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Sample records for previous studies focusing

  1. Magnetoencephalographic localization of peritumoral temporal epileptic focus previous surgical resection.

    Science.gov (United States)

    Amo, Carlos; Saldaña, Cristóbal; Hidalgo, Mercedes González; Maestú, Fernando; Fernández, Alberto; Arrazola, Juan; Ortiz, Tomás

    2003-01-01

    Magnetoencephalography (MEG) is suggested as a localizing technique of epileptogenic areas in drug-resistant seizure patients due to intracraneal lesions. A male 42-year-old patient who begins at 26 with partial complex drug-resistant seizures is put forward. MRI shows a 9 mm diameter lesion located in left superior temporal gyrus which seems compatible with cavernoma. Both conventional and sleep deprivation EEGs have proved normal. Sleep EEG shows sharp waves in left temporal region. MEG helps to localize interictal spike and spike-wave activity, as well as wide slow wave (2-7 Hz) activity areas. Craniotomy under analgesia and aware sedation conditions is carried out. Intrasurgery cortical electric stimulation assisted by neuronavigator causes a limited partial complex seizure which the patient recognizes to be exactly like his. Thus, MEG localization of the epileptogenic area is confirmed. Surgical resection of both the lesion and the epileptogenic area is carried out. The patient remains free from seizures 9 months after surgery. A control MEG study reveals no epileptogenic nor slow wave activity. in this particular case, MEG has proven to be a useful presurgical evaluation technique to localize epileptogenic activity, validated by intrasurgical cortical stimulation.

  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. A study of plasma focus

    International Nuclear Information System (INIS)

    Hirano, Katsumi; Majima, Kazuo

    1976-01-01

    The behavior of the plasma acceleration between electrodes, the phenomena due to the pinch effect at the top of the electrodes and the neutron emission mechanism were experimentally studied. The plasma focus device was a Mather type coaxial discharge device, and the instruments used for the present purpose were a Rogoski coil, an image converter camera, a scintillation detector and a silver foil activation counter. The results of the present experiment were as follows. Plasma focus was not definitely made under the same condition. When the focus was seen, a dip was observed in the discharge wave form, and the emissions of X-ray and neutrons were detected. The angular anisotropy of neutron emission was observed, and corresponds to a beam target model. The phenomena showing the occurrence of focus were seen, when the current sheet was produced at a delayed time after discharge, and arrived at the muzzle with large velocity. The relation between the number of emitted neutrons and the velocity of the current sheet was obtained, whereas no systematic relation exists between the number of emitted neutrons and the velocity of pinch. When the focus was not observed, no dip was seen in current wave form, and the emissions of X-ray and neutrons were not detected. The reason of no focus was considered. (Kato, T.)

  5. 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)

  6. Successful Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for Recurrent Uterine Fibroid Previously Treated with Uterine Artery Embolization

    Directory of Open Access Journals (Sweden)

    Sang-Wook Yoon

    2010-01-01

    Full Text Available A 45-year-old premenopausal woman was referred to our clinic due to recurring symptoms of uterine fibroids, nine years after a uterine artery embolization (UAE. At the time of screening, the patient presented with bilateral impairment and narrowing of the uterine arteries, which increased the risk of arterial perforation during repeated UAE procedures. The patient was subsequently referred for magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS treatment. Following the treatment, the patient experienced a significant improvement in symptoms (symptom severity score was reduced from 47 to 12 by 1 year post-treatment. MR images at 3 months showed a 49% decrease in fibroid volume. There were no adverse events during the treatment or the follow-up period. This case suggests that MRgFUS can be an effective treatment option for patients with recurrent fibroids following previous UAE treatment.

  7. Focus: Composition and Language Study, K-6.

    Science.gov (United States)

    Stewart, Donald, Ed.

    1974-01-01

    This issue of "Kansas English" focus on composition and language study, kindergarten through grade six. The articles and authors are "Evaluating Process and Product in Children's Writing" by Robert L. Hillerich, "Written Language Development and Instruction of Elementary School Children" by Lester S. Golub, "From a Reading Desk" by Myrline…

  8. 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...

  9. 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

  10. 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.

  11. Magnetohydrodynamic studies of the strong Focus device

    International Nuclear Information System (INIS)

    Vezin, Robert

    1971-01-01

    The POTTER magnetohydrodynamic code is used. It consists of a two-dimensional fluid model with two temperatures Te, Ti and transverse transport coefficients for a fully ionized plasma. Applied to the FOCUS geometry used at Limeil, it gives temperatures consistent with the BENNETT law but much lower than those evaluated experimentally by the X-ray absorbing foils technique. (author) [fr

  12. Understanding weight stigmatization: a focus group study.

    Science.gov (United States)

    Cossrow, N H; Jeffery, R W; McGuire, M T

    2001-01-01

    The purpose of this research was to investigate, in a nonclinical sample of adults, thoughts on and experiences with weight stigmatization. Focus groups were used to collect information. Participants were recruited through a newspaper advertisement and flyers posted in public places in Minneapolis and St. Paul. During the focus groups, participants were led in a discussion about their thoughts on weight stigmatization and personal experiences of being treated differently or poorly because of their weight. Six gender-specific focus groups consisted of 31 adult volunteers (17 women and 14 men). Perceptions of weight-based stereotypes and weight stigmatization and personal reports of having been treated differently or poorly owing to weight were measured. Participants reported a variety of experiences of being treated differently or poorly because of their weight. These included teasing, harassment, slurs and insults, negative judgments and assumptions, and perceived discrimination. Participants reported that such experiences occurred at home, among friends and strangers, at work, and in health care settings. Women reported a greater number and a greater variety of negative experiences than men. The results indicated that participants experienced weight-based stigmatization in many aspects of their lives. Awareness of these experiences may assist in the development of treatments for overweight individuals.

  13. 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

  14. 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.

  15. 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.

  16. Finding focus: a study of the historical development of focus in English

    NARCIS (Netherlands)

    Komen, E.R.

    2013-01-01

    This study reveals how two important focus articulations change over time in written English. Constituent focus, often accompanied by contrast, makes use of the clause-initial position in the oldest stages of English, but as this position comes to be used for the grammatical subject over time, the

  17. 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.

  18. 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

  19. 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...

  20. 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

  1. 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

  2. Final focus system tuning studies towards Compact Linear Collider feasibility

    Science.gov (United States)

    Marin, E.; Latina, A.; Tomás, R.; Schulte, D.

    2018-01-01

    In this paper we present the latest results regarding the tuning study of the baseline design of the final focus system of the Compact Linear Collider (CLIC-FFS). CLIC aims to provide collisions to the experiments at a luminosity above 1034 c m-2 s-1 . In order to deliver such luminosity in a single pass machine, the vertical beam size at the interaction point (IP) is reduced to about 1 nm, which imposes unprecedented tuning difficulties to the system. In previous studies, 90% of the machines reached 90% of the nominal luminosity at the expense of 18 000 luminosity measurements, when considering beam position monitor errors and transverse misalignments of magnets for a single beam case. In the present study, additional static imperfections as, roll misalignments, strength v2.epss are included. Moreover both e- and e+ beamlines are properly simulated. A new tuning procedure based on linear and nonlinear knobs is implemented to effectively cure the most relevant beam size aberrations at the IP. The obtained results for single and double beam studies under solely static imperfections are presented.

  3. 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.

  4. 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

  5. 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.

  6. Expanded studies of linear collider final focus systems at the Final Focus Test Beam

    International Nuclear Information System (INIS)

    Tenenbaum, P.G.

