects of the Green Deals could be enhanced. [nl

  10. The Public Health Responsibility Deal: brokering a deal for public health, but on whose terms?

    Science.gov (United States)

    Panjwani, Clare; Caraher, Martin

    2014-02-01

    Coalitions of multinational food and drink businesses have pledged to reformulate their products and to market them responsibly. Largely business-led and self-regulated, the integrity of these voluntary initiatives has been questioned. The Public Health Responsibility Deal in England is an example of a voluntary initiative that is government-led. Does this approach provide evidence that with public leadership there is potential for voluntary actions to deliver meaningful results for public health? The subject of the research is the calorie reduction initiative of the Responsibility Deal. Source material was obtained primarily through a series of UK Freedom of Information requests and comprises previously unpublished Department of Health documentation relating to relevant meetings held during 2011 and 2012. The Responsibility Deal approach to calorie reduction deliberately involves the food industry in the specification of the measures it is to implement (reformulation and portion control). Finding the common ground between private and public interests has resulted in the deflection of public health objectives and the preclusion of adequate monitoring and evaluation. The Responsibility Deal approach is fundamentally flawed in its expectation that industry will take voluntary actions that prioritise public health interests above its own. Being government-led counts for little in the absence of sanctions to drive compliance. Instead the initiative affords private interests the opportunity to influence in their favour the public health policies and strategies that affect their products. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Looking for a Link : Comparing Faculty Citations Pre and Post Big Deals

    OpenAIRE

    Taylor, Donald

    2007-01-01

    Big Deals expand an institution’s access to scholarly literature, with usage statistics showing that previously unavailable journals receive significant usage. To determine if faculty use these new e-journals in their research, the Simon Fraser University (SFU) Library analyzed SFU citation data to journals from selected Big Deals for two years prior to signing a major Big Deal (1993 and 1998) and for two consecutive years following the Big Deal (2004 and 2005). Pre Big Deal, the percentage o...

  12. Dealing with Y2K

    Science.gov (United States)

    Showstack, Randy

    In 17 months, the ball drops in New York's Times Square to usher in a new millennium and new year ending in the digits 00. However, internal clocks in computers around the world may recognize the date as 1900 rather than 2000 if governments and businesses drop the ball in dealing with a simple computer design flaw that has ballooned into a complex management issue of correcting billions of lines of computer code worldwide.In a speech at the National Academy of Sciences in Washington, D.C, in July, U.S. President Bill Clinton proposed new legislation to make it easier for the private sector to collaborate in solving this problem.

  13. Polychlorinated biphenyl exposure, diabetes and endogenous hormones: a cross-sectional study in men previously employed at a capacitor manufacturing plant.

    Science.gov (United States)

    Persky, Victoria; Piorkowski, Julie; Turyk, Mary; Freels, Sally; Chatterton, Robert; Dimos, John; Bradlow, H Leon; Chary, Lin Kaatz; Burse, Virlyn; Unterman, Terry; Sepkovic, Daniel W; McCann, Kenneth

    2012-08-29

    Studies have shown associations of diabetes and endogenous hormones with exposure to a wide variety of organochlorines. We have previously reported positive associations of polychlorinated biphenyls (PCBs) and inverse associations of selected steroid hormones with diabetes in postmenopausal women previously employed in a capacitor manufacturing plant. This paper examines associations of PCBs with diabetes and endogenous hormones in 63 men previously employed at the same plant who in 1996 underwent surveys of their exposure and medical history and collection of bloods and urine for measurements of PCBs, lipids, liver function, hematologic markers and endogenous hormones. PCB exposure was positively associated with diabetes and age and inversely associated with thyroid stimulating hormone and triiodothyronine-uptake. History of diabetes was significantly related to total PCBs and all PCB functional groupings, but not to quarters worked and job score, after control for potential confounders. None of the exposures were related to insulin resistance (HOMA-IR) in non-diabetic men. Associations of PCBs with specific endogenous hormones differ in some respects from previous findings in postmenopausal women employed at the capacitor plant. Results from this study, however, do confirm previous reports relating PCB exposure to diabetes and suggest that these associations are not mediated by measured endogenous hormones.

  14. Quantifying the influence of previously burned areas on suppression effectiveness and avoided exposure: A case study of the Las Conchas Fire

    Science.gov (United States)

    Matthew P. Thompson; Patrick Freeborn; Jon D. Rieck; Dave Calkin; Julie W. Gilbertson-Day; Mark A. Cochrane; Michael S. Hand

    2016-01-01

    We present a case study of the Las Conchas Fire (2011) to explore the role of previously burned areas (wildfires and prescribed fires) on suppression effectiveness and avoided exposure. Methodological innovations include characterisation of the joint dynamics of fire growth and suppression activities, development of a fire line effectiveness framework, and...

  15. Study of some physical aspects previous to design of an exponential experiment; Estudio de algunos aspectos fisicos previos al diseno de una experiencia exponencial

    Energy Technology Data Exchange (ETDEWEB)

    Caro, R; Francisco, J L. de

    1961-07-01

    This report presents the theoretical study of some physical aspects previous to the design of an exponential facility. The are: Fast and slow flux distribution in the multiplicative medium and in the thermal column, slowing down in the thermal column, geometrical distribution and minimum needed intensity of sources access channels and perturbations produced by possible variations in its position and intensity. (Author) 4 refs.

  16. Dealing with multiliteracies in literacy pegagogy II

    DEFF Research Database (Denmark)

    Laursen, Helle; Lundqvist, ulla; Orluf, Birgit

    2010-01-01

    meaning from the information available to them in their social environment. In this paper, we discuss the relevance of a multiliteracies approach to literacy pedagogy and present some preliminary observations and considerations from our research study with special attention to the challenge......Dealing with multiliteracies in literacy pedagogy II Focus on multimodality Ulla Lundqvist, Birgit Orluf, Uffe Ladegaard & Helle Pia Laursen This paper is the second of two interconnected papers dealing with multiliteracies in literacy pedagogy. Ten years ago the Multiliteracies Project (Cope...... & Kalantzis, 2000) reflected on the changing semiotic landscape of literacy teaching and learning and asked the question how these changes could be taken into account in designing literacy pedagogies. The notion of Multiliteracies combined a focus on the multiplicity of representational modes (multimodal...

  17. Dealing with multiliteracies in literacy pedagogy I

    DEFF Research Database (Denmark)

    Laursen, Helle; Daugaard, Line Møller; Østergaard, Winnie

    2010-01-01

    meaning from the information available to them in their social environment. In this paper, we discuss the relevance of a multiliteracies approach to literacy pedagogy and present some preliminary observations and considerations from our research study with special attention to the challenge......Dealing with multiliteracies in literacy pedagogy I. Focus on multilingualism Line Møller Daugaard, Winnie Østergaard & Helle Pia Laursen This paper is the first of two interconnected papers dealing with multiliteracies in literacy pedagogy Ten years ago the Multiliteracies Project (Cope...... & Kalantzis, 2000) reflected on the changing semiotic landscape of literacy teaching and learning and asked the question how these changes could be taken into account in designing literacy pedagogies. The notion of Multiliteracies combined a focus on the multiplicity of representational modes (multimodal...

  18. Elevated risk of incarceration among street-involved youth who initiate drug dealing

    Directory of Open Access Journals (Sweden)

    Carly Hoy

    2016-11-01

    Full Text Available Abstract Background Street-involved youth are known to be an economically vulnerable population that commonly resorts to risky activities such as drug dealing to generate income. While incarceration is common among people who use illicit drugs and associated with increased economic vulnerability, interventions among this population remain inadequate. Although previous research has documented the role of incarceration in further entrenching youth in both the criminal justice system and street life, less is known whether recent incarceration predicts initiating drug dealing among vulnerable youth. This study examines the relationship between incarceration and drug dealing initiation among street-involved youth. Methods Between September 2005 and November 2014, data were collected through the At-Risk Youth Study, a cohort of street-involved youth who use illicit drugs, in Vancouver, Canada. An extended Cox model with time-dependent variables was used to examine the relationship between recent incarceration and initiation into drug dealing, controlling for relevant confounders. Results Among 1172 youth enrolled, only 194 (16.6% were drug dealing naïve at baseline and completed at least one additional study visit to facilitate the assessment of drug dealing initiation. Among this sample, 56 (29% subsequently initiated drug dealing. In final multivariable Cox regression analysis, recent incarceration was significantly associated with initiating drug dealing (adjusted hazard ratio = 2.31; 95% confidence interval (CI 1.21–4.42, after adjusting for potential confounders. Measures of recent incarceration lagged to the prior study follow-up were not found to predict initiation of drug dealing (hazard ratio = 1.50; 95% CI 0.66–3.42. Conclusions These findings suggest that among this study sample, incarceration does not appear to significantly propel youth to initiate drug dealing. However, the initiation of drug dealing among youth coincides

  19. A cross-sectional study of tuberculosis drug resistance among previously treated patients in a tertiary hospital in Accra, Ghana: public health implications of standardized regimens.

    Science.gov (United States)

    Forson, Audrey; Kwara, Awewura; Kudzawu, Samuel; Omari, Michael; Otu, Jacob; Gehre, Florian; de Jong, Bouke; Antonio, Martin

    2018-04-02

    Mycobacterium tuberculosis drug resistance is a major challenge to the use of standardized regimens for tuberculosis (TB) therapy, especially among previously treated patients. We aimed to investigate the frequency and pattern of drug resistance among previously treated patients with smear-positive pulmonary tuberculosis at the Korle-Bu Teaching Hospital Chest Clinic, Accra. This was a cross-sectional survey of mycobacterial isolates from previously treated patients referred to the Chest Clinic Laboratory between October 2010 and October 2013. The Bactec MGIT 960 system for mycobactrerial culture and drug sensitivity testing (DST) was used for sputum culture of AFB smear-positive patients with relapse, treatment failure, failure of smear conversion, or default. Descriptive statistics were used to summarize patient characteristics, and frequency and patterns of drug resistance. A total of 112 isolates were studied out of 155 from previously treated patients. Twenty contaminated (12.9%) and 23 non-viable isolates (14.8%) were excluded. Of the 112 studied isolates, 53 (47.3%) were pan-sensitive to all first-line drugs tested Any resistance (mono and poly resistance) to isoniazid was found in 44 isolates (39.3%) and any resistance to streptomycin in 43 (38.4%). Thirty-one (27.7%) were MDR-TB. Eleven (35.5%) out of 31 MDR-TB isolates were pre-XDR. MDR-TB isolates were more likely than non-MDR isolates to have streptomycin and ethambutol resistance. The main findings of this study were the high prevalence of MDR-TB and streptomycin resistance among previously treated TB patients, as well as a high prevalence of pre-XDR-TB among the MDR-TB patients, which suggest that first-line and second-line DST is essential to aid the design of effective regimens for these groups of patients in Ghana.

  20. From Pre-Revolutionary Study of Religion to Soviet Religious Studies: a Transformation of Scientific Method and Research Techniques and the Formation of the Soviet Way of Dealing with Religious Questions

    Directory of Open Access Journals (Sweden)

    Konstantin Antonov

    2013-12-01

    Full Text Available The author attempts a step by step analysis of the way religion was studied during the Soviet period. Discussing the way Soviet techniques differed from those of the Tsarist period, the author insists that any idea of a normal progression of ideas must be rejected and that instead we are dealing with a transformation of basic principles and a definitive break with the past. In the first part of his article, the author reviews the transformation of the way religion was dealt with from 1910 until the beginning of the 1930's with the aid of some key concepts put forth by Michel Foucault in his Archeology of Knowledge. Following the suggestions of Imre Lakatos regarding a research programs, the author describes the contributions of the main directives of religious thought during this period: the programs dealing with the spiritual-academic, religious-philosophical, and anthropological sectors. The author concludes by describing the main phases of development, the characteristic aspects, and the particularities of the Soviet approach to religion. The forgoing analysis permits the author to conclude that the Soviet approach to religion represents in no way a development but rather a complete break with pre-revolutionary ways of looking at religion and must be treated as a specific phenomenon. Neither can the Soviet approach, judging by its basic principles, be considered to have anything in common with a normal scientific method of studying religion as this term is generally accepted today. Rather, it was a system conditioned by external factors which clearly took precedence over internal ones to the detriment of any objective study of religion.

  1. Is email a reliable means of contacting authors of previously published papers? A study of the Emergency Medicine Journal for 2001.

    Science.gov (United States)

    O'Leary, F

    2003-07-01

    To determine whether it is possible to contact authors of previously published papers via email. A cross sectional study of the Emergency Medicine Journal for 2001. 118 articles were included in the study. The response rate from those with valid email addresses was 73%. There was no statistical difference between the type of email address used and the address being invalid (p=0.392) or between the type of article and the likelihood of a reply (p=0.197). More responses were obtained from work addresses when compared with Hotmail addresses (86% v 57%, p=0.02). Email is a valid means of contacting authors of previously published articles, particularly within the emergency medicine specialty. A work based email address may be a more valid means of contact than a Hotmail address.

  2. Previous dropout from diabetic care as a predictor of patients' willingness to use mobile applications for self-management: A cross-sectional study.

    Science.gov (United States)

    Yamaguchi, Satoko; Waki, Kayo; Tomizawa, Nobuko; Waki, Hironori; Nannya, Yasuhito; Nangaku, Masaomi; Kadowaki, Takashi; Ohe, Kazuhiko

    2017-07-01

    Preventing dropout is crucial in managing diabetes. Accordingly, we investigated whether patients who had dropped out of diabetic care are suitable candidates for the use of mobile technologies - such as smartphone applications - to support self-management (mHealth), which might help prevent dropout. We carried out a cross-sectional study in Tokyo, Japan. Patients aged 20 years or older who were clinically diagnosed as diabetic and who regularly visited the outpatient unit at the University of Tokyo Hospital were recruited between August 2014 and March 2015. Data were collected through face-to-face structured interviews, physical measurements and medical records. Participants were asked whether they were willing to use mHealth after being shown DialBetics - an mHealth application for diabetics - as an example, and about their history of dropout and previous mHealth experience. Data were analyzed by multivariate logistic regression models. Of 307 patients with type 1 and type 2 diabetes, 34 (11.1%) had previously dropped out from diabetic care. Multivariate analysis identified previous mHealth experience as a negative predictor of dropout (odds ratio 0.211, P = 0.023). Of those 34 patients, 27 (79.4%) expressed willingness to use mHealth, a significantly higher percentage than for those who had never dropped out (51.5%, P = 0.002). After adjusting for confounders, history of dropout remained a strong predictor of willingness (odds ratio 3.870, P = 0.004). Patients who previously dropped out of diabetic care are suitable candidates for mHealth. Future studies must evaluate whether mHealth is effective for preventing repeated dropout and improving glycemic control among this population. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  3. Mortality and cardiovascular risk associated with different insulin secretagogues compared with metformin in type 2 diabetes, with or without a previous myocardial infarction: a nationwide study

    DEFF Research Database (Denmark)

    Schramm, Tina Ken; Gislason, Gunnar Hilmar; Vaag, Allan

    2011-01-01

    Aims The impact of insulin secretagogues (ISs) on long-term major clinical outcomes in type 2 diabetes remains unclear. We examined mortality and cardiovascular risk associated with all available ISs compared with metformin in a nationwide study. Methods and results All Danish residents >20 years......, initiating single-agent ISs or metformin between 1997 and 2006 were followed for up to 9 years (median 3.3 years) by individual-level linkage of nationwide registers. All-cause mortality, cardiovascular mortality, and the composite of myocardial infarction (MI), stroke, and cardiovascular mortality...... associated with individual ISs were investigated in patients with or without previous MI by multivariable Cox proportional-hazard analyses including propensity analyses. A total of 107 806 subjects were included, of whom 9607 had previous MI. Compared with metformin, glimepiride (hazard ratios and 95...

  4. Heart failure programmes in countries with a primary care-based health care system. Are additional trials necessary? Design of the DEAL-HF study

    NARCIS (Netherlands)

    de la Porte, PWFBA; Lok, DJA; van Wijngaarden, J; Cornel, JH; Pruijsers-Lamers, D; van Veldhuisen, DJ; Hoes, AW

    Background: Several randomised studies of heart failure (HF) management programmes in the United States, Australia and Europe have shown a considerable reduction in hospitalisation rates for HE In this article, a comprehensive review of these studies will be provided and their applicability to

  5. Acceleration and Orientation Jumping Performance Differences Among Elite Professional Male Handball Players With or Without Previous ACL Reconstruction: An Inertial Sensor Unit-Based Study.

    Science.gov (United States)

    Setuain, Igor; González-Izal, Miriam; Alfaro, Jesús; Gorostiaga, Esteban; Izquierdo, Mikel

    2015-12-01

    Handball is one of the most challenging sports for the knee joint. Persistent biomechanical and jumping capacity alterations can be observed in athletes with an anterior cruciate ligament (ACL) injury. Commonly identified jumping biomechanical alterations have been described by the use of laboratory technologies. However, portable and easy-to-handle technologies that enable an evaluation of jumping biomechanics at the training field are lacking. To analyze unilateral/bilateral acceleration and orientation jumping performance differences among elite male handball athletes with or without previous ACL reconstruction via a single inertial sensor unit device. Case control descriptive study. At the athletes' usual training court. Twenty-two elite male (6 ACL-reconstructed and 16 uninjured control players) handball players were evaluated. The participants performed a vertical jump test battery that included a 50-cm vertical bilateral drop jump, a 20-cm vertical unilateral drop jump, and vertical unilateral countermovement jump maneuvers. Peak 3-dimensional (X, Y, Z) acceleration (m·s(-2)), jump phase duration and 3-dimensional orientation values (°) were obtained from the inertial sensor unit device. Two-tailed t-tests and a one-way analysis of variance were performed to compare means. The P value cut-off for significance was set at P handball athletes with previous ACL reconstruction demonstrated a jumping biomechanical profile similar to control players, including similar jumping performance values in both bilateral and unilateral jumping maneuvers, several years after ACL reconstruction. These findings are in agreement with previous research showing full functional restoration of abilities in top-level male athletes after ACL reconstruction, rehabilitation and subsequent return to sports at the previous level. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  6. Urban Planning Dealing with Change and Infrastructure

    Directory of Open Access Journals (Sweden)

    Sonja Deppisch

    2015-07-01

    Full Text Available This paper deals with urban planning and change processes potentially impacting local infrastructure. The overarching theoretical frame is social-ecological resilience thinking and its potential application to as well as implications for urban land-use development. The paper draws its main attention on if this concept can be of use for urban planners dealing with change and urban infrastructure and if a readiness towards its application can be identified. This endeavor is informed by two explorative studies in Germany. One study gains its material from a scenario process with planning practitioners and further urban stakeholders of a medium-sized city. Main topic was how to deal with the challenges of climate change impacts in urban planning and development. The second explorative study reflects research results on the readiness to apply the resilience concept to urban planning dealing with change and local infrastructure in a small community. The scenario process showed that applying social-ecological resilience thinking to urban planning helps to critically reflect so far taken paths in local built infrastructure, to take on an integrated perspective and to develop new and innovative strategies for further land-use development. Nevertheless, such a process requires additional financial as well as human resources and translation exercises. Also, the given path dependency as well as financial constrains are hindering to perceive any leeway in infrastructure development at the political level, so that any real implementation at the moment seems to be out of sight, which is also caused by multi-level dependencies.  Normal 0 21 false false false DE X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normale Tabelle"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm

  7. How do authors of systematic reviews deal with research malpractice and misconduct in original studies? A cross-sectional analysis of systematic reviews and survey of their authors.

    Science.gov (United States)

    Elia, Nadia; von Elm, Erik; Chatagner, Alexandra; Pöpping, Daniel M; Tramèr, Martin R

    2016-03-02

    To study whether systematic reviewers apply procedures to counter-balance some common forms of research malpractice such as not publishing completed research, duplicate publications, or selective reporting of outcomes, and to see whether they identify and report misconduct. Cross-sectional analysis of systematic reviews and survey of their authors. 118 systematic reviews published in four journals (Ann Int Med, BMJ, JAMA, Lancet), and the Cochrane Library, in 2013. Number (%) of reviews that applied procedures to reduce the impact of: (1) publication bias (through searching of unpublished trials), (2) selective outcome reporting (by contacting the authors of the original studies), (3) duplicate publications, (4) sponsors' and (5) authors' conflicts of interest, on the conclusions of the review, and (6) looked for ethical approval of the studies. Number (%) of reviewers who suspected misconduct are reported. The procedures applied were compared across journals. 80 (68%) reviewers confirmed their data. 59 (50%) reviews applied three or more procedures; 11 (9%) applied none. Unpublished trials were searched in 79 (66%) reviews. Authors of original studies were contacted in 73 (62%). Duplicate publications were searched in 81 (69%). 27 reviews (23%) reported sponsors of the included studies; 6 (5%) analysed their impact on the conclusions of the review. Five reviews (4%) looked at conflicts of interest of study authors; none of them analysed their impact. Three reviews (2.5%) looked at ethical approval of the studies. Seven reviews (6%) suspected misconduct; only 2 (2%) reported it explicitly. Procedures applied differed across the journals. Only half of the systematic reviews applied three or more of the six procedures examined. Sponsors, conflicts of interest of authors and ethical approval remain overlooked. Research misconduct is sometimes identified, but rarely reported. Guidance on when, and how, to report suspected misconduct is needed. Published by the BMJ

  8. Defining Good Deals in Business Collectives

    Directory of Open Access Journals (Sweden)

    Michael Ayukawa

    2011-03-01

    Full Text Available In the context of a current project at Carleton University to create creating a deal-making platform, this article presents the results of a recent review of the literature to determine: What is a good deal? This is question is asked from the perspective of the stakeholders in the development of a software-based collaboration tool that is designed to help streamline deal development between members. The stakeholders include the creators, the users, and the investors. We answer this question by examining several streams in the literature, all centered on understanding deals and deal-making processes. These streams explore the concept of a win-win deal, how value may be seen differently, and the group processes involved in deal making. A key contribution from this review suggests that deal goodness can be separated based on a Me-We construct: the impact to each and every stakeholder of the deal and the impact to the entire collective (not just the deal stakeholders. This implies one can separate the platform management problem into actor-centric (Me and linkage-centric (We domains. This is consistent with the notion of players balancing their self interest with the other stakeholders in the deal (Me-We. This is also consistent with the prospect of managing ecosystem health based on player and network-based metrics.

  9. Dealing with missing behavioral endpoints in health promotion research by modeling cognitive parameters in cost-effectiveness analyses of behavioral interventions : a validation study

    NARCIS (Netherlands)

    Prenger, Rilana; Pieterse, Marcel E.; Braakman-Jansen, Louise M.A.; Feenstra, Talitha L.; Smit, Eline S.; Hoving, Ciska; de Vries, Hein; van Ommeren, Jan-Kees; Evers, Silvia M.A.A.; van der Palen, Job

    2016-01-01

    Cost-effectiveness analyses (CEAs) of behavioral interventions typically use physical outcome criteria. However, any progress in cognitive antecedents of behavior change may be seen as a beneficial outcome of an intervention. The aim of this study is to explore the feasibility and validity of

  10. DEALING WITH MISSING BEHAVIORAL ENDPOINTS IN HEALTH PROMOTION RESEARCH BY MODELING COGNITIVE PARAMETERS IN COST-EFFECTIVENESS ANALYSES OF BEHAVIORAL INTERVENTIONS : A VALIDATION STUDY

    NARCIS (Netherlands)

    Prenger, Rilana; Pieterse, Marcel E.; Braakman-Jansen, Louise M. A.; Feenstra, Talitha L.; Smit, Eline S.; Hoving, Ciska; de Vries, Hein; van Ommeren, Jan-Kees; Evers, Silvia M. A. A.; van der Palen, Job

    Cost-effectiveness analyses (CEAs) of behavioral interventions typically use physical outcome criteria. However, any progress in cognitive antecedents of behavior change may be seen as a beneficial outcome of an intervention. The aim of this study is to explore the feasibility and validity of

  11. DEALING WITH MISSING BEHAVIORAL ENDPOINTS IN HEALTH PROMOTION RESEARCH BY MODELING COGNITIVE PARAMETERS IN COST-EFFECTIVENESS ANALYSES OF BEHAVIORAL INTERVENTIONS : A VALIDATION STUDY

    NARCIS (Netherlands)

    Prenger, Rilana; Pieterse, Marcel E; Braakman-Jansen, Louise M A; Feenstra, Talitha L; Smit, Eline S.; Hoving, Ciska; de Vries, Hein; van Ommeren, Jan-Kees; Evers, Silvia M A A; van der Palen, Job

    2014-01-01

    Cost-effectiveness analyses (CEAs) of behavioral interventions typically use physical outcome criteria. However, any progress in cognitive antecedents of behavior change may be seen as a beneficial outcome of an intervention. The aim of this study is to explore the feasibility and validity of

  12. Dealing with missing behavioral endpoints in health promotion research by modeling cognitive parameters in cost-effectiveness analyses of behavioral interventions: a validation study

    NARCIS (Netherlands)

    Prenger, R.; Pieterse, M.E.; Braakman-Jansen, L.M.A.; Feenstra, T.L.; Smit, E.S.; Hoving, C.; de Vries, H.; van Ommeren, J.K.; Evers, S.M.A.A.; van der Palen, J.

    2016-01-01

    Cost-effectiveness analyses (CEAs) of behavioral interventions typically use physical outcome criteria. However, any progress in cognitive antecedents of behavior change may be seen as a beneficial outcome of an intervention. The aim of this study is to explore the feasibility and validity of

  13. Why do some therapists not deal with outcome monitoring feedback? A feasibility study on the effect of regulatory focus and person–organization fit on attitude and outcome

    NARCIS (Netherlands)

    de Jong, Kim; de Goede, Marije

    2015-01-01

    Objective: Despite research on its effectiveness, many therapists still have negative attitudes toward using outcome monitoring feedback. The current study aims to investigate how the perceived match between values of an individual and those of the organization (Person–Organization fit; PO fit), and

  14. De novo adamantinomatous craniopharyngioma presenting anew in an elderly patient with previous normal CT and MRI studies: A case report and implications on pathogenesis

    Directory of Open Access Journals (Sweden)

    Amy Walker, B.S.

    2015-09-01

    Full Text Available Adamantinomatous craniopharyngiomas are histologically benign epithelial tumors which arise from embryonic remnants of the craniopharyngeal duct and Rathke’s pouch. They are thought to have a congenital origin and are histologically unique from papillary craniopharyngioma. We describe the case of an elderly male who presented with symptoms related to a large craniopharyngioma with previously normal brain magnetic resonance and computed tomography imaging studies. These findings dispute the embryogenic theory that craniopharyngiomas observed in adults develop from the persistent slow growth of embryonic remnants.

  15. Developing obesity prevention interventions among minority ethnic children in schools and places of worship: The DEAL (DiEt and Active Living) study.

    Science.gov (United States)

    Maynard, Maria J; Baker, Graham; Rawlins, Emma; Anderson, Annie; Harding, Seeromanie

    2009-12-21

    Childhood obesity is a major public health concern with serious implications for the sustainability of healthcare systems. Studies in the US and UK have shown that ethnicity is consistently associated with childhood obesity, with Black African origin girls in particular being more vulnerable to overweight and obesity than their White peers. Little is known, however, about what promotes or hinders engagement with prevention programmes among ethnic minority children. This paper describes the background and design of an exploratory study conducted in London, UK. The aim of the study was to assess the feasibility, efficacy and cultural acceptability of child- and family-based interventions to reduce risk factors for childhood and adolescent obesity among ethnic minorities. It investigated the use of a population approach (in schools) and a targeted approach (in places of worship). We used a mixture of focus group discussions, in-depth interviews and structured questionnaires to explore what children, parents, grandparents, teachers and religious leaders think hinder and promote engagement with healthy eating and active living choices. We assessed the cultural appropriateness of validated measures of physical activity, dietary behaviour and self efficacy, and of potential elements of interventions informed by the data collected. We are also currently assessing the potential for wider community support (local councils, community networks, faith forums etc) of the intervention. Analysis of the data is ongoing but the emergent findings suggest that while the school setting may be better for the main implementation of healthy lifestyle interventions, places of worship provide valuable opportunities for family and culturally specific support for implementation. Tackling the rise in childhood and adolescent obesity is a policy priority, as reflected in a range of government initiatives. The study will enhance such policy by developing the evidence base about culturally

  16. Developing obesity prevention interventions among minority ethnic children in schools and places of worship: The DEAL (DiEt and Active Living study

    Directory of Open Access Journals (Sweden)

    Anderson Annie

    2009-12-01

    Full Text Available Abstract Background Childhood obesity is a major public health concern with serious implications for the sustainability of healthcare systems. Studies in the US and UK have shown that ethnicity is consistently associated with childhood obesity, with Black African origin girls in particular being more vulnerable to overweight and obesity than their White peers. Little is known, however, about what promotes or hinders engagement with prevention programmes among ethnic minority children. Methods/Design This paper describes the background and design of an exploratory study conducted in London, UK. The aim of the study was to assess the feasibility, efficacy and cultural acceptability of child- and family-based interventions to reduce risk factors for childhood and adolescent obesity among ethnic minorities. It investigated the use of a population approach (in schools and a targeted approach (in places of worship. We used a mixture of focus group discussions, in-depth interviews and structured questionnaires to explore what children, parents, grandparents, teachers and religious leaders think hinder and promote engagement with healthy eating and active living choices. We assessed the cultural appropriateness of validated measures of physical activity, dietary behaviour and self efficacy, and of potential elements of interventions informed by the data collected. We are also currently assessing the potential for wider community support (local councils, community networks, faith forums etc of the intervention. Discussion Analysis of the data is ongoing but the emergent findings suggest that while the school setting may be better for the main implementation of healthy lifestyle interventions, places of worship provide valuable opportunities for family and culturally specific support for implementation. Tackling the rise in childhood and adolescent obesity is a policy priority, as reflected in a range of government initiatives. The study will enhance such

  17. Impact of Availability and Use of ART/PMTCT Services on Fertility Desires of Previously Pregnant Women in Rakai, Uganda: A Retrospective Cohort Study.

    Science.gov (United States)

    Litwin, Lindsay E; Makumbi, Frederick E; Gray, Ronald; Wawer, Maria; Kigozi, Godfrey; Kagaayi, Joseph; Nakigozi, Gertrude; Lutalo, Tom; Serwada, David; Brahmbhatt, Heena

    2015-07-01

    To assess fertility desires by availability and use of antiretroviral therapy and prevention of mother-to-child transmission (ART/PMTCT) services in Rakai, Uganda. Retrospective analyses of longitudinal data from the Rakai Community Cohort Study. Study participants were retrospectively identified and categorized by HIV status. Availability of ART/PMTCT services in Rakai was defined in three periods: (1) pre-ART/PMTCT (ART/PMTCT rollout (2005-2006), and (3) universal ART/PMTCT (>2006); and use of ART/PMTCT was coded as yes if the woman received services. Trends in fertility desires were assessed by χ. "Modified" Poisson regression was performed using generalized linear models with a log link and Poisson family to estimate prevalence rate ratios (PRRs) and 95% confidence intervals (CIs) of desire for another child among previously and currently pregnant women; PRRs were adjusted for demographic and behavioral factors. A total of 4227 sexually active women in Rakai, including 436 HIV+ women, contributed 13,970 observations over 5 survey rounds. Fertility desires increased in the population in the ART/PMTCT rollout [adjusted (adj.) PRR: 1.08, 95% CI: 1.04 to 1.13] and the universal availability periods (adj. PRR: 1.11, 95% CI: 1.08 to 1.14) compared with pre-ART/PMTCT period. A total of 862 woman observations used ART/PMTCT services. Fertility desires were similar among ART/PMTCT service users and nonusers in cross-sectional analysis (adj. PRR: 0.84, 95% CI: 0.62 to 1.14) and 1 year after ART/PMTCT use (adj. PRR: 1.27, 95% CI: 0.83 to 1.94). Availability of ART/PMTCT may increase fertility desires of previously pregnant women in Rakai, Uganda. Use of ART/PMTCT services was not correlated with fertility desires of previously or current pregnant women.

  18. Buying drugs on a Darknet market: A better deal? Studying the online illicit drug market through the analysis of digital, physical and chemical data.

    Science.gov (United States)

    Rhumorbarbe, Damien; Staehli, Ludovic; Broséus, Julian; Rossy, Quentin; Esseiva, Pierre

    2016-10-01

    Darknet markets, also known as cryptomarkets, are websites located on the Darknet and designed to allow the trafficking of illicit products, mainly drugs. This study aims at presenting the added value of combining digital, chemical and physical information to reconstruct sellers' activities. In particular, this research focuses on Evolution, one of the most popular cryptomarkets active from January 2014 to March 2015. Evolution source code files were analysed using Python scripts based on regular expressions to extract information about listings (i.e., sales proposals) and sellers. The results revealed more than 48,000 listings and around 2700 vendors claiming to send illicit drug products from 70 countries. The most frequent categories of illicit drugs offered by vendors were cannabis-related products (around 25%) followed by ecstasy (MDA, MDMA) and stimulants (cocaine, speed). The cryptomarket was then especially studied from a Swiss point of view. Illicit drugs were purchased from three sellers located in Switzerland. The purchases were carried out to confront digital information (e.g., the type of drug, the purity, the shipping country and the concealment methods mentioned on listings) with the physical analysis of the shipment packaging and the chemical analysis of the received product (purity, cutting agents, chemical profile based on minor and major alkaloids, chemical class). The results show that digital information, such as concealment methods and shipping country, seems accurate. But the illicit drugs purity is found to be different from the information indicated on their respective listings. Moreover, chemical profiling highlighted links between cocaine sold online and specimens seized in Western Switzerland. This study highlights that (1) the forensic analysis of the received products allows the evaluation of the accuracy of digital data collected on the website, and (2) the information from digital and physical/chemical traces are complementary to

  19. Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study.

    Science.gov (United States)

    Duncan, Edward A S; Colver, Keith; Dougall, Nadine; Swingler, Kevin; Stephenson, John; Abhyankar, Purva

    2014-02-22

    Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event. A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item's importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics. Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented. This study is the first to produce an expert consensus on the items and quantities of clinical equipment

  20. A Study on the Instructor Role in Dealing with Mixed Contents: How It Affects Learner Satisfaction and Retention in e-Learning

    Directory of Open Access Journals (Sweden)

    Seung Jae Lee

    2018-03-01

    Full Text Available The information and communication technology has become an indispensable part of modern education. The paradigm shift in the educational environment makes the instructors recollect the traditional roles in classroom education and adjust their responsibilities to accommodate a transformed pedagogy and learner expectations. This paper aims at the instructor’s role in on-line education and studies how the instructor affects the learner satisfaction via the instructor involvement. Modifying the information system success model, the learning-environment qualities are rearranged into two-tiered formats—rigid and flexible contents—depending on the instructor’s manageability. A partial least square analysis was used to examine the structural relationship among rigid and flexible contents qualities (i.e., technology-assisted learning-environment qualities, learner satisfaction, and learner retention, and found that the instructor involvement had a moderating effect on flexible contents qualities (test and activity; further, the moderating effect of instructor is captured as high involvement in tests and low involvement in activities. Consequently, this paper confirms the relationship between learning-environment qualities, learner satisfaction, and instructor involvement. Empirically, the instructor role in on-line education and the degree of instructor involvement in higher education are substantiated; the result of this study will also contribute to e-learning design or content delivery system development in a practical way.

  1. The Brazilian approach to dealing with problems associated to contaminated sites at conventional mining areas. A study case on the niobium industry

    International Nuclear Information System (INIS)

    Fernandes, H.M.; Pires do Rio, M.A.; Amaral, E.C.S.

    1996-01-01

    This work addresses the evaluation of the radiological environmental impacts associated to non-nuclear mining activities in Brazil. A study case on a niobium industry located at Minas Gerais State - south east region of the country - was carried out. It has been pointed out that the desliming, flotation and metallurgical operations were the main phases in radioactive wastes generation. However, the acid leaching of the ore removed large amounts of radionuclides from the host minerals (especially 226 Ra and 228 Ra) turning them out be in a more labile conditions and more available for remobilization processes. An estimated value of 0.26 mSv/y was obtained for the equivalent effective dose for an adult ingesting irrigated vegetables as a consequence of the radionuclides released with the liquid effluents. (author) 9 refs, 3 figs, 4 tabs

  2. Dealing with randomness and vagueness in business and management sciences: the fuzzy-probabilistic approach as a tool for the study of statistical relationships between imprecise variables

    Directory of Open Access Journals (Sweden)

    Fabrizio Maturo

    2016-06-01

    Full Text Available In practical applications relating to business and management sciences, there are many variables that, for their own nature, are better described by a pair of ordered values (i.e. financial data. By summarizing this measurement with a single value, there is a loss of information; thus, in these situations, data are better described by interval values rather than by single values. Interval arithmetic studies and analyzes this type of imprecision; however, if the intervals has no sharp boundaries, fuzzy set theory is the most suitable instrument. Moreover, fuzzy regression models are able to overcome some typical limitation of classical regression because they do not need the same strong assumptions. In this paper, we present a review of the main methods introduced in the literature on this topic and introduce some recent developments regarding the concept of randomness in fuzzy regression.

  3. Outcome of secondary high-grade glioma in children previously treated for a malignant condition: A study of the Canadian Pediatric Brain Tumour Consortium

    International Nuclear Information System (INIS)

    Carret, Anne-Sophie; Tabori, Uri; Crooks, Bruce; Hukin, Juliette; Odame, Isaac; Johnston, Donna L.; Keene, Daniel L.; Freeman, Carolyn; Bouffet, Eric

    2006-01-01

    Background and purpose: Reports of secondary high-grade glioma (HGG) in survivors of childhood cancer are scarce. The aim of this study was to review the pattern of diagnosis, the treatment, and outcome of secondary pediatric HGG. Patients and methods: We performed a multi-center retrospective study among the 17 paediatric institutions participating in the Canadian Pediatric Brain Tumour Consortium (CPBTC). Results: We report on 18 patients (14 males, 4 females) treated in childhood for a primary cancer, who subsequently developed a HGG as a second malignancy. All patients had previously received radiation therapy +/- chemotherapy for either acute lymphoblastic leukaemia (n = 9) or solid tumour (n = 9). All HGG occurred within the previous radiation fields. At the last follow-up, 17 patients have died and the median survival time is 9.75 months. Conclusion: Although aggressive treatment seems to provide sustained remissions in some patients, the optimal management is still to be defined. Further documentation of such cases is necessary in order to better understand the pathogenesis, the natural history and the prevention of these tumours

  4. Dealing with Difference: Building Culturally Responsive Classrooms

    Directory of Open Access Journals (Sweden)

    Nina Burridge

    2009-11-01

    Full Text Available Australia continues to develop as a multicultural society with levels of immigration increasing significantly over recent years as a result of government policies. More recently, the new period of financial turmoil, continuing threats from terrorism and environmental concerns, have all exacerbated the challenges of dealing with difference in our society. In response, schools continue to face the challenges of the impact of a range of different cultures, languages and religions among their student and school communities. How effectively schools deal with difference and how well they are supported in their endeavours to build culturally response classrooms is a perennial issue for both teachers and educators. A major challenge for teachers is to at a minimum, understand cultural differences as they manifest in their particular school settings and to draw on approaches that support student learning in culturally appropriate ways so to assist them to better realise their full potential. In this paper we will consider cultural diversity in the context of recent school policies, highlight a number of frameworks for addressing cultural diversity in the classroom, in particular the approaches by Kalantzis and Cope’s (1999 and Hickling-Hudson (2003. We also draw on the findings from a recent qualitative study of representations of cultural diversity in a number of Sydney metropolitan schools to discuss the need for more greater resource and policy support for progressive teaching approaches that support the development of a more tolerant and inclusive multicultural society. Key words: cultural diversity, schools, teacher education, classroom practice, social inclusion

  5. The handbook of dealing with workplace bullying

    CERN Document Server

    2015-01-01

    The topic of workplace bullying and abuse gained considerable public and media attention during 2013 when the scandal of events at the BBC was unveiled following an enquiry led by Dinah Rose QC. The Handbook of Dealing with Workplace Bullying, edited by Dr Anne-Marie Quigg, presents the collective wisdom and knowledge of a number of lawyers, management experts and academics from around the world. The key themes include understanding the law in each country represented and the responsibilities of individuals as well as management teams and governors in organizations. New case studies are supplied by people working with and within HR teams who have professional experience of dealing with the issue, as well as practical suggestions that are of use to managers, to people accused of bullying and also to people who find they are targets of bullying. Dr Quigg summarizes the range and scope of the contributions by the individual contributors, commenting on the research findings and professional experience that inform...

  6. Vitamin D deficiency in medical patients at a central hospital in Malawi: a comparison with TB patients from a previous study.

    Directory of Open Access Journals (Sweden)

    Yamikani Mastala

    Full Text Available OBJECTIVES: To determine the prevalence of vitamin D deficiency (VDD in adult medical, non-tuberculous (non-TB patients. To investigate associations with VDD. To compare the results with a similar study in TB patients at the same hospital. DESIGN: Cross-sectional sample. SETTING: Central hospital in Malawi. PARTICIPANTS: Adult non-TB patients (n = 157, inpatients and outpatients. OUTCOME MEASURES: The primary outcome was the prevalence of VDD. Potentially causal associations sought included nutritional status, in/outpatient status, HIV status, anti-retroviral therapy (ART and, by comparison with a previous study, a diagnosis of tuberculosis (TB. RESULTS: Hypovitaminosis D (≤75 nmol/L occurred in 47.8% (75/157 of patients, 16.6% (26/157 of whom had VDD (≤50 nmol/L. None had severe VDD (≤25 nmol/L. VDD was found in 22.8% (23/101 of in-patients and 5.4% (3/56 of out-patients. In univariable analysis in-patient status, ART use and low dietary vitamin D were significant predictors of VDD. VDD was less prevalent than in previously studied TB patients in the same hospital (68/161 = 42%. In multivariate analysis of the combined data set from both studies, having TB (OR 3.61, 95%CI 2.02-6.43 and being an in-patient (OR 2.70, 95%CI 1.46-5.01 were significant independent predictors of VDD. CONCLUSIONS: About half of adult medical patients without TB have suboptimal vitamin D status, which is more common in in-patients. VDD is much more common in TB patients than non-TB patients, even when other variables are controlled for, suggesting that vitamin D deficiency is associated with TB.

  7. Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

    Science.gov (United States)

    Fernando, Malindu Eranga; Crowther, Robert George; Pappas, Elise; Lazzarini, Peter Anthony; Cunningham, Margaret; Sangla, Kunwarjit Singh; Buttner, Petra; Golledge, Jonathan

    2014-01-01

    Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290-0.811, pdiabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.

  8. Phase II study of a 3-day schedule with topotecan and cisplatin in patients with previously untreated small cell lung cancer and extensive disease

    DEFF Research Database (Denmark)

    Sorensen, M.; Lassen, Ulrik Niels; Jensen, Peter Buhl

    2008-01-01

    INTRODUCTION: Treatment with a topoisomerase I inhibitor in combination with a platinum results in superior or equal survival compared with etoposide-based treatment in extensive disease small cell lung cancer (SCLC). Five-day topotecan is inconvenient and therefore shorter schedules of topotecan...... and cisplatin are needed. The aim of this phase II study was to establish the response rate and response duration in chemo-naive patients with SCLC receiving a 3-day topotecan and cisplatin schedule. METHODS: Simons optimal two-stage design was used. Patients with previously untreated extensive disease SCLC...... age was 59 (range 44-74), 79% had performance status 0 or 1. Thirty-one patients completed all six cycles. Grade 3/4 anemia, neutrocytopenia, and thrombocytopenia were recorded in 9.5%, 66.7%, and 21.4% of patients, respectively. Fourteen percent of patients experienced neutropenic fever. No episodes...

  9. Evaluating big deal journal bundles.

    Science.gov (United States)

    Bergstrom, Theodore C; Courant, Paul N; McAfee, R Preston; Williams, Michael A

    2014-07-01

    Large commercial publishers sell bundled online subscriptions to their entire list of academic journals at prices significantly lower than the sum of their á la carte prices. Bundle prices differ drastically between institutions, but they are not publicly posted. The data that we have collected enable us to compare the bundle prices charged by commercial publishers with those of nonprofit societies and to examine the types of price discrimination practiced by commercial and nonprofit journal publishers. This information is of interest to economists who study monopolist pricing, librarians interested in making efficient use of library budgets, and scholars who are interested in the availability of the work that they publish.

  10. Clarification of the confusion concerning the crystal-field quantities vs the zero-field splitting quantities in magnetism studies: Part II-Survey of literature dealing with model studies of spin systems

    International Nuclear Information System (INIS)

    Rudowicz, C.

    2008-01-01

    For respective quantities, i.e., Hamiltonians, parameters, and energy level splittings, related to two physically distinct notions X and Y, various cases of confused terminology have been identified in literature. Referring to a quantity related actually to the notion Y using incorrectly the name of another well-defined notion X constitutes, what may be defined for short as, the type X=Y confusion. An ongoing survey of magnetism literature indicates that quantities related to zero-field splitting (ZFS) or equivalently fine structure (FS) are most often confused with those related to crystal-field (CF) or equivalently ligand field (LF). In this review the CF=ZFS confusion cases, i.e., labelling actual ZFS/FS quantities as purportedly 'CF/LF' ones, appearing in magnetism studies are surveyed and clarified. Part I covers the cases occurring in literature dealing with specific compounds. In this part model studies of spin systems are surveyed. The cases of terminology mixing up actual ZFS/FS quantities with purported CF/LF ones are identified and presented comprehensively in tabular form. To facilitate discussion, problems pertinent for the CF=ZFS confusion are categorized into several groups, including origin of the two notions, physical consequences, usage of specific numerical values, invoking real magnetic spin systems, and properties of spin S=1/2 systems. Physical implications of this confusion for interpretation of model results are also considered. Overall implications of incorrect terminology go beyond simple semantic issues and concern possible misinterpretation of data describing various physical properties of models studied. Such terminology contributes also to misleading keyword classifications of papers in journals and scientific databases. Other types of confusion identified in survey of magnetism literature will be discussed in separate reviews

  11. EXPERIMENTAL CHALLENGE STUDY OF FV3-LIKE RANAVIRUS INFECTION IN PREVIOUSLY FV3-LIKE RANAVIRUS INFECTED EASTERN BOX TURTLES (TERRAPENE CAROLINA CAROLINA) TO ASSESS INFECTION AND SURVIVAL.

    Science.gov (United States)

    Hausmann, Jennifer C; Wack, Allison N; Allender, Matthew C; Cranfield, Mike R; Murphy, Kevin J; Barrett, Kevin; Romero, Jennell L; Wellehan, James F X; Blum, Stella A; Zink, M Christine; Bronson, Ellen

    2015-12-01

    The Maryland Zoo in Baltimore experienced an outbreak of Frog virus-3 (FV3)-like ranavirus during the summer of 2011, during which 14 of 27 (52%) of its captive eastern box turtles (Terrapene carolina carolina) survived. To assess survival, immunity, and viral shedding, an experimental challenge study was performed in which the surviving, previously infected turtles were reinfected with the outbreak strain of FV3-like ranavirus. Seven turtles were inoculated with virus intramuscularly and four control turtles received saline intramuscularly. The turtles were monitored for 8 wk with blood and oral swabs collected for quantitative polymerase chain reaction (qPCR). During that time, one of seven (14%) inoculated turtles and none of the controls (0%) died; there was no significant difference in survival. Clinical signs of the inoculated turtles, except for the turtle that died, were mild compared to the original outbreak. Quantitative PCR for FV3-like ranavirus on blood and oral swabs was positive for all inoculated turtles and negative for all controls. The turtle that died had intracytoplasmic inclusion bodies in multiple organs. Three inoculated and two control turtles were euthanized at the end of the study. No inclusion bodies were present in any of the organs. Quantitative PCR detected FV3-like ranavirus in the spleen of a control turtle, which suggested persistence of the virus. The surviving five turtles were qPCR-negative for FV3-like ranavirus from blood and oral swabs after brumation. Quantitative PCR for Terrapene herpesvirus 1 found no association between ranavirus infection and herpesvirus loads. In conclusion, previously infected eastern box turtles can be reinfected with the same strain of FV3-like ranavirus and show mild to no clinical signs but can shed the virus from the oral cavity.

  12. Trial of labour and vaginal birth after previous caesarean section: A population based study of Eastern African immigrants in Victoria, Australia.

    Science.gov (United States)

    Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

    2017-03-01

    Variations in caesarean section (CS) between some immigrant groups and receiving country populations have been widely reported. Often, African immigrant women are at higher risk of CS than the receiving population in developed countries. However, evidence about subsequent mode of birth following CS for African women post-migration is lacking. The objective of this study was to examine differences in attempted and successful vaginal birth after previous caesarean (VBAC) for Eastern African immigrants (Eritrea, Ethiopia, Somalia and Sudan) compared with Australian-born women. A population-based observational study was conducted using the Victorian Perinatal Data Collection. Pearson's chi-square test and logistic regression analysis were performed to generate adjusted odds ratios for attempted and successful VBAC. Victoria, Australia. 554 Eastern African immigrants and 24,587 Australian-born eligible women with previous CS having singleton births in public care. 41.5% of Eastern African immigrant women and 26.1% Australian-born women attempted a VBAC with 50.9% of Eastern African immigrants and 60.5% of Australian-born women being successful. After adjusting for maternal demographic characteristics and available clinical confounding factors, Eastern African immigrants were more likely to attempt (OR adj 1.94, 95% CI 1.57-2.47) but less likely to succeed (OR adj 0.54 95% CI 0.41-0.71) in having a VBAC. There are disparities in attempted and successful VBAC between Eastern African origin and Australian-born women. Unsuccessful VBAC attempt is more common among Eastern African immigrants, suggesting the need for improved strategies to select and support potential candidates for vaginal birth among these immigrants to enhance success and reduce potential complications associated with failed VBAC attempt. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  13. Power Deals. Mergers and acquisitions activity within the global electricity and gas market. 2007 Annual Review

    International Nuclear Information System (INIS)

    2007-01-01

    The year 2007 saw a continued remarkable expansion in the total number and value of deals in the power utilities sector (electricity and gas) worldwide. A 25% increase put the total power deal value of USD 372.5bn nearly nine times above the US$43bn recorded just four years earlier in 2003. Records continue to be set in the sector for the total number and value of deals and for the size of individual deals. There was little sign of the sector pausing for breath in 2007. There were fewer mega-deals, reflecting the complexity of getting really huge deals over the political and regulatory hurdles, but this was more than compensated by a rise in mid-size deal numbers. There was no clear evidence of a fall-off in deal activity in the second half of the year as the credit crisis broke. Indeed, 57% of all power sector deals, 441 of the total 768 deals, came in the second half. Strong deal momentum characterised all the major markets and, with the restructuring of the Russian electricity sector, 2007 marked the year when deals in the Russian Federation made a significant impact on the worldwide totals. Thus, for the first time, Power Deals 2007 includes a specific section on the Russian deals and we separate them out from the wider Asia Pacific totals where they featured in previous editions

  14. Power Deals. Mergers and acquisitions activity within the global electricity and gas market. 2007 Annual Review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-01-15

    The year 2007 saw a continued remarkable expansion in the total number and value of deals in the power utilities sector (electricity and gas) worldwide. A 25% increase put the total power deal value of USD 372.5bn nearly nine times above the US$43bn recorded just four years earlier in 2003. Records continue to be set in the sector for the total number and value of deals and for the size of individual deals. There was little sign of the sector pausing for breath in 2007. There were fewer mega-deals, reflecting the complexity of getting really huge deals over the political and regulatory hurdles, but this was more than compensated by a rise in mid-size deal numbers. There was no clear evidence of a fall-off in deal activity in the second half of the year as the credit crisis broke. Indeed, 57% of all power sector deals, 441 of the total 768 deals, came in the second half. Strong deal momentum characterised all the major markets and, with the restructuring of the Russian electricity sector, 2007 marked the year when deals in the Russian Federation made a significant impact on the worldwide totals. Thus, for the first time, Power Deals 2007 includes a specific section on the Russian deals and we separate them out from the wider Asia Pacific totals where they featured in previous editions.

  15. Biomarker-driven trial in metastatic pancreas cancer: feasibility in a multicenter study of saracatinib, an oral Src inhibitor, in previously treated pancreatic cancer

    International Nuclear Information System (INIS)

    Arcaroli, John; Quackenbush, Kevin; Dasari, Arvind; Powell, Rebecca; McManus, Martine; Tan, Aik-Choon; Foster, Nathan R; Picus, Joel; Wright, John; Nallapareddy, Sujatha; Erlichman, Charles; Hidalgo, Manuel; Messersmith, Wells A

    2012-01-01

    Src tyrosine kinases are overexpressed in pancreatic cancers, and the oral Src inhibitor saracatinib has shown antitumor activity in preclinical models of pancreas cancer. We performed a CTEP-sponsored Phase II clinical trial of saracatinib in previously treated pancreas cancer patients, with a primary endpoint of 6-month survival. A Simon MinMax two-stage phase II design was used. Saracatinib (175 mg/day) was administered orally continuously in 28-day cycles. In the unselected portion of the study, 18 patients were evaluable. Only two (11%) patients survived for at least 6 months, and three 6-month survivors were required to move to second stage of study as originally designed. The study was amended as a biomarker-driven trial (leucine rich repeat containing protein 19 [LRRC19] > insulin-like growth factor-binding protein 2 [IGFBP2] “top scoring pairs” polymerase chain reaction [PCR] assay, and PIK3CA mutant) based on preclinical data in a human pancreas tumor explant model. In the biomarker study, archival tumor tissue or fresh tumor biopsies were tested. Biomarker-positive patients were eligible for the study. Only one patient was PIK3CA mutant in a 3′ untranslated region (UTR) portion of the gene. This patient was enrolled in the study and failed to meet the 6-month survival endpoint. As the frequency of biomarker-positive patients was very low (<3%), the study was closed. Although we were unable to conclude whether enriching for a subset of second/third line pancreatic cancer patients treated with a Src inhibitor based on a biomarker would improve 6-month survival, we demonstrate that testing pancreatic tumor samples for a biomarker-driven, multicenter study in metastatic pancreas cancer is feasible

  16. Deal or No Deal: using games to improve student learning, retention and decision-making

    Science.gov (United States)

    Chow, Alan F.; Woodford, Kelly C.; Maes, Jeanne

    2011-03-01

    Student understanding and retention can be enhanced and improved by providing alternative learning activities and environments. Education theory recognizes the value of incorporating alternative activities (games, exercises and simulations) to stimulate student interest in the educational environment, enhance transfer of knowledge and improve learned retention with meaningful repetition. In this case study, we investigate using an online version of the television game show, 'Deal or No Deal', to enhance student understanding and retention by playing the game to learn expected value in an introductory statistics course, and to foster development of critical thinking skills necessary to succeed in the modern business environment. Enhancing the thinking process of problem solving using repetitive games should also improve a student's ability to follow non-mathematical problem-solving processes, which should improve the overall ability to process information and make logical decisions. Learning and retention are measured to evaluate the success of the students' performance.

  17. Dealing with ADHD: What You Need to Know

    Science.gov (United States)

    ... Consumers Home For Consumers Consumer Updates Dealing with ADHD: What You Need to Know Share Tweet Linkedin ... symptoms of both inattention and hyperactivity-impulsivity) Diagnosing ADHD Studies show that the number of children being ...

  18. Structural design of DEALS magnet

    International Nuclear Information System (INIS)

    Bezler, P.; Hsieh, S.Y.; Balderes, T.; Brown, T.; Bundy, J.

    1979-01-01

    A design for the extraneous magnet structure to support all the magnet loads was developed. The structure consists of two demountable structural systems designed to support the in-plane and out-of-plane loads, respectively. The in-plane loads are resisted by a cold central bucking cylinder and pin connected, plate-beam structural members following the outer periphery of each coil. The out-of-plane, torsional loads are resisted by the concerted action of the central bucking column and a continuous plate structure interconnecting all the coils. The adequacy of the structures were assessed by application of finite element analysis methods. The design study proved the feasibility of resisting the magnetic loadings with a demountable support structure extraneous to the superconducting coil. The resulting magnet system, although estimated to be higher in cost than a continuous coil, incorporates a means for complete coil replacement in a time scale commensurate with conventional nuclear power plant repairs and without the dismantling of the toroidal blanket and plasma shell systems

  19. Women's decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study.

    Science.gov (United States)

    Chen, Shu-Wen; Hutchinson, Alison M; Nagle, Cate; Bucknall, Tracey K

    2018-01-17

    Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women's decision-making processes and the influences on their mode of birth following a previous CS. A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks' gestation. Stage II involved interviews with pregnant women at 35-37 weeks' gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis. Ensuring the safety of mother and baby was the focus of women's decisions. Women's decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians' recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians' professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions. The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women's interactions with obstetricians regarding birth choices

  20. Shady Car Dealings and Taxing Work Practices

    DEFF Research Database (Denmark)

    Boll, Karen

    2014-01-01

    of the oligopticon and on Foucault’s notion of the panopticon. The analysis shows that tax inspectors produce oligoptic and panoptic visions when they account for taxpayers’ economic activities and that tax inspectors’ visions are received differently by the represented taxpayers. Some taxpayers fall out of sight......, whereas others are highly visible and are interrogated in detail. Using the concepts of the oligopticon and the panopticon to analyse the tax audit process is significant for interpretative tax and accounting studies, because this theoretical approach represents an original method of conceptualising......The empirical focus of this article is a ten-month ethnography of a tax audit process led by the Danish Tax and Customs Administration. The tax audit concerns a number of shady car dealings from which taxable income is not reported. This article focuses on the process whereby the tax administration...

  1. Dealing with Human Death: The Floating Perspective.

    Science.gov (United States)

    Kenyon, Gary M.

    1991-01-01

    Explores approach to dealing with human death. Describes floating perspective, based on insights from Choron and Jaspers, as suggesting it is possible to deal with human death by refraining from taking ultimate position on the problem. Position encourages openness to death. Examines role of anxiety and describes possible meaningful outcomes of…

  2. Four Forensic Entomology Case Studies: Records and Behavioral Observations on Seldom Reported Cadaver Fauna With Notes on Relevant Previous Occurrences and Ecology.

    Science.gov (United States)

    Lindgren, Natalie K; Sisson, Melissa S; Archambeault, Alan D; Rahlwes, Brent C; Willett, James R; Bucheli, Sibyl R

    2015-03-01

    A yearlong survey of insect taxa associated with human decomposition was conducted at the Southeast Texas Applied Forensic Science (STAFS) facility located in the Center for Biological Field Studies of Sam Houston State University in Huntsville, TX. During this study, four insect-cadaver interactions were observed that represent previously poorly documented yet forensically significant interactions: Syrphidae maggots colonized a corpse in an aquatic situation; Psychodidae adults mated and oviposited on an algal film that was present on a corpse that had been recently removed from water; several Panorpidae were the first insects to feed upon a freshly placed corpse in the autumn; and a noctuid caterpillar was found chewing and ingesting dried human skin. Baseline knowledge of insect-cadaver interactions is the foundation of forensic entomology, and unique observations have the potential to expand our understanding of decomposition ecology. © The Author 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Late tamoxifen in patients previously operated for breast cancer without postoperative tamoxifen: 5-year results of a single institution randomised study

    International Nuclear Information System (INIS)

    Veronesi, Andrea; Miolo, GianMaria; Magri, Maria D; Crivellari, Diana; Scalone, Simona; Bidoli, Ettore; Lombardi, Davide

    2010-01-01

    A population of breast cancer patients exists who, for various reasons, never received adjuvant post-operative tamoxifen (TAM). This study was aimed to evaluate the role of late TAM in these patients. From 1997 to 2003, patients aged 35 to 75 years, operated more than 2 years previously for monolateral breast cancer without adjuvant TAM, with no signs of metastases and no contraindication to TAM were randomized to TAM 20 mg/day orally for 2 years or follow-up alone. Events were categorized as locoregional relapse, distant metastases, metachronous breast cancer, tumours other than breast cancer and death from any causes, whichever occurred first. The sample size (197 patients per arm, plus 10% allowance) was based on the assumption of a 30% decrease in the number of events occurring at a rate of 5% annually in the 10 years following randomization. Four hundred and thirty-three patients were randomized in the study (TAM 217, follow-up 216). Patients characteristics (TAM/follow-up) included: median age 55/55 years, median time from surgery 25/25 months (range, 25-288/25-294), in situ carcinoma 18/24, oestrogen receptor (ER) positive in 75/68, negative in 70/57, unknown in 72/91 patients. Previous adjuvant treatment included chemotherapy in 131/120 and an LHRH analogue in 11/13 patients. Thirty-six patients prematurely discontinued TAM after a median of 1 month, mostly because of subjective intolerance. Eighty-three events (TAM 39, follow-up 44) occurred: locoregional relapse in 10/8, distant metastases in 14/16, metachronous breast cancer in 4/10, other tumours in 11/10 patients. Less ER-positive secondary breast cancers occurred in the TAM treated patients than in follow-up patients (1 vs 10, p = 0.005). Event-free survival was similar in both groups of patients. This 5-year analysis revealed significantly less metachronous ER-positive breast cancers in the TAM treated patients. No other statistically significant differences have emerged thus far

  4. Dipeptidyl Peptidase-4 Inhibitor Sitagliptin Prevented Weight Regain in Obese Women with Polycystic Ovary Syndrome Previously Treated with Liraglutide: A Pilot Randomized Study.

    Science.gov (United States)

    Ferjan, Simona; Janez, Andrej; Jensterle, Mojca

    2017-12-01

    Weight loss is often nonsustainable after liraglutide cessation. The present study is the first insight into the potential prevention of weight regain in obese subjects who have been withdrawn from liraglutide. We evaluated whether dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin in adjunct to metformin prevents body weight regain more effectively than metformin alone in obese polycystic ovary syndrome (PCOS) previously treated with liraglutide. A 12-week prospective randomized open-label study was conducted with 24 obese women with PCOS who had been pretreated with liraglutide 3.0 mg due to antiobesity management (aged 34.3 ± 6.8 years, body mass index [BMI] 36.3 ± 5.2 kg/m 2 , mean ± standard deviation). They were randomized to combined treatment (COMBO) with sitagliptin 100 mg per day (QD) and metformin (MET) 1000 mg twice daily (BID) (n = 12) or MET 1000 mg BID (n = 12). Lifestyle intervention was promoted in both groups. The primary outcome was change in anthropometric measures of obesity. Women treated with MET regain 4.7 ± 2.7 kg (P = 0.002) compared with a 0.9 ± 2.5 kg in COMBO (P = 0.147). BMI increased for 1.7 ± 0.9 kg/m 2 in MET (P = 0.002) compared with 0.3 ± 0.8 kg/m 2 increase in COMBO (P = 0.136). MET group regain 4.5% ± 2.5% of body weight as opposed to 0.8% ± 2.6% in COMBO. The between-treatment differences were significant for weight change (P weight change (P weight regain in obese women with PCOS previously treated with liraglutide.

  5. Power Deals. Mergers and acquisitions activity within the global electricity and gas market. 2008 Annual Review

    International Nuclear Information System (INIS)

    2009-01-01

    2008 was the year in which power deal values came down from their record-breaking highs of the two preceding years as the financial crisis and a number of market uncertainties had a negative impact on deal activity. Nonetheless, total deal numbers leapt by 24% as companies concentrated on smaller deals and took advantage of new opportunities that arose in the changed market conditions. Europe was least affected by the downturn in deal values and accounted for over half of all bidder and target power deal value. In contrast, power deals in Australia, which had previously been a main motor of growing M and A activity in the Asia Pacific region, virtually stalled as uncertainty over new carbon emission policies combined with the financial crisis to deter deal flow. In North America, like Europe, big deals were fewer but underlying deal activity was comparable with previous years. This report examines the rationale behind the overall trends and the key individual deals. We also highlight, in a series of deal dialogues throughout the report, some of the critical issues for companies engaging in deal activity within the sector, drawing on our global experience as an adviser to players in major deals throughout the sector in all key electricity and gas utilities markets. Looking to the future, the easing of the financial crisis will be key to deal flow but the near-term outlook looks less robust than the recent past, especially as debt markets will be further constrained by calls from the public financing required to support government bail-out programmes. Set against this, the underlying imperatives of consolidation, supply security and capitalisation remain in place and will create increasing pent-up deal demand. A lower energy price environment will change the metrics for more expensive cleaner power assets, placing an even higher importance on the outcome of global climate talks and the run-up to the December 2009 UN Climate Summit in Copenhagen

  6. Power Deals. Mergers and acquisitions activity within the global electricity and gas market. 2008 Annual Review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-01-15

    2008 was the year in which power deal values came down from their record-breaking highs of the two preceding years as the financial crisis and a number of market uncertainties had a negative impact on deal activity. Nonetheless, total deal numbers leapt by 24% as companies concentrated on smaller deals and took advantage of new opportunities that arose in the changed market conditions. Europe was least affected by the downturn in deal values and accounted for over half of all bidder and target power deal value. In contrast, power deals in Australia, which had previously been a main motor of growing M and A activity in the Asia Pacific region, virtually stalled as uncertainty over new carbon emission policies combined with the financial crisis to deter deal flow. In North America, like Europe, big deals were fewer but underlying deal activity was comparable with previous years. This report examines the rationale behind the overall trends and the key individual deals. We also highlight, in a series of deal dialogues throughout the report, some of the critical issues for companies engaging in deal activity within the sector, drawing on our global experience as an adviser to players in major deals throughout the sector in all key electricity and gas utilities markets. Looking to the future, the easing of the financial crisis will be key to deal flow but the near-term outlook looks less robust than the recent past, especially as debt markets will be further constrained by calls from the public financing required to support government bail-out programmes. Set against this, the underlying imperatives of consolidation, supply security and capitalisation remain in place and will create increasing pent-up deal demand. A lower energy price environment will change the metrics for more expensive cleaner power assets, placing an even higher importance on the outcome of global climate talks and the run-up to the December 2009 UN Climate Summit in Copenhagen.

  7. In vitro evaluation of oestrogenic/androgenic activity of the serum organochlorine pesticide mixtures previously described in a breast cancer case–control study

    International Nuclear Information System (INIS)

    Rivero, Javier; Luzardo, Octavio P.; Henríquez-Hernández, Luis A.; Machín, Rubén P.; Pestano, José; Zumbado, Manuel; Boada, Luis D.; Camacho, María; Valerón, Pilar F.

    2015-01-01

    Some organochlorine pesticides (OCs) have been individually linked to breast cancer (BC) because they exert oestrogenic effects on mammary cells. However, humans are environmentally exposed to more or less complex mixtures of these organochlorines, and the biological effects of these mixtures must be elucidated. In this work we evaluated the in vitro effects exerted on human BC cells by the OC mixtures that were most frequently detected in two groups of women who participated in a BC case–control study developed in Spain: healthy women and women diagnosed with BC. The cytotoxicity, oestrogenicity, and androgenicity of the most prevalent OC mixtures found in healthy women (H-mixture) and in BC patients (BC-mixture) were tested at concentrations that resembled those found in the serum of the evaluated women. Our results showed that both OC mixtures presented a similar oestrogenic activity and effect on cell viability, but BC-mixture showed an additional anti-androgenic effect. These results indicate that although the proliferative effect exerted by these mixtures on human breast cells seems to depend mainly on their oestrogenic action, the BC-mixture might additionally induce cell proliferation due to its anti-androgenic activity, therefore increasing the carcinogenic potential of this mixture. The findings of this study demonstrate that subtle variations in the composition of a mixture may induce relevant changes in its biological action. - Highlights: • E-screen and A-screen of two mixtures of organochlorine pesticides (OCP) • Assay concentrations based on a previous breast cancer case–control study • Only non-cytotoxic concentrations assayed • Both OCP mixtures induce proliferation mediated by oestrogen receptor. • OCP mixture of breast cancer patients exhibits additional androgenic activity.

  8. In vitro evaluation of oestrogenic/androgenic activity of the serum organochlorine pesticide mixtures previously described in a breast cancer case–control study

    Energy Technology Data Exchange (ETDEWEB)

    Rivero, Javier; Luzardo, Octavio P., E-mail: octavio.perez@ulpgc.es; Henríquez-Hernández, Luis A.; Machín, Rubén P.; Pestano, José; Zumbado, Manuel; Boada, Luis D.; Camacho, María; Valerón, Pilar F.

    2015-12-15

    Some organochlorine pesticides (OCs) have been individually linked to breast cancer (BC) because they exert oestrogenic effects on mammary cells. However, humans are environmentally exposed to more or less complex mixtures of these organochlorines, and the biological effects of these mixtures must be elucidated. In this work we evaluated the in vitro effects exerted on human BC cells by the OC mixtures that were most frequently detected in two groups of women who participated in a BC case–control study developed in Spain: healthy women and women diagnosed with BC. The cytotoxicity, oestrogenicity, and androgenicity of the most prevalent OC mixtures found in healthy women (H-mixture) and in BC patients (BC-mixture) were tested at concentrations that resembled those found in the serum of the evaluated women. Our results showed that both OC mixtures presented a similar oestrogenic activity and effect on cell viability, but BC-mixture showed an additional anti-androgenic effect. These results indicate that although the proliferative effect exerted by these mixtures on human breast cells seems to depend mainly on their oestrogenic action, the BC-mixture might additionally induce cell proliferation due to its anti-androgenic activity, therefore increasing the carcinogenic potential of this mixture. The findings of this study demonstrate that subtle variations in the composition of a mixture may induce relevant changes in its biological action. - Highlights: • E-screen and A-screen of two mixtures of organochlorine pesticides (OCP) • Assay concentrations based on a previous breast cancer case–control study • Only non-cytotoxic concentrations assayed • Both OCP mixtures induce proliferation mediated by oestrogen receptor. • OCP mixture of breast cancer patients exhibits additional androgenic activity.

  9. Evaluation of the Widal tube agglutination test for the diagnosis of typhoid fever among children admitted to a rural hdospital in Tanzania and a comparison with previous studies

    Directory of Open Access Journals (Sweden)

    Malahiyo Rajabu

    2010-06-01

    Full Text Available Abstract Background The diagnosis of typhoid fever is confirmed by culture of Salmonella enterica serotype Typhi (S. typhi. However, a more rapid, simpler, and cheaper diagnostic method would be very useful especially in developing countries. The Widal test is widely used in Africa but little information exists about its reliability. Methods We assessed the performance of the Widal tube agglutination test among febrile hospitalized Tanzanian children. We calculated the sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of various anti-TH and -TO titers using culture-confirmed typhoid fever cases as the "true positives" and all other febrile children with blood culture negative for S. typhi as the "true negatives." Results We found that 16 (1% of 1,680 children had culture-proven typhoid fever. A single anti-TH titer of 1:80 and higher was the optimal indicator of typhoid fever. This had a sensitivity of 75%, specificity of 98%, NPV of 100%, but PPV was only 26%. We compared our main findings with those from previous studies. Conclusion Among febrile hospitalized Tanzanian children with a low prevalence of typhoid fever, a Widal titer of ≥ 1:80 performed well in terms of sensitivity, specificity, and NPV. However a test with improved PPV that is similarly easy to apply and cost-efficient is desirable.

  10. Caring for women wanting a vaginal birth after previous caesarean section: A qualitative study of the experiences of midwives and obstetricians.

    Science.gov (United States)

    Foureur, Maralyn; Turkmani, Sabera; Clack, Danielle C; Davis, Deborah L; Mollart, Lyndall; Leiser, Bernadette; Homer, Caroline S E

    2017-02-01

    One of the greatest contributors to the overall caesarean section rate is elective repeat caesarean section. Decisions around mode of birth are often complex for women and influenced by the views of the doctors and midwives who care for and counsel women. Women may be more likely to choose a repeat elective caesarean section (CS) if their health care providers lack skills and confidence in supporting vaginal birth after caesarean section (VBAC). To explore the views and experiences of providers in caring for women considering VBAC, in particular the decision-making processes and the communication of risk and safety to women. A descriptive interpretive method was utilised. Four focus groups with doctors and midwives were conducted. The central themes were: 'developing trust', 'navigating the system' and 'optimising support'. The impact of past professional experiences; the critical importance of continuity of carer and positive relationships; the ability to weigh up risks versus benefits; and the language used were all important elements. The role of policy and guidelines on providing standardised care for women who had a previous CS was also highlighted. Midwives and doctors in this study were positively oriented towards assisting and supporting women to attempt a VBAC. Care providers considered that women who have experienced a prior CS need access to midwifery continuity of care with a focus on support, information-sharing and effective communication. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  11. Gefitinib plus cisplatin and radiotherapy in previously untreated head and neck squamous cell carcinoma: A phase II, randomized, double-blind, placebo-controlled study

    International Nuclear Information System (INIS)

    Gregoire, Vincent; Hamoir, Marc; Chen Changhu; Kane, Madeleine; Kawecki, Andrzej; Julka, Pramod K.; Wang, Hung-Ming; Prasad, Srihari; D'Cruz, Anil K.; Radosevic-Jelic, Ljiljana; Kumar, Rejnish R.; Korzeniowski, Stanislaw; Fijuth, Jacek; Machiels, Jean-Pascal; Sellers, Mark V.; Tchakov, Ilian; Raben, David

    2011-01-01

    Background and purpose: To assess the efficacy and safety of gefitinib given concomitantly and/or as maintenance therapy to standard cisplatin/radiotherapy for previously untreated, unresected, stage III/IV non-metastatic SCCHN. Materials and methods: In this phase II, double-blind, study, 226 patients were randomized to gefitinib 250 mg/day, 500 mg/day or placebo in two phases: a concomitant phase (gefitinib or placebo with chemoradiotherapy), followed by a maintenance phase (gefitinib or placebo alone). Primary endpoint was local disease control rate (LDCR) at 2 years; secondary endpoints were LDCR at 1 year, objective response rate, progression-free survival, overall survival, and safety and tolerability. Results: Gefitinib (250 and 500 mg/day) did not improve 2-year LDCR compared with placebo either when given concomitantly with chemoradiotherapy (32.7% vs. 33.6%, respectively; OR 0.921, 95% CI 0.508, 1.670 [1-sided p = 0.607]) or as maintenance therapy (28.8% vs. 37.4%, respectively; OR 0.684, 95% CI 0.377, 1.241 [1-sided p = 0.894]). Secondary efficacy outcomes were broadly consistent with the 2-year LDCR results. In both doses, gefitinib was well-tolerated and did not adversely affect the safety and tolerability of concomitant chemoradiotherapy. Conclusion: Gefitinib was well-tolerated, but did not improve efficacy compared with placebo when given concomitantly with chemoradiotherapy, or as maintenance therapy alone.

  12. Prevalence of pain in the head, back and feet in refugees previously exposed to torture: a ten-year follow-up study

    DEFF Research Database (Denmark)

    Olsen, Dorthe Reff; Montgomery, Edith; Bøjholm, Søren

    2007-01-01

    AIM: To estimate change over 10 years concerning the prevalence of pain in the head, back and feet, among previously tortured refugees settled in Denmark, and to compare associations between methods of torture and prevalent pain at baseline and at 10-year follow-up. METHODS: 139 refugees previous...... associated with the type and bodily focus of the torture. This presents a considerable challenge to future evidence-based development of effective treatment programs....

  13. Immunogenicity and safety of tetravalent dengue vaccine in 2-11 year-olds previously vaccinated against yellow fever: randomized, controlled, phase II study in Piura, Peru.

    Science.gov (United States)

    Lanata, Claudio F; Andrade, Teresa; Gil, Ana I; Terrones, Cynthia; Valladolid, Omar; Zambrano, Betzana; Saville, Melanie; Crevat, Denis

    2012-09-07

    In a randomized, placebo-controlled, monocenter, observer blinded study conducted in an area where dengue is endemic, we assessed the safety and immunogenicity of a recombinant, live, attenuated, tetravalent dengue vaccine candidate (CYD-TDV) in 2-11 year-olds with varying levels of pre-existing yellow-fever immunity due to vaccination 1-7 years previously. 199 children received 3 injections of CYD-TDV (months 0, 6 and 12) and 99 received placebo (months 0 and 6) or pneumococcal polysaccharide vaccine (month 12). One month after the third dengue vaccination, serotype specific neutralizing antibody GMTs were in the range of 178-190 (1/dil) (versus 16.7-38.1 in the control group), a 10-20 fold-increase from baseline, and 94% of vaccines were seropositive to all four serotypes (versus 39% in the control group). There were no vaccine-related SAEs. The observed reactogenicity profile was consistent with phase I studies, with severity grade 1-2 injection site pain, headache, malaise and fever most frequently reported and no increase after subsequent vaccinations. Virologically confirmed dengue cases were seen after completion of the 3 doses: 1 in the CYD-TDV group (N=199), and 3 in the control group (N=99). A 3-dose regimen of CYD-TDV had a good safety profile in 2-11 year olds with a history of YF vaccination and elicited robust antibody responses that were balanced against the four serotypes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. A phase II study of VP-16-ifosfamide-cisplatin combination chemotherapy plus early concurrent thoracic irradiation for previously untreated limited small cell lung cancer

    International Nuclear Information System (INIS)

    Woo, In Sook; Park, Young Suk; Kwon, Sung Hee

    2000-01-01

    At present the addition of thoracic irradiation to combination chemotherapy is a standard treatment for limited staged small cell ling cancer. However, there is still controversy about the optimum timing of chest irradiation. We conducted a phase II study of etoposide (VP-16)-ifosfamide-cisplatin (VIP) combination chemotherapy plus early concurrent thoracic irradiation for the patients with previously untreated limited small cell lung cancer in order to assess if the treatment modality could improve the response rate and the toxicity. Forty-four patients with limited small cell lung cancer were treated with etoposide-ifosfamide-cisplatin and concurrent thoracic irradiation. Combination chemotherapy consisted of etoposide 100 mg/m 2 (on day 1-3), ifosfamide 1000 mg/m 2 (on days 1 and 2) and cisplatin 100 mg/m 2 (on day 1). Concurrent thoracic irradiation consisted of a total of 4000 cGy over 4 weeks starting on the first day of the first chemotherapy. All patients who showed a complete response were given prophylactic cranial irradiation for 2.5 weeks. Forty-four of the 49 patients who entered the study from May 1994 to August 1998 were evaluable. The median age was 59 years and 40 patients had a performance status of 0 or 1. The median survival time was 22.5 months. Twenty-eight patients (62%) showed a complete response and 16 (38%) a partial response. Twenty-four patients (54%) developed grade 3 or 4 neutropenia; there was a 9% RTOG score 3 or 4 esophagitis. VIP combination chemotherapy and early concurrent thoracic irradiation for patients with limited stage small cell lung cancer revealed excellent antitumor response with tolerable toxicity. (author)

  15. 4 Healthy Ways to Deal With Emotions

    Science.gov (United States)

    Emotions can be a healthy, normal response to difficult situations and people. But sometimes they can feel overwhelming, and we reach for other things – like cigarettes or “comfort foods” to deal.

  16. Brain Aneurysm: Dealing with Emotional Distress

    Science.gov (United States)

    ... a great deal to do with initiation and motivation, and survivors with damage to this area may ... uncaring. The family of a survivor with poor motivation may become upset if they believe that the ...

  17. The American People and the New Deal

    Directory of Open Access Journals (Sweden)

    Michael Kazan

    2009-01-01

    Full Text Available Analysis of the Popular Front created by Franklin Roosevelt during the New Deal in which he was able to appeal to a broad spectrum of society across class, socioeconomic, religious, and political lines.

  18. Risky Business: Dealing with Your Teen's Behavior

    Science.gov (United States)

    ... Issues Subscribe September 2011 Print this issue Risky Business Dealing With Your Teen’s Behavior Send us your ... go it alone. You can find helpful resources online and in community and school programs (See our ...

  19. Food and Drug Administration criteria for the diagnosis of drug-induced valvular heart disease in patients previously exposed to benfluorex: a prospective multicentre study.

    Science.gov (United States)

    Maréchaux, Sylvestre; Rusinaru, Dan; Jobic, Yannick; Ederhy, Stéphane; Donal, Erwan; Réant, Patricia; Arnalsteen, Elise; Boulanger, Jacques; Garban, Thierry; Ennezat, Pierre-Vladimir; Jeu, Antoine; Szymanski, Catherine; Tribouilloy, Christophe

    2015-02-01

    The Food and Drug Administration (FDA) criteria for diagnosis of drug-induced valvular heart disease (DIVHD) are only based on the observation of aortic regurgitation ≥ mild and/or mitral regurgitation ≥ moderate. We sought to evaluate the diagnostic value of FDA criteria in a cohort of control patients and in a cohort of patients exposed to a drug (benfluorex) known to induce VHD. This prospective, multicentre study included 376 diabetic control patients not exposed to valvulopathic drugs and 1000 subjects previously exposed to benfluorex. Diagnosis of mitral or aortic DIVHD was based on a combined functional and morphological echocardiographic analysis of cardiac valves. Patients were classified according to the FDA criteria [mitral or aortic-FDA(+) and mitral or aortic-FDA(-)]. Among the 376 control patients, 2 were wrongly classified as mitral-FDA(+) and 17 as aortic-FDA(+) (0.53 and 4.5% of false positives, respectively). Of those exposed to benfluorex, 48 of 58 with a diagnosis of mitral DIVHD (83%) were classified as mitral-FDA(-), and 901 of the 910 patients (99%) without a diagnosis of the mitral DIVHD group were classified as mitral-FDA(-). All 40 patients with a diagnosis of aortic DIVHD were classified as aortic-FDA(+), and 105 of the 910 patients without a diagnosis of aortic DIVHD (12%) were classified aortic-FDA(+). Older age and lower BMI were independent predictors of disagreement between FDA criteria and the diagnosis of DIVHD in patients exposed to benfluorex (both P ≤ 0.001). FDA criteria solely based on the Doppler detection of cardiac valve regurgitation underestimate for the mitral valve and overestimate for the aortic valve the frequency of DIVHD. Therefore, the diagnosis of DIVHD must be based on a combined echocardiographic and Doppler morphological and functional analysis of cardiac valves. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  20. SAFETY AND ACTIVITY OF TEMSIROLIMUS AND BEVACIZUMAB IN PATIENTS WITH ADVANCED RENAL CELL CARCINOMA PREVIOUSLY TREATED WITH TYROSINE KINASE INHIBITORS: A PHASE 2 CONSORTIUM STUDY

    Science.gov (United States)

    Merchan, Jaime R.; Qin, Rui; Pitot, Henry; Picus, Joel; Liu, Glenn; Fitch, Tom; Maples, William J.; Flynn, Patrick J.; Fruth, Briant F.; Erlichman, Charles

    2015-01-01

    Purpose Bevacizumab or Temsirolimus regimens have clinical activity in the first line treatment of advanced renal cell carcinoma (RCC). This phase I/II trial was conducted to determine the safety of combining both agents and its efficacy in RCC patients who progressed on at least one prior anti-VEGF receptor tyrosine kinase inhibitor (RTKI) agent. Methods In the phase I portion, eligible patients were treated with Temsirolimus (25 mg IV weekly) and escalating doses of IV Bevacizumab (level 1=5mg/kg; level 2=10 mg/kg) every other week. The primary endpoint for the phase II portion (RTKI resistant patients) was the 6-month progression free rate. Secondary endpoints were response rate, toxicity evaluation, PFS and OS. Results MTD was not reached at the maximum dose administered in 12 phase I patients. Forty evaluable patients were treated with the phase II recommended dose (Temsirolimus 25 mg IV weekly and Bevacizumab 10 mg/kg IV every two weeks). The 6-month progression free rate was 40% (16/40 pts). Median PFS was 5.9 (4-7.8) months, and median OS was 20.6 (11.5-23.7) months. Partial response/stable/progressive disease were seen in 23%/63%/14% of patients. Most common grade 3-4 AEs included fatigue (17.8%), hypertriglyceridemia (11.1%), stomatitis (8.9%), proteinuria (8.9%), abdominal pain (6.7%), and anemia (6.7%). Baseline levels of serum sFLT-1 and VEGF-A were inversely correlated with PFS and OS, respectively. Conclusions Temsirolimus and Bevacizumab is a feasible combination in patients with advanced RCC previously exposed to oral anti-VEGF agents. The safety and efficacy results warrant further confirmatory studies in this patient population. PMID:25556030

  1. Low-calorie energy drink improves physiological response to exercise in previously sedentary men: a placebo-controlled efficacy and safety study.