    1995-12-01

    In order to meet their luminosity goals, linear colliders operating in the center-of-mass energy range from 3,50 to 1,500 GeV will need to deliver beams which are as small as a few Manometers tall, with x:y aspect ratios as large as 100. The Final Focus Test Beam (FFTB) is a prototype for the final focus demanded by these colliders: its purpose is to provide demagnification equivalent to those in the future linear collider, which corresponds to a focused spot size in the FFTB of 1.7 microns (horizontal) by 60 manometers (vertical). In order to achieve the desired spot sizes, the FFTB beam optics must be tuned to eliminate aberrations and other errors, and to ensure that the optics conform to the desired final conditions and the measured initial conditions of the beam. Using a combination of incoming-beam diagnostics. beam-based local diagnostics, and global tuning algorithms, the FFTB beam size has been reduced to a stable final size of 1.7 microns by 70 manometers. In addition, the chromatic properties of the FFTB have been studied using two techniques and found to be acceptable. Descriptions of the hardware and techniques used in these studies are presented, along with results and suggestions for future research

  7. Expanded studies of linear collider final focus systems at the Final Focus Test Beam

    Energy Technology Data Exchange (ETDEWEB)

    Tenenbaum, Peter Gregory [Stanford Univ., CA (United States)

    1995-12-01

    In order to meet their luminosity goals, linear colliders operating in the center-of-mass energy range from 3,50 to 1,500 GeV will need to deliver beams which are as small as a few Manometers tall, with x:y aspect ratios as large as 100. The Final Focus Test Beam (FFTB) is a prototype for the final focus demanded by these colliders: its purpose is to provide demagnification equivalent to those in the future linear collider, which corresponds to a focused spot size in the FFTB of 1.7 microns (horizontal) by 60 manometers (vertical). In order to achieve the desired spot sizes, the FFTB beam optics must be tuned to eliminate aberrations and other errors, and to ensure that the optics conform to the desired final conditions and the measured initial conditions of the beam. Using a combination of incoming-beam diagnostics. beam-based local diagnostics, and global tuning algorithms, the FFTB beam size has been reduced to a stable final size of 1.7 microns by 70 manometers. In addition, the chromatic properties of the FFTB have been studied using two techniques and found to be acceptable. Descriptions of the hardware and techniques used in these studies are presented, along with results and suggestions for future research.

  8. MHSS 2020 Focused Study on Biotechnology & Nanotechnology, 29 July 1997

    National Research Council Canada - National Science Library

    1998-01-01

    .... This focused study on biotechnology and nanotechnology has two primary goals: (1) examine the future strategic impact of biotechnology and nanotechnology as it relates to the military health system, and (2...

  9. 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

  10. 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

  11. 100-BC-1 Operable Unit focused feasibility study

    International Nuclear Information System (INIS)

    Day, R.E.

    1994-01-01

    The standard Comprehensive Environmental Response, Compensation, and Liability Act feasibility study includes development and screening of alternatives (Phases 1 and 2) and the detailed analysis of alternatives (Phase 3). This focused feasibility study constitutes the Phase 3 portion of the feasibility study process for the remedial alternatives initially developed and screened in the 100 Area Feasibility Study Phases 1 and 2 (DOE-RL 1993a). The focused feasibility study process is conducted in two stages, a Process Document (DOE-RL 1994a) and an operable unit-specific focused feasibility study document, such as this one. The focused feasibility study process is performed by implementing a ''plug-in'' style approach; as defined in greater detail in the Process Document, which is a companion to this document. The objective of this focused feasibility study is to provide decision makers with sufficient information to allow appropriate and timely selection of interim remedial measures for candidate waste sites associated with the 100-BC-1 Operable Unit which is located in the north-central part of the Hanford Site. The interim remedial measure candidate waste sites are determined in the Limited Field Investigation (DOE-RL 1993b). Site profiles are developed for each of these waste sites. The site profiles are used in the application of the plug-in approach. The waste site either plugs into the analysis of the alternatives for the group, or deviations from the developed group alternatives are described and documented

  12. Situational Factors in Focus Group Studies: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Arne Orvik MPolSc

    2013-02-01

    Full Text Available The aim of this study was to see how contextual factors are expressed, used, and analyzed in data collected in focus group discussions (FGDs. The study includes an assessment of how the methodological reporting of contextual factors might influence and improve the trustworthiness of articles. Articles reporting workplace health, stress, and coping among health professionals were identified in a systematic review and used in the analysis. By using Vicsek's framework of situational factors for analysis of focus group results as a starting point, we found that contextual factors were most frequently described in the method sections and less frequently in the results and discussion sections. Vicsek's framework for the analysis of focus group results covers six contextual and methodological dimensions: interactional factors, personal characteristics of the participants, the moderator, the environment, time factors, and the content of FGDs. We found that the framework does not include a consideration of psychological safety, ethical issues, or organizational information. To deepen the analysis of focus group results, we argue that contextual factors should be analyzed as methodological dimensions and be considered as a sensitizing concept. Credibility, confirmability, dependability, and transferability can be strengthened by using, reporting, and discussing contextual factors in detail. The study contributes to elucidating how reporting of contextual data may enrich the analysis of focus group results and strengthen the trustworthiness. Future research should focus on clear reporting of contextual factors as well as further develop Vicsek's model to enhance reporting accuracy and transferability.

  13. Systematic study on the performance of elliptic focusing neutron guides

    International Nuclear Information System (INIS)

    Martin Rodriguez, D.; DiJulio, D.D.; Bentley, P.M.

    2016-01-01

    In neutron scattering experiments there is an increasing trend towards the study of smaller volume samples, which make the use of focusing optics more important. Focusing guide geometries based on conic-sections, such as those with parabolic and elliptic shapes, have been extensively used in both recently built neutron instruments and upgrades of existing hardware. A large fraction of proposed instruments at the European Spallation Source feature the requirement of good performance when measuring on small samples. The optimised design of a focusing system comes after time consuming Monte-Carlo (MC) simulations. Therefore, in order to help reduce the time needed to design such focusing systems, it is necessary to study systematically the performance of focusing guides. In the present work, we perform a theoretical analysis of the focusing properties of neutron beams, and validate them using a combination of Monte-Carlo simulations and Particle Swarm Optimisations (PSOs), where there is a close correspondence between the maximum divergence of the beam and the shape of the guide. The analytical results show that two limits can be considered, which bound a range of conic section shapes that provide optimum performance. Finally, we analyse a more realistic guide example and we give an assessment of the importance of the contribution from multiple reflections in different systems.

  14. 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.

  15. Numerical Study of Radiation Emissions from the Plasma Focus

    International Nuclear Information System (INIS)

    Akel, M.; Salo, S.

    2013-12-01

    Ion populations of studied plasma have been calculated versus electron temperatures. The expected emission spectra (full, Bremsstrahlung, recombination, and line) of plasma focus operated with different gases (nitrogen, oxygen, neon, argon, krypton and xenon) have been studied for different conditions using POPULATE, SPECTRA, XRAYFIL and FLYCHK codes for non-local thermodynamic equilibrium model (NLTE). The suitable electron temperatures ranges for soft X-ray and extreme ultraviolet (EUV) emissions from plasma focus have been investigated. The Ratio- BPX65.F code has been written in FORTRAN 77 for studying the soft X-ray emission of plasma focus using BPX65 PIN Diode X-ray Spectrometer technique. The X-ray ratio curves for various electron temperatures with probable electron and ion densities of the studied plasma produced have been computed with the assumption of non-LTE model for the distribution of the ionic species. The calculated X-ray ratio curves have been compared with experimental results for the argon plasma focus. These ratio curves could be used for electron temperatures deduction of plasma focus (author).

  16. 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

  17. 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)

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. Study of electron beam production by a plasma focus

    International Nuclear Information System (INIS)

    Smith, J.R.; Luo, C.M.; Rhee, M.J.; Schneider, R.F.

    1983-01-01

    A preliminary investigation of the electron beam produced by a plasma focus device using a current charged transmission line is described. Electron beam currents as high as 10 kA were measured. Interaction of the extracted beam and the filling gas was studied using open shutter photography

  3. Reallocating resources to focused factories: a case study in chemotherapy

    NARCIS (Netherlands)

    Vanberkel, P.T.; Boucherie, Richardus J.; Hans, Elias W.; Hurink, Johann L.; Litvak, Nelli; van Lent, W.A.M.; van Harten, Willem H.; van Harten, Wim H.; Blake, J.; Carter, M.