    Science.gov (United States)

    Lockwood, Christopher M; Moon, Jordan R; Smith, Abbie E; Tobkin, Sarah E; Kendall, Kristina L; Graef, Jennifer L; Cramer, Joel T; Stout, Jeffrey R

    2010-08-01

    Energy drink use has grown despite limited research to support efficacy or safety and amid concerns when combined with exercise. The purpose of this study was to assess the effects of 10 weeks of once-daily energy drink consumption or energy drink consumption with exercise on measures of body composition, cardiorespiratory fitness, strength, mood, and safety in previously sedentary males. Thirty-eight males were randomly assigned to energy drink + exercise (EX-A), energy drink (NEX-A), placebo + exercise (EX-B), or placebo (NEX-B). All participants consumed 1 drink per day for 10 weeks; EX-A and EX-B participated in 10 weeks of resistance and endurance exercise. Testing was performed before (PRE) and after (POST) the 10-week intervention. No significant (p > 0.05) changes were observed for body composition, fitness, or strength in NEX-A; however, significantly greater decreases in fat mass and percentage body fat and increases in VO2peak were observed in EX-A versus EX-B. Ventilatory threshold (VT), minute ventilation, VO2 at VT, and power output at VT improved significantly PRE to POST in EX-A but not in EX-B or nonexercising groups. Clinical markers for hepatic, renal, cardiovascular, and immune function, as determined by PRE and POST blood work revealed no adverse effects in response to the energy drink. Mood was not affected by energy drink use. Absent energy restriction or other dietary controls, chronic ingestion of a once-daily low-calorie energy drink appears ineffective at improving body composition, cardiorespiratory fitness, or strength in sedentary males. However, when combined with exercise, preworkout energy drink consumption may significantly improve some physiological adaptations to combined aerobic and resistance training.

  2. Phase I/II study of gefitinib (Iressa(®)) and vorinostat (IVORI) in previously treated patients with advanced non-small cell lung cancer.

    Science.gov (United States)

    Han, Ji-Youn; Lee, Soo Hyun; Lee, Geon Kook; Yun, Tak; Lee, Young Joo; Hwang, Kum Hui; Kim, Jin Young; Kim, Heung Tae

    2015-03-01

    Vorinostat has been shown to overcome resistance to gefitinib. We performed a phase I/II study combining gefitinib with vorinostat in previously treated non-small cell lung cancer (NSCLC). A 3 + 3 dose-escalation design was used to determine maximum tolerated dose (MTD) and recommended phase II dose (RP2D). Three dose levels were tested: 250 mg/day gefitinib on days 1-28 and 200, 300 or 400 mg/day vorinostat on days 1-7, and 15-21 out of every 28 days. The primary endpoint was median progression-free survival (PFS). Fifty-two patients were enrolled and treated (43 in phase II). The median age was 59 years, 28 patients were male, 44 had adenocarcinoma, 29 had never smoked, and 36 had undergone one prior treatment. Twenty-two patients exhibited sensitive EGFR mutations. Planned dose escalation was completed without reaching the MTD. The RP2D was 250 mg gefitinib and 400 mg vorinostat. In 43 assessable patients in phase II, the median PFS was 3.2 months; the overall survival (OS) was 19.0 months. There were 16 partial responses and six cases of stable disease. In EGFR-mutant NSCLC, response rate was 77 %, median PFS was 9.1 months, and median OS was 24.1 months. The most common adverse events were anorexia and diarrhea. Treatment with 250 mg gefitinib daily with biweekly 400 mg/day vorinostat was feasible and well tolerated. In an unselected patient population, this combination dose did not improve PFS. However, this combination showed a potential for improving efficacy of gefitinib in EGFR-mutant NSCLC (NCT01027676).

  3. Effect of donepezil in patients with Alzheimer's disease previously untreated or treated with memantine or nootropic agents in Germany: an observational study.

    Science.gov (United States)

    Klinger, Tatjana; Ibach, Bernd; Schoenknecht, Peter; Kamleiter, Martin; Silver, Gabrielle; Schroeder, Johannes; Mielke, Ruediger

    2005-05-01

    This open-label, prospective, observational, Post-Marketing Surveillance (PMS) study assessed the efficacy and safety of donepezil in patients who had been switched from therapies currently used in Germany to treat Alzheimer's disease (AD), such as memantine and nootropics, due to insufficient efficacy or poor tolerability. A treatment-naive population was included as a comparator. Patients with AD were treated with donepezil and observed for a period of approximately 3 months. A cognitive assessment was made using the Mini-Mental State Examination (MMSE). Quality of life (QoL) was assessed by the investigators who answered the question 'How did therapy with donepezil influence the QoL of the patient and/or his family over the observation period?' and was graded using three ratings: improved/unchanged/worsened. Adverse events (AEs) were also monitored. A total of 913 patients entered the study (mean +/- SD MMSE score 18.03 +/- 5.34). Efficacy assessments were analyzed for three groups: an overall group of patients who had received any form of prior AD drug therapy (N+ group; n = 709); a subgroup of patients from the N+ group who had received prior memantine therapy only (M+ group; n = 111) and patients who were drug treatment naive (N- group; n = 204). In the evaluable population donepezil improved MMSE scores by 2.21 +/- 3.47 points on average, with similar improvements observed in all three groups. QoL was judged to be improved in at least 70% of patients, again with similar results obtained for all three groups. Donepezil was well tolerated, with 85 of 913 (9.3%) patients reporting AEs. The most common AEs were those typically seen with cholinergic therapies (i.e., diarrhoea, vomiting and nausea). In this observational PMS study, donepezil was shown to be efficacious and well tolerated in patients who were being insufficiently treated with memantine or nootropic therapy. The magnitude of response was similar to that observed in patients who were previously

  4. Victimological aspect of a corruption deal

    Directory of Open Access Journals (Sweden)

    Anna A. Ivanova

    2015-12-01

    Full Text Available Objective to present the author39s concept of the victimological aspect of corruption crime. Methods dialectical method of cognition mainly the systemic approach analysis. Results the article discusses the concept of corruption deal as an unlawful act statutory offence bribery and subornation law abuse by the authorized entity. The illegal most common and manipulative types of corruption deals and their mechanisms are defined as well as the ways of their implementation which include mutually beneficial bilateral trade extortion and initiative active bribery. The diverse negative effects of corruption on the legal relationships are proved. The danger of the crime deal is shown as the factor of corrupt behavior and active means of formation of corruption networks which increases victimogenity of corruption acts doing harm not only to physical but also legal entities. In accordance with this the point of view supported and proved that it is necessary to expand the notion of victim of corruption offences to legal persons. The conclusion is made about the feasibility of a legal assessment of corruption deals as a qualifying feature of a criminal offense. Scientific novelty the article justifies the author39s position in relation to an assessment of corruption victimization of the deal victimological characteristic of a corrupt deals victim are given critical analysis of basic victimological concepts is made to identify the potential corrupt deals victims and ensure victim safety. Practical significance the idea is expressed of reorienting public consciousness views on corruption as a way of solving problems of changing tolerance to corruption due to which the legal subjects become victims of corrupt deals of amending the anticorruption policies towards more careful attention to the protection of the legal relations subjects against the corruption threat. nbsp

  5. Sunburn and sun-protective behaviors among adults with and without previous nonmelanoma skin cancer (NMSC): A population-based study.

    Science.gov (United States)

    Fischer, Alexander H; Wang, Timothy S; Yenokyan, Gayane; Kang, Sewon; Chien, Anna L

    2016-08-01

    Individuals with previous nonmelanoma skin cancer (NMSC) are at increased risk for subsequent skin cancer, and should therefore limit ultraviolet exposure. We sought to determine whether individuals with previous NMSC engage in better sun protection than those with no skin cancer history. We pooled self-reported data (2005 and 2010 National Health Interview Surveys) from US non-Hispanic white adults (758 with and 34,161 without previous NMSC). We calculated adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI), taking into account the complex survey design. Individuals with previous NMSC versus no history of NMSC had higher rates of frequent use of shade (44.3% vs 27.0%; aPOR 1.41; 95% CI 1.16-1.71), long sleeves (20.5% vs 7.7%; aPOR 1.55; 95% CI 1.21-1.98), a wide-brimmed hat (26.1% vs 10.5%; aPOR 1.52; 95% CI 1.24-1.87), and sunscreen (53.7% vs 33.1%; aPOR 2.11; 95% CI 1.73-2.59), but did not have significantly lower odds of recent sunburn (29.7% vs 40.7%; aPOR 0.95; 95% CI 0.77-1.17). Among those with previous NMSC, recent sunburn was inversely associated with age, sun avoidance, and shade but not sunscreen. Self-reported cross-sectional data and unavailable information quantifying regular sun exposure are limitations. Physicians should emphasize sunburn prevention when counseling patients with previous NMSC, especially younger adults, focusing on shade and sun avoidance over sunscreen. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  6. A cross-sectional study of 'yaws' in districts of Ghana which have previously undertaken azithromycin mass drug administration for trachoma control.

    Directory of Open Access Journals (Sweden)

    Rosanna Ghinai

    2015-01-01

    Full Text Available Yaws, caused by Treponema pallidum ssp. pertenue, is reportedly endemic in Ghana. Mass distribution of azithromycin is now the cornerstone of the WHO yaws eradication campaign. Mass distribution of azithromycin at a lower target dose was previously undertaken in two regions of Ghana for the control of trachoma. Ongoing reporting of yaws raises the possibility that resistance may have emerged in T. pallidum pertenue, or that alternative infections may be responsible for some of the reported cases. We conducted a cross-sectional survey in thirty communities in two districts of Ghana where MDA for trachoma had previously been conducted. Children aged 5-17 years with ulcerative lesions compatible with yaws were enrolled. Samples for treponemal serology and lesion PCR were collected from all children. 90 children with 98 lesions were enrolled. Syphilis serology was negative in all of them. PCR for T. pallidum ssp pertenue was negative in all children, but Haemophilus ducreyi DNA was detected in 9 lesions. In these communities, previously treated for trachoma, we found no evidence of ongoing transmission of yaws. H. ducreyi was associated with a proportion of skin lesions, but the majority of lesions remain unexplained. Integration of diagnostic testing into both pre and post-MDA surveillance systems is required to better inform yaws control programmes.

  7. Extra-Training I-deals

    DEFF Research Database (Denmark)

    Elgoibar, Patricia; Lindholst, Morten

    2016-01-01

    illustrates the negotiation process between a team manager at TNK - a leading multinational software development company- and one of his team members. The employee is willing to negotiate an I-deal with the objective of attending a training course abroad. This case is a two-party employment deal-making......, and professionals; as well as in students from different cultural backgrounds. The feedback from the students shows a clear understanding of the information described in the test as well as a satisfactory learning experience in the concept of I-deals terms, understanding of the concept of BATNA in negotiation......, and the importance of taking into account the interests of the other party and parties when negotiating this type of agreements....

  8. Ex-ante evaluation of Green Deals Energy; Ex-ante evaluatie van Green Deals Energie

    Energy Technology Data Exchange (ETDEWEB)

    Elzenga, H.; Kruitwagen, S.

    2012-06-15

    An overview is given of the results of a study of the bottlenecks experienced by initiators in the realization of green projects, the solutions for which the Dutch government has chosen, and the role that local authorities play in it. An important research question is to what extent it is likely that Green Deal projects will lead to imitation by others. The research has focused on four themes: Onshore wind energy, Energy production from co- fermentation of manure, Energy conservation of heat in the built environment, and Decentralised electricity generation with solar panels [Dutch] Een overzicht wordt gegeven van de resultaten van een onderzoek naar de knelpunten die initiatiefnemers ervaren bij de realisatie van groene projecten, de oplossingsrichtingen waarvoor de Rijksoverheid heeft gekozen, en de rol die decentrale overheden daarin spelen. Een belangrijke onderzoeksvraag is in hoeverre het aannemelijk is dat Green Deal-projecten zullen leiden tot navolging door anderen. Het onderzoek heeft zich toegespitst op vier thema's: Windenergie op land, Energieproductie uit (co)vergisting van mest, Energiebesparing op warmte in de gebouwde omgeving, en Decentrale elektriciteitsopwekking met zonnepanelen.

  9. Non-verbal communication barriers when dealing with Saudi sellers

    Directory of Open Access Journals (Sweden)

    Yosra Missaoui

    2015-12-01

    Full Text Available Communication has a major impact on how customers perceive sellers and their organizations. Especially, the non-verbal communication such as body language, appearance, facial expressions, gestures, proximity, posture, eye contact that can influence positively or negatively the first impression of customers and their experiences in stores. Salespeople in many countries, especially the developing ones, are just telling about their companies’ products because they are unaware of the real role of sellers and the importance of non-verbal communication. In Saudi Arabia, the seller profession has been exclusively for foreign labor until 2006. It is very recently that Saudi workforce enters to the retailing sector as sellers. The non-verbal communication of those sellers has never been evaluated from consumer’s point of view. Therefore, the aim of this paper is to explore the non-verbal communication barriers that customers are facing when dealing with Saudi sellers. After discussing the non-verbal communication skills that sellers must have in the light of the previous academic research and the depth interviews with seven focus groups of Saudi customers, this study found that the Saudi customers were not totally satisfied with the current non-verbal communication skills of Saudi sellers. Therefore, it is strongly recommended to develop the non-verbal communication skills of Saudi sellers by intensive trainings, to distinguish more the appearance of their sellers, especially the female ones, to focus on the time of intervention as well as the proximity to customers.

  10. External Audit Green Deal Approach. Final report; Externe Audit Green Deal Aanpak. Eindrapport

    Energy Technology Data Exchange (ETDEWEB)

    Van Mil, B.P.A.; Gooskens, B.J.F.; Van Schelven, R.M.; Stutje, A.

    2013-10-15

    External audit of the effectiveness of the Green Deals, based on the question how the Green Deal contributes to green growth. The central idea of this new tool is that the Dutch government facilitates initiatives of businesses, societal organisations, local governments and citizens by removing bottlenecks as much as possible [Dutch] Externe audit over (de effectiviteit van) de Green Deal aanpak, op basis van de volgende onderzoeksvraag: 'Hoe draagt de Green Deal aanpak bij aan het bevorderen van groene groei?' De centrale gedachte van dit nieuwe instrument is dat de overheid initiatieven van bedrijven, maatschappelijke organisaties, decentrale overheden en burgers faciliteert door het wegnemen van knelpunten.

  11. Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study

    Directory of Open Access Journals (Sweden)

    Lopez-Saura Pedro

    2009-07-01

    Full Text Available Abstract Background Aggressive non-melanoma skin cancer (deeply infiltrating, recurrent, and morphea form lesions are therapeutically challenging because they require considerable tissue loss and may demand radical disfiguring surgery. Interferons (IFN may provide a non-surgical approach to the management of these tumors. The aim of this work was to evaluate the effect of a formulation containing IFNs-α and -γ in synergistic proportions on patients with recurrent, advanced basal cell (BCC or squamous cell skin carcinomas (SCSC. Methods Patients with extensive, recurrent, resistant to other procedures BCC or SCSC received the IFN formulation peri- and intralesionally, three times per week for 3 weeks. They had been previously treated with surgery and/or radiotherapy or chemotherapy. Thirteen weeks after the end of treatment, the original lesion sites were examined for histological evidence of remaining tumor. Results Sixteen elder (median 70 years-old patients were included. They beared 12 BCC and 4 SCSC ranging from 1.5 to 12.5 cm in the longest dimension. At the end of treatment 47% CR (complete tumor elimination, 40% PR (>30% tumor reduction, and 13% stable disease were obtained. None of the patients relapsed during the treatment period. The median duration of the response was 38 months. Only one patient with complete response had relapsed until today. Principal adverse reactions were influenza-like symptoms well known to occur with interferon therapy, which were well tolerated. Conclusion The peri- and intralesional combination of IFNs-α and -γ was safe and showed effect for the treatment of advanced, recurrent and resistant to previous treatments of BCC and SCSC in elder patients. This is the first report of such treatment in patients with advance non-melanoma skin cancer. The encouraging result justifies further confirmatory trials. Trial registration Current Controlled Trials RPCEC00000052.

  12. Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study

    International Nuclear Information System (INIS)

    Anasagasti-Angulo, Lorenzo; Garcia-Vega, Yanelda; Barcelona-Perez, Silvia; Lopez-Saura, Pedro; Bello-Rivero, Iraldo

    2009-01-01

    Aggressive non-melanoma skin cancer (deeply infiltrating, recurrent, and morphea form lesions) are therapeutically challenging because they require considerable tissue loss and may demand radical disfiguring surgery. Interferons (IFN) may provide a non-surgical approach to the management of these tumors. The aim of this work was to evaluate the effect of a formulation containing IFNs-α and -γ in synergistic proportions on patients with recurrent, advanced basal cell (BCC) or squamous cell skin carcinomas (SCSC). Patients with extensive, recurrent, resistant to other procedures BCC or SCSC received the IFN formulation peri- and intralesionally, three times per week for 3 weeks. They had been previously treated with surgery and/or radiotherapy or chemotherapy. Thirteen weeks after the end of treatment, the original lesion sites were examined for histological evidence of remaining tumor. Sixteen elder (median 70 years-old) patients were included. They beared 12 BCC and 4 SCSC ranging from 1.5 to 12.5 cm in the longest dimension. At the end of treatment 47% CR (complete tumor elimination), 40% PR (>30% tumor reduction), and 13% stable disease were obtained. None of the patients relapsed during the treatment period. The median duration of the response was 38 months. Only one patient with complete response had relapsed until today. Principal adverse reactions were influenza-like symptoms well known to occur with interferon therapy, which were well tolerated. The peri- and intralesional combination of IFNs-α and -γ was safe and showed effect for the treatment of advanced, recurrent and resistant to previous treatments of BCC and SCSC in elder patients. This is the first report of such treatment in patients with advance non-melanoma skin cancer. The encouraging result justifies further confirmatory trials. Current Controlled Trials RPCEC00000052

  13. Missing Strands? Dealing with Hair Loss

    Science.gov (United States)

    ... 2017 Print this issue Missing Strands? Dealing with Hair Loss En español Send us your comments Hair loss is often associated with men and aging, but ... or their treatments, and many other things cause hair loss. The most common type of hair loss is ...

  14. Helping Children Deal with the Nuclear Threat.

    Science.gov (United States)

    Schirmer, Peggy

    1982-01-01

    Suggests how elementary school teachers can address the topic of nuclear warfare with young children. Emphasizes that educating children for peace requires that parents and teachers (1) recognize and deal with the anxieties provoked by nuclear war and that (2) they provide role models by participating in the antinuclear movement. (GC)

  15. How Can I Deal with My Asthma?

    Science.gov (United States)

    ... they want — even endurance or cold-weather sports . Sports can boost your mood, and that's a great help for those times when you may feel frustrated about having asthma. Using a management plan to deal with asthma is good for ...

  16. Extending DTGolog to deal with POMDPs

    CSIR Research Space (South Africa)

    Rens, G

    2008-11-01

    Full Text Available For sophisticated robots, it may be best to accept and reason with noisy sensor data, instead of assuming complete observation and then dealing with the effects of making the assumption. We shall model uncertainties with a formalism called...

  17. Secondary market prices and Mexico's Brady Deal

    NARCIS (Netherlands)

    van Wijnbergen, S.J.G.; Claessens, C.A.M.F.

    1993-01-01

    Analyzes wether or not the use of official funds in debt reduction packages as in Mexico's 1989 Brady deal is tantamount to a creditor bailout. Review of events; option-pricing approach to sovereign debt valuation; market valuation of the Brady debt package; positive impact of Brady plan on debt

  18. "Dealing with Racial Conflicts in Schools."

    Science.gov (United States)

    Holman, Ben

    In dealing with racial tension and conflict, the principal is not limited to a wing and a prayer and benign neglect. The roots of conflict can be identified. Conflict can be planned for and utilized constructively. For 10 years, in approximately 2,000 instances, conciliators and mediators of the Community Relations Service have stood side-by-side…

  19. Does stigma predict a belief in dealing with depression alone?

    Science.gov (United States)

    Griffiths, Kathleen M; Crisp, Dimity A; Jorm, Anthony F; Christensen, Helen

    2011-08-01

    Community surveys indicate that many people with depressive disorders do not obtain professional help and that a preference for self-reliance is an important factor in this treatment gap. The current study sought to investigate whether stigmatising attitudes predict a belief in the helpfulness of dealing with depression without external assistance. Data were collected as part of a national household survey of 2000 Australian adults aged 18 years and above. Participants were presented with either a vignette depicting depression (n=1001) or a vignette depicting depression with suicidal ideation (n=999) and asked if it would be helpful or harmful to deal alone with the problem. Logistic regression analyses were conducted to determine if belief in dealing with depression alone was predicted by personal stigma, perceived stigma or sociodemographic characteristics. Higher levels of personal stigma independently predicted a belief in the helpfulness of dealing alone with both depression and depression with suicidal ideation. By contrast, lower levels of perceived stigma were associated with a belief in the helpfulness of dealing alone with depression without suicidal ideation. Personal stigma is associated with a belief in the helpfulness of self-reliance in coping with depression. Public health programs should consider the possibility that a belief in self-reliance is partly attributable to stigma. The findings also point to the potential importance of providing evidence-based self-help programs for those who believe in self-care. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Prognostic factors in multiple myeloma: definition of risk groups in 410 previously untreated patients: a Grupo Argentino de Tratamiento de la Leucemia Aguda study.

    Science.gov (United States)

    Corrado, C; Santarelli, M T; Pavlovsky, S; Pizzolato, M

    1989-12-01

    Four hundred ten previously untreated multiple myeloma patients entered onto two consecutive Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) protocols were analyzed to identify significant prognostic factors influencing survival. The univariate analysis selected the following variables: performance status, renal function, percentage of bone marrow plasma cells at diagnosis, hemoglobin, and age. A multivariate analysis showed that performance status, renal function, percentage of bone marrow plasma cells, hemoglobin, and age were the best predictive variables for survival. A score was assigned to each patient according to these variables, which led to their classification in three groups: good, intermediate, and poor risk, with a probability of survival of 26% and 10% at 96 months, and 5% at 56 months, and median survival of 60, 37, and 14 months, respectively (P = .0000). In our patient population, this model proved to be superior to the Durie-Salmon staging system in defining prognostic risk groups, and separating patients with significantly different risks within each Durie-Salmon stage.

  1. Implementation of an electronic medical record system in previously computer-naïve primary care centres: a pilot study from Cyprus.

    Science.gov (United States)

    Samoutis, George; Soteriades, Elpidoforos S; Kounalakis, Dimitris K; Zachariadou, Theodora; Philalithis, Anastasios; Lionis, Christos

    2007-01-01

    The computer-based electronic medical record (EMR) is an essential new technology in health care, contributing to high-quality patient care and efficient patient management. The majority of southern European countries, however, have not yet implemented universal EMR systems and many efforts are still ongoing. We describe the development of an EMR system and its pilot implementation and evaluation in two previously computer-naïve public primary care centres in Cyprus. One urban and one rural primary care centre along with their personnel (physicians and nurses) were selected to participate. Both qualitative and quantitative evaluation tools were used during the implementation phase. Qualitative data analysis was based on the framework approach, whereas quantitative assessment was based on a nine-item questionnaire and EMR usage parameters. Two public primary care centres participated, and a total often health professionals served as EMR system evaluators. Physicians and nurses rated EMR relatively highly, while patients were the most enthusiastic supporters for the new information system. Major implementation impediments were the physicians' perceptions that EMR usage negatively affected their workflow, physicians' legal concerns, lack of incentives, system breakdowns, software design problems, transition difficulties and lack of familiarity with electronic equipment. The importance of combining qualitative and quantitative evaluation tools is highlighted. More efforts are needed for the universal adoption and routine use of EMR in the primary care system of Cyprus as several barriers to adoption exist; however, none is insurmountable. Computerised systems could improve efficiency and quality of care in Cyprus, benefiting the entire population.

  2. Teaching Prospect Theory with the "Deal or No Deal" Game Show

    Science.gov (United States)

    Baker, Ardith; Bittner, Teresa; Makrigeorgis, Christos; Johnson, Gloria; Haefner, Joseph

    2010-01-01

    Recent evidence indicates that decision makers are more sensitive to potential losses than gains. Loss aversion psychology has led behavioural economists to look beyond expected utility by developing "prospect theory." We demonstrate this theory using the "Deal or No Deal" game show.

  3. Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement.

    Science.gov (United States)

    Garcia, Patrícia A; Dias, João M D; Silva, Silvia L A; Dias, Rosângela C

    2015-01-01

    The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. (i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa = 0.595) and recurrent fallers (Kappa = 0.589). The limits of agreement were 0.35 ± 1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning.

  4. The importance of continued exercise participation in quality of life and psychological well-being in previously inactive postmenopausal women: a pilot study.

    Science.gov (United States)

    Asbury, Elizabeth A; Chandrruangphen, Pornpat; Collins, Peter

    2006-01-01

    Exercise and physical activity provide a wide range of health benefits for postmenopausal women, although the impact of maintained exercise participation on psychological well-being is unclear. An exploration of continued exercise participation in psychological well-being after a moderate-intensity exercise program in previously inactive postmenopausal women was therefore undertaken. : Twenty-three healthy sedentary postmenopausal women (age 56 +/- 4 years) were randomly assigned to two groups. All participants completed the Short Form-36, Hospital Anxiety and Depression Scale (HADS), and Health Anxiety Questionnaire (HAQ) and then began a 6-week walking program at 50% heart rate reserve defined by (.-)V(O(2)) treadmill testing. Post-intervention, all participants underwent (.-)V(O(2)) treadmill testing and questionnaires. Group 1 was then instructed to continue exercising, whereas group 2 was instructed to desist for an additional 6-week period. On completion of the 6-week follow-up, participants completed a final set of questionnaires. Participants performed 97% of the prescribed 15-hour (900 minute) exercise program (875.1 +/- 177.4 minutes) in an average of 26 +/- 5 sessions. Total HAQ (P = 0.001), health worry (P = 0.001), fear of illness (P = 0.037), reassurance seeking behavior (P = 0.037), SF-36 well-being (P = 0.037), total HADS (P = 0.019), and HADS depression (P = 0.015) improved significantly following the exercise program. At follow-up, group 1 had lower HADS anxiety (P = 0.013), total HADS (P = 0.02), total HAQ (P = 0.03), and HAQ interference with life (P = 0.03) and significantly higher SF-36 energy (P = 0.01) than group 2. Healthy postmenopausal women gain significant psychological benefit from moderate-intensity exercise. However, exercise participation must continue to maintain improvements in psychological well-being and quality of life.

  5. Strategies For Dealing With Problems Faced By Men Participating In ...

    African Journals Online (AJOL)

    The purpose of this study was to identify strategies for dealing with problems faced by men in Umkhanyakude using a participatory and inclusive approach. Men in Umkhanyakude were invited to a workshop in January 2004 to carefully think through the problems that they face, then to prioritize these problems using a ...

  6. Do gender and personality traits influence use of deal sites?

    DEFF Research Database (Denmark)

    Sudzina, Frantisek; Pavlicek, Antonin

    2017-01-01

    There is a growing body of literature on impact of personality traits on technology adoption. But majority of these studies are never replicated and, therefore, it is hard to estimate how general are their findings. The focus of this paper is adoption of deal sites, and its aim to replicate...

  7. "Exclusive Dealing Contract and Inefficient Entry Threat"

    OpenAIRE

    Noriyuki Yanagawa; Ryoko Oki

    2008-01-01

    This paper examines the effects of exclusive dealing contracts in a simple model with manufacturers-distributors relations. We consider entrants in both manufacturing and distribution sectors. It is well-known that a potential entry threat is welfare increasing under homogenous price competition, even though the potential entrant is less productive. This paper reexamines this intuition by employing the above model. We show that the entry threat of a less-productive manufacturer is welfare dec...

  8. Dealing with duplicate regulations and conflicting jurisdictions

    International Nuclear Information System (INIS)

    Aamodt, P.L.

    1991-01-01

    There are a number of situations where mixed wastes are regulated by dual regulations and regulators. This presentation attempts to show where such duplication exists and how it evolved historically through legislative actions. The presentation includes a discussion of strategies that have been used to deal with the problems that result from duplicate regulations and jurisdictional conflicts. The RCRA and AEA regulations are really more similar than dissimilar. There are significant issues that must be worked through with the regulators. It is most important to work with your regulators early in process. The following are suggestions for dealing with the regulators. (1) Know the regulations in advance of discussions. (2) Begin dialogue with the regulator(s) as early as possible and get to know the people you will be dealing with -- and let them know you. (3) Explain the technical/regulatory issues/problems that you face at your facility in sufficient detail that they are clearly understood, and work with the regulator(s) to reasonably address them in the language/requirements of the permit. (4) Always attempt to comply with the regulations first before going in with a variance request -- document your efforts, and be honest with your assessment of issues. (5) Don't be adversarial -- remember that the regulator has the same objectives as you do. 1 tab

  9. The material, moral, and affective worlds of dealing and crime among young men entrenched in an inner city drug scene.

    Science.gov (United States)

    Fast, Danya; Shoveller, Jean; Kerr, Thomas

    2017-06-01

    A large body of previous research has elucidated how involvement in drug dealing and crime among marginalized urban youth who use drugs is shaped by the imperatives of addiction and survival in the context of poverty. However, a growing body of research has examined how youth's involvement in these activities is shaped by more expansive desires and moralities. In this paper, we examine the material, moral, and affective worlds of loosely gang affiliated, street level dealing and crime among one group of young men in Vancouver, Canada. Drawing on longitudinal interviews with 44 young men from 2008 to 2016, and ethnographic fieldwork with a group of approximately 15 of those young men over the same time period, we argue that for these youth, dealing and crime were not solely about economic survival, or even the accrual of highly meaningful forms of "street capital" in the margins. Rather, as "regimes of living," dealing and crime also opened up new value systems, moral logics, and affects in relation to the tremendous risks, potential rewards, and crushing boredom of life in the margins. These activities were also understood as a way into deeply desired forms of social spatial belonging in the city, which had previously only been imagined. However, across time dealing and crime "embedded" young men in cycles of incarceration, destitution, addictions, and mental health crises that ultimately reinforced their exclusion-from legal employment, but also within the world of crime. The findings of this study underscore the importance of adopting a life course perspective in order to meaningfully address the harms associated with involvement in dealing and crime among youth in our setting. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. The possibility of previous epidemiological data to serve as baseline for future national oral health surveys--a study in Vietnam.

    NARCIS (Netherlands)

    Palenstein Helderman, W.H. van; Truin, G.J.; Can, N.; Khanh, N.D.

    2001-01-01

    AIM: The purpose of this paper is to review the most recent epidemiological data (1985-2000) on dental caries and periodontal diseases in Vietnam in an attempt to obtain a 'baseline' for future national oral health surveys. METHODS: Studies on periodontal diseases and caries were included when CPITN

  11. Deal or No Deal? Decision Making under Risk in a Large-Stake TV Game Show and Related Experiments

    NARCIS (Netherlands)

    M.J. van den Assem (Martijn)

    2008-01-01

    textabstractThe central theme of this dissertation is the analysis of risky choice. The first two chapters analyze the choice behavior of contestants in a TV game show named “Deal or No Deal” (DOND). DOND provides a unique opportunity to study risk behavior, because it is characterized by very large

  12. Alfalfa (Medicago sativa L.) is tolerant to higher levels of salinity than previous guidelines indicated: Implications of field and greenhouse studies

    Science.gov (United States)

    Putnam, Daniel H.; Benes, Sharon; Galdi, Giuliano; Hutmacher, Bob; Grattan, Steve

    2017-04-01

    Alfalfa (Medicago sativa L.) is the most widely grown leguminous forage crop in North America and is valued for high productivity, quality, economic value, and for dairy productivity. Alfalfa has historically been classified as moderately sensitive to saline conditions, with yield declines predicted at >2 dS/m in the saturated soil paste extract. However, greenhouse, sand tank, and field studies over the past five years have confirmed that alfalfa can be grown with limited negative effects at much higher salinity levels. A broad collection of alfalfa varieties has exhibited a range of resistance at irrigation water salinities >5 dS/m ECw in greenhouse trials, with significant variation due to variety. USDA-ARS sand tank studies indicated similar or greater tolerances closer to 8 dS/m in the soil water, in addition to confirmation of significant varietal differences. A three-year field study on clay loam soil with applications of 5-7 dS/m ECw irrigation water indicated normal yields and excellent stand survivability. A second field study in the same soil type with levels from 8-10 dS/m ECw showed yield reductions of 10-15% but economic yields were still achieved at those levels. Field and greenhouse studies were conducted with mixed salt saline sodic waters typical of the San Joaquin Valley of California. Field evaluation of variety performance was subject to greater variation due to secondary salinity-soil interactions including water infiltration and crusting problems, not only salinity per-se. Thus, adequate irrigation water availability to the crop may be as important as salinity in impacting yields under field conditions. Once established, the deep-rooted characteristics of alfalfa enable utilization of deeper subsurface moisture, even at moderate to high salinity levels, as documented by USDA lysimeter studies. Significant advantages to salinity-tolerant varieties have been observed. It will be important to consider specific management factors which may enable

  13. Effect of benzalkonium chloride?free travoprost on intraocular pressure and ocular surface symptoms in patients with glaucoma previously on latanoprost: an open-label study

    OpenAIRE

    Lopes, Joao F.; Hubatsch, Douglas A.; Amaris, Patricia

    2015-01-01

    Background Prostaglandin analogs reduce intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension; however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). Methods This was an open-label, single-arm study conducted in Latin America from February 2012 to May 2013. Patients with open-angle glaucoma or ocular hypertension who were intolerant of latanoprost 0.005?% were transitioned to recei...

  14. Effect of benzalkonium chloride-free travoprost on intraocular pressure and ocular surface symptoms in patients with glaucoma previously on latanoprost: an open-label study.

    Science.gov (United States)

    Lopes, Joao F; Hubatsch, Douglas A; Amaris, Patricia

    2015-11-12

    Prostaglandin analogs reduce intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension; however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). This was an open-label, single-arm study conducted in Latin America from February 2012 to May 2013. Patients with open-angle glaucoma or ocular hypertension who were intolerant of latanoprost 0.005 % were transitioned to receive once-daily BAK-free travoprost 0.004 % containing polyquaternium-1 (Travatan® preserved with POLYQUAD® [PQ], Alcon Laboratories, Inc; Fort Worth, TX) for 12 weeks. Mean change in IOP from baseline (primary efficacy endpoint) and the percentage of patients who achieved a target IOP of ≤18 mmHg were evaluated at all on-therapy visits. Ocular hyperemia, patient preference, and self-projected adherence were assessed at week 12. Adverse events (AEs) were monitored throughout the study. All enrolled patients were included in the analysis (n = 191); the majority of patients (90.6 %, n = 173/191) completed the study. Mean (SD) patient age was 67.5 (11.3) years, and mean baseline IOP was 14.8 mmHg. Mean IOP was reduced by 0.94 mmHg at week 6 and by 1.09 mmHg at week 12 (P glaucoma or ocular hypertension who were intolerant of latanoprost. BAK-free travoprost 0.004 % is a viable alternative for patients who require switching their IOP-lowering medications because of tolerability issues. ClinicalTrials.gov identifier, NCT01510145.

  15. Does hyperbaric oxygen treatment have the potential to increase salivary flow rate and reduce xerostomia in previously irradiated head and neck cancer patients? A pilot study

    DEFF Research Database (Denmark)

    Forner, Lone; Hansen, Ole Hyldegaard; von Brockdorff, Annet Schack

    2011-01-01

    in irradiated head and neck cancer patients. Eighty patients eligible for HBO treatment on the indication of prevention/treatment of osteoradionecrosis or soft tissue radiation injury were consecutively sampled, of whom 45 had hyposalivation (i.e. unstimulated whole saliva (UWS) flow rate......Irradiated head and neck cancer survivors treated in the Hyperbaric Oxygen (HBO) Unit, Copenhagen University Hospital, spontaneously reported improvement of radiation-induced dry mouth feeling. The aim of this pilot study was to evaluate salivary flow rate and xerostomia before and after HBO...

  16. An investigation of consumers' exploratory tendencies as motivators of their responsive behaviour to deals

    Directory of Open Access Journals (Sweden)

    Surajit Ghosh Dastidar

    2016-06-01

    Full Text Available An understanding of the motivators of consumer deal redemption behaviour is expected to enable marketers to use deals more effectively. In this study, consumers' exploratory tendencies (CET have been assessed as potential motivators of proneness to eight types of deals, during the purchase of shampoo and refrigerator—two product categories. Consumers showed varying proneness to different types of deals depending on the type of exploratory tendency that they needed to satisfy and the type of good that was on sale. These findings can enable marketers to choose the most appropriate type of deal to achieve their sales target.

  17. Previous study for the setting up and optimization of detection of ZnS(Ag) scintillation applied to the measure of alpha radioactivity index

    International Nuclear Information System (INIS)

    Pujol, L.; Suarez-Navarro, J.A.; Montero, M.

    1998-01-01

    The determination of radiological water quality is useful for a wide range of environmental studies. In these cases, the gross alpha activity is one of the parameters to determine. This parameter permits to decide if further radiological analyses are necessary in order to identify and quantify the presence of alpha emitters in water. The usual method for monitoring the gross alpha activity includes sample evaporation to dryness on a disk and counting using ZnS(Ag) scintillation detector. Detector electronics is provided with two components which are adjustable by the user the high-voltage applied to the photomultiplier tubes and the low level discriminator that is used to eliminate the electronic noise. The high-voltage and low level discriminator optimization are convenient in order to reach the best counting conditions. This paper is a preliminary study of the procedure followed for the setting up and optimization of the detector electronics in the laboratories of CEDEX for the measurement of gross alpha activity. (Author)

  18. [Mutations of resistance of HIV-1 in previously untreated patients at penitentiary centers of the Autonomous Community of Valencia, Spain. REPRICOVA study].

    Science.gov (United States)

    García-Guerrero, Julio; Herrero, Agustín; Vera, Enrique; Almenara, José M; Araújo, Rosa; Saurí, Vicente V; Castellano, Juan C; Fernández-Clemente, Luis; Bedia, Miguel; Llorente, María I; González-Morán, Francisco

    2002-03-02

    Our purpose was to determine the prevalence of mutations of resistance to nucleoside inhibitors of reverse transcriptase (NIRT) and protease inhibitors (PI) in the HIV-1 genotype of naïve infected subjects in the prisons of the Autonomous Community of Valencia, Spain. Multicentric, descriptive, cross-sectional study of prevalence including a systematic stratified and randomised sampling by centres. Demographic, clinical, virological and immunological data were collected. The HIV gene of protease and transcriptase was studied in peripheral blood plasma samples by means of double PCR amplification and subsequent automatic sequence. Reference: wild strain HXB2. Plasma was obtained from 133 individuals (119 men and 14 women). 117 samples were selected and the rest did not have enough copies for transcription. With regard to NIRT, 7 samples (5.2% of total) showed some mutation of resistance: M41L, D67N, L210W and K219Q, all them secondary to and associated with resistance to zidovudine, abacavir as well as group B multinucleoside-resistance. With regard to PI, only one sample showed a primary mutation, M46I, which was associated with resistance to indinavir. Moreover, a further 41 samples were found to express some secondary mutation. In our series, there was a low number of primary mutations of resistance. These results allow us to exclude the systematic use of resistance tests before an initiation antiretroviral therapy.

  19. In Vitro Fertilization Outcomes After Placement of Essure Microinserts in Patients With Hydrosalpinges Who Previously Failed In Vitro Fertilization Treatment: A Multicenter Study.

    Science.gov (United States)

    Cohen, Shlomo B; Bouaziz, Jerome; Schiff, Eyal; Simon, Alexander; Nadjary, Michel; Goldenberg, Mordechai; Orvieto, Raoul; Revel, Ariel

    2016-01-01

    To investigate whether hysteroscopic proximal tubal occlusion with Essure microinserts (Conceptus Inc.; Bayer, AG, North Rhine-Westphalia, Germany) can improve pregnancy rates in patients with hydrosalpinges who had failed in vitro fertilization (IVF) treatment. A prospective cohort study. University-affiliated tertiary centers. Twenty-four consecutive women with hydrosalpinges who had failed IVF treatment were included. Hysteroscopic placement of Essure microinserts for hydrosalpinx blockage followed by IVF treatment. Ongoing pregnancy and live birth rates were recorded. Of the 24 patients undergoing a total of 42 IVF cycles after Essure insertion, 18 (75% of patients and 42.8% of IVF cycle attempts) conceived and 16 delivered live births (66.6% of patients and 38.1% of IVF cycle attempts). Hysteroscopic proximal occlusion of hydrosalpinges with Essure microinserts is a valuable alternative to laparoscopic salpingectomy, resulting in reasonable pregnancy rates. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  20. Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort Study.

    Science.gov (United States)

    Mishra, Rakesh K; Yang, Wei; Roy, Jason; Anderson, Amanda H; Bansal, Nisha; Chen, Jing; DeFilippi, Christopher; Delafontaine, Patrice; Feldman, Harold I; Kallem, Radhakrishna; Kusek, John W; Lora, Claudia M; Rosas, Sylvia E; Go, Alan S; Shlipak, Michael G

    2015-07-01

    Chronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF. We studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4). Symptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors. © 2015 American Heart Association, Inc.

  1. The new deal at the top.

    Science.gov (United States)

    Doz, Yves L; Kosonen, Mikko

    2007-06-01

    What makes a company strategically agile--able to alter its strategies and business models rapidly in response to major changes in its market space, and to do so repeatedly without major trauma? Three years of in-depth case research on a dozen large companies worldwide showed the authors that one key factor is a new leadership model at the top. Senior executives at agile companies assume collective rather than individual responsibility for results. They build interdependencies among units and divisions, motivating themselves to engage with one another, and carefully manage their dealings to promote collaboration that is frequent, intense, informal, open, and focused on shared issues and the long term. Challenges to conventional thinking are encouraged. This is the new deal, and it's not easy to strike, because it requires executives to act in ways that are far from comfortable. After all, the corporate ladder at most firms favors independent types with a deep need for power and autonomy. At executive meetings, disagreement is suppressed or expressed passive-aggressively, eroding any real sense of belonging to a team. Switching to the new deal almost always requires a huge shift in the company's culture, values, and norms of interaction. The authors describe three approaches to making the shift: Executives can be given formal responsibility not for a business unit but for different stages in the company's value chain. This worked well for SAP, which has a relatively focused business portfolio. When a company's portfolio is less uniform, like Nokia's, business and functional units can be organized to crisscross on a matrix. And when a company is widely diverse, like easyGroup, it can emphasize the learning opportunities that units with common business models may share.

  2. RapidArc, intensity modulated photon and proton techniques for recurrent prostate cancer in previously irradiated patients: a treatment planning comparison study

    International Nuclear Information System (INIS)

    Weber, Damien C; Miralbell, Raymond; Wang, Hui; Cozzi, Luca; Dipasquale, Giovanna; Khan, Haleem G; Ratib, Osman; Rouzaud, Michel; Vees, Hansjoerg; Zaidi, Habib

    2009-01-01

    A study was performed comparing volumetric modulated arcs (RA) and intensity modulation (with photons, IMRT, or protons, IMPT) radiation therapy (RT) for patients with recurrent prostate cancer after RT. Plans for RA, IMRT and IMPT were optimized for 7 patients. Prescribed dose was 56 Gy in 14 fractions. The recurrent gross tumor volume (GTV) was defined on 18 F-fluorocholine PET/CT scans. Plans aimed to cover at least 95% of the planning target volume with a dose > 50.4 Gy. A maximum dose (D Max ) of 61.6 Gy was allowed to 5% of the GTV. For the urethra, D Max was constrained to 37 Gy. Rectal D Median was < 17 Gy. Results were analyzed using Dose-Volume Histogram and conformity index (CI 90 ) parameters. Tumor coverage (GTV and PTV) was improved with RA (V 95% 92.6 ± 7.9 and 83.7 ± 3.3%), when compared to IMRT (V 95% 88.6 ± 10.8 and 77.2 ± 2.2%). The corresponding values for IMPT were intermediate for the GTV (V 95% 88.9 ± 10.5%) and better for the PTV (V 95% 85.6 ± 5.0%). The percentages of rectal and urethral volumes receiving intermediate doses (35 Gy) were significantly decreased with RA (5.1 ± 3.0 and 38.0 ± 25.3%) and IMPT (3.9 ± 2.7 and 25.1 ± 21.1%), when compared to IMRT (9.8 ± 5.3 and 60.7 ± 41.7%). CI 90 was 1.3 ± 0.1 for photons and 1.6 ± 0.2 for protons. Integral Dose was 1.1 ± 0.5 Gy*cm 3 *10 5 for IMPT and about a factor three higher for all photon's techniques. RA and IMPT showed improvements in conformal avoidance relative to fixed beam IMRT for 7 patients with recurrent prostate cancer. IMPT showed further sparing of organs at risk

  3. Phase 2 study of tabalumab, a human anti-B-cell activating factor antibody, with bortezomib and dexamethasone in patients with previously treated multiple myeloma.

    Science.gov (United States)

    Raje, Noopur S; Moreau, Philippe; Terpos, Evangelos; Benboubker, Lotfi; Grząśko, Norbert; Holstein, Sarah A; Oriol, Albert; Huang, Shang-Yi; Beksac, Meral; Kuliczkowski, Kazimierz; Tai, Datchen F; Wooldridge, James E; Conti, Ilaria; Kaiser, Christopher J; Nguyen, Tuan S; Cronier, Damien M; Palumbo, Antonio

    2017-03-01

    In this double-blind, Phase 2 study, 220 patients with relapsed/refractory multiple myeloma were randomly assigned 1:1:1 to receive placebo (N = 72), tabalumab 100 mg (N = 74), or tabalumab 300 mg (N = 74), each in combination with dexamethasone 20 mg and subcutaneous bortezomib 1·3 mg/m 2 on a 21-day cycle. No significant intergroup differences were observed among primary (median progression-free survival [mPFS]) or secondary efficacy outcomes. The mPFS was 6·6, 7·5 and 7·6 months for the tabalumab 100, 300 mg and placebo groups, respectively (tabalumab 100 mg vs. placebo Hazard ratio (HR) [95% confidence interval (CI)] = 1·13 [0·80-1·59], P = 0·480; tabalumab 300 mg vs. placebo HR [95% CI] = 1·03 [0·72-1·45], P = 0·884). The most commonly-reported treatment-emergent adverse events were thrombocytopenia (37%), fatigue (37%), diarrhoea (35%) and constipation (32%). Across treatments, patients with low baseline BAFF (also termed TNFSF13B) expression (n = 162) had significantly longer mPFS than those with high BAFF expression (n = 55), using the 75th percentile cut-off point (mPFS [95% CI] = 8·3 [7·0-9·3] months vs. 5·8 [3·7-6·6] months; HR [95% CI] = 1·59 [1·11-2·29], P = 0·015). Although generally well tolerated, PFS was not improved during treatment with tabalumab compared to placebo. A higher dose of 300 mg tabalumab did not improve efficacy compared to the 100 mg dose. Nonetheless, BAFF appears to have some prognostic value in patients with multiple myeloma. © 2016 John Wiley & Sons Ltd.

  4. Great deal achieved at Cape's nuclear island

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Since the civil engineering contract commenced a great deal has been achieved at Escom's Koeberg nuclear power station north of Cape Town. About 50 percent of the civil work has now been done and the entire project remains on schedule for a January 1982 start-up on nuclear reactor unit number one and a January 1983 start-up on unit two. Final handover is scheduled for January 1984. Completion of the civil works is scheduled for December 1981. The construction of the Koeberg nuclear power station is discussed, as well as the contractors for the civil engineering work

  5. Previously unknown species of Aspergillus.

    Science.gov (United States)

    Gautier, M; Normand, A-C; Ranque, S

    2016-08-01

    The use of multi-locus DNA sequence analysis has led to the description of previously unknown 'cryptic' Aspergillus species, whereas classical morphology-based identification of Aspergillus remains limited to the section or species-complex level. The current literature highlights two main features concerning these 'cryptic' Aspergillus species. First, the prevalence of such species in clinical samples is relatively high compared with emergent filamentous fungal taxa such as Mucorales, Scedosporium or Fusarium. Second, it is clearly important to identify these species in the clinical laboratory because of the high frequency of antifungal drug-resistant isolates of such Aspergillus species. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been shown to enable the identification of filamentous fungi with an accuracy similar to that of DNA sequence-based methods. As MALDI-TOF MS is well suited to the routine clinical laboratory workflow, it facilitates the identification of these 'cryptic' Aspergillus species at the routine mycology bench. The rapid establishment of enhanced filamentous fungi identification facilities will lead to a better understanding of the epidemiology and clinical importance of these emerging Aspergillus species. Based on routine MALDI-TOF MS-based identification results, we provide original insights into the key interpretation issues of a positive Aspergillus culture from a clinical sample. Which ubiquitous species that are frequently isolated from air samples are rarely involved in human invasive disease? Can both the species and the type of biological sample indicate Aspergillus carriage, colonization or infection in a patient? Highly accurate routine filamentous fungi identification is central to enhance the understanding of these previously unknown Aspergillus species, with a vital impact on further improved patient care. Copyright © 2016 European Society of Clinical Microbiology and

  6. Dealing with pupils digital everyday life

    Directory of Open Access Journals (Sweden)

    Carl F. Dons.

    2008-11-01

    Full Text Available The main aim of this article is to answer the following research question: How can we prepare student teachers to deal with pupils who have a wide range of day-to-day experiences of the digital world? This question arises out of the understanding that today's student-teacher training is inadequately equipped to realize the potential for learning found in the way that digital technology is now an integral part of the social and cultural practices of children and young people. Based on theory and practice from research and development activities in primary and lower secondary school, the article points out some perspectives connected to the technology culture of children and young people that may have importance for the professional training of student teachers. The article concludes by summarizing some findings from a research project in general teacher education, where it is argued that student teachers can be qualified to cope with the way children and young people use technology by teaching them to adopt solutions based on personal publishing. In many ways the article deals with classical issues in the education field; how the relations between cognition, learning, technology and fellow-citizenship raise practical issues connected to teaching and learning (Dewey, 1915; 1938; 1958.

  7. [Dealing with diagnostic uncertainty in general practice].

    Science.gov (United States)

    Wübken, Magdalena; Oswald, Jana; Schneider, Antonius

    2013-01-01

    In general, the prevalence of diseases is low in primary care. Therefore, the positive predictive value of diagnostic tests is lower than in hospitals where patients are highly selected. In addition, the patients present with milder forms of disease; and many diseases might hide behind the initial symptom(s). These facts lead to diagnostic uncertainty which is somewhat inherent to general practice. This narrative review discusses different sources of and reasons for uncertainty and strategies to deal with it in the context of the current literature. Fear of uncertainty correlates with higher diagnostic activities. The attitude towards uncertainty correlates with the choice of medical speciality by vocational trainees or medical students. An intolerance of uncertainty, which still increases as medicine is making steady progress, might partly explain the growing shortage of general practitioners. The bio-psycho-social context appears to be important to diagnostic decision-making. The effect of intuition and heuristics are investigated by cognitive psychologists. It is still unclear whether these aspects are prone to bias or useful, which might depend on the context of medical decisions. Good communication is of great importance to share uncertainty with the patients in a transparent way and to alleviate shared decision-making. Dealing with uncertainty should be seen as an important core component of general practice and needs to be investigated in more detail to improve the respective medical decisions. Copyright © 2013. Published by Elsevier GmbH.

  8. Review of previous geophysical and geological studies

    Digital Repository Service at National Institute of Oceanography (India)

    Levchenko, O.V.; Neprochnov, Y.P; Rao, D.G; Subrahmanyam, C.; Murthy, K.S

    stream_size 5 stream_content_type text/plain stream_name Mem_Geol_Soc_India_39_5.pdf.txt stream_source_info Mem_Geol_Soc_India_39_5.pdf.txt Content-Encoding ISO-8859-1 Content-Type text/plain; charset=ISO-8859-1 ...

  9. Preoperative screening: value of previous tests.

    Science.gov (United States)

    Macpherson, D S; Snow, R; Lofgren, R P

    1990-12-15

    To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. Retrospective cohort analysis of computerized laboratory data (complete blood count, sodium, potassium, and creatinine levels, prothrombin time, and partial thromboplastin time). Urban tertiary care Veterans Affairs Hospital. Consecutive sample of 1109 patients who had elective surgery in 1988. At admission, 7549 preoperative tests were done, 47% of which duplicated tests performed in the previous year. Of 3096 previous results that were normal as defined by hospital reference range and done closest to the time of but before admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat values were outside a range considered acceptable for surgery. Most of the abnormalities were predictable from the patient's history, and most were not noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%; CI, 13% to 20%) repeat values at admission were outside a range considered acceptable for surgery (P less than 0.001, frequency of clinically important abnormalities of patients with normal previous results with those with abnormal previous results). Physicians evaluating patients preoperatively could safely substitute the previous test results analyzed in this study for preoperative screening tests if the previous tests are normal and no obvious indication for retesting is present.

  10. Dealing with Uncertainties in Initial Orbit Determination

    Science.gov (United States)

    Armellin, Roberto; Di Lizia, Pierluigi; Zanetti, Renato

    2015-01-01

    A method to deal with uncertainties in initial orbit determination (IOD) is presented. This is based on the use of Taylor differential algebra (DA) to nonlinearly map the observation uncertainties from the observation space to the state space. When a minimum set of observations is available DA is used to expand the solution of the IOD problem in Taylor series with respect to measurement errors. When more observations are available high order inversion tools are exploited to obtain full state pseudo-observations at a common epoch. The mean and covariance of these pseudo-observations are nonlinearly computed by evaluating the expectation of high order Taylor polynomials. Finally, a linear scheme is employed to update the current knowledge of the orbit. Angles-only observations are considered and simplified Keplerian dynamics adopted to ease the explanation. Three test cases of orbit determination of artificial satellites in different orbital regimes are presented to discuss the feature and performances of the proposed methodology.

  11. Dealing with local and international media - experience of Lithuania

    International Nuclear Information System (INIS)

    Bieliauskas, V.

    2000-01-01

    Public acceptance is one of most serious conditions for nuclear power introduction or successful operation of nuclear power plants. After restoring it's independence, Lithuania inherited large nuclear power plant RBMK type reactors widely known as Chernobyl type reactors. Several small case studies of dealing with the media on nuclear matters are presented and efforts to adopt an active attitude on different levels are described. (author)

  12. Golimumab in patients with active rheumatoid arthritis who have previous experience with tumour necrosis factor inhibitors: results of a long-term extension of the randomised, double-blind, placebo-controlled GO-AFTER study through week 160

    NARCIS (Netherlands)

    Smolen, Josef S.; Kay, Jonathan; Landewé, Robert B. M.; Matteson, Eric L.; Gaylis, Norman; Wollenhaupt, Jurgen; Murphy, Frederick T.; Zhou, Yiying; Hsia, Elizabeth C.; Doyle, Mittie K.

    2012-01-01

    The aim of this study was to assess long-term golimumab therapy in patients with rheumatoid arthritis (RA) who discontinued previous tumour necrosis factor alpha (TNFα) inhibitor(s) for any reason. Results through week 24 of this multicentre, randomised, double-blind, placebo-controlled study of

  13. Impact of frequency of use of deal sites on intention to use deal sites

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2016-01-01

    Deal sites are used as a marketing communication tool for some time now. But there is still only a limited number of papers investigating its adoption and use. The Technology Adoption Model posits that there is a link between the intention to use technology and the actual use of technology...

  14. Subsequent pregnancy outcome after previous foetal death

    NARCIS (Netherlands)

    Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.

    Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to

  15. Do Gender and Personality Traits Influence Frequency of Use of Deal Sites?

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2016-01-01

    Although deal sites cannot be considered a new technology anymore, there is still only a limited amount of quantitative research on the topic. The paper aims to expand the body of knowledge. The study investigates impact of gender and personality traits on frequency of use of deal sites. Big Five...... Inventory-10 is used to measure personality traits. Three models are tested. First, all respondents are taken into account, i.e. also ones not aware of deal sites. In the first model, only gender is significant. Second, only respondents aware of deal sites are taken into account. In the second model...

  16. Has evolution 'prepared' us to deal with death ...

    African Journals Online (AJOL)

    Has evolution 'prepared' us to deal with death? ... brain with its enlarged Broca's area suggests the possibility of a sophisticated communication system and an enhanced way of dealing with emotion. ... Some attention is given to this thesis.

  17. Aspects of dealing with orphan sources

    International Nuclear Information System (INIS)

    Lovjagina, Irina

    2008-01-01

    Full text: Since Latvia joined the European Union (EU) in 2004, State have to apply EURATOM Council Directives on 2003/122/EURATOM with provisions of IAEA Code of Conduct for the Safety and Security of Radioactive Sources to comply with the Directive before 31 December 2005, to harmonize controls within European Community Member States. It is mentioned, that State have to bring into a force the laws, regulations and administrative provisions to comply with a requirements, to ensuring that each source is kept under control. Radiation sources are used around the world for variose applications, in industries, research, medicine and nuclear issues. Instead planned risk for normal use of those, for orphane sources often at the first stage of early response we have lot of uncertainties: unknown composition of radionuclides, wide activity frames, different construction and question of possible external contamination. Taken into account importance of this issue in the last few years in Latvia the control on custom, borders, scrapt yards control of transit of goods, incl. metals, were reinforced and normative basis is the country were improved. Finding of sources in scrapt metal or metal production/processing facilities become often events. Such sources may be dangerous not only to persons dealing with source, but local environment too, cause releases, contamination of facility and production, extra high costs for monitoring, cleaning up and wide variety of decontamination procedures applying. Prevention of radiological incidents starts from planning of our work, and transparency the whole 'life cycle' of source, from producer to disposal, recorded and verified, as well as notified to the Authorities. Early warning response (24-hours duty) and consultative phone service at Radiation Protection Authority is maintained; guidelines and working procedures within Authority and other Institutions involving were developed and implemented. As a result, Co-60, Cs-137 and Sr-90

  18. Global Green New Deal. Policy Brief

    International Nuclear Information System (INIS)

    2009-03-01

    The 'Global Green New Deal' (GGND) presented here has three broad objectives. It should make a major contribution to reviving the world economy, saving and creating jobs, and protecting vulnerable groups. It should promote sustainable and inclusive growth and the achievement of the MDGs, especially ending extreme poverty by 2015. Also, it must reduce carbon dependency and ecosystem degradation. These are key risks along a path to a sustainable world economy. Our consultations and our commissioned research, summarized here in this Policy Brief, make a strong case for the active 'greening' of proposed fiscal stimulus packages. However, this must also be backed by necessary changes in international and domestic policy architectures, as the current framework is biased in favour of resurrecting an unsustainable 'brown economy'. Our proposals are therefore grouped under three categories - targeted stimulus spending in 2009-10, changes in domestic policies, and changes in international policy architecture. Furthermore, we recognize that many less developed countries do not have the resources of their own and will have to rely on foreign aid and support, both financial and non-financial. We propose that the fiscal stimulus (to be applied over 2009 and 2010) should prioritize energy efficient buildings and investments in sustainable transport and renewable energy. Developing countries should prioritize investment in agricultural productivity measures, freshwater management, and sanitation, as these have demonstrable and exceptional social returns. Domestic policy reforms are recommended to substantially reduce perverse subsidies (eg: fossil fuels) and instead to create positive incentives and appropriate taxes which will encourage a greener economy. Domestic reforms should also address some common issues in land use and urban policy. Integrated management of freshwater would also require some domestic policy changes, and this should be prioritized by developing countries

  19. How Should Generation Enterprises Deal with Crisis?

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Since October 2008,China's social consumption of electricity had,for the first time,grown negatively compared to the same period of the previous year,and in November the negative growth range further expanded. The major pressure faced by the electricity industry has now turned from the contradiction between coal and electricity to electricity quantity. This is undoubtedly a true and new test to electricity enterprises which get used to high growth but are now suffering great losses. The reform of electricit...

  20. Actual Problems of Civil Law Deals Signing in Internet

    Directory of Open Access Journals (Sweden)

    Makhinya E. A.

    2013-10-01

    Full Text Available The article deals with the problems connected with making deals in Internet. Here is analyzed the legal regulation of electronic transactions. The special attention is paid to the most characteristic peculiarities of making elec- tronic transactions such as identification of participants, transactional character of making electronic deals.

  1. DEALS: a maintainable superconducting magnet system for tokamak fusion reactors

    International Nuclear Information System (INIS)

    Hseih, S.Y.; Danby, G.; Powell, J.R.

    1979-01-01

    The feasibility of demountable superconducting magnet systems has been examined in a design study of a DEALS [Demountable Externally Anchored Low Stress] TF magnet for an HFITR [High Field Ignition Test Reactor] Tokamak device. All parts of the system appear feasible, including the demountable superconducting joints. Measurements on small scale prototype joints indicate that movable pressure contact joints exhibit acceptable electrical, mechanical, and cryogenic performance. Such joints permit a relatively simple support structure and are readily demountable. Assembly and disassembly sequences are described whereby any failed portion of the magnet, or any part of the reactor inside the TF coils can be removed and replaced if necessary

  2. Dealing with hunger: Metabolic stress responses in tumors

    Directory of Open Access Journals (Sweden)

    Michael A Reid

    2013-01-01

    Full Text Available Increased nutrient uptake and usage is a hallmark of many human malignancies. During the course of tumorigenesis, cancer cells often outstrip their local nutrient supply leading to periods of nutrient deprivation. Interestingly, cancer cells often develop strategies to adapt and survive these challenging conditions. Accordingly, understanding these processes is critical for developing therapies that target cancer metabolism. Exciting new progress has been made in elucidating the mechanisms used by cancer cells under nutrient restricted conditions. In this review, we highlight recent studies that have brought insight into how cancer cells deal with low nutrient environments.

  3. ECONOMICS NOBEL: Dealing With Biases and Discrete Choices.

    Science.gov (United States)

    Seife, C

    2000-10-20

    This year's Bank of Sweden Prize in Economic Sciences, given in honor of Alfred Nobel, goes to two researchers who gave the field of microeconomics--the study of individuals' economic behavior--new tools to help draw conclusions from imperfect data. James Heckman of the University of Chicago wins half of this year's prize for coming up with ways to deal with selection biases. Daniel McFadden of the University of California, Berkeley, tackled a different conundrum: how to quantify discrete choices rather than continuous ones.

  4. How would we deal with radiation related issues in high school educational programs?

    International Nuclear Information System (INIS)

    Saeki, Kuniko

    1999-01-01

    Current educational curriculum will be more improved and the materials in schools will be somewhat different by the year of 2002 when students have two days off in a week. It is a well known fact that recent Japanese people's level of understanding about Science and Technology is the second from the bottom among OECD nations and, as a matter of fact, few schools are dealing with scientific issues such as atomic energy or radiation. High school teachers need to survey what students know about atomic power and radiation, how deep they studied in previous schools and what kind of interest they have in conservation of world energy sources or environmental issues discussed today. Through questionnaires to 328 students, it became clear that they were most interesting to the effect of radiation or radioactivity on any kind of things in the environment, and that they want to know solutions for those problems such as greenhouse effect, ozone layers and Garbage disposal. (M. Suetake)

  5. Columnar modelling of nucleation burst evolution in the convective boundary layer – first results from a feasibility study Part IV: A compilation of previous observations for valuation of simulation results from a columnar modelling study

    Directory of Open Access Journals (Sweden)

    O. Hellmuth

    2006-01-01

    according to the parameterisation of the collision-controlled binary nucleation rate proposed by Weber et al. (1996, H2O vapour does not explicitly affect the particle formation. Since the H2SO4 concentration is overpredicted in the simulations presented in Paper III, the nucleation rates are too high compared to previous estimations. Therefore, the results are not directly comparable to measurements. Especially NPF events, where organics are suspected to play a key role, such as those observed at the boreal forest station in Hyytiälä (Southern Finland or at Hohenpeissenberg (mountain site in Southern Germany, can not be explained by employing simple sulphur/ammonia chemistry. However, some valuable hints regarding the role of CBL turbulence in NPF can be obtained. In the literature a number of observations on the link between turbulence and NPF can be found, whose burst patterns support a strong contribution of CBL turbulence to the NPF burst evolution simulated here. Observations, that do not correspond to the scenarios are discussed with respect to possible reasons for the differences between model and observation. The model simulations support some state-of-the-art hypotheses on the contribution of CBL turbulence to NPF. Considering the application of box models, the present study shows, that CBL turbulence, not explicitly considered in such models, can strongly affect the spatio-temporal NPF burst evolution. The columnar high-order model presented here is a helpful tool to elucidate gas-aerosol-turbulence interactions, especially the genesis of NPF bursts in the CBL. An advanced description of the cluster formation and condensation growth is required as well as a comprehensive verification/validation study using observed high-order moments. Further scenario simulations remain to be performed.

  6. Concurrent Chemoradiotherapy Followed by Consolidation Chemotherapy With Bi-Weekly Docetaxel and Carboplatin for Stage III Unresectable, Non-Small-Cell Lung Cancer: Clinical Application of a Protocol Used in a Previous Phase II Study

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, Jun-Ichi, E-mail: junsaito@sannet.ne.jp [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Sakai, Hiroshi; Kurimoto, Futoshi [Division of Respiratory Disease, Saitama Cancer Center, Saitama (Japan); Kato, Shingo [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Shibuya, Kei [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan)

    2012-04-01

    Purpose: To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC). Methods and Materials: Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m{sup 2}, and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy. Results: The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade {>=}3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade {>=}3 severity were observed in 2.6% and 1.7% of patients, respectively. Conclusions: The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

  7. Concurrent Chemoradiotherapy Followed by Consolidation Chemotherapy With Bi-Weekly Docetaxel and Carboplatin for Stage III Unresectable, Non-Small-Cell Lung Cancer: Clinical Application of a Protocol Used in a Previous Phase II Study

    International Nuclear Information System (INIS)

    Saitoh, Jun-Ichi; Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro; Sakai, Hiroshi; Kurimoto, Futoshi; Kato, Shingo; Shibuya, Kei

    2012-01-01

    Purpose: To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC). Methods and Materials: Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m 2 , and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy. Results: The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade ≥3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade ≥3 severity were observed in 2.6% and 1.7% of patients, respectively. Conclusions: The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

  8. Obama: towards an energy green new deal?

    International Nuclear Information System (INIS)

    2009-09-01

    After the announcement of the very ambitious 'New Energy for America' plan, the author comments what could change, and what may not change in the U.S. energy policy. He recalls that most of the previous American presidents stressed a necessary energy independence which, in fact, has never been reached. He indicates that energy consumption per capita is particularly high in this country as well as greenhouse gas emissions which has been increasing during the last decades. The author highlights the heterogeneous situations which can be observed among the different states in terms of sources of energy and of electricity import. This heterogeneity renders rather difficult to reach a consensus on issues like carbon dioxide market. Then, the author discusses the influence of climate change on public awareness. In the second part of the article, the author discusses the relationship between energy consumption and economic growth in an historical perspective. He notices that some efforts in energy saving may finally result in an increase of energy consumption, that which questions the American way of life

  9. Subsequent childbirth after a previous traumatic birth.

    Science.gov (United States)

    Beck, Cheryl Tatano; Watson, Sue

    2010-01-01

    Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.

  10. Towards a grand deal on subsidies and climate change

    International Nuclear Information System (INIS)

    Moor, Andre de

    2001-01-01

    Recent studies have identified public subsidies as a principal cause of unsustainable development. Worldwide, governments are spending up to $US950 billion a year on subsidies. Many of these public subsidies fail to serve their purpose and in fact, often turn out as policy failures as they further distort trade and cause environmental harm. The energy sector is among the most subsidized sectors in the world, receiving over $US240 billion per annum of public subsidies. This article highlights current energy subsidies and their implications. The article examines: (i) the global size and distribution of energy subsidies in industrialized and developing countries; (ii) the impact of these subsidies on the economy, equity and the environment ana their role as barriers for sustainable development; (iii) the political economy behind public subsidies and the various political and institutional barriers and lock-in mechanisms that cause subsidies to become entrenched in economic and public structures; and (iv) proposals for effective subsidy reform in energy policies, suggesting a global strategy to eliminate energy subsidies. OECD governments are in a position to take the lead, and the UN Framework Convention on Climate Change presents an excellent opportunity of striking a political grand deal and linking the reform of energy subsidies to a meaningful participation of developing countries to the Kyoto Protocol. Moreover, if sinks are to be included in the clean development mechanism (CDM), it is crucial to include the removal of forestry subsidies in the grand deal. (author)

  11. Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors

    Directory of Open Access Journals (Sweden)

    Ali Harlak

    2010-01-01

    Full Text Available PURPOSE: Sacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease. METHOD: Previously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients. RESULTS: Stiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001. With an adjusted odds ratio of 1.3 (p<.001, body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease. CONCLUSIONS: Hairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible.

  12. Do Gender and Personality Traits Influence Awareness of Deal Sites?

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2015-01-01

    Deal sites exist for a decade now but there are still some people who have not heard about them. The research pre-sented in the paper investigates if gender and personality traits influence awareness of deal sites. Big Five Inventory-10 is used to measure personality traits. The findings...... are that gender does not influence awareness, and neuroticism is the most significant personality trait influencing awareness of deal sites - the more neurotic the person is, the higher is the probability that he or she has never heard of deal sites....

  13. IRANIAN FOREIGN POLICY AFTER THE NUCLEAR DEAL

    Science.gov (United States)

    2016-02-16

    studies from Kings College London (KCL). He worked in several staff positions and he is currently a student at the Air War College at Maxwell Air...the north, and the Persian Gulf, Gulf of Oman and Indian Ocean to the south. 1 Zagros and Alborz mountain ranges are located in the western and...perception. Persia fell under foreign occupation several times. The fall of the Persian Achaemenian dynasty to Alexander the Great in (330 B.C.) is

  14. Strategies for Dealing with the Defense Budget

    Science.gov (United States)

    1983-08-17

    changes were computed and are shown in Tables B-3 and B-4, on pages B-66 and B-67. B.6 ACQUISITION PROGRAM TURBULENCE The purpose of this section is to...planning. The following brief overviev / of the NAVMAT study illustrates this cause of program turbulence. Figure C-13 shows the NAVMAT analytical...Inflation, Industrial Base, Life-Cycle Costs, Material Acquisition, Material Balance, Multi-year Contracting/procurement, Planning, Programming and

  15. Does local endometrial injury in the nontransfer cycle improve the IVF-ET outcome in the subsequent cycle in patients with previous unsuccessful IVF? A randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Sachin A Narvekar

    2010-01-01

    Full Text Available Background: Management of repeated implantation failure despite transfer of good-quality embryos still remains a dilemma for ART specialists. Scrapping of endometrium in the nontransfer cycle has been shown to improve the pregnancy rate in the subsequent IVF/ET cycle in recent studies. Aim: The objective of this randomized controlled trial (RCT was to determine whether endometrial injury caused by Pipelle sampling in the nontransfer cycle could improve the probability of pregnancy in the subsequent IVF cycle in patients who had previous failed IVF outcome. Setting: Tertiary assisted conception center. Design: Randomized controlled study. Materials and Methods: 100 eligible patients with previous failed IVF despite transfer of good-quality embryos were randomly allocated to the intervention group and control groups. In the intervention group, Pipelle endometrial sampling was done twice: One in the follicular phase and again in the luteal phase in the cycle preceding the embryo transfer cycle. Outcome Measure: The primary outcome measure was live birth rate. The secondary outcome measures were implantation and clinical pregnancy rates. Results: The live birth rate was significantly higher in the intervention group compared to control group (22.4% and 9.8% P = 0.04. The clinical pregnancy rate in the intervention group was 32.7%, while that in the control group was 13.7%, which was also statistically significant ( P = 0.01. The implantation rate was significantly higher in the intervention group as compared to controls (13.07% vs 7.1% P = 0.04. Conclusions: Endometrial injury in nontransfer cycle improves the live birth rate,clinical pregnancy and implantation rates in the subsequent IVF-ET cycle in patients with previous unsuccessful IVF cycles.

  16. The Efficacy and Safety of Icotinib in Patients with Advanced Non-Small Cell Lung Cancer Previously Treated with Chemotherapy: A Single-Arm, Multi-Center, Prospective Study.

    Directory of Open Access Journals (Sweden)

    Xingsheng Hu

    Full Text Available Icotinib is a small molecule targeting epidermal growth factor receptor tyrosine kinase, which shows non-inferior efficacy and better safety comparing to gefitinib in previous phase III trial. The present study was designed to further evaluate the efficacy and safety of icotinib in patients with advanced non-small-cell lung cancer (NSCLC previously treated with platinum-based chemotherapy.Patients with NSCLC progressing after one or two lines of chemotherapy were enrolled to receive oral icotinib (125 mg tablet, three times per day. The primary endpoint was progression-free survival. The secondary endpoints included overall survival, objective response rate, time to progression, quality of life and safety.From March 16, 2010 to October 9, 2011, 128 patients from 15 centers nationwide were enrolled, in which 124 patients were available for efficacy evaluation and 127 patients were evaluable for safety. The median progression-free survival and time to progression were 5.0 months (95%CI 2.9-6.6 m and 5.4 months (95%CI 3.1-7.9 m, respectively. The objective response rate and disease control rate were 25.8% and 67.7% respectively. Median overall survival exceeded 17.6 months (95%CI 14.2 m-NA according to censored data. Further follow-up of overall survival is ongoing. The most frequent treatment-related adverse events were rash (26%, 33/127, diarrhea (12.6%, 16/127 and elevation of transaminase (15.7%, 20/127.In general, this study showed similar efficacy and numerically better safety when compared with that in ICOGEN trial, further confirming the efficacy and safety of icotinib in treating patients with advanced NSCLC previously treated with chemotherapy.ClinicalTrials.gov NCT02486354.

  17. The Efficacy and Safety of Icotinib in Patients with Advanced Non-Small Cell Lung Cancer Previously Treated with Chemotherapy: A Single-Arm, Multi-Center, Prospective Study.

    Science.gov (United States)

    Hu, Xingsheng; Zhang, Li; Shi, Yuankai; Zhou, Caicun; Liu, Xiaoqing; Wang, Dong; Song, Yong; Li, Qiang; Feng, Jifeng; Qin, Shukui; Xv, Nong; Zhou, Jianying; Zhang, Li; Hu, Chunhong; Zhang, Shucai; Luo, Rongcheng; Wang, Jie; Tan, Fenlai; Wang, Yinxiang; Ding, Lieming; Sun, Yan

    2015-01-01

    Icotinib is a small molecule targeting epidermal growth factor receptor tyrosine kinase, which shows non-inferior efficacy and better safety comparing to gefitinib in previous phase III trial. The present study was designed to further evaluate the efficacy and safety of icotinib in patients with advanced non-small-cell lung cancer (NSCLC) previously treated with platinum-based chemotherapy. Patients with NSCLC progressing after one or two lines of chemotherapy were enrolled to receive oral icotinib (125 mg tablet, three times per day). The primary endpoint was progression-free survival. The secondary endpoints included overall survival, objective response rate, time to progression, quality of life and safety. From March 16, 2010 to October 9, 2011, 128 patients from 15 centers nationwide were enrolled, in which 124 patients were available for efficacy evaluation and 127 patients were evaluable for safety. The median progression-free survival and time to progression were 5.0 months (95%CI 2.9-6.6 m) and 5.4 months (95%CI 3.1-7.9 m), respectively. The objective response rate and disease control rate were 25.8% and 67.7% respectively. Median overall survival exceeded 17.6 months (95%CI 14.2 m-NA) according to censored data. Further follow-up of overall survival is ongoing. The most frequent treatment-related adverse events were rash (26%, 33/127), diarrhea (12.6%, 16/127) and elevation of transaminase (15.7%, 20/127). In general, this study showed similar efficacy and numerically better safety when compared with that in ICOGEN trial, further confirming the efficacy and safety of icotinib in treating patients with advanced NSCLC previously treated with chemotherapy. ClinicalTrials.gov NCT02486354.

  18. Dyadic coping within couples dealing with breast cancer

    DEFF Research Database (Denmark)

    Rottmann, Nina; Hansen, Dorte Gilså; Larsen, Pia Veldt

    2015-01-01

    OBJECTIVE: The way couples deal with stressors is likely to influence their adjustment after breast cancer diagnosis. Based on the systemic-transactional model, this study examined whether the supportive, delegated and negative dyadic coping provided by patients and partners and their common dyadic...... coping as a couple were associated with change in relationship quality and depressive symptoms over time. METHOD: Women with breast cancer and their male partners (N = 538 couples) participated in a longitudinal study (Time 1, ≤4 months after surgery; Time 2, 5 months later). Dyadic coping was assessed...... was adversely associated with both patients' and partners' outcomes. The more patients rated the couple as engaging in common dyadic coping, the higher relationship quality and the fewer depressive symptoms both patients and partners experienced. Patients experienced more depressive symptoms the more delegated...

  19. Dealing with death: medical students' experiences with patient loss.

    Science.gov (United States)

    Pessagno, Regina; Foote, Carrie E; Aponte, Robert

    This article explores medical students' experiences and coping strategies when confronting patient loss in their 3rd and 4th years of their programs. Much of the literature on the impact of patient losses focuses on physicians. This article joins a handful of works aimed at how medical students experience and cope with patient loss. In-depth interviews with 20 medical students provided rich descriptions of their varying experiences coping with death. Consistent with previous work, students experience substantial emotional stress coping with patient deaths, though some were more difficult to bear than others, such as when the dying patient was a child or when treatment errors could have contributed to deaths. Common coping mechanisms included talking through their emotions, thrusting themselves into continuing their rounds, crying, participating in infant death rituals, and turning to religion. When deaths occurred, senior personnel who exhibited empathy toward the deceased and tolerance toward the students' emotional responses were lauded and made the process easier. Also emotionally daunting, in many instances, was dealing with the families of dying patients. Most of the students did not view death as a failure, contrary to much earlier literature, except in instances in which human error or decision making may have played a part in causing the death of a patient.

  20. Staff competence in dealing with traditional approaches

    DEFF Research Database (Denmark)

    Kastrup, M.

    2008-01-01

    backgrounds of patients there is a need for mental health professionals to recognize the existence of traditional approaches and be aware of the parallel systems of care. Competent treatment of such patients requires that mental health professionals are aware of this and exhibit a willingness and ability...... to bridge between the more traditional and the Western approaches to treatment. The delineations and various aspects of the concept cultural competence and its dimensions will be discussed from a clinical perspective. Comparative studies of the various Western and the traditional approaches respectively...

  1. Talent development – dealing with potentiality

    DEFF Research Database (Denmark)

    Olesen, Jesper; Nielsen, Jens Christian; Søndergaard, Dorte Marie

    2017-01-01

    - and a talent development environment which, in their encounter, creates an affect that produces talent. Based on a case study on Jamie, a badminton player, we show that the combined talent/development assemblage is capable of maintaining a talent despite the fact that Jamie has a long-term injury...... and is completely unable to play badminton for long periods of time. We argue that talent development is a particular way of handling potentiality which, in the struggle to achieve the ultimate goal of excellence, results in a number of affects: it translates potential into a singular talent; it enables...

  2. New ways for dealing with radiations burns

    International Nuclear Information System (INIS)

    2015-01-01

    Cell therapy has revolutionized the treatment of radiation burns of the skin for 10 years. The injection of mesenchymal stem cells combined with surgery is a successful protocol but the use of mesenchymal stem cell brings risks in terms of time: the intervention on the wound is delayed till a sufficient population of mesenchymal cells is achieved through cultivation. Furthermore the original mesenchymal cells are obtained from an invasive and painful removal of bone marrow and the number of adequate cells in the sampling depends strongly on the patient's age. In order to tackle these issues, various options are being studied. First, a direct injection of the mesenchymal stem cells in the wound without awaiting their cultivation. An experimental study shows that this option favors the restoration of the dermis and the vascularisation of the wounded area. Secondly, the injection of endothelial progenitor cells (they are found in the umbilical cord) favors the vascularisation of the wound and as a consequence its healing. Thirdly, the injection of stem cells removed from fat tissues has proved to be efficient for both vascularisation and for generating skin cells. (A.C.)

  3. Effect of a supplementation with myo-inositol plus melatonin on oocyte quality in women who failed to conceive in previous in vitro fertilization cycles for poor oocyte quality: a prospective, longitudinal, cohort study.

    Science.gov (United States)

    Unfer, Vittorio; Raffone, Emanuela; Rizzo, Piero; Buffo, Silvia

    2011-11-01

    Several factors can affect oocyte quality and therefore pregnancy outcome in assisted reproductive technology (ART) cycles. Recently, a number of studies have shown that the presence of several compounds in the follicular fluid positively correlates with oocyte quality and maturation (i.e., myo-inositol and melatonin). In the present study, we aim to evaluate the pregnancy outcomes after the administration of myo-inositol combined with melatonin in women who failed to conceive in previous in vitro fertilization (IVF) cycles due to poor oocyte quality. Forty-six women were treated with 4 g/day myo-inositol and 3 mg/day melatonin (inofolic® and inofolic® Plus, Lo.Lipharma, Rome) for 3 months and then underwent a new IVF cycle. After treatment, the number of mature oocytes, the fertilization rate, the number of both, total and top-quality embryos transferred were statistically higher compared to the previous IVF cycle, while there was no difference in the number of retrieved oocyte. After treatment, a total of 13 pregnancies occurred, 9 of them were confirmed echographically; four evolved in spontaneous abortion. The treatment with myo-inositol and melatonin improves ovarian stimulation protocols and pregnancy outcomes in infertile women with poor oocyte quality.

  4. Big Data and medicine: a big deal?

    Science.gov (United States)

    Mayer-Schönberger, V; Ingelsson, E

    2018-05-01

    Big Data promises huge benefits for medical research. Looking beyond superficial increases in the amount of data collected, we identify three key areas where Big Data differs from conventional analyses of data samples: (i) data are captured more comprehensively relative to the phenomenon under study; this reduces some bias but surfaces important trade-offs, such as between data quantity and data quality; (ii) data are often analysed using machine learning tools, such as neural networks rather than conventional statistical methods resulting in systems that over time capture insights implicit in data, but remain black boxes, rarely revealing causal connections; and (iii) the purpose of the analyses of data is no longer simply answering existing questions, but hinting at novel ones and generating promising new hypotheses. As a consequence, when performed right, Big Data analyses can accelerate research. Because Big Data approaches differ so fundamentally from small data ones, research structures, processes and mindsets need to adjust. The latent value of data is being reaped through repeated reuse of data, which runs counter to existing practices not only regarding data privacy, but data management more generally. Consequently, we suggest a number of adjustments such as boards reviewing responsible data use, and incentives to facilitate comprehensive data sharing. As data's role changes to a resource of insight, we also need to acknowledge the importance of collecting and making data available as a crucial part of our research endeavours, and reassess our formal processes from career advancement to treatment approval. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  5. Ibrutinib combined with bendamustine and rituximab compared with placebo, bendamustine, and rituximab for previously treated chronic lymphocytic leukaemia or small lymphocytic lymphoma (HELIOS): a randomised, double-blind, phase 3 study.

    Science.gov (United States)

    Chanan-Khan, Asher; Cramer, Paula; Demirkan, Fatih; Fraser, Graeme; Silva, Rodrigo Santucci; Grosicki, Sebastian; Pristupa, Aleksander; Janssens, Ann; Mayer, Jiri; Bartlett, Nancy L; Dilhuydy, Marie-Sarah; Pylypenko, Halyna; Loscertales, Javier; Avigdor, Abraham; Rule, Simon; Villa, Diego; Samoilova, Olga; Panagiotidis, Panagiots; Goy, Andre; Mato, Anthony; Pavlovsky, Miguel A; Karlsson, Claes; Mahler, Michelle; Salman, Mariya; Sun, Steven; Phelps, Charles; Balasubramanian, Sriram; Howes, Angela; Hallek, Michael

    2016-02-01

    Most patients with chronic lymphocytic leukaemia or small lymphocytic lymphoma relapse after initial therapy. Bendamustine plus rituximab is often used in the relapsed or refractory setting. We assessed the efficacy and safety of adding ibrutinib, an oral covalent inhibitor of Bruton's tyrosine kinase (BTK), to bendamustine plus rituximab in patients with previously treated chronic lymphocytic leukaemia or small lymphocytic lymphoma. The HELIOS trial was an international, double-blind, placebo-controlled, phase 3 study in adult patients (≥18 years of age) who had active chronic lymphocytic leukaemia or small lymphocytic lymphoma with measurable lymph node disease (>1·5 cm) by CT scan, and had relapsed or refractory disease following one or more previous lines of systemic therapy consisting of at least two cycles of a chemotherapy-containing regimen, an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and adequate bone marrow, liver, and kidney function. Patients with del(17p) were excluded because of known poor response to bendamustine plus rituximab. Patients who had received previous treatment with ibrutinib or other BTK inhibitors, refractory disease or relapse within 24 months with a previous bendamustine-containing regimen, or haemopoietic stem-cell transplant were also excluded. Patients were randomly assigned (1:1) by a web-based system to receive bendamustine plus rituximab given in cycles of 4 weeks' duration (bendamustine: 70 mg/m(2) intravenously on days 2-3 in cycle 1, and days 1-2 in cycles 2-6; rituximab: 375 mg/m(2) on day 1 of cycle 1, and 500 mg/m(2) on day 1 of cycles 2-6 for a maximum of six cycles) with either ibrutinib (420 mg daily orally) or placebo until disease progression or unacceptable toxicity. Patients were stratified according to whether they were refractory to purine analogues and by number of previous lines of therapy. The primary endpoint was independent review committee (IRC)-assessed progression

  6. Cutting through Red Tape: Strategies for Dealing with Bureaucrats.

    Science.gov (United States)

    Neugebauer, Roger

    1994-01-01

    This article discusses the characteristics of bureaucratic organizations and bureaucrats, focusing on how these attributes affect day-care centers that must deal with bureaucracies. Outlined are several strategies for dealing with the types of bureaucrats that child care directors are likely to encounter. (MDM)

  7. Do Gender and Personality Traits Influence Use of Deal Sites?

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2015-01-01

    Deal sites became widespread, there are numerous both international and local players in the market. The research presented in the paper investigates if gender and personality traits influence use (versus non-use) of deal sites. Big Five Inventory-10 is used to measure personality traits...