    2010-01-01

    This study investigates the expected service performance associated with a proposal to reallocate resources from a centralized chemotherapy department to a breast cancer focused factory. Using a slotted queueing model we show that a decrease in performance is expected and calculate the amount of

  4. Young Adults, Technology, and Weight Loss: A Focus Group Study

    OpenAIRE

    Stephens, Janna; Moscou-Jackson, Gyasi; Allen, Jerilyn K.

    2015-01-01

    Overweight and obesity are a major concern in young adults. Technology has been integrated into many weight loss interventions; however little is known about the use of this technology in young adults. The purpose of this study was to explore through focus group sessions the opinions of young adults on the use of technology for weight loss. A total of 17 young adults, between 18 and 25 years of age, participated in three focus group sessions. Major results indicated that young adults have ver...

  5. 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.

  6. 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

  7. Situational Factors in Focus Group Studies: A Systematic Review

    OpenAIRE

    Arne Orvik MPolSc; Lillebeth Larun PhD; Astrid Berland MSc; Karin C. Ringsberg PhD

    2013-01-01

    The aim of this study was to see how contextual factors are expressed, used, and analyzed in data collected in focus group discussions (FGDs). The study includes an assessment of how the methodological reporting of contextual factors might influence and improve the trustworthiness of articles. Articles reporting workplace health, stress, and coping among health professionals were identified in a systematic review and used in the analysis. By using Vicsek's framework of situational factors for...

  8. Living With Diabetes in Appalachia: A Focus Group Study.

    Science.gov (United States)

    Carpenter, Roger; Smith, Mary Jane

    This article presents an innovative holistic practice application based on evidence from a focus group study on managing diabetes. The purpose of this study addressed the research question: How do persons with type 2 diabetes describe ways of managing the challenge of living with diabetes? A second purpose was to link the findings on ways to manage diabetes to holistic nursing practice through story theory. Nine adults with type 2 diabetes living in rural West Virginia participated in 3 focus groups. Using content analysis, the study findings integrated themes with core qualities, and are as follows: living life as an evolving process is awakening to the present and doing it your way, being on guard is a vigilant ongoing responsibility, attending to bodily experience is awareness of body and facing life stress, and knowing the consequences is awareness of potential problems and taking charge. Merging the study findings with the concepts of story theory led to the development of an innovative practice application for managing diabetes. Managing diabetes in this practice application goes beyond problem-centeredness to a patient-centered approach, offering attention to individual preferences. Since managing diabetes is a major problem in Appalachia, there a need for innovative approaches. This study adds to the body of knowledge on how persons from Appalachia manage diabetes. In addition, it offers a story practice approach for managing diabetes-replacing a problem focus to a more holistic approach to practice leading to more meaningful and fulfilling outcomes.

  9. 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

  10. A study about Accounting Publications from a Semiotic Focus

    OpenAIRE

    Marcos Antonio de Souza; Carlos Alberto Diehl; Fernando Batista Fontana; Clea Beatriz Macagnan

    2013-01-01

    This paper was aimed at analyzing the contributions of semiotics teaching in Accounting. The actual development of semiotics as a modern science, which focuses on any language form, was only acknowledged between the 18th and 19thcenturies. Since then, several authors have studied this theme, using semiotics as an instrument to analyze other sciences. Many authors classify Accounting, considered a science, as a language. Hence, it can be analyzed based on the premises of semiotics. In this stu...

  11. 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.

  12. Virtual Gaming Simulation in Nursing Education: A Focus Group Study.

    Science.gov (United States)

    Verkuyl, Margaret; Hughes, Michelle; Tsui, Joyce; Betts, Lorraine; St-Amant, Oona; Lapum, Jennifer L

    2017-05-01

    The use of serious gaming in a virtual world is a novel pedagogical approach in nursing education. A virtual gaming simulation was implemented in a health assessment class that focused on mental health and interpersonal violence. The study's purpose was to explore students' experiences of the virtual gaming simulation. Three focus groups were conducted with a convenience sample of 20 first-year nursing students after they completed the virtual gaming simulation. Analysis yielded five themes: (a) Experiential Learning, (b) The Learning Process, (c) Personal Versus Professional, (d) Self-Efficacy, and (e) Knowledge. Virtual gaming simulation can provide experiential learning opportunities that promote engagement and allow learners to acquire and apply new knowledge while practicing skills in a safe and realistic environment. [J Nurs Educ. 2017;56(5):274-280.]. Copyright 2017, SLACK Incorporated.

  13. Young adults, technology, and weight loss: a focus group study.

    Science.gov (United States)

    Stephens, Janna; Moscou-Jackson, Gyasi; Allen, Jerilyn K

    2015-01-01

    Overweight and obesity are a major concern in young adults. Technology has been integrated into many weight loss interventions; however little is known about the use of this technology in young adults. The purpose of this study was to explore through focus group sessions the opinions of young adults on the use of technology for weight loss. A total of 17 young adults, between 18 and 25 years of age, participated in three focus group sessions. Major results indicated that young adults have very little knowledge on the use of Smartphone technology for weight loss but would like to use this type of technology to help them lose weight. Results also indicated that young adults struggle to make healthy food choices and have priorities that outweigh exercise and they need support and guidance to make better decisions. In conclusion, young adults would be open to using Smartphone technology for weight loss but also need feedback and guidance to help make healthy decisions.

  14. Adolescent girls' views on cosmetic surgery: A focus group study.

    Science.gov (United States)

    Ashikali, Eleni-Marina; Dittmar, Helga; Ayers, Susan

    2016-01-01

    This study examined adolescent girls' views of cosmetic surgery. Seven focus groups were run with girls aged 15-18 years (N = 27). Participants read case studies of women having cosmetic surgery, followed by discussion and exploration of their views. Thematic analysis identified four themes: (1) dissatisfaction with appearance, (2) acceptability of cosmetic surgery, (3) feelings about undergoing cosmetic surgery and (4) cosmetic surgery in the media. Results suggest the acceptability of cosmetic surgery varies according to the reasons for having it and that the media play an important role by normalising surgery and under-representing the risks associated with it. © The Author(s) 2014.

  15. Prosocial behaviours of young adolescents: a focus group study.

    Science.gov (United States)

    Bergin, Christi; Talley, Susan; Hamer, Lynne

    2003-02-01

    This study investigated young adolescents' perceptions of their peers' prosocial behaviours. In eight focus groups, 53 11- to 13-year olds described specific prosocial acts of their peers. Results suggest that traditional research has not addressed the diversity of prosocial behaviours that youth enact, nor emphasized behaviours that are salient to young adolescents. Such behaviours included standing up for others, encouraging others, helping others develop skills, including others who are left out, and being humorous. Facilitating emotional regulation of others emerged as an important component of prosocial behaviour. These data can help guide future research on prosocial development to include a broader array of authentic behaviours of young adolescents.

  16. Myths about autism: An exploratory study using focus groups.

    Science.gov (United States)

    John, Rachael Ps; Knott, Fiona J; Harvey, Kate N

    2017-08-01

    Individuals with autism are often stigmatised and isolated by their typically developing peers according to parental, teacher and self-reports. While quantitative studies often report negative attitudes towards individuals with autism, it is still unclear how understandings of autism influence attitudes. In this exploratory study, misconceptions or myths about autism, that is, the cognitive component of attitudes, were examined using focus groups. Purposive sampling was used to recruit undergraduate and postgraduate students, and adults with and without experience of autism, to one of the five focus groups (n = 37). Content analysis was used to identify emergent themes. The data identified seven commonly held beliefs about individuals with autism. The first four were related to social interaction, such as that people with autism do not like to be touched. The fifth reflected the view that all individuals with autism have a special talent, and the final two concerned beliefs that people with autism are dangerous. The findings from this study demonstrate that people with varying experience or knowledge of autism often hold inaccurate beliefs about autism. These findings improve our understandings of lay beliefs about autism and will aid the development and implementation of interventions designed to improve lay knowledge of autism.

  17. Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

    Science.gov (United States)

    Notenbomer, Annette; Roelen, Corné A M; van Rhenen, Willem; Groothoff, Johan W

    2016-01-01

    Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R) model as theoretical framework. Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

  18. 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...