  8. University Deals with Drug Companies Raise Concerns over Autonomy, Secrecy.

    Science.gov (United States)

    Nicklin, Julie L.

    1993-01-01

    The large, exclusive research deal the Scripps Research Institute (California) made with one drug company has drawn criticism for conflict of interest. Critics fear researchers will focus more on marketing than on pure science and will protect corporate interests. Much of the deal-making is with foreign companies, sending profits overseas. (MSE)

  9. Governance capabilities for dealing wisely with wicked problems

    NARCIS (Netherlands)

    Termeer, C.J.A.M.; Dewulf, A.; Breeman, G.E.; Stiller, S.J.

    2015-01-01

    This article explores an integrative approach for dealing with wicked problems. Wicked problems not only require alternative action strategies but also alternative ways of observing and enabling. Four governance capabilities are essential: (a) reflexivity, or the capability to deal with multiple

  10. The Oregon Shootings: Dealing with the Ethical Issues.

    Science.gov (United States)

    Smith, Saylor; Godbold, Jim; Carter, Paul

    1999-01-01

    Presents three short articles dealing with ethical issues facing the Thornton High School (Oregon) newspaper staff as they dealt with the aftermath of an incident in which an armed student allegedly entered the school cafeteria and began shooting. Discusses how the local newspaper covered the tragedy, and policies on dealing with reporting of…

  11. How to deal with the annoying Hot Spots in FEA

    DEFF Research Database (Denmark)

    Svenninggaard, Jon

    2017-01-01

    How do we deal with the annoying ”Hot Spots” in our solid structure Finite Element Analysis (FEA) and how do we justify the stresses in those areas?......How do we deal with the annoying ”Hot Spots” in our solid structure Finite Element Analysis (FEA) and how do we justify the stresses in those areas?...

  12. Using the genome aggregation database, computational pathogenicity prediction tools, and patch clamp heterologous expression studies to demote previously published long QT syndrome type 1 mutations from pathogenic to benign.

    Science.gov (United States)

    Clemens, Daniel J; Lentino, Anne R; Kapplinger, Jamie D; Ye, Dan; Zhou, Wei; Tester, David J; Ackerman, Michael J

    2018-04-01

    Mutations in the KCNQ1-encoded Kv7.1 potassium channel cause long QT syndrome (LQTS) type 1 (LQT1). It has been suggested that ∼10%-20% of rare LQTS case-derived variants in the literature may have been published erroneously as LQT1-causative mutations and may be "false positives." The purpose of this study was to determine which previously published KCNQ1 case variants are likely false positives. A list of all published, case-derived KCNQ1 missense variants (MVs) was compiled. The occurrence of each MV within the Genome Aggregation Database (gnomAD) was assessed. Eight in silico tools were used to predict each variant's pathogenicity. Case-derived variants that were either (1) too frequently found in gnomAD or (2) absent in gnomAD but predicted to be pathogenic by ≤2 tools were considered potential false positives. Three of these variants were characterized functionally using whole-cell patch clamp technique. Overall, there were 244 KCNQ1 case-derived MVs. Of these, 29 (12%) were seen in ≥10 individuals in gnomAD and are demotable. However, 157 of 244 MVs (64%) were absent in gnomAD. Of these, 7 (4%) were predicted to be pathogenic by ≤2 tools, 3 of which we characterized functionally. There was no significant difference in current density between heterozygous KCNQ1-F127L, -P477L, or -L619M variant-containing channels compared to KCNQ1-WT. This study offers preliminary evidence for the demotion of 32 (13%) previously published LQT1 MVs. Of these, 29 were demoted because of their frequent sighting in gnomAD. Additionally, in silico analysis and in vitro functional studies have facilitated the demotion of 3 ultra-rare MVs (F127L, P477L, L619M). Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  13. Employee-oriented leadership and quality of working life: mediating roles of idiosyncratic deals.

    Science.gov (United States)

    Hornung, Severin; Glaser, Jürgen; Rousseau, Denise M; Angerer, Peter; Weigl, Matthias

    2011-02-01

    Leader consideration has long been suggested to be conducive to quality of working life experienced by employees. The present study links this classic leadership dimension with more recent research on idiosyncratic deals, referring to personalized conditions workers negotiate in their employment relationships. A two-wave survey study (N = 159/142) among German hospital physicians suggests that authorizing idiosyncratic deals is a manifestation of employee-oriented leader behavior. Consideration had consistent positive effects on idiosyncratic deals regarding both professional development and working time flexibility. These two types had differential effects on two indicators of the quality of working life. Development related positively to work engagement, flexibility related negatively to work-family conflict. Cross-lagged correlations supported the proposed direction of influence between consideration and idiosyncratic deals in a subsample of repeating responders (n=91). The relation between development and engagement appeared to be reciprocal. Longitudinal results for the association between flexibility and work-family conflict were inconclusive.

  14. South African pension fund conversions: Dealing with environmental change

    Directory of Open Access Journals (Sweden)

    D. T. George

    2007-12-01

    Full Text Available Purpose: The purpose of this paper is to analyse South African pension fund conversions from defined benefit to defined contribution structures and to develop a model for dealing with environmental change. Design/Methodology/Approach: Qualitative research methodology was used. Industry experts were interviewed to obtain a macro view of the phenomenon and specific manifestations of the phenomenon were also considered in case studies.Feedback from semi-structured interviews was categorised into several emergent themes. Within-case and cross-case analyses were conducted. Findings: Results indicated that an environmental shock exerted a substantial influence on the course of events. Under these: • Various factors combined to drive organisational evolution (i.e. adaptation to the environment. • Adaptation speed was inappropriate and exceeded that which was required for sufficient thought. • Uncertainty and vacuum circumstances arose leading to consequences that require redress. • The relative power of the stakeholders changed and influenced the strategic outcome. • An imbalance in stakeholder interests arose and ethical factors became consequential. • Business acted to restore certainty for itself. Implications: This paper provides insight into organisational behaviour during periods of environmental shock. Environmental shock can be defined as "a condition that arises where business or societal rules are inadequate, or do not exist, to deal with unfolding events". An environmental shock has greater magnitude than a competitive shock, and can include several competitive shocks. Originality/Value: Analysis of pension fund conversions revealed organisational behaviour during periods of environmental shock and the emerging model can be applied in other instances of environmental shock, such as broad-based black economic empowerment (B-B BEE, land redistribution, sanctions and constitutional development.

  15. How students deal with inconsistencies in health knowledge.

    Science.gov (United States)

    Bientzle, Martina; Cress, Ulrike; Kimmerle, Joachim

    2013-07-01

    In their work, health care professionals have to deal daily with inconsistent health information and are confronted with differing therapeutic health concepts. Medical education should prepare students to handle these challenges adequately. The aim of this study was to contribute to a better understanding of how students deal with inconsistencies in health knowledge when they are presented with either a therapeutic concept they accept or one they reject. Seventy-six students of physiotherapy participated in this 2 × 2 experiment with health information (consistent versus inconsistent information) and therapeutic concept (congruent versus contradictory therapeutic concept) as between-group factors. The participants' task was to improve the quality of a text about the effectiveness of stretching; participants were randomly assigned to one of four texts. Knowledge acquisition and text modification were measured as dependent variables. Students acquired more knowledge when they worked with a text containing inconsistent information. Medical information that was presented in agreement with a student's therapeutic concept was also more readily acquired than the same information presented posing a contradictory therapeutic concept. Participants modified the contradictory text in order to adapt it to their own point of view. Disagreement resulted in a disregard or devaluation of the information itself, which in turn was detrimental to learning. It is a problem when prospective health care professionals turn a blind eye to discrepancies that do not fit their view of the world. It may be useful for educational purposes to include a knowledge conflict caused by a combination of conviction and inconsistent information to facilitate learning processes. © 2013 John Wiley & Sons Ltd.

  16. Dealing with fear - from the perspective of adolescent girls with cancer.

    Science.gov (United States)

    Anderzén-Carlsson, Agneta; Sörlie, Venke; Kihlgren, Annica

    2012-07-01

    Previously fears in adolescents with cancer has been identified in relation to medical procedures, death, altered appearance and as having an overall influence on life, but to our knowledge young people's perspectives on dealing with fear have not been previously investigated. To examine adolescents' perspectives on dealing with cancer related fear. Six girls participated in qualitative interviews focussing on their fear and and how they dealt with it. Data were analysed by means of qualitative content analysis. The results revealed two perspectives. First, the adolescents' own personal battle with fear. Second, they reported that they were not alone with their fear, as they shared it with significant others. An environment characterized by emotional presence helped them to deal with their fear, as well as prevented it from occurring. There is a need for staff and parents to be vigilant to the adolescents' need to feel cared for and allow them the opportunity to deal with their own fear, as at times they want to manage in their own way. Young patients have resources to cope with their fears and therefore should not be viewed as victims, but as young people with a great amount of competence, who benefit from a supportive environment. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Which surgery should be offered for carpal tunnel syndrome in a patient who was previously treated for recurrence on the contralateral side? Preliminary study of 13 patients with the Canaletto® implant.

    Science.gov (United States)

    Illuminati, I; Seigle-Murandi, F; Gouzou, S; Fabacher, T; Facca, S; Hidalgo Diaz, J J; Liverneaux, P

    2017-12-01

    There are no published studies on the management of carpal tunnel syndrome (CTS) patients who have already been operated for recurrent CTS on the contralateral side. The aim of this study was to evaluate 13 patients with CTS who underwent primary release using a Canaletto ® implant. The 13 patients had all been operated for recurrent CTS previously. On the contralateral side, they all had subjective signs, and two of them already had complications. All were operated with the Canaletto ® implant according to Duché's technique, in a mean of 20minutes. After a mean 19.3-month follow-up, paresthesia, pain, and QuickDASH scores were significantly improved, even in one patient who underwent revision at another facility. This preliminary study suggests that use of a Canaletto ® implant as first-line treatment for CTS in patients who already underwent revision surgery on the other side is a simple and safe technique, without worsening of symptoms. These findings should be assessed with a prospective randomized controlled trial. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

  18. "It's Your Problem. Deal with It." Performers' Experiences of Psychological Challenges in Music.

    Science.gov (United States)

    Pecen, Ellis; Collins, David J; MacNamara, Áine

    2017-01-01

    Musicians need to deal with a range of challenges during their performance career and in response to these have reported a number of conditions that impact on their performance. Although social support from peers and teachers has been identified as part of the process of dealing with these challenges, little is understood about musicians' coping methods, beliefs and their attitudes toward support. Therefore, this study aimed to explore (a) performers' previous experiences of psychological challenges, (b) the types of support they used and, (c) how this might inform future support programs in learning environments. Fifteen interviews were conducted with pre-elite ( n = 5) transitioning elite ( n = 3) and established elite performers ( n = 7) in order to elicit data on psychological challenges, coping, beliefs and preferences for support. Inductive content analysis suggested that elite performers in this sample reported positive health habits, philosophical views of performance, health and life, positive anxiety reappraisal, and use of various psychological strategies, albeit without being explicitly aware of it. The need for various professional skills (e.g., communication, business, self-management, and organizational skills) was emphasized by all participants. Transition into conservatoire was marked by severe psychological challenges, disorders and trauma. Primary sources of support included friends, family and self-help literature. Professional help was predominantly sought for physical problems. The impact of teachers was paramount, yet securing good teachers was considered a matter of "luck." The most negative aspects recounted included abusive teachers, unsupportive environments, social comparison, competition, and disillusionment after entering the profession. Participants believed that talent could be developed and also valued wellbeing in relation to performance. Positive effects of late specialization on social development and professional skills were

  19. Validation of Theory of Consumption Values Scales for Deal Sites

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2016-01-01

    Deal sites became a widely used artefact. But there is still only a limited number of papers investigating their adoption and use. Most of the research published on the topic is qualitative. It is typical for an early stage of investigation of any new artefact. The Theory of Consumption Values ex...... explains purchase behavior. The aim of this paper is to validate scales for the Theory of Consumption Values for deal sites. This should pave a way for quantitative investigation of motives for purchasing using deal sites....

  20. Suboptimal investments and M&A deals in emerging capital markets

    Directory of Open Access Journals (Sweden)

    Cherkasova Victoria

    2016-01-01

    Full Text Available This paper focuses on the efficiency of target-company investment decisions before and after Merger & Acquisition deals. We study whether M&A deals help to solve the problem of suboptimal investment after the acquisition. Using a sample of 145 target companies from BRICS countries that were acquired during the period 2004-2014, we outline those that had over- or underinvested before the deal and show that more than half the companies managed to optimize the investment level after the deal. We determine the key factors that improve the inefficiency of investment decisions and demonstrate that the industry and country have an impact on the degree of suboptimal investment.

  1. Usefulness of indirect alcohol biomarkers for predicting recidivism of drunk-driving among previously convicted drunk-driving offenders: results from the recidivism of alcohol-impaired driving (ROAD) study.

    Science.gov (United States)

    Maenhout, Thomas M; Poll, Anneleen; Vermassen, Tijl; De Buyzere, Marc L; Delanghe, Joris R

    2014-01-01

    In several European countries, drivers under the influence (DUI), suspected of chronic alcohol abuse are referred for medical and psychological examination. This study (the ROAD study, or Recidivism Of Alcohol-impaired Driving) investigated the usefulness of indirect alcohol biomarkers for predicting drunk-driving recidivism in previously convicted drunk-driving offenders. The ROAD study is a prospective study (2009-13) that was performed on 517 randomly selected drivers in Belgium. They were convicted for drunk-driving for which their licence was confiscated. The initial post-arrest blood samples were collected and analysed for percentage carbohydrate-deficient transferrin (%CDT), transaminsase activities [alanine amino transferase (ALT), aspartate amino transferase (AST)], gamma-glutamyltransferase (γGT) and red cell mean corpuscular volume (MCV). The observation time for each driver was 3 years and dynamic. A logistic regression analysis revealed that ln(%CDT) (P drunk-driving. The ROAD index (which includes ln(%CDT), ln(γGT), -ln(ALT) and the sex of the driver) was calculated and had a significantly higher area under the receiver operator characteristic curve (0.71) than the individual biomarkers for drunk-driving recidivism. Drivers with a high risk of recidivating (ROAD index ≥ 25%; third tertile) could be distinguished from drivers with an intermediate risk (16% ≤ ROAD index drunk-driving. The association with gamma-glutamyltransferase, alanine amino transferase and the sex of the driver could have additional value for identifying drunk-drivers at intermediate risk of recidivism. Non-specific indirect alcohol markers, such as alanine amino transferase, gamma-glutamyltransferase, aspartate amino transferase and red cell mean corpuscular volume have minimal added value to % carbohydrate-deficient transferrin for distinguishing drunk drivers with a low or high risk of recidivism. © 2013 Society for the Study of Addiction.

  2. Underestimation of Severity of Previous Whiplash Injuries

    Science.gov (United States)

    Naqui, SZH; Lovell, SJ; Lovell, ME

    2008-01-01

    INTRODUCTION We noted a report that more significant symptoms may be expressed after second whiplash injuries by a suggested cumulative effect, including degeneration. We wondered if patients were underestimating the severity of their earlier injury. PATIENTS AND METHODS We studied recent medicolegal reports, to assess subjects with a second whiplash injury. They had been asked whether their earlier injury was worse, the same or lesser in severity. RESULTS From the study cohort, 101 patients (87%) felt that they had fully recovered from their first injury and 15 (13%) had not. Seventy-six subjects considered their first injury of lesser severity, 24 worse and 16 the same. Of the 24 that felt the violence of their first accident was worse, only 8 had worse symptoms, and 16 felt their symptoms were mainly the same or less than their symptoms from their second injury. Statistical analysis of the data revealed that the proportion of those claiming a difference who said the previous injury was lesser was 76% (95% CI 66–84%). The observed proportion with a lesser injury was considerably higher than the 50% anticipated. CONCLUSIONS We feel that subjects may underestimate the severity of an earlier injury and associated symptoms. Reasons for this may include secondary gain rather than any proposed cumulative effect. PMID:18201501

  3. Success Factors in Offset Deals: A Case Study Based Examination

    OpenAIRE

    Heinz Kirchwehm

    2014-01-01

    The requests for offset obligations occurs primarily in the area of arms imports and covers the full range of industrial and commercial benefits that companies provide to foreign governments as inducements or conditions for the purchase of military goods and services. Increasingly, all major contracts ask for offset obligations. They are now key differentiators in major contracts and it is a fast growing market. For the suppliers, offsets are a key differentiator in earning new business and t...

  4. Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia.

    Science.gov (United States)

    Kuenzli, Esther; Juergensen, David; Kling, Kerstin; Jaeger, Veronika K; DeCrom, Susan; Steffen, Robert; Widmer, Andreas F; Battegay, Manuel; Hatz, Christoph; Neumayr, Andreas

    2017-09-01

    Travellers' diarrhoea is the most common health problem in travellers. Depending on the region visited, up to 40% of travellers develop diarrhoea during a 2-week trip. The aim of this study was to assess risk factors for TD among travellers to the Indian subcontinent. An observational prospective multicentre cohort study investigated travellers to the Indian subcontinent. Participants completed questionnaires assessing the incidence of travellers' diarrhoea and identifying potential risk factors. Covariates were assessed univariately, followed by a multivariate regression. Two-hundred and twenty-six travellers were enrolled into the study, 178 filled in both pre- and post-travel questionnaires. Overall, the attack rate of travellers' diarrhoea was 38.2%. Travel destination is a key risk factor for the occurrence of TD. Travelling to India or Nepal vs Bhutan is associated with an increased risk for TD (OR 6.68 and 6.62, respectively). A length of stay of more than 3 weeks compared to less than 2 weeks is also associated with a significantly increased risk (OR 5.45). Having stayed in a high-risk area for travellers' diarrhoea within the past year before the current trip is associated with a significantly decreased risk (OR 0.19). No association was found between consumption of high risk food (i.e. tap water, ice cream, raw meat and hamburgers) and travellers' diarrhoea. Travellers' diarrhoea is a frequent problem in travellers to the Indian subcontinent. Previous exposure in a high-risk area for travellers' diarrhoea within the past year appears to have a significant protective effect. Furthermore, an association between the occurrence of travellers' diarrhoea and travel destination and length of stay, respectively, was observed. Consumption of risk food did not confer a TD risk in our study. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  5. Wisdom and narrative: Dealing with complexity and judgement in ...

    African Journals Online (AJOL)

    Wisdom and narrative: Dealing with complexity and judgement in translator education. ... This article explores wisdom as concept to guide translator education in institutions of higher education. It uses the work ... AJOL African Journals Online.

  6. Therapeutic commitment for general nurses in dealing with mental ...

    African Journals Online (AJOL)

    sionals who care for people living with HIV/AIDS (PLWHA) and they are expected to deal with the mental ... such as depression and psychosis. Hence it is important ... nurse's therapeutic commitment, knowledge and skills in providing mental ...

  7. Myocardial adaption to HI(R)T in previously untrained men with a randomized, longitudinal cardiac MR imaging study (Physical adaptions in Untrained on Strength and Heart trial, PUSH-trial).

    Science.gov (United States)

    Scharf, Michael; Oezdemir, Derya; Schmid, Axel; Kemmler, Wolfgang; von Stengel, Simon; May, Matthias S; Uder, Michael; Lell, Michael M

    2017-01-01

    Although musculoskeletal effects in resistance training are well described, little is known about structural and functional cardiac adaption in formerly untrained subjects. We prospectively evaluated whether short term high intensity (resistance) training (HI(R)T) induces detectable morphologic cardiac changes in previously untrained men in a randomized controlled magnetic resonance imaging (MRI) study. 80 untrained middle-aged men were randomly assigned to a HI(R)T-group (n = 40; 43.5±5.9 years) or an inactive control group (n = 40; 42.0±6.3 years). HI(R)T comprised 22 weeks of training focusing on a single-set to failure protocol in 2-3 sessions/week, each with 10-13 exercises addressing main muscle groups. Repetitions were decreased from 8-10 to 3-5 during study period. Before and after HI(R)T all subjects underwent physiologic examination and cardiac MRI (cine imaging, tagging). Indexed left (LV) and right ventricular (RV) volume (LV: 76.8±15.6 to 78.7±14.8 ml/m2; RV: 77.0±15.5 to 78.7±15.1 ml/m2) and mass (LV: 55.5±9.7 to 57.0±8.8 g/m2; RV: 14.6±3.0 to 15.0±2.9 g/m2) significantly increased with HI(R)T (all pHI(R)T-group did not alter with training (0.73g/mL and 0.19g/mL, respectively [p = 0.96 and p = 0.87]), indicating balanced cardiac adaption. Indexed LV (48.4±11.1 to 50.8±11.0 ml/m2) and RV (48.5±11.0 to 50.6±10.7 ml/m2) stroke volume significantly increased with HI(R)T (pHI(R)T (36.2±7.9 to 37.0±8.4 ml/m2, p = 0.411), the ratio to end-diastolic LV volume at baseline and post-training was unchanged (0.47 vs. 0.47, p = 0.79). 22 weeks of HI(R)T lead to measurable, physiological changes in cardiac atrial and ventricular morphologic characteristics and function in previously untrained men. The PUSH-trial is registered at the US National Institutes of Health (ClinicalTrials.gov), NCT01766791.

  8. [Dealing with uncertainty--the hypermodernity of general practice].

    Science.gov (United States)

    Barth, Niklas; Nassehi, Armin; Schneider, Antonius

    2014-01-01

    The general practitioner is fundamentally dealing with uncertainty. On the one hand, we want to demonstrate that uncertainty cannot simply be stipulated as a matter of fact. Instead, we will show that this uncertainty is a performative effect of the primary care setting. On the other hand, we want to point out that the general practitioner's ability to bear uncertainty is a genuinely hypermodern way of productively dealing with uncertainty. Copyright © 2013. Published by Elsevier GmbH.

  9. Ten Rules for Dealing with Negative Contributions in Social Media

    OpenAIRE

    Adriana Stránská; Václav Stříteský

    2015-01-01

    Social media is becoming a key part of business communication strategy. Despite all the advantages, social media also poses a threat to business reputation. Dissatisfied customers can reach a large audience and share their negative experiences with others. This paper deals with the impact of social media on the practice of public relations. The goal of the paper is to formulate a set of rules for dealing with negative contributions and generally with crisis communication in social media. It...

  10. How to deal with public concerns and resistance

    International Nuclear Information System (INIS)

    Kach, V.D.

    1988-01-01

    First hand experience dealing with the public's perception of radiation, their reaction to a proposed installation of a Cobalt-60 industrial irradiator in their neighbourhood, and the tactics employed by nuclear critics have allowed the author to make some observations. Among these observations is the requirement for a public education program, discernment of the appropriate incentive to the community, and sufficient time to accomplish the education/information process and to deal with objections. (author)

  11. Dealing with School Violence: The Effect of School Violence Prevention Training on Teachers' Perceived Self-Efficacy in Dealing with Violent Events

    Science.gov (United States)

    Sela-Shayovitz, Revital

    2009-01-01

    This study deals with the relationship between school violence prevention training and teachers' perceived self-efficacy in handling violent events. Three indicators were used to examine teachers' self-efficacy: personal teaching efficacy (PTE), teachers' efficacy in the school as an organisation (TESO), and teachers' outcome efficacy (TOE). Data…

  12. THE LIS STUDY (LYUBERTSY STUDY ON MORTALITY RATE IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION. EVALUATION OF DRUG THERAPY. PART 2. INFLUENCE OF PREVIOUS DRUG TREATMENT ON LONG-TERM LIFE PROGNOSIS

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-12-01

    Full Text Available Aim. To evaluate drug therapy received by patients who had survived acute myocardial infarction (AMI in the framework of the AMI register (the “LIS” study and estimate this therapy influence on long-term outcomes of the disease. Material and methods. The total of 961 patients of 1133 enrolled in the “LIS” study , were discharged from hospital. 191 patients had died during follow-up. 632 patients (who had survived and consented to visit out-patient clinic underwent repeated examination (median of follow-up 1.6 [1.0; 2.4] years. Data about treatment before and during AMI were received from patient’s charts; data about treatment after AMI were obtained from out-patient medical records. Results. Before reference AMI only a small number of the patients received the main drug groups (antiplatelet agents, β-blockers, ACE inhibitors, statins, at that ACE inhibitors were prescribed more often than the others. Use of β-blockers and ACE inhibitors before reference AMI significantly improved long-term life prognosis [relative risk (RR 0.70 and 0.66, respectively]. Rate of the main drug groups prescribed in hospital was rather high with the exception of thrombolytics (less than 10%. Thrombolytics, β-blockers and antiplatelet agents prescribed in hospital significantly improved long-term life prognosis of patients (RR 0.42, 0.65 and 0.58 respectively. At the second visit (according to data of out-patient medical records rate of antiplatelet agents, ACE inhibitors, β-blockers and statins prescription exceeded 60%. Conclusion. Very low prevalence of adequate drug therapy preceding AMI determines high mortality rate among survived acute stage of myocardial infarction patients in long-term period.

  13. Automatic electromagnetic valve for previous vacuum

    International Nuclear Information System (INIS)

    Granados, C. E.; Martin, F.

    1959-01-01

    A valve which permits the maintenance of an installation vacuum when electric current fails is described. It also lets the air in the previous vacuum bomb to prevent the oil ascending in the vacuum tubes. (Author)

  14. Meta-Analysis With Complex Research Designs: Dealing With Dependence From Multiple Measures and Multiple Group Comparisons

    Science.gov (United States)

    Scammacca, Nancy; Roberts, Greg; Stuebing, Karla K.

    2013-01-01

    Previous research has shown that treating dependent effect sizes as independent inflates the variance of the mean effect size and introduces bias by giving studies with more effect sizes more weight in the meta-analysis. This article summarizes the different approaches to handling dependence that have been advocated by methodologists, some of which are more feasible to implement with education research studies than others. A case study using effect sizes from a recent meta-analysis of reading interventions is presented to compare the results obtained from different approaches to dealing with dependence. Overall, mean effect sizes and variance estimates were found to be similar, but estimates of indexes of heterogeneity varied. Meta-analysts are advised to explore the effect of the method of handling dependence on the heterogeneity estimates before conducting moderator analyses and to choose the approach to dependence that is best suited to their research question and their data set. PMID:25309002

  15. Forensic considerations when dealing with incinerated human dental remains.

    Science.gov (United States)

    Reesu, Gowri Vijay; Augustine, Jeyaseelan; Urs, Aadithya B

    2015-01-01

    Establishing the human dental identification process relies upon sufficient post-mortem data being recovered to allow for a meaningful comparison with ante-mortem records of the deceased person. Teeth are the most indestructible components of the human body and are structurally unique in their composition. They possess the highest resistance to most environmental effects like fire, desiccation, decomposition and prolonged immersion. In most natural as well as man-made disasters, teeth may provide the only means of positive identification of an otherwise unrecognizable body. It is imperative that dental evidence should not be destroyed through erroneous handling until appropriate radiographs, photographs, or impressions can be fabricated. Proper methods of physical stabilization of incinerated human dental remains should be followed. The maintenance of integrity of extremely fragile structures is crucial to the successful confirmation of identity. In such situations, the forensic dentist must stabilise these teeth before the fragile remains are transported to the mortuary to ensure preservation of possibly vital identification evidence. Thus, while dealing with any incinerated dental remains, a systematic approach must be followed through each stage of evaluation of incinerated dental remains to prevent the loss of potential dental evidence. This paper presents a composite review of various studies on incinerated human dental remains and discusses their impact on the process of human identification and suggests a step by step approach. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Individualisation of Lean Concept in Companies Dealing with Mass Production

    Science.gov (United States)

    Bednár, Roman

    2012-12-01

    The methods of lean manufacturing primarily designed for businesses dealing with serial production, are also used in other types of production. However the concept of lean production was not designed for these types of businesses, they are utilized only partially. Paper focuses on applying methods of lean concept in companies which are dealing with mass production and their options of exchange for other methods in the event of disagreement. Basis of the article is a list of lean methods with its description and its utilization in practice. The questionnaire was utilized to identify information from the practice. Based on this survey were identified the critical methods that are no longer appropriate for companies dealing with mass production. However, there are alternative methods of describing the problem. It is possible to say that companies are trying to get closer to their goal by modification of the basic concepts. And the concept of Lean Enterprise serves as a standard.

  17. Logic of Accounting: The Case of Reporting Previous Options in Norwegian Activation Encounters

    Science.gov (United States)

    Solberg, Janne

    2017-01-01

    The article deals with the enactment of client resistance in Norwegian vocational rehabilitation encounters. More specific, a practice here called "reporting previous options" is analyzed by using the resources of ethnomethodological conversation analysis (CA) in five instances as doing some sort of accounting. In response to the…

  18. How does an invasive social wasp deal with changing contextual cues while foraging?

    Science.gov (United States)

    Lozada, M; D'Adamo, P

    2009-06-01

    In this study, we explore how an invasive social wasp, Vespula germanica (F.), deals with contextual changes while searching for a food source that is no longer available. Four experiments were conducted to evaluate the effect of different degrees of context modification on wasp behavior. Learning sessions consisted of a variable number of feeding trials during which an individual wasp fed from a landmark array made up of a feeder surrounded by four cylinders of the same color. The food and cylinders were subsequently removed from the training site, and this learned landmark array was modified in such a way that information relating to color and/or location of the resulting feeding arrays varied from that previously learned. The results indicate that the color most recently associated with food is prioritized over a formerly learned color, and this pattern is also maintained when wasps have learned the alternative color during a higher number of feeding experiences. This highlights the high plasticity with which V. germanica responds to unpredictable contextual changes while foraging.

  19. How would we deal with radiation related issues in high school educational programs?

    Energy Technology Data Exchange (ETDEWEB)

    Saeki, Kuniko [Attached High School of Akita Keizai Houka Univ., Akita (Japan)

    1999-09-01

    Current educational curriculum will be more improved and the materials in schools will be somewhat different by the year of 2002 when students have two days off in a week. It is a well known fact that recent Japanese people's level of understanding about Science and Technology is the second from the bottom among OECD nations and, as a matter of fact, few schools are dealing with scientific issues such as atomic energy or radiation. High school teachers need to survey what students know about atomic power and radiation, how deep they studied in previous schools and what kind of interest they have in conservation of world energy sources or environmental issues discussed today. Through questionnaires to 328 students, it became clear that they were most interesting to the effect of radiation or radioactivity on any kind of things in the environment, and that they want to know solutions for those problems such as greenhouse effect, ozone layers and Garbage disposal. (M. Suetake)

  20. 77 FR 70176 - Previous Participation Certification

    Science.gov (United States)

    2012-11-23

    ... participants' previous participation in government programs and ensure that the past record is acceptable prior... information is designed to be 100 percent automated and digital submission of all data and certifications is... government programs and ensure that the past record is acceptable prior to granting approval to participate...

  1. Choosing the right M and A deal structure

    International Nuclear Information System (INIS)

    Love, A.G.

    1998-01-01

    The legal aspects of going into a merger and acquisition deal within the petroleum industry were reviewed for the benefit of non-lawyers. The types of acquisitions included are asset purchases and sale, a private share purchase and sale, a takeover bid, an amalgamation or a plan of arrangement. How to make the structure choice that is right in the circumstances was discussed. It was emphasized that choosing the right merger and acquisition deal structure depends on the objectives of the parties, the volume and quality of the information about the particular transaction, and proper analysis of alternative acquisition structures in the context of the objectives and information

  2. Randomized Phase II Study of R-CHOP With or Without Bortezomib in Previously Untreated Patients With Non-Germinal Center B-Cell-Like Diffuse Large B-Cell Lymphoma.

    Science.gov (United States)

    Leonard, John P; Kolibaba, Kathryn S; Reeves, James A; Tulpule, Anil; Flinn, Ian W; Kolevska, Tatjana; Robles, Robert; Flowers, Christopher R; Collins, Robert; DiBella, Nicholas J; Papish, Steven W; Venugopal, Parameswaran; Horodner, Andrew; Tabatabai, Amir; Hajdenberg, Julio; Park, Jaehong; Neuwirth, Rachel; Mulligan, George; Suryanarayan, Kaveri; Esseltine, Dixie-Lee; de Vos, Sven

    2017-11-01

    Purpose To evaluate the impact of the addition of bortezomib to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) on outcomes in previously untreated patients with non-germinal center B-cell-like (non-GCB) diffuse large B-cell lymphoma (DLBCL). Patients and Methods After real-time determination of non-GCB DLBCL using the Hans immunohistochemistry algorithm, 206 patients were randomly assigned (1:1; stratified by International Prognostic Index [IPI] score) to six 21-day cycles of standard R-CHOP alone or R-CHOP plus bortezomib 1.3 mg/m 2 intravenously on days 1 and 4 (VR-CHOP). The primary end point, progression-free survival (PFS), was evaluated in 183 patients with centrally confirmed non-GCB DLBCL who received one or more doses of study drug (91 R-CHOP, 92 VR-CHOP). Results After a median follow-up of 34 months, with 25% (R-CHOP) and 18% (VR-CHOP) of patients having had PFS events, the hazard ratio (HR) for PFS was 0.73 (90% CI, 0.43 to 1.24) with VR-CHOP ( P = .611). Two-year PFS rates were 77.6% with R-CHOP and 82.0% with VR-CHOP; they were 65.1% versus 72.4% in patients with high-intermediate/high IPI (HR, 0.67; 90% CI, 0.34 to 1.29), and 90.0% versus 88.9% (HR, 0.85; 90% CI, 0.35 to 2.10) in patients with low/low-intermediate IPI. Overall response rate with R-CHOP and VR-CHOP was 98% and 96%, respectively. The overall survival HR was 0.75 (90% CI, 0.38 to 1.45); 2-year survival rates were 88.4% and 93.0%, respectively. In the safety population (100 R-CHOP and 101 VR-CHOP patients), grade ≥ 3 adverse events included neutropenia (53% v 49%), thrombocytopenia (13% v 29%), anemia (7% v 15%), leukopenia (26% v 25%), and neuropathy (1% v 5%). Conclusion Outcomes for newly diagnosed, prospectively enrolled patients with non-GCB DLBCL were more favorable than expected with R-CHOP and were not significantly improved by adding bortezomib.

  3. Dealing with Tight Couplings and Multiple Interactions in Complex Technological Systems

    DEFF Research Database (Denmark)

    Aanestad, M.; Jensen, Tina Blegind; Grisot, M.

    In this paper we discuss the challenges of dealing with interdependencies in complex assemblages of heterogeneous and interconnected information systems (IS), which we conceptualize as organizationwide information infrastructures. We draw on Perrow's studies of complex technological systems, where...... couplings between information systems, actors, and work practices in the hospital environment. The paper's main focus is on describing what it entails in practice to deal with these interdependencies during and after implementation. We emphasize the work of sorting out and dealing with various types...... interactions, mechanisms, and couplings are emphasized. We base our paper on an empirical case study from a Norwegian hospital, where a seemingly trivial project aimed at the introduction of scanners turned out to be more complex than expected. This we claim is partly due to the interdependencies and tight...

  4. The nuclear deal with Iran: Le moment suprême?

    NARCIS (Netherlands)

    Blockmans, S.

    2015-01-01

    More than two years in the making, the agreement concluded by China, the EU, France, Germany, Russia, the UK and the US with Iran to prevent the ‘weaponisation’ of the latter’s nuclear programme is a big deal. But, cautions Steven Blockmans in this CEPS Commentary, it is not the silver bullet to the

  5. Vulnerable Derivatives and Good Deal Bounds: A Structural Model

    DEFF Research Database (Denmark)

    Murgoci, Agatha

    2013-01-01

    We price vulnerable derivatives -- i.e. derivatives where the counterparty may default. These are basically the derivatives traded on the over-the-counter (OTC) markets. Default is modeled in a structural framework. The technique employed for pricing is good deal bounds (GDBs). The method imposes...

  6. Validation of UTAUT and UTAUT2 scales for deal sites

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2016-01-01

    , that is usual for an early stage of investigation of anything. The Unified Theory of Acceptance and Use of Technology explains adoption and continues usage motives. The aim of this paper is to validate scales for the first and the second version of the Unified Theory of Acceptance and Use of Technology for deal...

  7. The development of a GIS for New Deal Archaeology

    Directory of Open Access Journals (Sweden)

    Bernard K. Means

    2011-05-01

    Full Text Available I have recently launched an effort to create a GIS of all New Deal-funded archaeological investigations conducted in the 48 states that comprised the USA during the Great Depression (Means 2011. This effort was inspired by the persistent notion that New Deal archaeology was largely limited to the southeastern United States, where the generally warmer climate was seen as conducive to the lengthy field seasons that ensured continuous work for the unemployed (Lyon 1996. The large mound sites that dotted the southeastern USA also ensured that there would be sufficient work for the large relief crews seen as ideal from the perspective of federal officials. While it may prove true that the majority of New Deal archaeology was conducted in the southeast, it is also demonstrably true that the various ‘Alphabet Soup’ work relief programs – notably the Civilian Conservation Corps (CCC and the Works Progress Administration/Work Projects Administration (WPA – supported archaeological investigations throughout the USA. In my preliminary efforts to create a GIS for New Deal archaeology, I have determined that at least 75 percent of the 48 states that comprised the USA during the Great Depression had some form of federally funded work relief survey or excavation.

  8. Semiparametric analysis to estimate the deal effect curve

    NARCIS (Netherlands)

    Van Heerde, HJ; Leeflang, PSH; Wittink, DR

    The marketing literature suggests several phenomena that may contribute to the nature of the relationship between sales and price discounts. These phenomena can produce complex nonlinearities and interactions in the deal effect curve that are best captured with a flexible approach. Because a fully

  9. The Fallacy of International Land Deals in Transforming the Rural ...

    African Journals Online (AJOL)

    The impact of international land deals on the rural populations has become a contested terrain among academics and in public discourse. While some people argue that foreign land investments can facilitate rural development by occasioning employment creation, increasing productivity and markets, as well as promoting ...

  10. The Politics of Climate Change: Can a Deal be Done?

    OpenAIRE

    Tobin, Paul

    2015-01-01

    The Paris climate conference in December 2015 has been heralded as a crucial opportunity for achieving global agreement on climate change. Paul Tobin analyses the structure of these negotiations and identifies the key barriers to striking a deal on climate change.

  11. Dealing with Malfunction: Locus of Control in Web-Conferencing

    Science.gov (United States)

    Klebl, Michael

    2014-01-01

    This paper considers how students deal with malfunctions that occur during the use of web conferencing systems in learning arrangements. In a survey among participants in online courses that make use of a web-conferencing system (N = 129), the relationship between a preference for internal or external locus of control and the perception of…

  12. How Communities Deal with Traumatic Memory: Lessons from Aceh ...

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

    This comparative research analyzes reparation processes underway in Aceh and Timor-Leste. It aims to foster a deeper understanding of how communities and individual victims of massive human rights abuses can deal with their traumatic past, while seeking justice on issues such as population displacement and political ...

  13. How the Courts Deal with Bullying in Schools

    Science.gov (United States)

    Diamantes, Thomas

    2010-01-01

    School officials have a difficult time dealing with cases of bullying. Often, it is one student's word against another. Also, many victims of bullying are reluctant to report instances for fear of retribution. As in sexual harassment cases, school officials need to be seen doing something about the problem. Courts view indifference to these…

  14. Conquering complexity - Dealing with uncertainty and ambiguity in water management

    NARCIS (Netherlands)

    Hommes, Saskia

    2008-01-01

    Water management problems are embedded in a natural and social system that is characterized by complexity. Knowledge uncertainty and the existence of divergent actors’ perceptions contribute to this complexity. Consequently, dealing with water management issues is not just a knowledge uncertainty

  15. Dealing with big data: The case of Twitter

    NARCIS (Netherlands)

    Tjong Kim Sang, E.; van den Bosch, A.

    2013-01-01

    As data sets keep growing, computational linguists are experiencing more big data problems: challenging demands on storage and processing caused by very large data sets. An example of this is dealing with social media data: including metadata, the messages of the social media site Twitter in 2012

  16. Annual individual doses for personnel dealing with ionizing radiation sources

    International Nuclear Information System (INIS)

    Poplavskij, K.K.

    1982-01-01

    Data on annual individual doses for personnel of national economy enterprises, research institutes, high schools, medical establishments dealing with ionizing radiation sources are presented. It is shown that radiation dose for the personnel constitutes only shares of standards established by sanitary legislation. Numeral values of individual doses of the personnel are determined by the type, character and scope of using ionizing radiation sources

  17. Looking for Reasons behind Success in Dealing with Requirements Change

    NARCIS (Netherlands)

    de Wit, J.J.; Ponisio, Laura

    2008-01-01

    During development, requirements of software systems are subject to change. Unfortunately, managing changing requirements can take a lot of time and effort. Yet some companies show a better management of changes in requirements than others. Why? What is it that makes some projects deal with changing

  18. The European Patent System: Dealing with emerging technologies.

    NARCIS (Netherlands)

    Kica, Evisa; Groenendijk, Nico

    2011-01-01

    In light of recent controversial patent decisions in biotechnology, this article argues that the current European patent examination and opposition procedures do not suffice to balance the patent system These procedures do not provide sufficient guidance for patent examiners to deal effectively with

  19. Therapeutic commitment for general nurses in dealing with mental ...

    African Journals Online (AJOL)

    therapeutic commitment in dealing with mental health problems of PL-. WHA. However, therapeutic .... commitment, knowledge and skills in relation to age, gender, work experience, workplace or whether mental health lectures had been ... coefficients that a medium positive linear correlation exists between therapeutic ...

  20. Implant breast reconstruction after salvage mastectomy in previously irradiated patients.

    Science.gov (United States)

    Persichetti, Paolo; Cagli, Barbara; Simone, Pierfranco; Cogliandro, Annalisa; Fortunato, Lucio; Altomare, Vittorio; Trodella, Lucio

    2009-04-01

    The most common surgical approach in case of local tumor recurrence after quadrantectomy and radiotherapy is salvage mastectomy. Breast reconstruction is the subsequent phase of the treatment and the plastic surgeon has to operate on previously irradiated and manipulated tissues. The medical literature highlights that breast reconstruction with tissue expanders is not a pursuable option, considering previous radiotherapy a contraindication. The purpose of this retrospective study is to evaluate the influence of previous radiotherapy on 2-stage breast reconstruction (tissue expander/implant). Only patients with analogous timing of radiation therapy and the same demolitive and reconstructive procedures were recruited. The results of this study prove that, after salvage mastectomy in previously irradiated patients, implant reconstruction is still possible. Further comparative studies are, of course, advisable to draw any conclusion on the possibility to perform implant reconstruction in previously irradiated patients.

  1. Green Deal Sustainability of Solid Biomass. Report 1 - 2012; Green Deal Duurzaamheid Vaste Biomassa. Rapportage 1 - 2012

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-15

    In the title Green Deal, Dutch energy producers agreed late 2012 to report annually on the sustainability of the currently used solid biomass for energy production. This report provides insight over 2012 in the nature and origin of biomass, applied certification systems to demonstrate the sustainability, and the reduction of greenhouse gas emission [Dutch] In de titel Green Deal hebben Nederlandse energieproducenten eind 2012 afgesproken jaarlijks te rapporteren over de duurzaamheid van de gebuikte vaste biomassa voor de energieproductie. Deze rapportage over 2012 biedt inzicht in onder meer de aard en herkomst van de biomassa, gehanteerde certificeringssystemen om de duurzaamheid aan te tonen en de reductie in broeikasgasemissies.

  2. “Handle with care”: The mediating role of schedule i-deals in the relationship between supervisors' own caregiving responsibilities and employee outcomes

    NARCIS (Netherlands)

    Las Heras, M.; Heijden, B.I.J.M. van der; Jong, J. de; Rofcanin, Y.

    2017-01-01

    Drawing on theories of perspective-taking and i-deals, this study explores the impact of supervisors' own caregiving responsibilities for elders and parental status on subordinates' schedule i-deals. Moreover, we investigate the extent to which schedule i-deals mediate the relationship between

  3. Impact of UTAUT/UTAUT2 motives on intention to use deal sites

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2017-01-01

    existing theories. The unified theory of acceptance and use of technology (UTAUT) is an information systems theory that explains adoption and continued usage behavior. There already exists the second version of the theory. The aim of this research is to test if UTAUT and UTAUT2 motives influence intention...... to use deal sites. As it is a preliminary study, only four core UTAUT and core seven UTUAT2 (a superset of UTAUT) motives are investigated, not factors moderating the core motives. Data were collected in Denmark, and they are analyzed using multiple linear regression. Considering only UTAUT motives, only...... performance expectancy was found to significantly influence intention to use deal sites. Considering UTAUT2 motives, besides performance expectancy, also price value, and habit were found to significantly influence intention to use deal sites. The two additional factor increase R2 from .48 to .53....

  4. Experience of dealing with moral responsibility as a mother with cancer.

    Science.gov (United States)

    Elmberger, Eva; Bolund, Christina; Lützén, Kim

    2005-05-01

    This study explored how women with a diagnosis of cancer (lymphoma) deal with moral concerns related to their responsibility as parents. Ten women with cancer and who had children living at home were interviewed. The interviews were analysed according to the constant comparative method used in grounded theory. In order to provide a focus for the analysis, the ethics of care and the concept of mothering were used as sensitizing concepts. The core concept 'experience of dealing with moral responsibility of being a parent with cancer by redefining oneself as a mother was identified. The processes involved were: interrupted mothering; facing the life-threatening illness and children's reactions; striving to be a good mother; attempting to deal with moral responsibility; and coming to terms with being a mother.

  5. Influence of the physico-chemical process as previous treatment to the electrocoagulation. Study with leachate of a landfill; Influencia del proceso fisicoquimico como tratamiento previo a la electrocoagulacion. Estudio con lixiviados de un relleno

    Energy Technology Data Exchange (ETDEWEB)

    Mercado Martinez, I. D.; Reyes Avila, D.

    2007-07-01

    This article has as purpose to show the influence of the method physico-chemical as previous process to the novel technique of electrocoagulation, presenting as a new alternative to depurate wastewaters. to obtain it, was done tests measuring the very parameters to leachates so much affluent as effluent from treatment plant of the Sanitary Landfill La Esmeralda, situated near to the Manizales city(Colombia), and so much before as later to apply this electrochemical technology, looking for this way to compare the obtained removals. (Author)

  6. Challenges dealing with depleted uranium in Germany - Reuse or disposal

    International Nuclear Information System (INIS)

    Moeller, Kai D.

    2007-01-01

    During enrichment large amounts of depleted Uranium are produced. In Germany every year 2.800 tons of depleted uranium are generated. In Germany depleted uranium is not classified as radioactive waste but a resource for further enrichment. Therefore since 1996 depleted Uranium is sent to ROSATOM in Russia. However it still has to be dealt with the second generation of depleted Uranium. To evaluate the alternative actions in case a solution has to be found in Germany, several studies have been initiated by the Federal Ministry of the Environment. The work that has been carried out evaluated various possibilities to deal with depleted uranium. The international studies on this field and the situation in Germany have been analyzed. In case no further enrichment is planned the depleted uranium has to be stored. In the enrichment process UF 6 is generated. It is an international consensus that for storage it should be converted to U 3 O 8 . The necessary technique is well established. If the depleted Uranium would have to be characterized as radioactive waste, a final disposal would become necessary. For the planned Konrad repository - a repository for non heat generating radioactive waste - the amount of Uranium is limited by the licensing authority. The existing license would not allow the final disposal of large amounts of depleted Uranium in the Konrad repository. The potential effect on the safety case has not been roughly analyzed. As a result it may be necessary to think about alternatives. Several possibilities for the use of depleted uranium in the industry have been identified. Studies indicate that the properties of Uranium would make it useful in some industrial fields. Nevertheless many practical and legal questions are open. One further option may be the use as shielding e.g. in casks for transport or disposal. Possible techniques for using depleted Uranium as shielding are the use of the metallic Uranium as well as the inclusion in concrete. Another

  7. Dealing with colon cancer: one woman's emotional journey.

    Science.gov (United States)

    Wilson, Candice T; Fletcher, Paula C

    2002-11-01

    Although death is inevitable, it continues to remain a taboo issue for society. A failure to discuss the unavoidable may represent a safeguard to avoid dealing with mortality and related fears. Many patients who are terminally ill spend their days feeling alone, misunderstood, and afraid. Kubler-Ross attempted to strip death of its negative connotations and to provide a venue for the terminally ill to have a voice. Using information from more than 200 clinical interviews, Kubler-Ross revealed a trend in emotions over time in most, but not all, of her patients, which enabled her to formulate a model of coping with death that included 5 interdependent emotional stages: denial, anger, bargaining, depression, and acceptance. This model has become the most widely accepted and popularized model on death and dying, often cited as the Five Stages of Grief." However, given the lack of research concerning Kubler-Ross's model, completing work in this area seems warranted. The purpose of this case study was to examine one individual's emotional journey after being diagnosed with terminal colon cancer. More specifically, the goals were twofold: (1) to provide the participant with a voice and to allow her story to be told by examining the major external events (ie,surgery, chemotherapy) occurring since the diagnosis that affected her emotional and physical well-being and (2) to determine whether the participant's emotional journey paralleled Kubler-Ross's model, to what extent, and whether new emotions or stages occurred. The participant, a 50-year-old female, was diagnosed with stage 4 Duke Stage D colon cancer. Qualitative information was collected in face-to-face interviews, newspaper articles about the participant, and e-mail correspondence (as form letters to a group of friends and supporters) and subsequently analyzed for trends. The overall results revealed clear existence of the 5 stages of grief as outlined in the Kubler-Ross model. Analyses also revealed that the

  8. How Dutch orthoptists deal with noncompliance with occlusion therapy for amblyopia.

    Science.gov (United States)

    Tjiam, A M; Vukovic, E; Asjes-Tydeman, W L; Holtslag, G; Loudon, S E; Sinoo, M M; Simonsz, H J

    2010-12-01

    We previously found that compliance with occlusion therapy for amblyopia is poor, especially among children of non-native parents who spoke Dutch poorly and who were low educated. We investigated conception, awareness, attitude, and actions to deal with noncompliance among Dutch orthoptists. Orthoptists working in non-native, low socioeconomic status (SES) areas and a selection of orthoptists working elsewhere in the Netherlands were studied. They were observed in their practice, received a structured questionnaire, and underwent a semi-structured interview. Finally, a short survey was sent to all working orthoptists in the Netherlands. Nine orthoptists working in non-native, low-SES areas and 23 working elsewhere in the Netherlands participated. One hundred and fifty-one orthoptists returned the short survey. Major discrepancies existed in conception, awareness, and attitude. Opinions differed on what should be defined as noncompliance and on what causes noncompliance. Some orthoptists found noncompliance annoying, unpleasant, and hard to imagine, others were more understanding. Many pitied the noncompliant child. Almost all thought that the success of occlusion therapy lies both with the parents and the orthoptist, but one third thought that noncompliance was not solely their responsibility. Patients' compliance was estimated at 69.3% in non-native, low-SES areas (electronically, 52% had been measured), at 74.1% by the other 23 orthoptists, and at 73.8% in the short survey. Actions to improve compliance were diverse; some increased occlusion hours whereas others decreased them. In non-native, low-SES areas, 22% spoke Dutch moderately to none; the allotted time for a patient's first visit was 21'; the time spent on explaining to the parents was 2'30" and to the child 10". In practices of the other 23 orthoptists, 6% spoke Dutch moderately to none (P<0.0001), the time for a patient's first visit was 27'24" (P=0.47), and the periods spent explaining were 2'51" (P=0

  9. Previous utilization of service does not improve timely booking in ...

    African Journals Online (AJOL)

    Previous utilization of service does not improve timely booking in antenatal care: Cross sectional study ... Journal Home > Vol 24, No 3 (2010) > ... Results: Past experience on antenatal care service utilization did not come out as a predictor for ...

  10. Appropriate Educational Means of Dealing with the Phenomenon of Smoking among Zarqa University Students

    Science.gov (United States)

    hatamleh, habes Moh'd; al Khaza'leh, Mohammed Salman

    2016-01-01

    The study aimed to identify the (appropriate educational means of dealing with the phenomenon of smoking among Zarqa University students), and to achieve this goal, the descriptive approach has been used, also used a questionnaire submitted to (800) students of the sample, and a couple of open questions has been submitted to 70 members of the…

  11. The human fallibility of scientists : Dealing with error and bias in academic research

    NARCIS (Netherlands)

    Veldkamp, Coosje

    2017-01-01

    THE HUMAN FALLIBILITY OF SCIENTISTS Dealing with error and bias in academic research Recent studies have highlighted that not all published findings in the scientific lit¬erature are trustworthy, suggesting that currently implemented control mechanisms such as high standards for the reporting of

  12. INTERNATIONAL LEGAL ASPECTS OF DEALING WITH THE CONTEMPORARY TERRORISM THREATS

    Directory of Open Access Journals (Sweden)

    Vesna Poposka

    2017-05-01

    Full Text Available Recent challenges in international security posed by two terrorist organizations, Al Qaeda and ISIS, have highlighted an urgent domestic and foreign policy challenge. Terrorism has been, for more than a decade, top headline in the world media, and the cost of terrorist activities is expressed in numerous human lives and enormous material damage. Yet to date, international organizations and governments have not been successful in the attempt to find a common definition or uniform approach. Up to now, the approaches towards terrorist activities differ from case to case. There is no single legal regime to deal with terrorist activities, and the legal regime is what gives the answer and the framework for the counter-terrorist activities of the security forces, in order to be able to deal with the threat. This paper will attempt to answer at least some of the dilemmas.

  13. Ten Rules for Dealing with Negative Contributions in Social Media

    Directory of Open Access Journals (Sweden)

    Adriana Stránská

    2015-03-01

    Full Text Available Social media is becoming a key part of business communication strategy. Despite all the advantages, social media also poses a threat to business reputation. Dissatisfied customers can reach a large audience and share their negative experiences with others. This paper deals with the impact of social media on the practice of public relations. The goal of the paper is to formulate a set of rules for dealing with negative contributions and generally with crisis communication in social media. It is based on two surveys. Individual interviews with social media experts are the core part of the analysis. They are complemented by questioning of consumers to get deeper insight into complaining behavior via social media. The defined set of rules provides a useful tool for the social media crisis management.

  14. Dealing with scientific integrity issues: the Spanish experience.

    Science.gov (United States)

    Puigdomènech, Pere

    2014-02-01

    Integrity has been an important matter of concern for the scientific community as it affects the basis of its activities. Most countries having a significant scientific activity have dealt with this problem by different means, including drafting specific legal or soft law regulations and the appointment of stable or ad hoc committees that take care of these questions. This has also been the case in Spain. After the period of transition between dictatorship to a democratic regime, and, particularly, after the entrance in the European Union, scientific activity has increased in the country. As it could be expected, problems of misconduct have appeared and different institutions have been dealing with these matters. One of the best examples is that of Consejo Superior de Investigaciones Cientificas (CSIC), the largest institution devoted to scientific research belonging to the Spanish Government. The experience of the CSIC’s Ethics Committee in dealing with conflicts related to scientific practices is discussed here.

  15. Pricing summer day options by good-deal bounds

    International Nuclear Information System (INIS)

    Kanamura, Takashi; Ohashi, Kazuhiko

    2009-01-01

    Despite the worldwide popularity of CDD- and HDD-type weather derivatives based on temperature, a different class of weather derivatives, so-called summer day options, is more popular in Japan; the payoffs are determined by the number of summer days (i.e., the days whose average temperature is above 25 C) during the contract period. In this paper, we price such summer day options by the good-deal bounds of Cochrane and Saa-Requejo [Cochrane, J.H., and J. Saa-Requejo, 2000, Beyond Arbitrage: Good-Deal Asset Price Bounds in Incomplete Markets, Journal of Political Economy 108, 79-119.], using temperature data for Tokyo. (author)

  16. Arrangements for dealing with emergencies at civil nuclear installations

    International Nuclear Information System (INIS)

    Turner, M.J.; Robinson, I.F.

    1989-01-01

    This paper covers arrangements for dealing with nuclear emergencies at sites licensed by the Health and Safety Executive/Nuclear Installations Inspectorate. Such arrangements are over and above the contingency plans required for radiation incidents as required by the Ionising Radiations Regulations. The statutory position of the NII is described and, although the NII is limited to regulating the activities of the operator, the functions of the other organisations that could be involved in dealing with an emergency are briefly covered in order to give as complete a picture as possible. The basis for emergency planning is given together with the consequences and countermeasures for mitigation of a nuclear emergency, including the use of ERLs. The requirements for emergency exercises are explained. (author)

  17. Dealing with interests, values and knowledge in managing risk

    International Nuclear Information System (INIS)

    2004-01-01

    Radioactive waste management is an area of public interest in which Stakeholder involvement has largely proven itself to be beneficial to all parties and processes concerned. With growing experience, sharing best practice can be useful at the international level. These workshop proceedings deal with the local partnership methodology employed in Belgium in order to develop an integrated proposal to the national Government to construct and operate a disposal facility for low-level radioactive waste that is adapted to local conditions. The partnerships are formed amongst representatives of local organisations in affected communities and representatives of the Belgian national radioactive waste management agency. Insights are provided into a unique - and so far very successful - governance approach to dealing with interests, values and knowledge in managing risk. (author)

  18. Books average previous decade of economic misery.

    Science.gov (United States)

    Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade.

  19. Books Average Previous Decade of Economic Misery

    Science.gov (United States)

    Bentley, R. Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20th century since the Depression, we find a strong correlation between a ‘literary misery index’ derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

  20. Strategies for dealing with resistance to recommendations from accident investigations

    OpenAIRE

    Lundberg, Jonas; Rollenhagen, Carl; Hollnagel, Erik; Rankin, Amy

    2012-01-01

    Accident investigation reports usually lead to a set of recommendations for change. These recommendations are, however, sometimes resisted for reasons such as various aspects of ethics and power. When accident investigators are aware of this, they use several strategies to overcome the resistance. This paper describes strategies for dealing with four different types of resistance to change. The strategies were derived from qualitative analysis of 25 interviews with Swedish accident investigat...

  1. No discrimination against previous mates in a sexually cannibalistic spider

    Science.gov (United States)

    Fromhage, Lutz; Schneider, Jutta M.

    2005-09-01

    In several animal species, females discriminate against previous mates in subsequent mating decisions, increasing the potential for multiple paternity. In spiders, female choice may take the form of selective sexual cannibalism, which has been shown to bias paternity in favor of particular males. If cannibalistic attacks function to restrict a male's paternity, females may have little interest to remate with males having survived such an attack. We therefore studied the possibility of female discrimination against previous mates in sexually cannibalistic Argiope bruennichi, where females almost always attack their mate at the onset of copulation. We compared mating latency and copulation duration of males having experienced a previous copulation either with the same or with a different female, but found no evidence for discrimination against previous mates. However, males copulated significantly shorter when inserting into a used, compared to a previously unused, genital pore of the female.

  2. Iran’s geopolitics in Eurasia after the nuclear deal

    Directory of Open Access Journals (Sweden)

    Noemi Rocca

    2017-06-01

    Full Text Available Since the positive conclusion of the Iran nuclear deal, Iran is enhancing economic, military, energy and security ties with many countries, particularly with its Caucasus and Central Asian neighbours. Relations with Russia and China — which never stopped — are experiencing a new boom. Access to international financial markets — allowed by the progressive lifting of sanctions — coupled with the expected revenues from oil exports will modernise the Iranian industrial structure and make resources available for new infrastructure projects. This article approaches Iran’s geopolitics from a peculiar angle, that is through analysis of the offers Iran made in 2003 and 2005 to the United States and the European Union for solving the nuclear dispute. This article argues, firstly, that these proposals — focused not just on nuclear issues, but also on geopolitical matters — can shed light on how Iran shapes and conveys its geopolitical role in the Middle East and Central Asia; secondly, that such a role has been “legitimised” by global players like the United States, China, Russia, France, Germany, the United Kingdom and the European Union (i.e., the 5 + 1 countries which participated at the last round of the nuclear deal through the positive conclusion of the deal; and, finally, that Iran’s geopolitical role within the greater Eurasian space will increasingly assume more important dimensions.

  3. Societal and economic valuation of technology-transfer deals

    Science.gov (United States)

    Holmes, Joseph S., Jr.

    2009-09-01

    The industrial adoption of concepts such as open innovation brings new legitimacy to activities technology-transfer professionals have conducted for over 20 years. This movement highlights the need for an increased understanding of the valuation of intellectual property (IP) and technology-transfer deals. Valuation, though a centerpiece of corporate finance, is more challenging when applied to the inherent uncertainty surrounding innovation. Technology-transfer professionals are often overwhelmed by the complexity and data requirements of valuation techniques and skeptical of their applicability to and utility for technology transfer. The market longs for an approach which bridges the gap between valuation fundamentals and technology-transfer realities. This paper presents the foundations of a simple, flexible, precise/accurate, and useful framework for considering the valuation of technology-transfer deals. The approach is predicated on a 12-factor model—a 3×4 value matrix predicated on categories of economic, societal, and strategic value. Each of these three categories consists of three core subcategories followed by a fourth "other" category to facilitate inevitable special considerations. This 12-factor value matrix provides a framework for harvesting data during deals and for the application of best-of-breed valuation techniques which can be employed on a per-factor basis. Future work will include framework implementation within a database platform.

  4. International land deals, local people's livelihood, and environment nexus (How to create win-win land deals in Ethiopia?)

    Science.gov (United States)

    Teklemariam Gebremeskel, Dereje; Witlox, Frank; Azadi, Hossein; Haile, Mitiku; Nyssen, Jan

    2013-04-01

    Following the global raise in demand for food and biofuel production, transnational companies are acquiring large scale agricultural land in developing countries such as Ethiopia. Considering land as one of the factors to be outsourced for development, the government of Ethiopia is supplying millions of hectares of land to transnational companies in the form of longterm lease. Many of the companies which engage in large scale land acquisition are of Indian, Chinese, Ethiopian diaspora, German, Malaysian, Italian, British, Dutch, Turkish, and Saudi-Arabian origin. The boom in the acquisition of farm land in the country has sparked an all-rounded debate among civil society groups, international institutions, nongovernmental organizations and independent development experts. The common reflections concerning the land deals in Ethiopia and elsewhere contain much rhetoric and hype which lack analysis of the real situation "on the ground" giving different connotations such as 'land grabbing', 'agricultural outsourcing', 'neo-colonialism', 'agrarian colonialism', and 'land underdevelopment'. However, deforestation, soil degradation, marginalization of local indigenous communities, and minimally unfair gains from investment by the host country are among the real points of concern arising out of the long term land lease contracts. Scientific evidence is lacking concerning the pragmatic impacts of large scale agricultural land acquisitions by transnational companies upon the natural environment (forest and land), local peoples' livelihood, and the contacting parties (the host country and the companies). The major objective of this study is to investigate the impacts in the context of Ethiopia, orienting to reinvent win-win land use models which constitute sustainable land use, local peoples' livelihood and the company-host country interests. To achieve this overall objective, the study employs a number of methods and methodologies constituting both qualitative and

  5. Dealing with difficult deformations: Construction of a knowledge-based deformation atlas

    DEFF Research Database (Denmark)

    Thorup, Signe Strann; Darvann, T.A.; Hermann, N.V.

    2010-01-01

    from pre- to post-surgery using thin-plate spline warping. The registration results are convincing and represent a first move towards an automatic registration method for dealing with difficult deformations due to this type of surgery. New or breakthrough work to be presented: The method provides...... was needed. We have previously demonstrated that non-rigid registration using B-splines is able to provide automated determination of point correspondences in populations of infants without cleft lip. However, this type of registration fails when applied to the task of determining the complex deformation...

  6. REDD+ emissions estimation and reporting: dealing with uncertainty

    International Nuclear Information System (INIS)

    Pelletier, Johanne; Potvin, Catherine; Martin, Davy

    2013-01-01

    The United Nations Framework Convention on Climate Change (UNFCCC) defined the technical and financial modalities of policy approaches and incentives to reduce emissions from deforestation and forest degradation in developing countries (REDD+). Substantial technical challenges hinder precise and accurate estimation of forest-related emissions and removals, as well as the setting and assessment of reference levels. These challenges could limit country participation in REDD+, especially if REDD+ emission reductions were to meet quality standards required to serve as compliance grade offsets for developed countries’ emissions. Using Panama as a case study, we tested the matrix approach proposed by Bucki et al (2012 Environ. Res. Lett. 7 024005) to perform sensitivity and uncertainty analysis distinguishing between ‘modelling sources’ of uncertainty, which refers to model-specific parameters and assumptions, and ‘recurring sources’ of uncertainty, which refers to random and systematic errors in emission factors and activity data. The sensitivity analysis estimated differences in the resulting fluxes ranging from 4.2% to 262.2% of the reference emission level. The classification of fallows and the carbon stock increment or carbon accumulation of intact forest lands were the two key parameters showing the largest sensitivity. The highest error propagated using Monte Carlo simulations was caused by modelling sources of uncertainty, which calls for special attention to ensure consistency in REDD+ reporting which is essential for securing environmental integrity. Due to the role of these modelling sources of uncertainty, the adoption of strict rules for estimation and reporting would favour comparability of emission reductions between countries. We believe that a reduction of the bias in emission factors will arise, among other things, from a globally concerted effort to improve allometric equations for tropical forests. Public access to datasets and methodology

  7. REDD+ emissions estimation and reporting: dealing with uncertainty

    Science.gov (United States)

    Pelletier, Johanne; Martin, Davy; Potvin, Catherine

    2013-09-01

    The United Nations Framework Convention on Climate Change (UNFCCC) defined the technical and financial modalities of policy approaches and incentives to reduce emissions from deforestation and forest degradation in developing countries (REDD+). Substantial technical challenges hinder precise and accurate estimation of forest-related emissions and removals, as well as the setting and assessment of reference levels. These challenges could limit country participation in REDD+, especially if REDD+ emission reductions were to meet quality standards required to serve as compliance grade offsets for developed countries’ emissions. Using Panama as a case study, we tested the matrix approach proposed by Bucki et al (2012 Environ. Res. Lett. 7 024005) to perform sensitivity and uncertainty analysis distinguishing between ‘modelling sources’ of uncertainty, which refers to model-specific parameters and assumptions, and ‘recurring sources’ of uncertainty, which refers to random and systematic errors in emission factors and activity data. The sensitivity analysis estimated differences in the resulting fluxes ranging from 4.2% to 262.2% of the reference emission level. The classification of fallows and the carbon stock increment or carbon accumulation of intact forest lands were the two key parameters showing the largest sensitivity. The highest error propagated using Monte Carlo simulations was caused by modelling sources of uncertainty, which calls for special attention to ensure consistency in REDD+ reporting which is essential for securing environmental integrity. Due to the role of these modelling sources of uncertainty, the adoption of strict rules for estimation and reporting would favour comparability of emission reductions between countries. We believe that a reduction of the bias in emission factors will arise, among other things, from a globally concerted effort to improve allometric equations for tropical forests. Public access to datasets and methodology

  8. [Electronic cigarettes - effects on health. Previous reports].

    Science.gov (United States)

    Napierała, Marta; Kulza, Maksymilian; Wachowiak, Anna; Jabłecka, Katarzyna; Florek, Ewa

    2014-01-01

    Currently very popular in the market of tobacco products have gained electronic cigarettes (ang. E-cigarettes). These products are considered to be potentially less harmful in compared to traditional tobacco products. However, current reports indicate that the statements of the producers regarding to the composition of the e- liquids not always are sufficient, and consumers often do not have reliable information on the quality of the product used by them. This paper contain a review of previous reports on the composition of e-cigarettes and their impact on health. Most of the observed health effects was related to symptoms of the respiratory tract, mouth, throat, neurological complications and sensory organs. Particularly hazardous effects of the e-cigarettes were: pneumonia, congestive heart failure, confusion, convulsions, hypotension, aspiration pneumonia, face second-degree burns, blindness, chest pain and rapid heartbeat. In the literature there is no information relating to passive exposure by the aerosols released during e-cigarette smoking. Furthermore, the information regarding to the use of these products in the long term are not also available.

  9. Teens' Self-Efficacy to Deal with Dating Violence as Victim, Perpetrator or Bystander.

    Science.gov (United States)

    Van Camp, Tinneke; Hébert, Martine; Guidi, Elisa; Lavoie, Francine; Blais, Martin

    2014-09-01

    Multiple studies have demonstrated that adolescent dating violence is highly prevalent and associated with internalizing and externalizing problems. A number of prevention initiatives are being implemented in North-American high schools. Such initiatives do not only aim to raise awareness among potential victims and offenders but also among peer bystanders. Since teenagers mainly reach out to their peers when experiencing adversity, it is important to address adolescents' efficiency to deal with witnessing dating violence or with friends disclosing dating abuse, in addition to increasing ability to deal with experienced dating violence victimization or perpetration. The aim of this study is to explore adolescents' self-efficacy to deal with dating violence victimization and perpetration in their relationships and those of their peers. A paper-and-pencil questionnaire was completed by 259 14-18 years olds in Quebec, Canada. The data allows building insight into adolescents' confidence to reach out for help or to help others in a situation of dating violence victimization and perpetration. We also considered the impact of gender and dating victimization history. Results suggest that dating violence prevention can build on teens' self-efficacy to deal with dating violence and offer them tools to do so efficiently.

  10. Raw data from orientation studies in crystalline rock areas of the southeastern United States. [Maps, tables of field data and analytical data for sections of North and South Carolina and Georgia, previously reported sites of uranium mineralization

    Energy Technology Data Exchange (ETDEWEB)

    Price, V.

    1976-03-01

    Raw data are presented on orientation studies conducted in crystalline rock areas of the Southeast which were chosen because of published references to uranium mineralization. Preliminary data for four orientation study areas are included. These areas are Lamar County, Georgia; Oconee County, South Carolina; Brush Creek, North Carolina; and North Harper, North Carolina. Sample locality maps, tables of field data, and tables of analytical data are included for each study area. (JGB)

  11. Measurement errors in polymerase chain reaction are a confounding factor for a correct interpretation of 5-HTTLPR polymorphism effects on lifelong premature ejaculation: a critical analysis of a previously published meta-analysis of six studies.

    Science.gov (United States)

    Janssen, Paddy K C; Olivier, Berend; Zwinderman, Aeilko H; Waldinger, Marcel D

    2014-01-01

    To analyze a recently published meta-analysis of six studies on 5-HTTLPR polymorphism and lifelong premature ejaculation (PE). Calculation of fraction observed and expected genotype frequencies and Hardy Weinberg equilibrium (HWE) of cases and controls. LL,SL and SS genotype frequencies of patients were subtracted from genotype frequencies of an ideal population (LL25%, SL50%, SS25%, p = 1 for HWE). Analysis of PCRs of six studies and re-analysis of the analysis and Odds ratios (ORs) reported in the recently published meta-analysis. Three studies deviated from HWE in patients and one study deviated from HWE in controls. In three studies in-HWE the mean deviation of genotype frequencies from a theoretical population not-deviating from HWE was small: LL(1.7%), SL(-2.3%), SS(0.6%). In three studies not-in-HWE the mean deviation of genotype frequencies was high: LL(-3.3%), SL(-18.5%) and SS(21.8%) with very low percentage SL genotype concurrent with very high percentage SS genotype. The most serious PCR deviations were reported in the three not-in-HWE studies. The three in-HWE studies had normal OR. In contrast, the three not-in-HWE studies had a low OR. In three studies not-in-HWE and with very low OR, inadequate PCR analysis and/or inadequate interpretation of its gel electrophoresis resulted in very low SL and a resulting shift to very high SS genotype frequency outcome. Consequently, PCRs of these three studies are not reliable. Failure to note the inadequacy of PCR tests makes such PCRs a confounding factor in clinical interpretation of genetic studies. Currently, a meta-analysis can only be performed on three studies-in-HWE. However, based on the three studies-in-HWE with OR of about 1 there is not any indication that in men with lifelong PE the frequency of LL,SL and SS genotype deviates from the general male population and/or that the SL or SS genotype is in any way associated with lifelong PE.

  12. Measurement errors in polymerase chain reaction are a confounding factor for a correct interpretation of 5-HTTLPR polymorphism effects on lifelong premature ejaculation: a critical analysis of a previously published meta-analysis of six studies.

    Directory of Open Access Journals (Sweden)

    Paddy K C Janssen

    Full Text Available OBJECTIVE: To analyze a recently published meta-analysis of six studies on 5-HTTLPR polymorphism and lifelong premature ejaculation (PE. METHODS: Calculation of fraction observed and expected genotype frequencies and Hardy Weinberg equilibrium (HWE of cases and controls. LL,SL and SS genotype frequencies of patients were subtracted from genotype frequencies of an ideal population (LL25%, SL50%, SS25%, p = 1 for HWE. Analysis of PCRs of six studies and re-analysis of the analysis and Odds ratios (ORs reported in the recently published meta-analysis. RESULTS: Three studies deviated from HWE in patients and one study deviated from HWE in controls. In three studies in-HWE the mean deviation of genotype frequencies from a theoretical population not-deviating from HWE was small: LL(1.7%, SL(-2.3%, SS(0.6%. In three studies not-in-HWE the mean deviation of genotype frequencies was high: LL(-3.3%, SL(-18.5% and SS(21.8% with very low percentage SL genotype concurrent with very high percentage SS genotype. The most serious PCR deviations were reported in the three not-in-HWE studies. The three in-HWE studies had normal OR. In contrast, the three not-in-HWE studies had a low OR. CONCLUSIONS: In three studies not-in-HWE and with very low OR, inadequate PCR analysis and/or inadequate interpretation of its gel electrophoresis resulted in very low SL and a resulting shift to very high SS genotype frequency outcome. Consequently, PCRs of these three studies are not reliable. Failure to note the inadequacy of PCR tests makes such PCRs a confounding factor in clinical interpretation of genetic studies. Currently, a meta-analysis can only be performed on three studies-in-HWE. However, based on the three studies-in-HWE with OR of about 1 there is not any indication that in men with lifelong PE the frequency of LL,SL and SS genotype deviates from the general male population and/or that the SL or SS genotype is in any way associated with lifelong PE.

  13. Injection drug users’ involvement in drug dealing in the downtown eastside of Vancouver: Social organization and systemic violence

    Science.gov (United States)

    Small, Will; Maher, Lisa; Lawlor, Jeff; Wood, Evan; Shannon, Kate; Kerr, Thomas

    2014-01-01

    Background Illicit drug markets are a key component of the risk environment surrounding injection drug use. However, relatively few studies have explored how injection drug users’ (IDUs) involvement in drug dealing shapes their experiences of drug market-related harm. This exploratory qualitative study aims to understand IDUs’ dealing activities and roles, as well as the perceived benefits and risks related to participation in illicit drug markets, including experiences of drug market violence. Methods Ten IDUs with extensive involvement in drug dealing activities were recruited from the Vancouver Injection Drug User Study (VIDUS) and participated in semi-structured qualitative interviews, which elicited discussion of experiences dealing drugs, perceived benefits and hazards related to dealing, and understandings of drug market violence. Results Participant's involvement in drug market activities included corporate sales, freelance or independent sales, and opportunistic sales termed “middling” as well as drug market-related hustles entailing selling bogus drugs and robbing dealers. Participants primarily dealt drugs to support their own illicit drug use, and we found that arrest and criminal justice involvement, hazards stemming from drug debts, and drug market-related violence were key risks related to dealing activities. Conclusion The challenges of managing personal consumption while selling drugs exacerbates the hazards associated with drug dealing. Efforts to address drug dealing among IDUs should consider both drug dependency and the material conditions that propel drug users towards dealing activities. Interventions should explore the potential of combining enhanced drug treatment programs with low threshold employment and alternative income generation opportunities. PMID:23664788

  14. Diversity and equity: dealing with biological and social differences

    Directory of Open Access Journals (Sweden)

    Friedhelm Nachreiner

    2004-12-01

    Full Text Available In the context of the design of working hours inequities in health associated with biological, psychological, social, and socioeconomic diversities can be observed. The paper first tries to set up a frame of reference for a discussion of this topic, relating to the Universal Declaration of Human Rights and some recent discussions on equity in health and then goes into some factors that produce inequities in health in the context of the design of working hours, dealing with sex or gender, age and job age, personality traits, marital status, social support, diversities in values, and socio-economic differences; the discussion deals with approaches on how to deal with these differences and inequities.No contexto do planejamento das horas de trabalho, observam-se iniqüidades na saúde associadas à diversidade biológica, psicológica, social e socioeconômica. Inicialmente, procura-se criar uma estrutura de referência para a discussão do assunto, relacionando-o à Declaração Universal dos Direitos Humanos e a discussões recentes sobre eqüidade em saúde. Em seguida, passa-se a alguns fatores que causam iniqüidades em saúde no contexto do planejamento das horas de trabalho, associados ao sexo ou gênero, idade e tempo de permanência no serviço, características de personalidade, estado civil, apoio social, diversidades de valores e diferenças socioeconômicas; a discussão estende-se sobre enfoques para lidar com estas diferenças e iniqüidades.

  15. Strategies for dealing with resistance to recommendations from accident investigations

    DEFF Research Database (Denmark)

    Lundberg, J.; Rollenhagen, C.; Hollnagel, E.

    2012-01-01

    Accident investigation reports usually lead to a set of recommendations for change. These recommendations are, however, sometimes resisted for reasons such as various aspects of ethics and power. When accident investigators are aware of this, they use several strategies to overcome the resistance....... This paper describes strategies for dealing with four different types of resistance to change. The strategies were derived from qualitative analysis of 25 interviews with Swedish accident investigators from seven application domains. The main contribution of the paper is a better understanding of effective...... strategies for achieving change associated with accident investigation. (C) 2011 Elsevier Ltd. All rights reserved....

  16. Panorama 2001 energy and petroleum, the new international deal

    International Nuclear Information System (INIS)

    Giannesini, J.F.

    2001-01-01

    This document analyses the main events of the petroleum and gas industries, in year 2000. A great importance is given to the petroleum price which governs the industry activity. A second part deals with the impacts of exploration-production investments. The environmental impacts of the hydrocarbons consumption is also discussed with the analysis of the carbon dioxide emission and the associated climatic change. The green book on the energy supplying safety is presented and discussed as the forecasting scenario concerning the energy policy. (A.L.B.)

  17. Strategies for dealing with resistance to recommendations from accident investigations.

    Science.gov (United States)

    Lundberg, Jonas; Rollenhagen, Carl; Hollnagel, Erik; Rankin, Amy

    2012-03-01

    Accident investigation reports usually lead to a set of recommendations for change. These recommendations are, however, sometimes resisted for reasons such as various aspects of ethics and power. When accident investigators are aware of this, they use several strategies to overcome the resistance. This paper describes strategies for dealing with four different types of resistance to change. The strategies were derived from qualitative analysis of 25 interviews with Swedish accident investigators from seven application domains. The main contribution of the paper is a better understanding of effective strategies for achieving change associated with accident investigation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Empowerment perceptions of educational managers from previously ...

    African Journals Online (AJOL)

    Erna Kinsey

    In the empirical study, a self-administered questionnaire was dis- ... The task of management at all levels in the education system is to create and sustain .... improved school performance (better policies and more innovative fresh ideas);.

  19. INDEXES OF OBESITY AND COMPARISONS WITH PREVIOUS NATIONAL SURVEY DATA IN 9-YEAR-OLD AND 10-YEAR-OLD BLACK-AND-WHITE GIRLS - THE NATIONAL HEART, LUNG, AND BLOOD INSTITUTE GROWTH AND HEALTH STUDY

    NARCIS (Netherlands)

    CAMPAIGNE, BN; MORRISON, JA; SCHUMANN, BC; FALKNER, F; LAKATOS, E; SPRECHER, D; SCHREIBER, GB

    Objective: To (I) describe anthropometric and body-size measurements in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) population at baseline and (2) examine potential secular trends in the prevalence of obesity in young black and white girls by comparing NGHS baseline

  20. A previous hamstring injury affects kicking mechanics in soccer players.

    Science.gov (United States)

    Navandar, Archit; Veiga, Santiago; Torres, Gonzalo; Chorro, David; Navarro, Enrique

    2018-01-10

    Although the kicking skill is influenced by limb dominance and sex, how a previous hamstring injury affects kicking has not been studied in detail. Thus, the objective of this study was to evaluate the effect of sex and limb dominance on kicking in limbs with and without a previous hamstring injury. 45 professional players (males: n=19, previously injured players=4, age=21.16 ± 2.00 years; females: n=19, previously injured players=10, age=22.15 ± 4.50 years) performed 5 kicks each with their preferred and non-preferred limb at a target 7m away, which were recorded with a three-dimensional motion capture system. Kinematic and kinetic variables were extracted for the backswing, leg cocking, leg acceleration and follow through phases. A shorter backswing (20.20 ± 3.49% vs 25.64 ± 4.57%), and differences in knee flexion angle (58 ± 10o vs 72 ± 14o) and hip flexion velocity (8 ± 0rad/s vs 10 ± 2rad/s) were observed in previously injured, non-preferred limb kicks for females. A lower peak hip linear velocity (3.50 ± 0.84m/s vs 4.10 ± 0.45m/s) was observed in previously injured, preferred limb kicks of females. These differences occurred in the backswing and leg-cocking phases where the hamstring muscles were the most active. A variation in the functioning of the hamstring muscles and that of the gluteus maximus and iliopsoas in the case of a previous injury could account for the differences observed in the kicking pattern. Therefore, the effects of a previous hamstring injury must be considered while designing rehabilitation programs to re-educate kicking movement.

  1. INTRODUCTION Previous reports have documented a high ...

    African Journals Online (AJOL)

    Conclusion: The positive effect of education on oral hygiene practices is highlighted in this study. However there is still need for proper health enlightenment in this population with regards to use of the available oral health care facilities. Keywords: Oral hygiene, Pregnancy, Nigeria. Annals of Ibadan Postgraduate Medicine.

  2. Energy Security: From Deal Killers to Game Changers

    Science.gov (United States)

    Cooke, Charlie

    2010-03-01

    Five energy security ``deal killers" are identified: 1) Global warming and CO2 emissions from fossil fuel combustion; 2) Intermittent energy sources (wind, solar) and the presence and stability of the grid; 3) Penetration of plant defenses to produce transportation fuels from biomass; 4) Mimicking nature: artificial photosynthesis for solar energy to fuels; and 5) Spent fuel from nuclear power reactors. Transformational basic research is required to successfully change the ground rules, to transform these ``deal killers" into ``game changers." T hey are: 1) Offsetting carbon capture and storage costs through enhanced oil recovery and methane generation from high temperature geothermal saline aquifers; 2) Electrical energy storage, through batteries and super-capacitors; 3) Genetic modification of plant cell walls, and catalytic methods for transforming plant sugars into fuels; 4) Separation of solar-induced electrons from holes, and catalysis to produce fuels; and 5) Closing the nuclear fuel cycle. Basic research can revolutionize our approach to carbon-free energy by enhancing nature to achieve energy security.

  3. Methods Used to Deal with Peace Process Spoilers

    Directory of Open Access Journals (Sweden)

    MA. Bilbil Kastrati

    2014-06-01

    Full Text Available The conflicts of the past three decades have shown that the major problems which peace processes face are the spoilers. Spoilers are warring parties and their leaders who believe that peaceful settlement of disputes threatens their interests, power and their reputation; therefore, they use all means to undermine or completely spoil the process. Spoilers of peace processes can be inside or outside of the process and are characterized as limited, greedy or total spoilers. Their motives for spoiling can be different, such as: political, financial, ethnic, security, etc. Furthermore, it is important to emphasise that spoilers are not only rebels and insurgents, but can often be governments, diasporas, warlords, private military companies, etc. In order to counteract the spoilers, the international community has adopted and implemented three methods: inducement, socialization and coercion. Often all three methods are used to convince the spoilers to negotiate, accept and implement peace agreements. Hence, this paper will examine the methods used to deal with peace process spoilers through an assessment of the strategies employed, impact, success and failures. This paper will also argue that the success or failure of the peace process depends on the method(s used to deal with spoilers. If the right method is chosen, with a persistent engagement of the international community, the peace process will be successful; on the contrary, if they fail to do so, the consequences will be devastating.