  19. A study about Accounting Publications from a Semiotic Focus

    Directory of Open Access Journals (Sweden)

    Marcos Antonio de Souza

    2013-03-01

    Full Text Available This paper was aimed at analyzing the contributions of semiotics teaching in Accounting. The actual development of semiotics as a modern science, which focuses on any language form, was only acknowledged between the 18th and 19thcenturies. Since then, several authors have studied this theme, using semiotics as an instrument to analyze other sciences. Many authors classify Accounting, considered a science, as a language. Hence, it can be analyzed based on the premises of semiotics. In this study, bibliographic research and content analysis are used, the latter applied to the papers published about the theme in the following congresses: Associação Brasileira de Custo, USP de Controladoria e Contabilidade and Encontros da ANPAD. In addition, a search was undertaken in 22 international scientific Accounting journals. In conclusion, few theoretical contributions have been published in Brazilian congresses and in international scientific journals, but mainly practical contributions about the use of semiotics in Accounting.

  20. The importance of bioequivalence study: focus on clopidogrel

    Directory of Open Access Journals (Sweden)

    Arini Setiawati

    2011-05-01

    Full Text Available Bioequivalence (BE study is required to show whether a generic copy product can be interchangeable with the brand innovator product. The aim of this article is to provide the rationale for conducting BE studies, the main products requiring BE studies, the design and conduct of BE studies in general, with focus on clopidogrel. All of the clopidogrel generic products in Indonesia have been shown to be BE to the innovator product Plavix® and they contain API (active pharmaceutical ingredient clopidogrel form 1 that complies with USP 30, 1997 requirements: the R-enantiomer content is not more than 1%. A proof that bioequivalence (BE means therapeutic equivalence (TE is also provided for cardiovascular drugs. Clopidogrel has 2 polymorphic forms, form 1 and form 2, which have the same indications. At least one pivotal study of clopidogrel, CAPRIE, used clopidogrel form 1. An atherothrombotic event may be associated with clopidogrel resistance, which occur in about 4 to 30% of patients treated with conventional doses of clopidogrel. (Med J Indones 2011; 20:149-53Keywords: bioequivalent, clopidogrel

  1. Woman focused smoking cessation programming: a qualitative study.

    Science.gov (United States)

    Minian, Nadia; Penner, Jessica; Voci, Sabrina; Selby, Peter

    2016-03-12

    Several studies of smoking cessation programs in clinical settings have revealed poorer outcomes for women compared to men, including counselling alone or in combination with pharmacotherapy. The objective of the current study was to explore treatment and program structure needs and preferences among female clients in a specialized smoking cessation clinic in an academic mental health and addiction health science centre in order to inform program design so that it meets the needs of female clients. Four focus groups were conducted with current and former female clients (n = 23, mode age range = 50-59 years old, 56.5% were still smoking and 43.5% had quit) who had registered for outpatient smoking cessation treatment. Questions were designed to examine what aspects of the services were helpful and what changes they would like to see to better assist them and other women with quitting smoking. A thematic analysis of the raw data (audio recordings and notes taken during the focus groups) was conducted using a phenomenological theoretical framework. Themes that emerged indicated that females trying to quit smoking are best supported if they have choice from a variety of services so that treatment can be individualized to meet their specific needs; psychosocial support is provided both one-one-one with health care professionals and by peers in support groups; free pharmacotherapy is available to eliminate financial barriers to use; women-specific educational topics and support groups are offered; the clinic is accessible with evening/weekend hours, options to attend a local clinic, and childcare availability; and communication about clinic services and operation are clear, readily available, and regularly updated. An ideal smoking cessation program for women includes a women's centred approach with sufficient variety and choice, free pharmacotherapy, non-judgmental support, accessible services and clear communication of program options and changes. Findings may suggest

  2. Gender-based education during clerkships: a focus group study

    Directory of Open Access Journals (Sweden)

    van Leerdam L

    2014-02-01

    Full Text Available Lotte van Leerdam, Lianne Rietveld, Doreth Teunissen, Antoine Lagro-JanssenDepartment of Primary and Community Care, Gender and Women's Health, Radboud University Medical Center, Nijmegen, The NetherlandsObjectives: One of the goals of the medical master's degree is for a student to become a gender-sensitive doctor by applying knowledge of gender differences in practice. This study aims to investigate, from the students’ perspective, whether gender medicine has been taught in daily practice during clerkship.Methods: A focus group study was conducted among 29 medical students from Radboud University, Nijmegen, The Netherlands, who had just finished either their internal medicine or surgical clerkships. Data were analyzed in line with the principles of constant comparative analysis.Results: Four focus groups were conducted with 29 participating students. Clinical teachers barely discuss gender differences during students’ clerkships. The students mentioned three main explanatory themes: insufficient knowledge; unawareness; and minor impact. As a result, students feel that they have insufficient competencies to become gender-sensitive doctors.Conclusion: Medical students at our institution perceive that they have received limited exposure to gender-based education after completing two key clinical clerkships. All students feel that they have insufficient knowledge to become gender-sensitive doctors. They suppose that their clinical teachers have insufficient knowledge regarding gender sensitivity, are unaware of gender differences, and the students had the impression that gender is not regarded as an important issue. We suggest that the medical faculty should encourage clinical teachers to improve their knowledge and awareness of gender issues.Keywords: medical education, clerkship, gender, hidden curriculum, clinical teachers

  3. Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

    Directory of Open Access Journals (Sweden)

    Annette Notenbomer

    Full Text Available Research investigating frequent sickness absence (3 or more episodes per year is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves.We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R model as theoretical framework.Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills were regarded as solutions to reduce frequent sickness absence.The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

  4. 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...

  5. 100-KR-1 Operable Unit focused feasibility study report

    International Nuclear Information System (INIS)

    1994-11-01

    The standard Comprehensive Environmental Response, Compensation, and Liability Act of 1980 Feasibility Study (FS) includes development and screening of alternatives and the detailed analysis of alternatives. This focused feasibility study (FFS) was conducted for the 100-KR-1 Operable Unit at the Hanford Site in southeastern Washington. The objective of this operable unit-specific FFS is to provide decision makers with sufficient information to allow appropriate and timely selection of interim remedial measures (IRM) for the five sites (116-K-1 crib, 116-K-2 trench, 116-KE-4 and 116-KW-3 retention basins, and process effluent pipelines) associated with the 100-KR-1 Operable Unit. The IRM candidate waste sites are determined in the limited field investigation. Site profiles are developed for each of these waste site. The site profiles are used in the application of the plug-in approach. The waste site either plugs into the analysis of the alternatives for the group, or deviations from the developed group alternatives are described and documented

  6. Occupational therapists' perceptions of gender - a focus group study.

    Science.gov (United States)

    Liedberg, Gunilla M; Björk, Mathilda; Hensing, Gunnel

    2010-10-01

    Women and men are shaped over the courses of their lives by culture, society and human interaction according to the gender system. Cultural influences on individuals' social roles and environment are described in occupational therapy literature, but not specifically from a gender perspective. The purpose of this qualitative study was to explore how a sample of occupational therapists perceives the 'gender' concept. Four focus group interviews with 17 occupational therapists were conducted. The opening question was: 'How do you reflect on the encounter with a client depending on whether it is a man or a woman?' The transcribed interviews were analysed and two main themes emerged: 'the concept of gender is tacit in occupational therapy' and 'client encounters'. The occupational therapists expressed limited theoretical knowledge of 'gender'. Furthermore, the occupational therapists seemed to be 'doing gender' in their encounters with the clients. For example, in their assessment of the client, they focussed their questions on different spheres: with female clients, on the household and family; with male clients, on their paid work. This study demonstrated that occupational therapists were unaware of the possibility that they were 'doing gender' in their encounters with clients. There is a need to increase occupational therapists' awareness of their own behaviour of 'doing gender'. Furthermore, there is a need to investigate whether gendered perceptions will shorten or lengthen a rehabilitation period and affect the chosen interventions, and in the end, the outcome for the clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

  7. Italian Adolescents and Emergency Contraception: A Focus Group Study.

    Science.gov (United States)

    Olivari, Maria Giulia; Cuccì, Gaia; Confalonieri, Emanuela

    2017-02-01

    Using a qualitative method, the purpose of this study was to: (1) obtain information directly from the adolescents on their attitudes and knowledge regarding emergency contraception; and (2) investigate the presence of differences between male and female participants' attitudes and knowledge. This study consisted of 24 single-sex focus groups with 160 adolescents (male = 46.3% (74 of 160); female = 53.7% (86 of 160)) aged 15-19 years conducted among high schools in 3 regions of Italy. Data were analyzed through thematic analysis taking into account gender differences and 2 main themes emerged. The first was labeled "Adolescents' attitudes toward emergency contraception" and it was divided into 3 subthemes: You should be aware; It's a life line; and Everything but a child. The second theme was labeled "Adolescents' knowledge toward emergency contraception" and it was divided into 3 subthemes: False myths; Baseline information; and Just take it. Italian adolescents believed it is important to prevent the risk of unprotected sex by using contraceptive methods and their motivation to use emergency contraception is related to critical attitudes toward the consequences of irresponsible/ineffective contraception. Although adolescents have an awareness of emergency contraception, more comprehensive knowledge is needed. These findings can inform specific interventions aimed at educating adolescents in need of emergency contraception. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  8. 100-HR-2 Operable Unit Focused Feasibility study report

    International Nuclear Information System (INIS)

    1995-01-01

    The standard Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) Feasibility Study (FS) includes development and screening of alternatives (Phases 1 and 2) and the detailed analysis of alternatives (Phase 3). This focused feasibility study (FFS) was conducted for the 100-HR-2 Operable Unit (OU) at the Hanford Site in southeastern Washington. This FFS constitutes the Phase 3 portion of the FS process for the remedial alternatives initially developed and screened in the 100 Area Feasibility Study Phases 1 and 2 (DOE-RL 1993a). The objective of this OU-specific FFS is to provide decision makers with sufficient information to allow appropriate and timely selection of interim remedial measures (IRM) for the seven IRM candidate sites associated with the 100-HR-2 OU. The IRM candidate waste sites identified in Table ES-1 are determined in the limited field investigation (DOE-RL 1994b). Site profiles are developed for each of these waste sites. The site profiles are used in the application of the plug-in approach. The waste site either plugs into the analysis of the alternatives for the group, or deviations from the developed group alternatives are described and documented. A summary for the 100-HR-2 IRM candidate waste site is as follows: none of the waste sites require additional alternative development. six of the seven waste sites directly plug into the waste site group alternatives. The site-specific detailed analysis is conducted, referencing the waste site group analysis as appropriate. A waste site detailed analysis summary is presented in Table ES-1.A comparative analysis of remedial alternatives is presented for each waste site. A summary of the comparative analysis is presented in Table ES-2

  9. Experimental studies of plasma wake-field acceleration and focusing

    International Nuclear Information System (INIS)

    Rosenzweig, J.B.; Cole, B.; Ho, C.; Argonne National Lab., IL

    1989-01-01

    More than four years after the initial proposal of the Plasma Wake-field Accelerator (PWFA), it continues to be the object of much investigation, due to the promise of the ultra-high accelerating gradients that can exist in relativistic plasma waves driven in the wake of charged particle beams. These large amplitude plasma wake-fields are of interest in the laboratory, both for the wealth of basic nonlinear plasma wave phenomena which can be studied, as well as for the applications of acceleration of focusing of electrons and positrons in future linear colliders. Plasma wake-field waves are also of importance in nature, due to their possible role in direct cosmic ray acceleration. The purpose of the present work is to review the recent experimental advances made in PWFA research at Argonne National Laboratory, in which many interesting beam and plasma phenomena have been observed. Emphasis is given to discussion of the nonlinear aspects of the PWFA beam-plasma interaction. 29 refs., 13 figs

  10. Meaning making in cancer survivors: a focus group study.

    Directory of Open Access Journals (Sweden)

    Nadia van der Spek

    Full Text Available BACKGROUND: Confrontation with a life-threatening disease like cancer can evoke existential distress, which can trigger a search for meaning in people after having survived this disease. METHODS: In an effort to gain more insight in the meaning making process, we conducted four focus groups with 23 cancer survivors on this topic. Participants responded to questions about experienced meaning making, perceived changes in meaning making after cancer and the perceived need for help in this area. RESULTS: Most frequently mentioned meaning making themes were relationships and experiences. We found that, in general, cancer survivors experienced enhanced meaning after cancer through relationships, experiences, resilience, goal-orientation and leaving a legacy. Some participants, however, also said to have (also experienced a loss of meaning in their lives through experiences, social roles, relationships and uncertainties about the future. CONCLUSIONS: The results indicated that there is a group of cancer survivors that has succeeded in meaning making efforts, and experienced sometimes even more meaning in life than before diagnosis, while there is also a considerable group of survivors that struggled with meaning making and has an unmet need for help with that. The results of this study contribute to develop a meaning centered intervention for cancer survivors.

  11. Study of microwave emission from a dense plasma focus

    International Nuclear Information System (INIS)

    Gerdin, G.; Venneri, F.; Tanisi, M.

    1985-01-01

    Microwave emission was detected in a 12.5 kJ dense plasma focus, using microwave horns and detectors placed in various locations outside the device. The results show that the parallel plates connecting the focus to its capacitor banks act as antennas and transmission lines, rather than wave guides. Subsequent measurements were performed with a microwave detector (R-band) attached to the focus anode, directly looking into the coaxial gun region, allowing to restrict the microwave emitting region to the muzzle end of the focus. The microwave frequency spectrum, determined with a time of flight detection system, strongly suggests the lower hybrid instability as the driving mechanism of the emissions. Comparing the time sequence of the emissions with those of other observable phenomena in the focus, a model was developed, to explain the possible relationship between the generation of microwave radiation and turbulence induced resistivity in the focus pinch. According to the model, microwaves and enhanced resistivity are caused by current driven instabilities occurring in the current sheath produced at the outer boundary of the pinch during the initial compression phase. Comparisons of the model predictions with observed experimental results are presented, including time resolved measurements of the pinch resistivity

  12. 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.

  13. 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

  14. 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

  15. 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

  16. Preliminary studies on a plasma focus opening switch

    Energy Technology Data Exchange (ETDEWEB)

    Wong, C S; Moo, S P; Singh, J P [Univ. of Malaya, Kuala Lumpur (Malaysia). Physics Dept., Plasma Research Laboratory; Choi, P [Ecole Polytechnique, Palaiseau (France). Laboratoire de Physique des Milieux Ionises

    1997-12-31

    The small plasma focus device UNU/ICTP PFF has been modified to assess the operation of a plasma focus based long conduction (> 2 {mu}s) opening switch, with a plasma filled diode as the load. The UNU/ICTP PFF is a Mather type plasma focus device powered by a single 15 kV, 30 {mu}F capacitor delivering a peak current of 150 kA when discharged at 15 kV. The device has been optimized for reproducible focusing in various gases including deuterium, argon, carbon dioxide, helium as well as in air. In particular, the optimum operating pressure for air is between 0.5 to 1.1 mbar, whereas for argon it is between 0.3 to 3 mbar. For the operation of the UNU/ICTP PFF as an opening switch, the electrode geometry is modified to redirect the plasma motion at the end of the axial rundown phase to avoid the normal plasma focus action, and the operating regime is shifted to low pressure to favour plasma opening switch action. With air as the working gas, pressure as low as 10{sup -3} mbar was tested. At such a low pressure, a set of 12 plasma injection cable guns is used to initiate breakdown of the discharge. The design and operating principle is presented and some preliminary results obtained on the operational characteristics of this device are discussed. (author). 5 figs., 4 refs.

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. Study of opening switch characteristics of a plasma focus

    International Nuclear Information System (INIS)

    Rhee, M.J.; Schneider, R.F.