  4. The predictive effect of fear-avoidance beliefs on low back pain among newly qualified health care workers with and without previous low back pain: a prospective cohort study

    DEFF Research Database (Denmark)

    Jensen, Jette Nygaard; Albertsen, Karen; Borg, Vilhelm

    2009-01-01

    Health care workers have a high prevalence of low back pain (LBP). Although physical exposures in the working environment are linked to an increased risk of LBP, it has been suggested that individual coping strategies, for example fear-avoidance beliefs, could also be important in the development...... and maintenance of LBP. Accordingly, the main objective of this study was to examine (1) the association between physical work load and LBP, (2) the predictive effect of fear-avoidance beliefs on the development of LBP, and (3) the moderating effect of fear-avoidance beliefs on the association between physical...

  5. Impact of the use of autologous stem cell transplantation at first relapse both in naïve and previously rituximab exposed follicular lymphoma patients treated in the GELA/GOELAMS FL2000 study

    Science.gov (United States)

    Le Gouill, Steven; De Guibert, Sophie; Planche, Lucie; Brice, Pauline; Dupuis, Jehan; Cartron, Guillaume; Van Hoof, Achiel; Casasnovas, Olivier; Gyan, Emmanuel; Tilly, Hervé; Fruchart, Christophe; Deconinck, Eric; Fitoussi, Olivier; Gastaud, Lauris; Delwail, Vincent; Gabarre, Jean; Gressin, Rémy; Blanc, Michel; Foussard, Charles; Salles, Gilles

    2011-01-01

    Background We analyzed detailed characteristics and salvage treatment in 175 follicular lymphoma patients from the FL2000 study who were in progression after first-line therapy with or without addition of rituximab to chemotherapy and interferon. Design and Methods The impact of using autologous stem cell transplantation and/or rituximab administration at first progression was investigated, taking into account initial therapy. With a median follow up of 31 months, 3-year event free and overall survival rates after progression were 50% (95%CI 42–58%) and 72% (95%CI 64–78%), respectively. Results The 3-year event free rate of rituximab re-treated patients (n=112) was 52% (95%CI 41–62%) versus 40% (95%CI 24–55%) for those not receiving rituximab second line (n=53) (P=0.075). There was a significant difference in 3-year overall survival between patients receiving autologous stem cell transplantation and those not: 92% (95%CI 78–97%) versus 63% (95%CI 51–72%) (P=0.0003), respectively. In multivariate analysis, both autologous stem cell transplantation and period of progression/relapse affected event free and overall survival. Conclusions Regardless of front-line rituximab exposure, this study supports incorporating autologous stem cell transplantation in the therapeutic approach at first relapse for follicular lymphoma patients. PMID:21486862

  6. Twelve-week efficacy and safety study of mometasone furoate/formoterol 200/10 microg and 400/10 microg combination treatments in patients with persistent asthma previously receiving high-dose inhaled corticosteroids

    DEFF Research Database (Denmark)

    Weinstein, Steven F; Corren, Jonathan; Murphy, Kevin

    2010-01-01

    A significant unmet medical need exists in patients with uncontrolled asthma. The purpose of this study was to evaluate the efficacy and safety of mometasone furoate/formoterol (MF/F) 400/10 microg versus MF 400 microg administered twice-daily (b.i.d.) via metered-dose inhaler in patients...... with asthma uncontrolled on high-dose inhaled corticosteroids (ICS). In a 12-week, randomized, multicenter, double-blind, parallel-group study, patients (>or=12 years of age) were randomized to MF/F 200/10 microg, MF/F 400/10 microg, or MF 400 microg, b.i.d. after a 2- to 3-week open-label run in with MF 400...... microg b.i.d. The primary end point was mean change in area under the curve from 0 to 12 hours in forced expiratory volume in 1 second (FEV(1) AUC(0-12h)) from baseline to week 12 for MF/F 400/10 microg versus MF 400 microg. Effects of MF/F on asthma control and symptoms were evaluated and adverse events...

  7. Local recurrence risk after previous salvage mastectomy.

    Science.gov (United States)

    Tanabe, M; Iwase, T; Okumura, Y; Yoshida, A; Masuda, N; Nakatsukasa, K; Shien, T; Tanaka, S; Komoike, Y; Taguchi, T; Arima, N; Nishimura, R; Inaji, H; Ishitobi, M

    2016-07-01

    Breast-conserving surgery is a standard treatment for early breast cancer. For ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery, salvage mastectomy is the current standard surgical procedure. However, it is not rare for patients with IBTR who have received salvage mastectomy to develop local recurrence. In this study, we examined the risk factors of local recurrence after salvage mastectomy for IBTR. A total of 118 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent salvage mastectomy without irradiation for IBTR between 1989 and 2008 were included from eight institutions in Japan. The risk factors of local recurrence were assessed. The median follow-up period from salvage mastectomy for IBTR was 4.6 years. Patients with pN2 or higher on diagnosis of the primary tumor showed significantly poorer local recurrence-free survival than those with pN0 or pN1 at primary tumor (p mastectomy for IBTR. Further research and validation studies are needed. (UMIN-CTR number UMIN000008136). Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Barbara Daly

    2018-01-01

    Full Text Available Gestational diabetes mellitus (GDM is associated with developing type 2 diabetes, but very few studies have examined its effect on developing cardiovascular disease.We conducted a retrospective cohort study utilizing a large primary care database in the United Kingdom. From 1 February 1990 to 15 May 2016, 9,118 women diagnosed with GDM were identified and randomly matched with 37,281 control women by age and timing of pregnancy (up to 3 months. Adjusted incidence rate ratios (IRRs with 95% confidence intervals (CIs were calculated for cardiovascular risk factors and cardiovascular disease. Women with GDM were more likely to develop type 2 diabetes (IRR = 21.96; 95% CI 18.31-26.34 and hypertension (IRR = 1.85; 95% CI 1.59-2.16 after adjusting for age, Townsend (deprivation quintile, body mass index, and smoking. For ischemic heart disease (IHD, the IRR was 2.78 (95% CI 1.37-5.66, and for cerebrovascular disease 0.95 (95% CI 0.51-1.77; p-value = 0.87, after adjusting for the above covariates and lipid-lowering medication and hypertension at baseline. Follow-up screening for type 2 diabetes and cardiovascular risk factors was poor. Limitations include potential selective documentation of severe GDM for women in primary care, higher surveillance for outcomes in women diagnosed with GDM than control women, and a short median follow-up postpartum period, with a small number of outcomes for IHD and cerebrovascular disease.Women diagnosed with GDM were at very high risk of developing type 2 diabetes and had a significantly increased incidence of hypertension and IHD. Identifying this group of women in general practice and targeting cardiovascular risk factors could improve long-term outcomes.

  9. Speaking as one, but not speaking up : dealing with new moral taint in an occupational online community

    OpenAIRE

    Vaast, Emmanuelle; Levina, Natalia

    2015-01-01

    This paper builds a process theory of how participants in an online community deal with a new identity threat. Based upon the in-depth, interpretive case study of an online community of retail bankers, it develops a grounded theory that reveals that participants in an online community deal with new taint by protecting their occupation's identity but not by attempting to repair its external image. In the investigated community, reactions progressed from rejecting the taint to distancing from i...

  10. Short-and long-term effects of discharged OBM cuttings, with and without previous washing, tested in field and laboratory studies on the Dutch continental shelf, 1985-1990

    International Nuclear Information System (INIS)

    De Jong, A.; Zevenboom, W.; Van Het Groenewoud, H.; Daan, R.

    1991-01-01

    This paper reports on a Dutch programme that was carried out to study the distribution of discharged washed and unwashed oil-containing cuttings in the sediment and waterphase and their effects on selected test species in the Dutch part of the North Sea. The distribution of OBM cuttings in sediment around drilling locations was related to the total amount of oil discharged in the watercolumn. Increased oil contents were found over a range of 1000 to 5000 m in residual current direction. Total oil contents remained high at locations where unwashed OBM cuttings were discharged. At one location oil was found in high concentrations up to 6 years after discharge of OBM cuttings, especially due to the persistence of the oil fractions Other peaks and UCM. Washing of OBM cuttings resulted in lower amounts of oil discharged, lower concentrations in the sediment in the vicinity of the platform (up to 100 m), equal concentrations at 250 m but higher concentrations up to at more than 500 m off the platform when compared with unwashed cuttings and the respective amount of oil discharged. However, within one year, degradation of oil seems to have taken place at one of the washed sites at 5000 m. During discharge in the watercolumn, oil was taken up by Mytilus edulis from washed cuttings as well as from unwashed cuttings. Leaching of oil from the sediment into the waterphase was measurable in the field for only a limited period to time, less than a year after discharge. Several sediment-inhabiting species were tested on their response to oil contamination. Four species tested in experimental boxcosm set-ups, Echinocardium cordatum, Amphiura filiformis, Lagis koreni and Nucula turgida responded to elevated contamination levels by increased mortality

  11. Endoscopic Third Ventriculostomy in Previously Shunted Children

    Directory of Open Access Journals (Sweden)

    Eva Brichtova

    2013-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%. There were two serious complications (4.7%—one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.

  12. Global Green New Deal. Together we can do it; Global Green New Deal. Samen kunnen we het doen

    Energy Technology Data Exchange (ETDEWEB)

    Van Dieren, W. [Institute for Environment and System Analysis, Amsterdam (Netherlands)

    2009-12-15

    From 26-27 October 2009, the annual meeting of the Club of Rome, the 'Global Assembly'. This is an open conference where the most influential thinkers about sustainability work together with the participants on the Amsterdam Declaration. This Declaration is a final call to the negotiators at the UN Climate Conference (COP15) who are to lay the foundation for growth within the boundaries of what planet Earth can handle. The author comments on the annual meeting of the Club of Rome and explains why we are in need of a Global Green New Deal. [Dutch] Van 26-27 oktober 2009 vond in Amsterdam de jaarvergadering plaats van de Club van Rome, de 'Global Assembly'. Dit is een open conferentie waar de meest invloedrijke denkers over duurzaamheid samen met de deelnemers werken aan de Verklaring van Amsterdam. Deze Verklaring is een laatste oproep aan de onderhandelaars die op de VN-klimaatconferentie (COP15) in december in Kopenhagen het fundament moeten leggen voor groei binnen de grenzen van wat de planeet aarde kan dragen. De auteur geeft commentaar op de jaarvergadering van de Club of Rome, en legt uit waarom we een Global Green New Deal nodig hebben.

  13. Ultrasound screening of thyroid nodules in adults with no previous exposed to irradiation comparison between scanning, palpation and fine needle aspiration cytology. A study in Ghaem Hospital, Mashhad, North East of Iran

    International Nuclear Information System (INIS)

    Rahrouh, M.; Namadanian, G.R.; Zakavi, S.R.; Rezaei, H.

    2003-01-01

    There are a great number of studies on the association between childhood radiation exposure and thyroid nodules and cancer. Ultrasound imaging of thyroid nodules is valuable part of diagnostics and identifies abnormalities, because ultrasound can detect nodules as small as 2-3 mm and no radiation is involved , it has gained wide acceptance for the screening of nodular thyroid disease. 500 subjects were selected randomly from medical students in university of medical sciences in Mashhad North East of Iran. Individuals were screened by a health survey , thyroid ultrasounds, 99mTc-pertechnetate scans, palpation and fine needle aspiration obtained as necessary. The ultrasound was performed with a 7.5-MHz transducer in direct contact with the lubricated skin of the extended neck. Each ultrasound exam was read independently by two radiologists and one endocrinologist. Each nodule was characterized as follows: 1) presence; 2) size ; 3) location; ant or post; 4) location; upper pole, midportion of lobe, lower pole, or isthmus; and 5) type; solid, cystic, or mixed. In 500 cases (312 men, 188 women; age range, 18 - 30 years) underwent neck sonography. Normal findings were verified by clinical follow-up and thyroid disease was found in (5%) of subjectes. A total of 25 certain thyroid nodules were detected by the ultrasound examinations. Eighty eight percent nodules were less than 1.0 cm dimension.Among the subjects who had them thyroid nodules,(48%) were cystic , (44%) were hypoechoic lesions and (8 %) were hyperechoic .The abnormality of thyroid echo was solitary in (1,8%) ,multiple in (1,4%) and diffuse in (0,6%) of subjectes. All abnormal findings were verified by fine needle aspiration biopsy and correlated with thyroid scan, and surgery. The results reported here can be compared to several reports on the prevalence of ultrasound detected thyroid nodules in adult populations not exposed to radiation .The major advantage is that ultrasound can find clinically important

  14. Eco Logic signs deal to destroy Japanese PCB stocks

    International Nuclear Information System (INIS)

    Anon.

    1997-01-01

    According to a recent announcement, Eco Logic of Rockwood, Ontario, has entered into a partnership with the Japanese companies Tokyo Boeki and Nippon Sharyo for the destruction of stockpiled PCB materials in Japan, using Eco Logic's non-incineration technology. The deal is reported to be worth about $50 million in revenues to Eco Logic, spread over the next few years. The agreement includes provisions for the Japanese companies to purchase, or manufacture under licence, a number of Eco Logic's gas phase chemical reduction processing units to serve the Japanese market. In exchange for exclusive rights to the Japanese market, Eco Logic will receive license fees and royalties of up to nine per cent for the use of its process. Eco Logic is currently building a demonstration unit under contract with the two Japanese companies. The Japanese PCB waste destruction market is estimated to be worth as much as $400 million. Incineration, the conventional form of disposal, is strongly opposed by local governments

  15. International negotiations on climate change towards a new international deal?

    International Nuclear Information System (INIS)

    2009-11-01

    This document reports the work performed by the French 'Centre d'Analyse Strategique' until the first of November within the perspective of a new international agreement to struggle against climate change beyond 2012. The basic idea is that such an agreement will have a meaning only if it is signed and ratified by the both main greenhouse gas emitting countries, the United States and China. A first part of this report describes the context and the post-2012 negotiation perspectives, as well as the status of international cooperation in the field of climate change. The two following chapters present syntheses of the climate policies and negotiation postures of China and United States. Then, the authors give an overview of the strategic interests and postures of some other big countries like India, Brazil, Russia, Canada, OPEC countries, and so on. The last part deals with issues of rights of intellectual property applied to the elaboration of 'clean' technologies and to international technological transfers

  16. Are land deals driving 'water grabs'?

    Energy Technology Data Exchange (ETDEWEB)

    Skinner, Jamie; Cotula, Lorenzo

    2011-11-15

    Investors in land often look for land with a high growing potential, which means land with lots of rainfall or land that can be irrigated. In multimillion dollar investments involving irrigation, investors typically want to secure water rights as part of the deal. Motivated by potential revenues from water fees and the prospect of improved agricultural productivity, many African governments are signing away water rights for decades to large investors. But they are doing so with little regard for how this will impact the millions of other users — from fishermen to pastoralists — whose livelihoods depend on customary access to water. Water managers must seriously consider the extent to which water rights should be linked to land in this way before setting a long-term precedent that could compromise sustainable and equitable supply to all users in the future.

  17. Trading guilds and business dealings in the mediaeval Dubrovnik

    Directory of Open Access Journals (Sweden)

    Blagojević Mirjana

    2014-01-01

    Full Text Available Trading guilds, regulated under the norms of the Dubrovnik Statute, were known under the names entega, collegantia and rogantia. The first one was an association of labour, capital and funds for carrying out business activities, the second one stood on the cross-road between the trading dealings and enterprising ventures, while the third one was, in actual fact, a form of intermediation. Some of their forms are recognised also in the legal systems of the other Adriatic communes, but the best developed regulating norms prevailed in Dubrovnik. It was there that the original forms of association, adopted from the Byzantine practice and law, found a fertile ground for further expansion. The most complex form of these associations, the entega, was not to be found after the 16th century, while collegantia gradually ascended into a limited partnership society, i.e. into the crediting business.

  18. Customer Satisfaction with Goods and Services Purchased on Deal Sites

    DEFF Research Database (Denmark)

    Sudzina, Frantisek; Pavlicek, Antonin

    2017-01-01

    influence whether customers are more prone to purchase problematic goods and services on deal sites, i.e. to experience problems with purchased coupons. Methodology/Approach: The research was conducted in the Czech Republic using an on-line questionnaire. Respondents were university students. Data were...... and mistrust. All these statements were measured on a Likert scale. Additional independent variables are age, and gender. In the first model, the dependent variable is if and if so, what problem the respondent experienced with purchased goods or services, such as the company did not exist, it was not possible...... cases. In the second model, the dependent variable is the percentage (predefined intervals) of problematic purchases. Ordinal logistic regression was used to test the model. In the third model, the dependent variable is if the purchased goods or services were of lower quality. Binomial logistic...

  19. DEALed : A tool suite for distributed real-time systems development

    NARCIS (Netherlands)

    Bolshakov, K.; Karpov, Y.; Sintotski, A.; Malyshkin, V.

    1999-01-01

    DEALed is a tool suite for development of distributed systems using DEAL language. DEAL is being developed at Eindhoven University of Technology as a part of DEDOS project. Area of application of the DEALed is the development of the distributed real- time safety-critical control systems.

  20. “It's Your Problem. Deal with It.” Performers' Experiences of Psychological Challenges in Music

    Directory of Open Access Journals (Sweden)

    Ellis Pecen

    2018-01-01

    Full Text Available Musicians need to deal with a range of challenges during their performance career and in response to these have reported a number of conditions that impact on their performance. Although social support from peers and teachers has been identified as part of the process of dealing with these challenges, little is understood about musicians' coping methods, beliefs and their attitudes toward support. Therefore, this study aimed to explore (a performers' previous experiences of psychological challenges, (b the types of support they used and, (c how this might inform future support programs in learning environments. Fifteen interviews were conducted with pre-elite (n = 5 transitioning elite (n = 3 and established elite performers (n = 7 in order to elicit data on psychological challenges, coping, beliefs and preferences for support. Inductive content analysis suggested that elite performers in this sample reported positive health habits, philosophical views of performance, health and life, positive anxiety reappraisal, and use of various psychological strategies, albeit without being explicitly aware of it. The need for various professional skills (e.g., communication, business, self-management, and organizational skills was emphasized by all participants. Transition into conservatoire was marked by severe psychological challenges, disorders and trauma. Primary sources of support included friends, family and self-help literature. Professional help was predominantly sought for physical problems. The impact of teachers was paramount, yet securing good teachers was considered a matter of “luck.” The most negative aspects recounted included abusive teachers, unsupportive environments, social comparison, competition, and disillusionment after entering the profession. Participants believed that talent could be developed and also valued wellbeing in relation to performance. Positive effects of late specialization on social development and professional

  1. Dealing with female sexuality: training, attitude, and practice of obstetrics and gynecology residents from a developing country.

    Science.gov (United States)

    Vieira, Teresa Cristina Souza Barroso; de Souza, Eduardo; da Silva, Ivaldo; Torloni, Maria Regina; Ribeiro, Meireluci Costa; Nakamura, Mary Uchiyama

    2015-05-01

    There is little research on how obstetrics and gynecology (Ob/Gyn) residents deal with female sexuality, especially during pregnancy. The aim of this study was to assess the training, attitude, and practice of Ob/Gyn residents about sexuality. A cross-sectional survey of Brazilian Ob/Gyn residents enrolling in an online sexology course was conducted. A questionnaire assessed their training in sexuality during medical school and residency and their attitude and practice on sexual issues during pregnancy. Training, attitude, and practice of Ob/Gyn residents regarding sexuality were the main outcome measures. A total of 197 residents, from 21 different programs, answered the online questionnaire. Mean age was 27.9 ± 2.2, most were female (87%), single (79%), and had graduated in the last 5 years (91%). Almost two-thirds (63%) stated that they did not receive any training at all and 28% reported having only up to 6 hours of training about sexuality in medical school. Approximately half of the respondents (49%) stated that they had received no formal training about sexuality during their residency up to that moment and 29% had received ≤6 hours of training. Over half (56%) never or rarely took a sexual history, 51% stated that they did not feel competent or confident to answer their pregnant patients' questions about sexuality, and 84% attributed their difficulties in dealing with sexual complaints to their lack of specific knowledge on the topic. The vast majority of Brazilian Ob/Gyn residents enrolling in a sexuality course had little previous formal training on this topic in medical school and during their residency programs. Most residents do not take sexual histories of pregnant patients, do not feel confident in answering questions about sexuality in pregnancy, and attribute these difficulties to lack of knowledge. These findings point to a clear need for additional training in sexuality among Brazilian Ob/Gyn residents. © 2015 International Society for

  2. Localising welfare-to-work? Territorial flexibility and the New Deal for Young People

    OpenAIRE

    Corinne Nativel; Peter Sunley; Ron Martin

    2002-01-01

    The move towards workfare and active labour-market policies is often alleged to be closely associated with the decentralisation and localisation of welfare delivery and agencies. In the United Kingdom, the New Deal for the young unemployed was designed to introduce local flexibility and discretion in delivery to mainstream labour-market policy. We use case studies of five local areas to examine the extent to which the programme has actually been decentralised and benefited from 'local flexibi...

  3. Dealing with uncertainties in the nanotech workplace practice: making the precautionary approach operational.

    Science.gov (United States)

    van Broekhuizen, Pieter

    2011-02-01

    If the risk management for the professional use of dispersive nanomaterials is hampered by a lack of reliable information, the reliable manager and the policy makers have to chose to make the precautionary principle operational for nanotech workplace. This study presents some tools that can be useful for the health & safety manager and for nanotech workers to deal with uncertainties in the nano-workplace.

  4. Influence of previous knowledge in Torrance tests of creative thinking

    OpenAIRE

    Aranguren, María; Consejo Nacional de Investigaciones Científicas y Técnicas CONICET

    2015-01-01

    The aim of this work is to analyze the influence of study field, expertise and recreational activities participation in Torrance Tests of Creative Thinking (TTCT, 1974) performance. Several hypotheses were postulated to explore the possible effects of previous knowledge in TTCT verbal and TTCT figural university students’ outcomes. Participants in this study included 418 students from five study fields: Psychology;Philosophy and Literature, Music; Engineering; and Journalism and Advertisin...

  5. The job satisfaction of principals of previously disadvantaged schools

    African Journals Online (AJOL)

    The aim of this study was to identify influences on the job satisfaction of previously disadvantaged ..... I am still riding the cloud … I hope it lasts. .... as a way of creating a climate and culture in schools where individuals are willing to explore.

  6. The job satisfaction of principals of previously disadvantaged schools

    African Journals Online (AJOL)

    The aim of this study was to identify influences on the job satisfaction of previously disadvantaged school principals in North-West Province. Evans's theory of job satisfaction, morale and motivation was useful as a conceptual framework. A mixedmethods explanatory research design was important in discovering issues with ...

  7. Abiraterone in metastatic prostate cancer without previous chemotherapy

    NARCIS (Netherlands)

    Ryan, Charles J.; Smith, Matthew R.; de Bono, Johann S.; Molina, Arturo; Logothetis, Christopher J.; de Souza, Paul; Fizazi, Karim; Mainwaring, Paul; Piulats, Josep M.; Ng, Siobhan; Carles, Joan; Mulders, Peter F. A.; Basch, Ethan; Small, Eric J.; Saad, Fred; Schrijvers, Dirk; van Poppel, Hendrik; Mukherjee, Som D.; Suttmann, Henrik; Gerritsen, Winald R.; Flaig, Thomas W.; George, Daniel J.; Yu, Evan Y.; Efstathiou, Eleni; Pantuck, Allan; Winquist, Eric; Higano, Celestia S.; Taplin, Mary-Ellen; Park, Youn; Kheoh, Thian; Griffin, Thomas; Scher, Howard I.; Rathkopf, Dana E.; Boyce, A.; Costello, A.; Davis, I.; Ganju, V.; Horvath, L.; Lynch, R.; Marx, G.; Parnis, F.; Shapiro, J.; Singhal, N.; Slancar, M.; van Hazel, G.; Wong, S.; Yip, D.; Carpentier, P.; Luyten, D.; de Reijke, T.

    2013-01-01

    Abiraterone acetate, an androgen biosynthesis inhibitor, improves overall survival in patients with metastatic castration-resistant prostate cancer after chemotherapy. We evaluated this agent in patients who had not received previous chemotherapy. In this double-blind study, we randomly assigned

  8. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2012-01-31

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  9. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2011-01-01

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  10. [Population policy and women: the relevance of previous studies].

    Science.gov (United States)

    De Barbieri, M T

    1983-01-01

    Although Mexico has had high rates of population growth since the 1930s caused by continuing high fertility but declining infant and general mortality, and has undergone deep structural change including declining agricultural production, rapid industrialization, urbanization, and increasing urban umemployment, it was not until the 1970s that the government began to adopt measures aimed at controlling population growth. Opponents of family planning argued that economic and social development would lead to fertility decline, but its proponents believed that reducing population growth would free resources for productive investment that otherwise would have to be used to finance services for the ever-growing population. At the same time that the constitution and laws were changed to allow or promote family planning, Mexican civil and labor laws were changed to provide for equality of men and women. Some background is necessary to understand the effect of such changes in the role and status of the Mexican woman. A relationship has been noted between demographic models--the form in which a society reproduces over a given time--and the social condition of women. Women have generally been subordinated to men during known history, but recent research indicates that their history has not been as uniform as once supposed. The particular form in which each society defines the natural-biological basis of sex roles varies; social definitions of sex and gender vary depending on the extension of "natural-biological" character to specific areas and tasks. The cases of French women in the 16th-18th centuries and German women under Hitler illustrate different ways in which demographic models and the condition of women have varied within a general framework of subordination of women. But when attempts are made to change a given demographic model, the condition of women is redefined at the level of practice as well as of value orientations concerning motherhood, female labor force participation, and the role of women in society. Moreover, the literature concerning fertility decline contains numerous statements by both those opposed to and in favor of birth control, that improving the status of women is 1 of the most effective means of reducing population growth. It can then be asked what changes in the role of women in Mexico will attend application of a fertility reduction policy. The crude birth rate declined from 44.2 in 1970 to 34.4 in 1980, with fertility falling among all age groups but especially among women over 40. The decline occurred primarily among urban nonmanual occupations. More research must be done on recent fertility change in Mexico and on related changes in the role orientations of men and women in different classes and life cycle stages, that have occurred at various stages of the population debate.

  11. The New Deal. By Conkin, Paul K. New York: Thomas Y. Crowell Company, 1967 The New Deal. By Conkin, Paul K. New York: Thomas Y. Crowell Company, 1967

    Directory of Open Access Journals (Sweden)

    Donald Richardson

    2008-04-01

    Full Text Available Material Covered: Chapter 1 of Conkin's book is a study of Roosevelt's personality and of his political activities during the thirties. The book starts with a quite detailed description of Roosevelt's life as a child, student, husband, father, friend, governor, etc., trying to pinpoint especially those personality traits which would later affect his political career, his policies and the life of the country. The remaining three chapters of the book are dedicated to the analysis of Roosevelt's New Deal programs—their successes and failures, their influence on labor unions, on the political Left and on the Republican Party. Material Covered: Chapter 1 of Conkin's book is a study of Roosevelt's personality and of his political activities during the thirties. The book starts with a quite detailed description of Roosevelt's life as a child, student, husband, father, friend, governor, etc., trying to pinpoint especially those personality traits which would later affect his political career, his policies and the life of the country. The remaining three chapters of the book are dedicated to the analysis of Roosevelt's New Deal programs—their successes and failures, their influence on labor unions, on the political Left and on the Republican Party.

  12. Trade Credit, Future Earnings, and Stock Returns: A Self-Dealing Perspective

    Directory of Open Access Journals (Sweden)

    Jigao Zhu

    2009-12-01

    Full Text Available Chinese listed firms are characterized by a great magnitude of long-duration accounts receivable from controlling shareholders and their affiliates, and they often do not make bad debt allowances. On many occasions, these receivables are never collected. We find that firms with a great magnitude of accounts receivable demonstrate a low level of future profitability and low stock returns. It does not appear that the low earnings persistence of these firms is responsible for their poor future performance as predicted by the accrual anomaly, because the firms also report low concurrent earnings. In the context of the Chinese stock market, we interpret the results as being consistent with self-dealing through trade credit by controlling shareholders. This study contributes to the self-dealing literature by identifying a more subtle channel of expropriation of minority shareholders in China.

  13. HOW TO DEAL WITH CORPORATE SOCIAL RESPONSIBILITY RELATED TO EMPLOYEES

    Directory of Open Access Journals (Sweden)

    Stoian Ciprian-Dumitru

    2013-07-01

    Full Text Available The aim of the paper is to examine an area which was not thoroughly researched until present. We refer on how Corporate Social Responsibility (CSR practices are nowadays reflecting its actions to employees / labor force. This paper represents a theoretical research related to the latest developments in this field. We had documented our paper based on actual references on this matter. In order to make correct assessments, this material seeks firstly to examine the level of understanding in respect of internal CSR actions related to employees. It is very important to understand and to briefly describe how previous studies described the link between CSR actions assigned to own employees. Secondly, this paper focuses on presenting and commenting an idea prescribing that pyramids (i.e. the pyramid of Maslow’s hierarchy of human needs and the pyramid of Carroll’s corporate social responsibility put together generate a clear feedback related to companies’ reactions in respect of CSR for their employees. In a practical manner, it is assumed that each level on the pyramid of Maslow has a correspondent in the pyramid of Carroll and vice-versa. This model is then precisely reflected when looking at the employees and their needs reflected through CSR actions. Thirdly, this paper also emphasizes the importance of the labor unions for employees’ CSR. We discuss about an out-of-the-box role for the labor unions, which should be engaged more and more in the employees updated wishes, one of them being about various CSR actions that need to be focused on employees. We assume that CSR efforts directed in the field of employees would make them more responsible, more eager to work and more productive in their day-to-day work.

  14. On dealing with the past, transitional justice and archives

    Directory of Open Access Journals (Sweden)

    Syrri Despina

    2008-01-01

    Full Text Available This paper aims to explore initiatives in dealing with the past in South East Europe, particularly with regard to archives, and to reflect on discussions about the documentation of atrocities and sufferings and the shift from war to peace, ongoing in the Balkan countries affected by the 1991-1999 wars while the countries are still struggling to find the best way(s to deal with the past and its consequences. Transitional justice may be framed as opening up different approaches to create collective memories, to share and to transfer these through time-space. New technologies used in archiving are assumed to open new avenues to democratization and accountability, in communication and free circulation of information, and to create a much broader negotiating process, with significant opportunities for the preservation of memory(ies, documentation and contestation - a far more multi-sited, multi-scalar and multi-level board where novel alliances formations and mediations might arise. One particular case is that of the digitization and public accessibility of the tribunals’ archives, which are supposed to constitute an important legal and cultural heritage that belongs to the world community, as well as to the states and the citizens involved. The information contained in these archives is expected to be made available for new forms of use, such as scientific research and investigation by/for surviving rela­tives, while respecting different legal constraints. The archives would also serve the advancement of the international justice system by explaining the workings of the tribunals to the general public. Consequently the important question that arises is the ownership of these archives. The reciprocal "production" and "consumption" (shaping of the colonial narrative of history and identity entail that the former colonizers and colonized are a community of records, sharing a common archival heritage. Therefore, what in Western archival practice is

  15. Response to health insurance by previously uninsured rural children.

    Science.gov (United States)

    Tilford, J M; Robbins, J M; Shema, S J; Farmer, F L

    1999-08-01

    To examine the healthcare utilization and costs of previously uninsured rural children. Four years of claims data from a school-based health insurance program located in the Mississippi Delta. All children who were not Medicaid-eligible or were uninsured, were eligible for limited benefits under the program. The 1987 National Medical Expenditure Survey (NMES) was used to compare utilization of services. The study represents a natural experiment in the provision of insurance benefits to a previously uninsured population. Premiums for the claims cost were set with little or no information on expected use of services. Claims from the insurer were used to form a panel data set. Mixed model logistic and linear regressions were estimated to determine the response to insurance for several categories of health services. The use of services increased over time and approached the level of utilization in the NMES. Conditional medical expenditures also increased over time. Actuarial estimates of claims cost greatly exceeded actual claims cost. The provision of a limited medical, dental, and optical benefit package cost approximately $20-$24 per member per month in claims paid. An important uncertainty in providing health insurance to previously uninsured populations is whether a pent-up demand exists for health services. Evidence of a pent-up demand for medical services was not supported in this study of rural school-age children. States considering partnerships with private insurers to implement the State Children's Health Insurance Program could lower premium costs by assembling basic data on previously uninsured children.

  16. The Public Health Responsibility Deal: making the workplace healthier?

    Science.gov (United States)

    Knai, Cécile; Scott, Courtney; D'Souza, Preethy; James, Lesley; Mehrotra, Anushka; Petticrew, Mark; Eastmure, Elizabeth; Durand, Mary Alison; Mays, Nicholas

    2017-06-01

    The Public Health Responsibility Deal (RD) in England is a public-private partnership which aims to improve public health by addressing issues such as health at work. This paper analyses the RD health at work pledges in terms of their likely effectiveness and added value. A review of evidence on the effectiveness of the RD 'health at work' pledges to improve health in the workplace; analysis of publically available data on signatory organizations' plans and progress towards achieving the pledges; and assessment of the likelihood that workplace activities pledged by signatories were brought about by participating in the RD. The 'health at work' pledges mostly consist of information sharing activities, and could be more effective if made part of integrated environmental change at the workplace. The evaluation of organizations' plans and progress suggests that very few actions (7%) were motivated by participation in the RD, with most organizations likely (57%) or probably (36%) already engaged in the activities they listed before joining the RD. The RD's 'health at work' pledges are likely to contribute little to improving workplace health as they stand but could contribute more if they were incorporated into broader, coherent workplace health strategies. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Russian joint ventures, upstream deals hit fast clip

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that Russia is stepping up the pace of joint ventures and imports of petroleum technology and hardware. Among the latest action: Polar Lights, a 50-50 venture of Conoco Timan-Pechora Ltd. and Arkhangelskgeologia (AAG), started drilling in the first new-field oil-development project in Russia to include a US partner; The governments of Oman and the Kazakhstan republic signed an agreement covering oil and gas exploration, field development, and production in Kazakhstan; Phibro Energy Inc., Greenwich, Conn., last week reported the sale and delivery of the first full cargo of Russian crude oil produced and exported by a Russian-American joint venture; Era Aviation Inc., Anchorage, Alas., is sending two helicopters with crewmen to Russia to help assess the feasibility of oil and gas development off Sakhalin Island; In deals involving Canadian companies, SNC-Lavalin Inc., Montreal, received a contract for initial work on a $350 million (US) modernization of the Volvograd refinery in southern Russia

  18. New website dealing with CERN-EU relations

    CERN Multimedia

    2005-01-01

    A new website dealing with CERN-EU relations (cern.ch/EU) is being brought into production. Thanks are due to several people for their contributions, and especially to the primary authors - Piotr Kurpiel, a Technical Student, and Miguel Marquina / IT. This site is designed to help people looking for information concerning interactions between Europe and particle physics in general, and the CERN programme in particular. FACILITIES AVAILABLE TO THE PUBLIC For members of the public, links are provided to several websites of general interest and there is also a search facility to help navigation among the main sources of information on EU programmes. FACILITIES ONLY AVAILABLE TO CERN USERS Entry to the CERN area of the site requires authentication via your NICE login name and password. In this area: You can look at information about present or past EU co-funded projects at CERN. For projects with their own websites you can click through to the site to obtain more detailed information. You can subscribe to ...

  19. Seismic as a negotiating tool in land deals

    International Nuclear Information System (INIS)

    Lefebvre, J.E.; Land, P.

    1999-01-01

    The use of seismic information as an important component in the technical evaluation of prospects was discussed. Such information is used to evaluate a play from a technical point of view. It is also only one of many pieces of information used by parties that own land and by those who want to exploit it. This paper focused on how this negotiating tool is used to make deals between an optionor and an optionee. Since their respective interests are not identical (from the optionor's point of view the shorter the period of time that the lands are tied up the better; the optionne's concern is the smallest possible financial commitment and the longest possible tie-up period for the lands) it is essential for both parties to do a lot of homework before submitting or accepting a proposal. The role of the seismic survey report in this complicated negotiation is the focus of this contribution, looking at the situation primarily from the vantage point of the optionnee

  20. China's capacity of hospitals to deal with infectious diseases in the context of climate change.

    Science.gov (United States)

    Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Xiang, Jianjun; Cameron, Scott; Liu, Qiyong; Liu, Xiaobo; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Bi, Peng

    2018-06-01

    Infectious diseases are a major cause of morbidity and mortality in China. The capacity of hospitals to deal with the challenge from emerging and re-emerging infectious diseases due to climate change is of great importance to population health. This study aimed to explore the capacity of hospitals in China to deal with such challenges. A cross-sectional questionnaire survey was utilized to gauge information regarding capacity of hospitals to deal with infectious diseases in the context of climate change among 611 clinical professionals whose roles pertained to infectious disease diagnosis, treatment and management in Anhui Province of China. Descriptive analysis and logistic regression analysis were performed on the data. More than 90% of participants believed climate change would have an adverse influence on population health and infectious disease control in China. Most indicated that their hospitals were well prepared for emerging infectious diseases at present, and they considered that logistical support in hospitals (e.g. administrative and maintenance services) should be strengthened for future capacity building. The majority of participants suggested that effective prevention and control measures, more interdisciplinary collaborations, more funding in rural areas for health care, and improved access to facilities enabling online reporting of infectious diseases, were extremely important strategies in building capacity to curb the population health impact of emerging and re-emerging infectious diseases due to climate change in China. Clinical professionals recognized that climate change will likely increase the transmission of infectious diseases. Although rural health care and hospitals' logistical support need to be improved, most professionals believed their hospitals to be capable of dealing with emerging diseases. They thought that interdisciplinary and cross-regional collaborations, together with necessary resource support (e.g. improved facilities for

  1. Dealing with the three facets of uncertainty in planning: evidences ...

    African Journals Online (AJOL)

    Action theorists go far and envisage planning as a symbolic rationalization of previous choices and, finally the resource-dependence theorists figure planning as a legitimating strategy aiming at increasing credibility and attracting external resources. This article posits that there is a common ground to these apparently ...

  2. Dealing with disability; inquiries into a clinical craft

    NARCIS (Netherlands)

    Struhkamp, R.M.

    2004-01-01

    The tensions between clinical practice on the one hand and theoretical practices, their techniques and requirements on the other hand have been the main concerns of this book. In the previous chapters, I have demonstrated that outcome assessment, selfdetermined decision-making, treatment plans, and

  3. Challenging previous conceptions of vegetarianism and eating disorders.

    Science.gov (United States)

    Fisak, B; Peterson, R D; Tantleff-Dunn, S; Molnar, J M

    2006-12-01

    The purpose of this study was to replicate and expand upon previous research that has examined the potential association between vegetarianism and disordered eating. Limitations of previous research studies are addressed, including possible low reliability of measures of eating pathology within vegetarian samples, use of only a few dietary restraint measures, and a paucity of research examining potential differences in body image and food choice motives of vegetarians versus nonvegetarians. Two hundred and fifty-six college students completed a number of measures of eating pathology and body image, and a food choice motives questionnaire. Interestingly, no significant differences were found between vegetarians and nonvegetarians in measures of eating pathology or body image. However, significant differences in food choice motives were found. Implications for both researchers and clinicians are discussed.

  4. Afrontar el proceso de duelo To deal with grief

    Directory of Open Access Journals (Sweden)

    Mª Trinidad Pérez Vallejo

    2008-06-01

    Full Text Available Ana, con su testimonio y con su vida nos enseña como afrontar los procesos de duelo. La muerte de su esposo se produce en febrero de 2005, este suceso fue probablemente la experiencia más difícil e importante que ha pasado durante sus 74 años de vida. Ana cuidó a su esposo durante la enfermedad con celo, dedicación y sobre todo con mucho amor. Ahora nos cuenta su experiencia para que pueda servir a aliviar a todas aquellas personas que se hallan en una situación semejante, a la vez, que rinde homenaje a su esposo que con su vida llena de salud y vitalidad le enseñó a morir. Ana tiene una vida plena dedicada a ayudar a los más necesitados, y canaliza esa ayuda con la gente de su barrio visitando a los enfermos, a los que se encuentran solos y los que tienen condiciones económicas más adversas.Anne, in her testimony and life, teaches us how to deal with grief. The death of her husband, on February, 2005, was probably the most difficult and important occurance in the 74 years of her life. Anne had cared for her husband with zeal, dedication and most importantly, love. Anne shares her experience with us so that it may help to alleviate those of us who find ourselves in a similar situation, and at the same time, pays homage to her husband who, when he was filled whit health and vitality, taught to die. Now Anne has a full life dedicated to helping the most needy as she channels this help through the people of her neighbourhood, visiting the ill, the lonely and those in the most adverse economic circumstances.

  5. Modernized Techniques for Dealing with Quality Data and Derived Products

    Science.gov (United States)

    Neiswender, C.; Miller, S. P.; Clark, D.

    2008-12-01

    strategies to deal with data, Scripps Institution of Oceanography is able to produce and distribute well-formed, and quality-tested derived products, which aid research, understanding, and education.

  6. How many accelerograms to use and how to deal with scattering for transient non-linear seismic computations?

    International Nuclear Information System (INIS)

    Viallet, E.; Heinfling, G.

    2005-01-01

    Due to increased potentialities of computers, it is nowadays possible to perform dynamic non-linear computation of structures to evaluate their ultimate behavior under seismic loads using refined finite element models. Nevertheless, one key parameter for such complex computations is the input load (i.e. input time histories) which may lead to important discrepancies in the results and therefore difficulties to deal with for engineering purpose (variability, number of time histories to use...). In this situation, the number of accelerograms to be used and the way to deal with the results is to be carefully assessed. The objective of this study is to give some elements concerning (i) the number of accelerograms to be used for transient non-linear computations and (ii) the way to account for scattering of results. For this purpose, some simplified non-linear models are used. These models represent characteristic types of non-linearities such as : - Reinforce concrete (RC) structure model (with plastic non-linearity), - PWR core model (with impact non-linearity). For each type of non-linearity, different sets of accelerograms are used (artificial and natural ones). Each set is composed of a relatively high number of accelerograms in order to get proper trends. The results are expressed in term of average and standard deviation values of the characteristic parameters for each non-linearity (i.e. ductility drift for RC structure model and impact force for PWR core model). The results show that, a relatively large number of time histories may be necessary to get proper predictions of the average value of the characteristic non-linear parameter under consideration. In that situation, it should be difficult to deal with such a result for complex studies on reel structures. Nevertheless, it may be necessarily to perform transient non-linear seismic computations for design analyses but with a reduced number of calculations. For this purpose, the previous results are analyzed

  7. On the efficiency gains of emissions trading when climate deals are non-cooperative

    Energy Technology Data Exchange (ETDEWEB)

    Godal, Odd; Holtsmark, Bjart

    2011-07-15

    This paper studies, in a numerical environment, climate treaties with emissions trading when national quotas result from strategic individual choice. We find that the larger the number of parties to the deal, the smaller are the emissions reductions and the lower the welfare. If insisting on stability with respect to participation, climate treaties involve few parties and yield practically no emissions reductions. While these results contrast with some optimistic studies, our numerical example conforms established results if modelling the problem in the more traditional sense. (Author)

  8. Dealing with uncertainty in modeling intermittent water supply

    Science.gov (United States)

    Lieb, A. M.; Rycroft, C.; Wilkening, J.