    1985-01-01

    It is shown that a current charged transmission line and an opening switch can be used as an inductive energy storage system to produce a high power pulse. A plasma focus device, in which a transmission line is inserted in series with the capacitor bank and a coaxial gun, is considered as an inductive energy storage system. The m = 0 instability in the plasma focus is utilized as an opening switch and the disrupted plasma column is considered as bipolar diode. The system is described preferably by the transmission line theory rather than the lumped circuit theory. The relationship between the output voltage and the current drop is given by V = ΔIZ, where Z is the characteristic impedance of the transmission line. The current drop ΔI depends on the mismatched load impedance of the plasma diode which is governed by nature of the m = 0 instability

  2. Preliminary studies of the plasma focus as an opening switch

    International Nuclear Information System (INIS)

    Venneri, F.; Gerdin, G.

    1983-01-01

    Sharp current interruption at pinch time suggests the possible application of the plasma focus as an opening switch. Switch impedances on the order of 0.5 ohms or greater would be of interest to pulsed power applications if the rise time for the impedance is sufficiently short. The experimental determination of the magnitude of the plasma focus impedance at pinch time and its nature (R or L) are obviously important in assessing the feasibility of this application. An experimental estimate of the Spitzer resistance of the plasma focus based on soft-X-ray measurements indicates a Spitzer resistance of 9 mΩ. Estimates of resistance based on the maximum particle energy observed 4 (V about E /sub MAX/ /e) and the current at pinch time (R about E /sub MAX/ /eI /sub p/ ) would indicate an effective resistance of about one ohm. Estimates of resistance based on circuit parameters (L, I, q/C) yield about one third of an ohm. To resolve these discrepancies a exclamationBexclamation probe 5 is being developed to get a better estimate of L(t), L(t) and I(t) through spatially resolved measurements. Preliminary results are reported

  3. Parametric studies in a small plasma focus device

    International Nuclear Information System (INIS)

    Chuaqui, H.; Favre, M.; Silva, P.; Wyndham, E.

    1996-01-01

    Very high temperature and density plasmas can be produced in modest size plasma focus devices at the kJ level. Much of the scaling parameters on the plasma focus have been evaluated, though many questions still remain. The modest cost and simple construction allows easy modification to the device and the discharge parameters. In this paper the authors report on a small plasma focus device, which is set-up to investigate the effect of some of those modifications on the plasma, with detailed experimental diagnostics. Experiments have been carried out in various gases and with mixtures of different ratios. Extended operating range from below 0.5 torr upwards has been achieved with the implementation of the auxiliary discharge circuit. Despite the low voltage and low energy operation, energetic beam formation has been observed at the time of the final compression, prior to disruption. Current sheath formation and evolution has been characterized using the magnetic probes array, in correlation with beam formation and plasma emission. The relationship of the current sheath structure and that of the pinched plasma, as shown by the filtered X-ray pinhole camera, has been investigated

  4. 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

  5. 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.

  6. 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.

  7. Medication errors in home care: a qualitative focus group study.

    Science.gov (United States)

    Berland, Astrid; Bentsen, Signe Berit

    2017-11-01

    To explore registered nurses' experiences of medication errors and patient safety in home care. The focus of care for older patients has shifted from institutional care towards a model of home care. Medication errors are common in this situation and can result in patient morbidity and mortality. An exploratory qualitative design with focus group interviews was used. Four focus group interviews were conducted with 20 registered nurses in home care. The data were analysed using content analysis. Five categories were identified as follows: lack of information, lack of competence, reporting medication errors, trade name products vs. generic name products, and improving routines. Medication errors occur frequently in home care and can threaten the safety of patients. Insufficient exchange of information and poor communication between the specialist and home-care health services, and between general practitioners and healthcare workers can lead to medication errors. A lack of competence in healthcare workers can also lead to medication errors. To prevent these, it is important that there should be up-to-date information and communication between healthcare workers during the transfer of patients from specialist to home care. Ensuring competence among healthcare workers with regard to medication is also important. In addition, there should be openness and accurate reporting of medication errors, as well as in setting routines for the preparation, alteration and administration of medicines. To prevent medication errors in home care, up-to-date information and communication between healthcare workers is important when patients are transferred from specialist to home care. It is also important to ensure adequate competence with regard to medication, and that there should be openness when medication errors occur, as well as in setting routines for the preparation, alteration and administration of medications. © 2017 John Wiley & Sons Ltd.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Focused Study of Thermonuclear Bursts on Neutron Stars

    Science.gov (United States)

    Chenevez, Jérôme

    2009-05-01

    X-ray bursters form a class of Low Mass X-Ray Binaries where accreted material from a donor star undergoes rapid thermonuclear burning in the surface layers of a neutron star. The flux released can temporarily exceed the Eddington limit and drive the photosphere to large radii. Such photospheric radius expansion bursts likely eject nuclear burning ashes into the interstellar medium, and may make possible the detection of photoionization edges. Indeed, theoretical models predict that absorption edges from 58Fe at 9.2 keV, 60Zn and 62Zn at 12.2 keV should be detectable by the future missions Simbol-X and NuSTAR. A positive detection would thus probe the nuclear burning as well as the gravitational redshift from the neutron star. Moreover, likely observations of atomic X-ray spectral components reflected from the inner accretion disk have been reported. The high spectral resolution capabilities of the focusing X-ray telescopes may therefore make possible to differentiate between the potential interpretations of the X-ray bursts spectral features.

  13. Medical Student Perspectives of Active Learning: A Focus Group Study.

    Science.gov (United States)

    Walling, Anne; Istas, Kathryn; Bonaminio, Giulia A; Paolo, Anthony M; Fontes, Joseph D; Davis, Nancy; Berardo, Benito A

    2017-01-01

    Phenomenon: Medical student perspectives were sought about active learning, including concerns, challenges, perceived advantages and disadvantages, and appropriate role in the educational process. Focus groups were conducted with students from all years and campuses of a large U.S. state medical school. Students had considerable experience with active learning prior to medical school and conveyed accurate understanding of the concept and its major strategies. They appreciated the potential of active learning to deepen and broaden learning and its value for long-term professional development but had significant concerns about the efficiency of the process, the clarity of expectations provided, and the importance of receiving preparatory materials. Most significantly, active learning experiences were perceived as disconnected from grading and even as impeding preparation for school and national examinations. Insights: Medical students understand the concepts of active learning and have considerable experience in several formats prior to medical school. They are generally supportive of active learning concepts but frustrated by perceived inefficiencies and lack of contribution to the urgencies of achieving optimal grades and passing United States Medical Licensing Examinations, especially Step 1.

  14. 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....

  15. Consumers' preferences for fresh yam: a focus group study.

    Science.gov (United States)

    Barlagne, Carla; Cornet, Denis; Blazy, Jean-Marc; Diman, Jean-Louis; Ozier-Lafontaine, Harry

    2017-01-01

    In West and Central Africa and in the Caribbean, yam is one of the most important sources of carbohydrates and has a great potential to improve food security. The yam production sector is, however, now challenged by the satisfaction of evolving consumers' preferences. Since little is known about consumers' preferences regarding yams' characteristics, product quality, and the drivers of yam purchase, six focus group discussions were conducted (for a total of 31 participants). Among the purchasing criteria, price was considered more important than the others. It was followed by the external damage, the origin, and the size of the tuber. The most frequently cited consumption criteria were the taste, the texture, and color of flesh after cooking. Taste was considered more important than the other criteria. Three consumers' profiles were established reflecting heterogeneity in preferences, especially as concerns the willingness to pay for yam and consumption habits. They were designated as the Hedonistic, the Thrifty and the Flexible. Our results suggest that innovations can be implemented to sustain and stimulate the development of the yam sector in Guadeloupe. Two main development paths were identified. The first path is the valorization of the great existing diversity of yam varieties and the increase in the level of information for consumers about product attributes such as the cooking mode, the origin, and the mode of production. Building a marketing strategy based on the valorization of this diversity can help maintain and preserve yam's agro-biodiversity and the satisfaction of rapidly evolving consumption habits. The second path is the definition of yam ideotypes that suit consumers' needs. We expect that tailoring the production to consumers' needs will have a positive impact on global food security in the Caribbean region.

  16. 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.

  17. 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.

  18. Strategically Focused Training in Six Sigma Way: A Case Study

    Science.gov (United States)

    Pandey, Ashish

    2007-01-01

    Purpose: The purpose of the current study is to examine the utility of Six Sigma interventions as a performance measure and explore its applicability for making the training design and delivery operationally efficient and strategically effective. Design/methodology/approach: This is a single revelatory case study. Data were collected from multiple…

  19. 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.

  20. What about N? A methodological study of sample-size reporting in focus group studies.

    Science.gov (United States)

    Carlsen, Benedicte; Glenton, Claire

    2011-03-11

    Focus group studies are increasingly published in health related journals, but we know little about how researchers use this method, particularly how they determine the number of focus groups to conduct. The methodological literature commonly advises researchers to follow principles of data saturation, although practical advise on how to do this is lacking. Our objectives were firstly, to describe the current status of sample size in focus group studies reported in health journals. Secondly, to assess whether and how researchers explain the number of focus groups they carry out. We searched PubMed for studies that had used focus groups and that had been published in open access journals during 2008, and extracted data on the number of focus groups and on any explanation authors gave for this number. We also did a qualitative assessment of the papers with regard to how number of groups was explained and discussed. We identified 220 papers published in 117 journals. In these papers insufficient reporting of sample sizes was common. The number of focus groups conducted varied greatly (mean 8.4, median 5, range 1 to 96). Thirty seven (17%) studies attempted to explain the number of groups. Six studies referred to rules of thumb in the literature, three stated that they were unable to organize more groups for practical reasons, while 28 studies stated that they had reached a point of saturation. Among those stating that they had reached a point of saturation, several appeared not to have followed principles from grounded theory where data collection and analysis is an iterative process until saturation is reached. Studies with high numbers of focus groups did not offer explanations for number of groups. Too much data as a study weakness was not an issue discussed in any of the reviewed papers. Based on these findings we suggest that journals adopt more stringent requirements for focus group method reporting. The often poor and inconsistent reporting seen in these

  1. What about N? A methodological study of sample-size reporting in focus group studies

    Directory of Open Access Journals (Sweden)

    Glenton Claire

    2011-03-01

    Full Text Available Abstract Background Focus group studies are increasingly published in health related journals, but we know little about how researchers use this method, particularly how they determine the number of focus groups to conduct. The methodological literature commonly advises researchers to follow principles of data saturation, although practical advise on how to do this is lacking. Our objectives were firstly, to describe the current status of sample size in focus group studies reported in health journals. Secondly, to assess whether and how researchers explain the number of focus groups they carry out. Methods We searched PubMed for studies that had used focus groups and that had been published in open access journals during 2008, and extracted data on the number of focus groups and on any explanation authors gave for this number. We also did a qualitative assessment of the papers with regard to how number of groups was explained and discussed. Results We identified 220 papers published in 117 journals. In these papers insufficient reporting of sample sizes was common. The number of focus groups conducted varied greatly (mean 8.4, median 5, range 1 to 96. Thirty seven (17% studies attempted to explain the number of groups. Six studies referred to rules of thumb in the literature, three stated that they were unable to organize more groups for practical reasons, while 28 studies stated that they had reached a point of saturation. Among those stating that they had reached a point of saturation, several appeared not to have followed principles from grounded theory where data collection and analysis is an iterative process until saturation is reached. Studies with high numbers of focus groups did not offer explanations for number of groups. Too much data as a study weakness was not an issue discussed in any of the reviewed papers. Conclusions Based on these findings we suggest that journals adopt more stringent requirements for focus group method

  2. 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.

  3. Courtesy stigma--a focus group study of relatives of schizophrenia patients.

    Science.gov (United States)

    Angermeyer, Matthias C; Schulze, Beate; Dietrich, Sandra

    2003-10-01

    Stigmatization of people with mental illness has been investigated in numerous studies. Little research, however, has been done to explore how relatives of people with schizophrenia perceive and experience stigmatization and how they can fight such stigmatization. Aiming to explore stigma from the perspective of relatives of people with schizophrenia, focus group interviews were conducted with 122 members of advocacy groups from different parts of Germany. Focus group sessions were tape- and video-recorded and transcribed. Transcripts were coded using an inductive method, generating categories (domains) from the material. The analysis of focus group data shows that, contrary to previous research findings, discrimination and disadvantages encountered by relatives of schizophrenia patients reach far beyond the spheres of direct social interaction and access to social roles. Our study revealed two additional domains in which relatives encounter stigmatization: structural discrimination and public images of mental illness. Furthermore, psychiatry has been identified as one important source of stigma. Relatives also suggested numerous anti-stigma interventions. These can be grouped into five main categories: communication measures, support for the ill and their relatives, changes in mental health care, education and training, and control and supervision. Based on our findings,ways of how relatives of schizophrenia patients and mental health professionals can fight against stigma are discussed.

  4. White phosphorus pits focused feasibility study final July 2007.

    Energy Technology Data Exchange (ETDEWEB)

    Davis, B.; Martino, L.

    2007-08-21

    The White Phosphorus Burning Pits (WPP) Area of Concern (AOC) is a site of about 5.5 acres (2.2 ha) located in the J-Field Study Area, in the Edgewood Area of Aberdeen Proving Ground (APG), Maryland (Figure 1.1). Considerable information about the WPP exists as a result of efforts to characterize the hazards associated with J-Field. Contamination in the J-Field Study Area was first detected during an environmental survey of the APG Edgewood Area conducted in 1977 and 1978 (Nemeth et al. 1983) by the U.S. Army Toxic and Hazardous Materials Agency (USATHAMA; predecessor to the U.S. Army Environmental Center). As part of a subsequent USATHAMA environmental survey, 11 wells were installed and sampled at J-Field (three of them at the WPP) (Nemeth 1989). Contamination was also detected in 1983 during a munitions disposal survey conducted by Princeton Aqua Science (1984). The Princeton Aqua Science investigation involved installing and sampling nine wells (four at the WPP) and collecting and analyzing surficial and deep composite soil samples (including samples from the WPP area). In 1986, the U.S. Environmental Protection Agency (EPA) issued a Resource Conservation and Recovery Act (RCRA) Permit (MD3-21-002-1355) requiring a post-wide RCRA Facility Assessment (RFA) and a hydrogeologic assessment of J-Field. In 1987, the U.S. Geological Survey (USGS) began a two-phase hydrogeologic assessment in which data were collected to model groundwater flow at J-Field. Soil-gas investigations were conducted, several well clusters were installed (four at the WPP), a groundwater flow model was developed, and groundwater and surface water monitoring programs were established that continue today. The results of the USGS study were published by Hughes (1993).

  5. Workplace Bullying Among Family Physicians: A Gender Focused Study.

    Science.gov (United States)

    Rouse, Linda P; Gallagher-Garza, Shalena; Gebhard, Roberta E; Harrison, Suzanne L; Wallace, Lorraine S

    2016-09-01

    Continuing gender disparities within the medical profession have raised concerns about the extent to which women physicians face an inhospitable work environment. The purpose of this study was to examine the types and frequency of workplace bullying reported by a national sample of family physicians employed in academic settings, as related to gender. Data for this study were gathered as part of the Council of Academic Family Medicine (CAMF) Educational Research Alliance (CERA) omnibus electronic survey. Respondents completed questions addressing sociodemographic and practice characteristics, general experience with bullying, types of bullying, actions in response to bullying, and outcomes. A total of 1065 academic family physicians (male = 56.8%; female = 43.2%), mostly non-Hispanic white (84.2%) or Asian (5.3%) and between the ages 30 and 60 (58.7%) completed the CERA survey. One in 10 respondents acknowledged bullying someone in the workplace; 30% had been personally bullied in the workplace. Compared to men, female physicians were more likely to report being bullied overall and, specifically, to experience having their opinions ignored, lack of recognition for good work, feeling pressured not to claim rightful benefits, and being given unmanageable workloads. Despite some gender differences in actions taken, outcomes for each kind of action were the same for men and women.