    2015-12-01

    Intermittency in urban water supply affects hundreds of millions of people in cities around the world, impacting water quality and infrastructure. Building on previous work to dynamically model the transient flows in water distribution networks undergoing frequent filling and emptying, we now consider the hydraulic implications of uncertain input data. Water distribution networks undergoing intermittent supply are often poorly mapped, and household metering frequently ranges from patchy to nonexistent. In the face of uncertain pipe material, pipe slope, network connectivity, and outflow, we investigate how uncertainty affects dynamical modeling results. We furthermore identify which parameters exert the greatest influence on uncertainty, helping to prioritize data collection.

  9. Laser manufacturing: strategies for dealing with the challenges

    Science.gov (United States)

    Barr, John R. M.

    2012-09-01

    Laser manufacturing in Edinburgh was initiated in 1963 by Ferranti (one of the previous names for SELEX Galileo). Since 2003 a modernized range of military lasers has been established. Innovation, both technical and in other aspects of the business, has enabled the design and manufacture of world leading laser designators and countermeasure lasers. Specific examples will be given including: the application of Geometric Algebra to resonator design; novel alignment free optical parametric oscillators; techniques for designing thermally insensitive laser diode pump heads; and methods for contamination control in lasers.

  10. 25 CFR 700.513 - Business dealings on behalf of the government.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Business dealings on behalf of the government. 700.513... RELOCATION PROCEDURES Employee Responsibility and Conduct § 700.513 Business dealings on behalf of the... the Commission. Employees shall observe courtesy, consideration and promptness in dealing with clients...

  11. Network Analyses in Systems Biology: New Strategies for Dealing with Biological Complexity

    DEFF Research Database (Denmark)

    Green, Sara; Serban, Maria; Scholl, Raphael

    2018-01-01

    of biological networks using tools from graph theory to the application of dynamical systems theory to understand the behavior of complex biological systems. We show how network approaches support and extend traditional mechanistic strategies but also offer novel strategies for dealing with biological...... strategies? When and how can network and mechanistic approaches interact in productive ways? In this paper we address these questions by focusing on how biological networks are represented and analyzed in a diverse class of case studies. Our examples span from the investigation of organizational properties...

  12. Ethical attitudes of Andalusian journalists to deal with especially sensitive issues

    Directory of Open Access Journals (Sweden)

    JC Suárez Villegas

    2013-04-01

    Full Text Available Introduction. This research article analyses the positions of Andalusian journalists in relation to especially sensitive issues. Methods. The study combines qualitative and quantitative techniques: in-depth interviews and a questionnaire-based survey, respectively. Results. The professional work of Andalusian journalists is based more on the predominant values of their communities than on the deontological codes of the profession, which are unknown by the vast majority. Conclusions. Journalists exhibit a liberal spirit, which is characteristic of a secular society, and believe that the freedom of expression should be respected when dealing with especially sensitive issues, which must be resolved according to the particular circumstances of each case.

  13. The incidence of congenital heart disease: Previous findings and perspectives

    Directory of Open Access Journals (Sweden)

    Miranović Vesna

    2014-01-01

    Full Text Available Congenital heart defects (CHD are the most common of all congenital anomalies, and represent a significant global health problem. Involvement of medical professionals of different profiles has led to drastic changes in survival and quality of life of children with CHD. The motivation for the implementation of the first large population studies on this subject was not only to obtain answers to the question on the level of incidence of CHD, but the harmonization of criteria and protocols for monitoring and treatment of certain defects as well as the planning of medical staff dealing with children with CHD. Data on the incidence varies from 4-10/1000 live births. Fetal echocardiography can have potential impact on decrease of CHD incidence. The increase in incidence may be due to the possibility that children with CHD will grow up and have offsprings. Owing to the progress that has been made, an increasing number of patients experiences adulthood, creating an entirely new and growing population of patients: patients with “adult” CHD. Survivors suffer morbidity resulting from their circulatory abnormalities as well as from medical and surgical therapies they have been subjected to. Application of the achievements of human genome projects will in time lead to drastic changes in the approach to the patients with CHD. Until the time when it is possible, the goal will be further improvement of the existing system of service: networking in a unique, multicenter clinical registry of patients with CHD, as well as upgrading of technical and non-technical conditions for the treatment of patients with CHD. We are in an unprecedented time of change, but are actually at the end of the beginning of making pediatric cardiac care a highly reliable institution.

  14. A model for dealing with parallel processes in supervision

    Directory of Open Access Journals (Sweden)

    Lilja Cajvert

    2011-03-01

    Supervision in social work is essential for successful outcomes when working with clients. In social work, unconscious difficulties may arise and similar difficulties may occur in supervision as parallel processes. In this article, the development of a practice-based model of supervision to deal with parallel processes in supervision is described. The model has six phases. In the first phase, the focus is on the supervisor’s inner world, his/her own reflections and observations. In the second phase, the supervision situation is “frozen”, and the supervisees are invited to join the supervisor in taking a meta-perspective on the current situation of supervision. The focus in the third phase is on the inner world of all the group members as well as the visualization and identification of reflections and feelings that arose during the supervision process. Phase four focuses on the supervisee who presented a case, and in phase five the focus shifts to the common understanding and theorization of the supervision process as well as the definition and identification of possible parallel processes. In the final phase, the supervisee, with the assistance of the supervisor and other members of the group, develops a solution and determines how to proceed with the client in treatment. This article uses phenomenological concepts to provide a theoretical framework for the supervision model. Phenomenological reduction is an important approach to examine and to externalize and visualize the inner words of the supervisor and supervisees. Een model voor het hanteren van parallelle processen tijdens supervisie Om succesvol te zijn in de hulpverlening aan cliënten, is supervisie cruciaal in het sociaal werk. Tijdens de hulpverlening kunnen impliciete moeilijkheden de kop opsteken en soortgelijke moeilijkheden duiken soms ook op tijdens supervisie. Dit worden parallelle processen genoemd. Dit artikel beschrijft een op praktijkervaringen gebaseerd model om dergelijke parallelle

  15. Mind the Gap: Dealing with Resource Revenue in Three Provinces

    Directory of Open Access Journals (Sweden)

    Ronald D. Kneebone

    2015-04-01

    history as background, I review the response of the government of Newfoundland and Labrador to the flood of revenue it has received over the past decade as a result of the development of off-shore oil fields. The evidence is clear that Newfoundland and Labrador has adopted the same high-risk budgeting strategy as Alberta and Saskatchewan; a strategy that has seen the province choose to fund health care, education and social assistance using revenues that are unreliable and unpredictable. As Newfoundland and Labrador prepares for the release of its budget for 2015-16, it must begin to deal with the effect on its revenues of a dramatic fall in oil prices, a historically large budget deficit and a threat to the financial viability of its health, education and social assistance programs.

  16. The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble. A 15-year follow-up study of risk indicators for self-reported sick-listing caused by low back trouble.

    Science.gov (United States)

    Müller, C F; Monrad, T; Biering-Sørensen, F; Darre, E; Deis, A; Kryger, P

    1999-08-01

    A 15-year follow-up study. To find risk indicators for self-reported sick-listing because of low back trouble and to evaluate which variables were the most important indicators of work incapacity resulting from low back trouble during the follow-up period of 15 years. The initial data were obtained from a health survey conducted in a general population from the Municipality of Glostrup, Denmark. The follow-up data included information from the Central Person Register, the Early Retirement Pension Register, and a postal questionnaire regarding self-reported sick-listing because of low back trouble. An epidemiologic study, in which logistic regression analyses were used for evaluation of the data. The model used consisted of the variable in question, age, gender, and previous experience of low back trouble, along with interactions. It was found that 22 of 37 variables were risk indicators for later self-reported sick-listing because of low back trouble during the preceding year or the 7 years before the date of follow-up evaluation. In analyzing the most significant variables simultaneously, it was found that information from the initial investigation about sick-listing in general during the previous 10 years, sciatic pain, use of analgesics for low back trouble, previous sick-listing because of low back trouble, and occupation were the most important risk indicators for self-reported work incapacity resulting from low back trouble during the follow-up period of 15 years. Findings showed that the strongest prognostic indicators of later sick-listing because of low back trouble involve information from the person about previous sick-listing behavior in general and previous experience of low back trouble episodes, especially if these had been accompanied by sciatic pain, use of analgesics, or previous low back trouble sick-listing.

  17. Factors influencing perceived effectiveness in dealing with self-harming patients in a sample of emergency department staff.

    Science.gov (United States)

    Egan, Rachel; Sarma, Kiran M; O'Neill, Meena

    2012-12-01

    Past self-harming behavior is one of the most significant predictors of future suicide. Each year in Ireland there are approximately 11,000 presentations of self-harm to emergency departments (EDs) across the country. This study examines predictors of perceived personal effectiveness in dealing with self-harming patients as reported by ED staff. The predictors are derived from past research and are influenced by Bandura's Social Cognitive Theory. One hundred twenty-five ED medical staff (28 doctors and 97 nurses) from five EDs in the West and South of Ireland completed a questionnaire. Predictor variables included in the design, and informed by past research, included knowledge of self-harm and suicidal behavior and confidence in dealing with incidents of self-harm. Standard multiple regression suggested a statistically significant model fit between the two predictors and the criterion variable, accounting for 24% of total variance. Knowledge and Confidence were significant contributors to perceived personal effectiveness in dealing with self-harming patients. Little is known regarding specific factors that influence perceived effectiveness in dealing with self-harming patients in the ED setting. These findings have implications for psycho-education and training content for staff. The findings suggest that increasing knowledge of self-harm and confidence in dealing with self-harming patients can lead to more positive perceived personal effectiveness in responding to clients' needs. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Dealing with missing data in a multi-question depression scale: a comparison of imputation methods

    Directory of Open Access Journals (Sweden)

    Stuart Heather

    2006-12-01

    Full Text Available Abstract Background Missing data present a challenge to many research projects. The problem is often pronounced in studies utilizing self-report scales, and literature addressing different strategies for dealing with missing data in such circumstances is scarce. The objective of this study was to compare six different imputation techniques for dealing with missing data in the Zung Self-reported Depression scale (SDS. Methods 1580 participants from a surgical outcomes study completed the SDS. The SDS is a 20 question scale that respondents complete by circling a value of 1 to 4 for each question. The sum of the responses is calculated and respondents are classified as exhibiting depressive symptoms when their total score is over 40. Missing values were simulated by randomly selecting questions whose values were then deleted (a missing completely at random simulation. Additionally, a missing at random and missing not at random simulation were completed. Six imputation methods were then considered; 1 multiple imputation, 2 single regression, 3 individual mean, 4 overall mean, 5 participant's preceding response, and 6 random selection of a value from 1 to 4. For each method, the imputed mean SDS score and standard deviation were compared to the population statistics. The Spearman correlation coefficient, percent misclassified and the Kappa statistic were also calculated. Results When 10% of values are missing, all the imputation methods except random selection produce Kappa statistics greater than 0.80 indicating 'near perfect' agreement. MI produces the most valid imputed values with a high Kappa statistic (0.89, although both single regression and individual mean imputation also produced favorable results. As the percent of missing information increased to 30%, or when unbalanced missing data were introduced, MI maintained a high Kappa statistic. The individual mean and single regression method produced Kappas in the 'substantial agreement' range

  19. Examination of Relationship between Self-esteem, Life Satisfaction of Riot Policemen and Their Approach to Dealing with Stress

    OpenAIRE

    Ruhi YİĞİT

    2012-01-01

    Main objective of this study is to examinate of relationship between self-esteem, life satisfaction of riot police and their approach to dealing with stress. Research data has been obtained through using self-esteem scale and inventory of approach to dealing with stress. The first finding is that there is a positive and meaningful relationship between self-esteem of riot police and their life satisfaction. As the self-esteem increases, so the life satisfaction does. The second finding is that...

  20. HEART TRANSPLANTATION IN PATIENTS WITH PREVIOUS OPEN HEART SURGERY

    Directory of Open Access Journals (Sweden)

    R. Sh. Saitgareev

    2016-01-01

    Full Text Available Heart Transplantation (HTx to date remains the most effective and radical method of treatment of patients with end-stage heart failure. The defi cit of donor hearts is forcing to resort increasingly to the use of different longterm mechanical circulatory support systems, including as a «bridge» to the follow-up HTx. According to the ISHLT Registry the number of recipients underwent cardiopulmonary bypass surgery increased from 40% in the period from 2004 to 2008 to 49.6% for the period from 2009 to 2015. HTx performed in repeated patients, on the one hand, involves considerable technical diffi culties and high risks; on the other hand, there is often no alternative medical intervention to HTx, and if not dictated by absolute contradictions the denial of the surgery is equivalent to 100% mortality. This review summarizes the results of a number of published studies aimed at understanding the immediate and late results of HTx in patients, previously underwent open heart surgery. The effect of resternotomy during HTx and that of the specifi c features associated with its implementation in recipients previously operated on open heart, and its effects on the immediate and long-term survival were considered in this review. Results of studies analyzing the risk factors for perioperative complications in repeated recipients were also demonstrated. Separately, HTx risks after implantation of prolonged mechanical circulatory support systems were examined. The literature does not allow to clearly defi ning the impact factor of earlier performed open heart surgery on the course of perioperative period and on the prognosis of survival in recipients who underwent HTx. On the other hand, subject to the regular fl ow of HTx and the perioperative period the risks in this clinical situation are justifi ed as a long-term prognosis of recipients previously conducted open heart surgery and are comparable to those of patients who underwent primary HTx. Studies

  1. Competition between Free-Floating Plants Is Strongly Driven by Previously Experienced Phosphorus Concentrations in the Water Column.

    Directory of Open Access Journals (Sweden)

    Edwin T H M Peeters

    experienced phosphorus concentrations should be taken into account in future studies dealing with competition between plants.

  2. Competition between Free-Floating Plants Is Strongly Driven by Previously Experienced Phosphorus Concentrations in the Water Column

    Science.gov (United States)

    Peeters, Edwin T. H. M.; Neefjes, Rozemarijn E. M.; van Zuidam, Bastiaan G.

    2016-01-01

    concentrations should be taken into account in future studies dealing with competition between plants. PMID:27622519

  3. Competition between Free-Floating Plants Is Strongly Driven by Previously Experienced Phosphorus Concentrations in the Water Column.

    Science.gov (United States)

    Peeters, Edwin T H M; Neefjes, Rozemarijn E M; Zuidam, Bastiaan G van

    2016-01-01

    concentrations should be taken into account in future studies dealing with competition between plants.

  4. How do primary health care professionals deal with pregnant women who are victims of domestic violence?

    Science.gov (United States)

    Salcedo-Barrientos, Dora Mariela; Miura, Paula Orchiucci; Macedo, Vanessa Dias; Egry, Emiko Yoshikawa

    2014-01-01

    Objectives to determine how Family Health Strategy professionals recognize and deal with domestic violence in pregnant women. Method qualitative study based on the Theory of Praxis Intervention in Collective Health Nursing (TIPESC). Fourteen professionals at a Basic Health Unit in the east side of Sao Paulo/Brazil were interviewed. Empirical data were categorized and discussed in thematic groups. For data analysis was used the technique of Discourse Analysis. Results we identified low number of reported cases of domestic violence; lack of education and training of health care professionals; failure in the identification and intervention process due to bias on their personal problems, moral attitudes and prejudice against these women. In addition, the study showed that their labor process was based entirely on the biological aspects of the women and to overcome this, they need of proper rapport between health care professionals and pregnant women to deal with of domestic violence. Conclusion professionals should develop skills to intervene in violence against pregnant women and also modify labor processes considering women in their totality and part of society. PMID:25029056

  5. How Do Higher-Education Students Use Their Initial Understanding to Deal with Contextual Logic-Based Problems in Discrete Mathematics?

    Science.gov (United States)

    Lubis, Asrin; Nasution, Andrea Arifsyah

    2017-01-01

    Mathematical reasoning in logical context has now received much attention in the mathematics curriculum documents of many countries, including Indonesia. In Indonesia, students start formally learning about logic when they pursue to senior-high school. Before, they previously have many experiences to deal with logic, but the earlier assignments do…

  6. Incidence of Acneform Lesions in Previously Chemically Damaged Persons-2004

    Directory of Open Access Journals (Sweden)

    N Dabiri

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Chemical gas weapons especially nitrogen mustard which was used in Iraq-Iran war against Iranian troops have several harmful effects on skin. Some other chemical agents also can cause acne form lesions on skin. The purpose of this study was to compare the incidence of acneform in previously chemically damaged soldiers and non chemically damaged persons. Materials & Methods: In this descriptive and analytical study, 180 chemically damaged soldiers, who have been referred to dermatology clinic between 2000 – 2004, and forty non-chemically damaged people, were chosen randomly and examined for acneform lesions. SPSS software was used for statistic analysis of the data. Results: The mean age of the experimental group was 37.5 ± 5.2 and that of the control group was 38.7 ± 5.9 years. The mean percentage of chemical damage in cases was 31 percent and the time after the chemical damage was 15.2 ± 1.1 years. Ninety seven cases (53.9 percent of the subjects and 19 people (47.5 percent of the control group had some degree of acne. No significant correlation was found in incidence, degree of lesions, site of lesions and age of subjects between two groups. No significant correlation was noted between percentage of chemical damage and incidence and degree of lesions in case group. Conclusion: Incidence of acneform lesions among previously chemically injured peoples was not higher than the normal cases.

  7. DEALS magnet concept and its applcations to high density, high field tokamak systems

    International Nuclear Information System (INIS)

    Hsieh, S.Y.; Powell, J.; Lehner, J.; Bezler, P.; Laverick, C.; Finkelman, M.; Brown, T.; Bundy, J.

    1977-01-01

    The goal of the DEALS program is to develop a demountable TF magnet system concept that will reduce construction and life cycle costs, enhance the accessibility of components inside the coil system, and increase the chances for being able to use large high-field magnet systems in post TFTR reactor experiments. These experiments are projected to occur during the mid 1980's, with conceptual designs beginning in two or three years. A number of recent studies have highlighted the need for Tokamak fusion reactor systems with reasonable down time for maintenance and repair and realistic operating capacity factors, as well as the need for smaller, lower cost reactors. Two scoping studies were carried out of recent Tokamak system concepts incorporating conventionally wound coils to assess the possibilities of using demountable coils of rectangular section with an active support system and a third more intensive study using a passive support with slight movement of the joints. These studies are described briefly

  8. The Effect of Cognitive Behavioral Oriented Psycho Education Program on Dealing with Loneliness: An Online Psychological Counseling Approach

    Science.gov (United States)

    Tatlilioglu, Kasim

    2013-01-01

    Loneliness is a very common problem which incorporates many disorders. The inadequacy of services to treat this problem makes it necessary to develop new treatment methods. For this purpose, it was aimed to test the effect of online psychological counseling on dealing with loneliness problem in this research. The research includes the study with…

  9. Dealing with emotions when the ability to cry is hampered: emotion processing and regulation in patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Leeuwen, N. van; Bossema, E.R.; Middendorp, H. van; Kruize, A.A.; Bootsma, H.; Bijlsma, J.W.J.; Geenen, R.

    2012-01-01

    OBJECTIVES: The hampered ability to cry in patients with Sjogren's syndrome may affect their ways of dealing with emotions. The aim of this study was to examine differences in emotion processing and regulation between people with and without Sjogren's syndrome and correlations of emotion processing

  10. "Dulling the Edges": Young Men's Use of Alcohol to Deal With Grief Following the Death of a Male Friend

    Science.gov (United States)

    Creighton, Genevieve; Oliffe, John; Matthews, Jennifer; Saewyc, Elizabeth

    2016-01-01

    Background: The death of a male friend can be challenging for men because expressions of grief can be governed and restrained by dominant ideals of masculinity. It is common for young men to engage in health risk practices, such as alcohol overuse, to deal with feelings of sadness. Objective: This qualitative study investigated the ways that young…

  11. Dealing with symptoms and issues of hospitalized patients with cancer in indonesia: the role of families, nurses, and physicians

    NARCIS (Netherlands)

    Effendy, C.; Vissers, K.; Tejawinata, S.; Vernooij-Dassen, M.J.F.J.; Engels, Y.M.

    2015-01-01

    OBJECTIVE: Patients with cancer often face physical, psychological, social, spiritual, and emotional symptoms. Our aim was to study symptoms and issues of hospitalized patients with cancer in Indonesia, a country with strong family ties, and how family members, nurses, and physicians deal with them.

  12. Impact of previously disadvantaged land-users on sustainable ...

    African Journals Online (AJOL)

    Impact of previously disadvantaged land-users on sustainable agricultural ... about previously disadvantaged land users involved in communal farming systems ... of input, capital, marketing, information and land use planning, with effect on ...

  13. Firms dealing with regulatory change: innovation and political influence strategies

    NARCIS (Netherlands)

    Wesseling, Joeri; Farla, Jacco; Hekkert, Marko

    2014-01-01

    Firm-level strategies, particularly political strategies, are overlooked in transition studies. Therefore, we study how car manufacturers combine and change their innovation and political influence strategies in response to a technology-forcing regulation that attempts to drive transition. We use

  14. 22 CFR 40.91 - Certain aliens previously removed.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  15. Polluted online information? Surfing Italian websites dealing with the topic of waste and health

    International Nuclear Information System (INIS)

    Orizio, G; Gelatti, U; Locatelli, M K; Caimi, L

    2011-01-01

    In the field of health communication, a particularly critical issue is communication to the public of environmental risks, especially on topics for which there is still a high degree of scientific uncertainty regarding risk estimates. One such topic is undoubtedly the impact of waste on people's health. The aim of this study was to evaluate the presence and characteristics of Italian websites dealing with the topic of waste and health. The keywords 'waste' and 'health' were entered in 2010 in the three most commonly used search engines, and the first five pages were analysed. The selected websites were coded according to the content analysis method. For websites of interest we evaluated the 'page rank'. Out of the 150 occurrences analysed, the number of websites found to deal with this subject was only 19, four of which were of an institutional nature. The majority of websites gave a message of increased health risk associated with the three kinds of waste disposal tackled. As regards visibility, only one of the four institutional websites maintained its position on the first page of the three search engines. We found that institutional health websites have low visibility, despite extensive media coverage of waste and health issues in Italy as a result of the Naples case, which was debated globally. This indicates that public health institutions' web strategies are basically unable to meet people's health information requirements, which could strengthen rival health information providers.

  16. The hidden practices and experiences of healthcare practitioners dealing with fuel poverty.

    Science.gov (United States)

    Mc Conalogue, D; Kierans, C; Moran, A

    2016-06-01

    Fuel poverty negatively impacts a population's health affecting life chances along the life course. Moreover, it represents a substantial inequality in the UK. Healthcare practitioners (HCPs) have a key role in identifying and supporting patients who are fuel poor. A qualitative inquiry with District Nurses and General Practitioners, to explore their understanding and experiences of dealing with patients living in fuel poverty. Participants recognize fuel poverty by observing material cues. They perceive their relationship with the patient as pivotal to recognizing the fuel poor. Practitioners' sense of responsibility for their patients' social concerns is determined by their knowledge about the link to health outcomes. The services that they sign-post to are motivated by their experience dealing with the service, or their patients' experiences of the service. Participants' reliance on temporary material cues resulted in few experiences of recognition of the fuel poor. HCPs' perceptions of patient pride and the lack of personal relationship between doctor and patient presented barriers to identifying fuel poor patients. A limitation of this study is the small sample size of nine participants. These came from two professional groups, which afforded more depth of exploration, but may limit applicability to other professionals. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Leaders' strategies for dealing with own and their subordinates' stress in public human service organisations.

    Science.gov (United States)

    Skagert, Katrin; Dellve, Lotta; Eklöf, Mats; Pousette, Anders; Ahlborg, Gunnar

    2008-11-01

    Despite the acknowledged key role of leaders for psychosocial work environment, few studies focus on how leaders can decrease work-related stress. To gain deeper knowledge of leaders' perceptions and strategies for dealing with their own and their subordinates' stress in public human service organisations (HSO), qualitative interviews were made with leaders from hospitals and regional social insurance offices (n=21), and analysed in line with grounded theory method. The leaders handled subordinates' stress and perceived leadership demands by acting as shock absorber (core category) and used strategies characterised as leading in continuous change whilst maintaining trustworthiness. To cope with their own stress from perceived leadership demands, they tried to sustain their own integrity (core category) by either identifying with or distancing themselves from the leader role. The strategies for dealing with leaders' own and subordinates' exposures to stressors was pervaded by perceived leadership demands and are probably influencing each other. Supportive structures and improved communication about everyday dilemmas seem to be needed in order, not just to prevent stress reactions, but to improve the basic conditions for practicing leadership in HSO.

  18. Polluted online information? Surfing Italian websites dealing with the topic of waste and health

    Science.gov (United States)

    Orizio, G.; Locatelli, M. K.; Caimi, L.; Gelatti, U.

    2011-10-01

    In the field of health communication, a particularly critical issue is communication to the public of environmental risks, especially on topics for which there is still a high degree of scientific uncertainty regarding risk estimates. One such topic is undoubtedly the impact of waste on people's health. The aim of this study was to evaluate the presence and characteristics of Italian websites dealing with the topic of waste and health. The keywords 'waste' and 'health' were entered in 2010 in the three most commonly used search engines, and the first five pages were analysed. The selected websites were coded according to the content analysis method. For websites of interest we evaluated the 'page rank'. Out of the 150 occurrences analysed, the number of websites found to deal with this subject was only 19, four of which were of an institutional nature. The majority of websites gave a message of increased health risk associated with the three kinds of waste disposal tackled. As regards visibility, only one of the four institutional websites maintained its position on the first page of the three search engines. We found that institutional health websites have low visibility, despite extensive media coverage of waste and health issues in Italy as a result of the Naples case, which was debated globally. This indicates that public health institutions' web strategies are basically unable to meet people's health information requirements, which could strengthen rival health information providers.

  19. Double-dealing behavior potentially promotes cooperation in evolutionary prisoner's dilemma games

    Science.gov (United States)

    Dai, Qionglin; Li, Haihong; Cheng, Hongyan; Li, Yuting; Yang, Junzhong

    2010-11-01

    We investigate the effects of double-dealing behavior on cooperation in evolutionary games. Each individual in a population has two attributes: character and action. One's action may be consistent with one's character or not. We provide analytical results by a mean-field description of evolutionary prisoner's dilemma games (PDGs). Moreover, we give numerical results on different networks, ranging from square lattices to scale-free networks (SFNs). Two important conclusions have been drawn from the results on SFNs. Firstly, if only non-influential individuals (those with low degrees) have chances of becoming double-dealers, cooperation is certain to deteriorate. Secondly, when influential individuals (those with high degrees) adopt double-dealing behavior moderately, cooperation would be enhanced, which is in opposition to the traditional belief. These results help us to understand better the social phenomenon of the existence of double-dealers. In addition to the PDG, other types of games including the snowdrift game, the stag-hunt game and the harmony game have also been studied on our model. The results for these three games are also presented, which are consistent with the results for the PDG qualitatively. Furthermore, we consider our model under the co-evolution framework, in which the probability of an individual changing into a double-dealer and the individual strategy both could evolve during the evolutionary process.

  20. Influence of Previous Knowledge in Torrance Tests of Creative Thinking

    Directory of Open Access Journals (Sweden)

    María Aranguren

    2015-07-01

    Full Text Available The aim of this work is to analyze the influence of study field, expertise and recreational activities participation in Torrance Tests of Creative Thinking (TTCT, 1974 performance. Several hypotheses were postulated to explore the possible effects of previous knowledge in TTCT verbal and TTCT figural university students’ outcomes. Participants in this study included 418 students from five study fields: Psychology;Philosophy and Literature, Music; Engineering; and Journalism and Advertising (Communication Sciences. Results found in this research seem to indicate that there in none influence of the study field, expertise and recreational activities participation in neither of the TTCT tests. Instead, the findings seem to suggest some kind of interaction between certain skills needed to succeed in specific studies fields and performance on creativity tests, such as the TTCT. These results imply that TTCT is a useful and valid instrument to measure creativity and that some cognitive process involved in innovative thinking can be promoted using different intervention programs in schools and universities regardless the students study field.

  1. Determining root correspondence between previously and newly detected objects

    Science.gov (United States)

    Paglieroni, David W.; Beer, N Reginald

    2014-06-17

    A system that applies attribute and topology based change detection to networks of objects that were detected on previous scans of a structure, roadway, or area of interest. The attributes capture properties or characteristics of the previously detected objects, such as location, time of detection, size, elongation, orientation, etc. The topology of the network of previously detected objects is maintained in a constellation database that stores attributes of previously detected objects and implicitly captures the geometrical structure of the network. A change detection system detects change by comparing the attributes and topology of new objects detected on the latest scan to the constellation database of previously detected objects.

  2. Dealing with sickness certification – a survey of problems and strategies among general practitioners and orthopaedic surgeons

    Directory of Open Access Journals (Sweden)

    Nilsson Gunnar

    2007-10-01

    Full Text Available Abstract Background In order to get sickness benefit a sick-listed person need a medical certificate issued by a physician; in Sweden after one week of self-certification. Physicians experience sick-listing tasks as problematic and conflicts may arise when patients regard themselves unable to work due to complaints that are hard to objectively verify for the physician. Most GPs and orthopaedic surgeons (OS deal regularly with sick-listing issues in their daily practice. The aim of this study was to explore perceived problems and coping strategies related to tasks of sickness certification among general practitioners (GP and orthopaedic surgeons (OS. Methods A cross-sectional study about sickness certification in two Swedish counties, with 673 participating GPs and 149 OSs, who answered a comprehensive questionnaire. Frequencies together with crude and adjusted (gender and working years Odds ratios were calculated. Results A majority of the GPs and OSs experienced problems in sickness certification every week. To assess the patient's work ability, to handle situations when they and the patient had different opinions about the need for sickness absence, and to issue prolongation certificates when the previous was issued by another physician were reported as problematic by a majority in both groups. Both GPs and OSs prolonged sickness certifications due to waiting times in health care or at Social Insurance Office (SIO. To handle experienced problems they used different strategies; OSs issued sickness certificates without personal appointment more often than the GPs, who on the other hand reported having contact with SIO more often than the OSs. A higher rate of GPs experienced support from management and had a common strategy for handling sickness certification at the clinic than the OSs. Conclusion Most GPs and OSs handled sickness certification weekly and reported a variety of problems in relation to this task, generally GPs to a higher extent

  3. Dealing with Drug Problems: Preventing and Treating Drug Abuse

    Science.gov (United States)

    ... Pittsburgh is looking at whether teaching healthy caregiving strategies to parents can help promote self-regulation skills in children and prevent substance abuse later on. Starting when children are two years old, Shaw’s study enrolls families at risk of substance use problems ...

  4. Dealing with Conflicts on Knowledge in Tutorial Groups

    Science.gov (United States)

    Aarnio, Matti; Lindblom-Ylanne, Sari; Nieminen, Juha; Pyorala, Eeva

    2013-01-01

    The aim of our study was to gain understanding of different types of conflicts on knowledge in the discussions of problem-based learning tutorial groups, and how such conflicts are dealt with. We examined first-year medical and dental students' (N = 33) conflicts on knowledge in four videotaped reporting phase tutorials. A coding scheme was…

  5. Psychodynamic Therapy and Intellectual Disabilities: Dealing with Challenging Behaviour.

    Science.gov (United States)

    Berry, Paul

    2003-01-01

    Four case studies concerning long-term psychodynamic treatment of German individuals with intellectual disabilities are presented: an aggressive young man with a mild intellectual disability; a young man with multiple disabilities with destructive behavior; a withdrawn young woman with self-destructive behavior; and a young man with autism with…

  6. Dealing with organizational change when implementing EHR systems

    DEFF Research Database (Denmark)

    Høstgaard, Anne Marie; Nøhr, Christian

    2004-01-01

    The article is based upon a case study carried out at Skejby Hospital in Denmark. The research shows that the employees have some expectations when implementing an EHR system, thus hospital management provided the organization with important information before the implementation of a new EHR system....

  7. To deal with fluidity in the networked society

    DEFF Research Database (Denmark)

    Levinsen, Karin Tweddell

    2010-01-01

    designs for teaching and learning for that purpose. We need research that aims to describe the phenomenology of acquiring digital literacy and self-programming in order to be able to identify relevant learning objectives and scaffolding. Findings from such studies are expected to be relevant for e...

  8. Is a Nuclear Deal with Iran Possible? An Analytical Framework for the Iran Nuclear Negotiations

    OpenAIRE

    Sebenius, James Kimble; Singh, Michael K.

    2012-01-01

    Varied diplomatic approaches by multiple negotiators over several years have failed to conclude a nuclear deal with Iran. Mutual hostility, misperception, and flawed diplomacy may be responsible. Yet, more fundamentally, no mutually acceptable deal may exist. To assess this possibility, a "negotiation analytic" framework conceptually disentangles two issues: 1) whether a feasible deal exists and 2) how to design the most promising process to achieve one. Focusing on whether a "zone of possibl...

  9. Do gender and personality traits influence visits of and purchases at deal sites?

    DEFF Research Database (Denmark)

    Sudzina, Frantisek; Pavlicek, Antonin

    2017-01-01

    As deal sites became widespread, there are multiple international and local players in the Czech market. The research presented in the paper investigates if gender and personality traits influence frequency of visits of deal sites and the number of coupon purchases. Big Five Inventory-10 is used...... to measure personality traits. None of the factors influenced frequency of visits of deal sites. Only openness to experience seems to positively influence the number of coupon purchases, though the its significance is borderline....

  10. Learning to deal with psychosocial strains at hospitals

    DEFF Research Database (Denmark)

    Hvid, Helge Søndergaard; Hagedorn-Rasmussen, Peter; Lund, Henrik Lambrecht

    This paper examines the psychosocial work environment in the hospital sector from a learning perspective. The paper is based on case studies in the Danish hospital system, characterized by professionalism, centralized management and constant organizational change. In all cases, the psychosocial...... and employees in the individual departments must learn to cope with the stress imposed. Learning-related concepts are found to be suitable for analysing how they actually do cope locally. However, these concepts not only pave the way for an analysis. They also open for reflection, interpretations and learning...... at the work site as a result of the incremental practice intervention. This might have a positive effect in reducing psychosocial stress. The paper focuses on one of the cases – a specialized hospital section with approx. 400 employees. It is investigated how learning-related activities, studied through three...

  11. Savvy Sellers: Dealing Drugs, Doing Gender, and Doing Difference

    Science.gov (United States)

    Ludwick, Micheline D.; Murphy, Sheigla; Sales, Paloma

    2016-01-01

    We present findings from two exploratory studies of San Francisco Bay Area women involved in illicit drug sales who saw both advantages and disadvantages to being women in traditionally male-dominated drug economies. We interviewed 160 sellers of street drugs and 50 sellers of prescription drugs during 2006-2009. Women perceived gender as a cover and managed their vulnerabilities by performing gendered actions and at times going against traditional gender expectations to protect themselves in harsh drug markets. The intersecting factors of race and type of drug sold played a crucial role, revealing the complex nature of women's social location in their drug-selling worlds. Study limitations are noted. PMID:26086305

  12. Impact of personality traits and demographic factors on relationship to deal sites

    DEFF Research Database (Denmark)

    Sudzina, Frantisek; Pavlicek, Antonin

    2017-01-01

    There is an increasing body of research about deal sites. But there is still exists a gap when it comes to factors influencing potential or existing users of deal sites. The aim of this paper is to investigate impact of gender, city of origin, and personality traits on relationship to deal sites....... Big Five Inventory framework is used for personality traits. The research was conducted in the Czech Republic. With regards to the findings, city of origin has a significant effect, and openness to experience a borderline significant effect on the relationship to deal sites....

  13. Acceleration Measurements Using Smartphone Sensors: Dealing with the Equivalence Principle

    OpenAIRE

    Monteiro, Martín; Cabeza, Cecilia; Martí, Arturo C.

    2014-01-01

    Acceleration sensors built into smartphones, i-pads or tablets can conveniently be used in the physics laboratory. By virtue of the equivalence principle, a sensor fixed in a non-inertial reference frame cannot discern between a gravitational field and an accelerated system. Accordingly, acceleration values read by these sensors must be corrected for the gravitational component. A physical pendulum was studied by way of example, and absolute acceleration and rotation angle values were derived...

  14. Deterrence and constrained enforcement: Alternative regimes to deal with bribery

    OpenAIRE

    Graf Lambsdorff, Johann

    2010-01-01

    This study embeds transaction cost analysis into a Law and Economics model to produce general recommendations on how to deter bribery. Governments may deter bribery either by high penalties and risks of detection, potentially supported by leniency given to those who report their infraction (deterrence regime). Another local optimum is achieved if the government amplifies the risk of opportunism, aggravating the difficulties of enforcing a bribe transaction. This involves a low probability of ...

  15. Being-child with asthma: assuming its particularities and dealing with restrictions

    Directory of Open Access Journals (Sweden)

    Karina Machado Siqueira

    2017-12-01

    Full Text Available The study aimed to comprehend how children with asthma and their families perceive themselves in their experience with the chronic disease and, how they develop their coping ways and care. We conducted a phenomenological study, with five families of children with moderate or severe asthma. Data collection occurred through interviews with the children and their families, during home visits, between September of 2013 and January of 2014. From the child’s perspective, the difficulty of dealing with fears, frustrations, and constraints related to the disease and treatment was apparent, especially at school. Family members emphasized the restrictions imposed in the child’s life and family environment, besides mentioning care attitudes demonstrating overprotection. Professionals involved in attention to childhood asthma need to value the child’s potentialities and the family autonomy in care actions, favoring the experience with the chronic disease and the empowerment for care.

  16. The long-term consequences of previous hyperthyroidism

    DEFF Research Database (Denmark)

    Hjelm Brandt Kristensen, Frans

    2015-01-01

    Thyroid hormones affect every cell in the human body, and the cardiovascular changes associated with increased levels of thyroid hormones are especially well described. As an example, short-term hyperthyroidism has positive chronotropic and inotropic effects on the heart, leading to a hyperdynamic...... with CVD, LD and DM both before and after the diagnosis of hyperthyroidism. Although the design used does not allow a stringent distinction between cause and effect, the findings indicate a possible direct association between hyperthyroidism and these morbidities, or vice versa....... vascular state. While it is biologically plausible that these changes may induce long-term consequences, the insight into morbidity as well as mortality in patients with previous hyperthyroidism is limited. The reasons for this are a combination of inadequately powered studies, varying definitions...

  17. Is Previous Respiratory Disease a Risk Factor for Lung Cancer?

    Science.gov (United States)

    Denholm, Rachel; Schüz, Joachim; Straif, Kurt; Stücker, Isabelle; Jöckel, Karl-Heinz; Brenner, Darren R.; De Matteis, Sara; Boffetta, Paolo; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Ahrens, Wolfgang; Pohlabeln, Hermann; Zaridze, David; Field, John K.; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kendzia, Benjamin; Peters, Susan; Behrens, Thomas; Vermeulen, Roel; Brüning, Thomas; Kromhout, Hans

    2014-01-01

    Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case–control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20–1.48 and OR, 1.50; 95% CI, 1.21–1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33–4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis “only.” Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. Conclusions: Findings from this large international case–control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer. PMID:25054566

  18. Twelve previously unknown phage genera are ubiquitous in global oceans.

    Science.gov (United States)

    Holmfeldt, Karin; Solonenko, Natalie; Shah, Manesh; Corrier, Kristen; Riemann, Lasse; Verberkmoes, Nathan C; Sullivan, Matthew B

    2013-07-30

    Viruses are fundamental to ecosystems ranging from oceans to humans, yet our ability to study them is bottlenecked by the lack of ecologically relevant isolates, resulting in "unknowns" dominating culture-independent surveys. Here we present genomes from 31 phages infecting multiple strains of the aquatic bacterium Cellulophaga baltica (Bacteroidetes) to provide data for an underrepresented and environmentally abundant bacterial lineage. Comparative genomics delineated 12 phage groups that (i) each represent a new genus, and (ii) represent one novel and four well-known viral families. This diversity contrasts the few well-studied marine phage systems, but parallels the diversity of phages infecting human-associated bacteria. Although all 12 Cellulophaga phages represent new genera, the podoviruses and icosahedral, nontailed ssDNA phages were exceptional, with genomes up to twice as large as those previously observed for each phage type. Structural novelty was also substantial, requiring experimental phage proteomics to identify 83% of the structural proteins. The presence of uncommon nucleotide metabolism genes in four genera likely underscores the importance of scavenging nutrient-rich molecules as previously seen for phages in marine environments. Metagenomic recruitment analyses suggest that these particular Cellulophaga phages are rare and may represent a first glimpse into the phage side of the rare biosphere. However, these analyses also revealed that these phage genera are widespread, occurring in 94% of 137 investigated metagenomes. Together, this diverse and novel collection of phages identifies a small but ubiquitous fraction of unknown marine viral diversity and provides numerous environmentally relevant phage-host systems for experimental hypothesis testing.

  19. Fuzzy Models to Deal with Sensory Data in Food Industry

    Institute of Scientific and Technical Information of China (English)

    Serge Guillaume; Brigitte Charnomordic

    2004-01-01

    Sensory data are, due to the lack of an absolute reference, imprecise and uncertain data. Fuzzy logic can handle uncertainty and can be used in approximate reasoning. Automatic learning procedures allow to generate fuzzy reasoning rules from data including numerical and symbolic or sensory variables. We briefly present an induction method that was developed to extract qualitative knowledge from data samples. The induction process is run under interpretability constraints to ensure the fuzzy rules have a meaning for the human expert. We then study two applied problems in the food industry: sensory evaluation and process modeling.

  20. Hypnotherapy: the salutogenic solution to dealing with phobias.

    Science.gov (United States)

    Williamson, Maria; Gregory, Colette

    2015-05-01

    Evidence suggests that around a quarter of women can suffer from an intense fear of giving birth (tocophobia). This can be costly to these women in terms of enduring negative effects of the increased use of medical interventions associated with tocophobia. Other phobias, such as white coat hypertension, can also be problematic in pregnancy. This article describes the establishment of a hypnotherapy service within the antenatal day assessment unit at East Lancashire Hospitals NHS Trust and recounts a recent case study in which the use of hypnotherapy was employed to help Rebecca, a white coat hypertension sufferer, to successfully manage her condition.