  6. Family-focused dementia care - a qualitative interview study

    DEFF Research Database (Denmark)

    Mohrsen Busted, Laila; Nielsen, Dorthe; Birkelund, Regner

    to decrease the experienced burden that relatives to persons with dementia experience. The qualitative research project consists of three parts; 1) An interview study to investigate the problem area as experienced by 24 relatives. 2) Initiate family intervention, conducted by professional caregivers......Relatives to persons with dementia are in the literature described as the "invisible second patients." They get a more burdensome responsibility to the family’s everyday life and relation within the family. Furthermore, relatives as caregivers provide most of the assistance and supervision...... to fulfill the basic needs of the person with dementia. The experience of being close to a person with dementia may seem as a burden that involves emotional chaos and uncertainty which can lead to stress and depressions. Family health therapeutic conversations may be an intervention to relieve the suffering...

  7. 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

  8. Beliefs, Behaviors, and Contexts of Adolescent Caffeine Use: A Focus Group Study.

    Science.gov (United States)

    Ludden, Alison B; O'Brien, Elizabeth M; Pasch, Keryn E

    2017-07-29

    Caffeinated products are widely available to adolescents, and consumption of caffeine products-energy drinks and coffee in particular-is on the rise in this age group (Branum, Rossen, & Schoendorf, 2014). Yet, little is known about the psychosocial context of caffeine use. Previous studies on adolescent caffeine use have focused on caffeine's acute physiological effects, rather than the psychosocial contexts and beliefs regarding different types of caffeinated beverages (e.g., coffee, energy drinks, soda). The current research examines the contexts and beliefs associated with adolescents' use of caffeinated beverages (e.g., coffee, energy drinks, soda) using a focus group approach. Eleven focus group interviews (49 total participants) addressed adolescents' motivations for and patterns of caffeine use; they were transcribed and axial coding was used to identify common themes. Coffee and energy drinks were perceived to be the most popular caffeinated beverages. Reasons for consuming caffeine included the effect of caffeine as a stimulant, the pleasant feelings experienced when drinking it, and the fact that caffeine was available. As for contexts, coffee was consumed in more diverse social contexts than other caffeinated beverages. Friends and sports were the most popular contexts for energy drink use. The present findings inform adolescent health promotion efforts and provide researchers and practitioners alike detailed information in adolescents' own words about how and why they use caffeine. Adolescents' beliefs about caffeinated products are not uniform; the reasons adolescents articulate regarding their use of coffee, soda, and energy drinks are different across contexts and beverage type.

  9. A simulation study of mutations in the genetic regulatory hierarchy for butterfly eyespot focus determination.

    Science.gov (United States)

    Marcus, Jeffrey M; Evans, Travis M

    2008-09-01

    The color patterns on the wings of butterflies have been an important model system in evolutionary developmental biology. A recent computational model tested genetic regulatory hierarchies hypothesized to underlie the formation of butterfly eyespot foci [Evans, T.M., Marcus, J.M., 2006. A simulation study of the genetic regulatory hierarchy for butterfly eyespot focus determination. Evol. Dev. 8, 273-283]. The computational model demonstrated that one proposed hierarchy was incapable of reproducing the known patterns of gene expression associated with eyespot focus determination in wild-type butterflies, but that two slightly modified alternative hierarchies were capable of reproducing all of the known gene expressions patterns. Here we extend the computational models previously implemented in Delphi 2.0 to two mutants derived from the squinting bush brown butterfly (Bicyclus anynana). These two mutants, comet and Cyclops, have aberrantly shaped eyespot foci that are produced by different mechanisms. The comet mutation appears to produce a modified interaction between the wing margin and the eyespot focus that results in a series of comet-shaped eyespot foci. The Cyclops mutation causes the failure of wing vein formation between two adjacent wing-cells and the fusion of two adjacent eyespot foci to form a single large elongated focus in their place. The computational approach to modeling pattern formation in these mutants allows us to make predictions about patterns of gene expression, which are largely unstudied in butterfly mutants. It also suggests a critical experiment that will allow us to distinguish between two hypothesized genetic regulatory hierarchies that may underlie all butterfly eyespot foci.

  10. Focused ion-beam line profiles: A study of some factors affecting beam broadening

    International Nuclear Information System (INIS)

    Templeton, I.M.; Champion, H.G.

    1995-01-01

    The current--density profile of a focused ion beam (FIB) has a central peak accompanied by broader ''wings'' that, while unimportant in lithographic applications, can lead to unwanted effects during an implantation operation. The origin of the wings, and hence the best way to minimize them, is not clear and needs further study. We have measured the line profiles of several of the ions available in our FIB machine as a function of a number of variables, under ultrahigh vacuum (UHV) conditions. No effects are observed from changes in emission current or deliberate defocusing of the objective lens. There are some changes with beam aperture and/or current, but the biggest differences seem to be associated with a change of source type and hence, possibly, with a change in the source/extractor configuration or in the alloy and the emission process. The wing amplitudes are appreciably lower than many previously observed, and their profiles, at least for the lighter ions studied (Be ++ , Be + , and B + ), are Gaussian rather than exponential. It seems possible that our UHV conditions may have eliminated a scattering mechanism responsible for the larger, exponential wings previously observed. The corresponding beam and rectangle-edge profiles have been calculated. copyright 1995 American Vacuum Society

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. Patient input into the development and enhancement of ED discharge instructions: a focus group study.

    Science.gov (United States)

    Buckley, Barbara A; McCarthy, Danielle M; Forth, Victoria E; Tanabe, Paula; Schmidt, Michael J; Adams, James G; Engel, Kirsten G

    2013-11-01

    Previous research indicates that patients have difficulty understanding ED discharge instructions; these findings have important implications for adherence and outcomes. The objective of this study was to obtain direct patient input to inform specific revisions to discharge documents created through a literacy-guided approach and to identify common themes within patient feedback that can serve as a framework for the creation of discharge documents in the future. Based on extensive literature review and input from ED providers, subspecialists, and health literacy and communication experts, discharge instructions were created for 5 common ED diagnoses. Participants were recruited from a federally qualified health center to participate in a series of 5 focus group sessions. Demographic information was obtained and a Rapid Estimate of Adult Literacy in Medicine (REALM) assessment was performed. During each of the 1-hour focus group sessions, participants reviewed discharge instructions for 1 of 5 diagnoses. Participants were asked to provide input into the content, organization, and presentation of the documents. Using qualitative techniques, latent and manifest content analysis was performed to code for emergent themes across all 5 diagnoses. Fifty-seven percent of participants were female and the average age was 32 years. The average REALM score was 57.3. Through qualitative analysis, 8 emergent themes were identified from the focus groups. Patient input provides meaningful guidance in the development of diagnosis-specific discharge instructions. Several themes and patterns were identified, with broad significance for the design of ED discharge instructions. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  16. 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

  17. 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

  18. 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.

  19. 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

  20. Somali women's view of physical activity--a focus group study.

    Science.gov (United States)

    Persson, Gerthi; Mahmud, Amina Jama; Hansson, Eva Ekvall; Strandberg, Eva Lena

    2014-10-23

    Physical inactivity presents a major public health challenge and is estimated to cause six to ten percent of the major non-communicable diseases. Studies show that immigrants, especially women, have an increased risk of non-communicable diseases compared to ethnic Swedes. Somali immigrant women have increased rates of overweight and obesity, low fitness levels and low levels of cardiorespiratory fitness compared to non-immigrant women. These findings suggest that Somali women are at increased risk of developing lifestyle-related diseases. Few studies explore determinants of physical activity among Somali women. The aim of this study was to explore Somali women's views and experiences of physical activity after migration to Sweden. A qualitative focused ethnographic approach was used in this study. Four focus groups were conducted with twenty-six Somali women ranging from 17 to 67 years of age. Focus group discussions were recorded, transcribed verbatim and analysed using qualitative content analysis. The analysis resulted in four main themes and ten categories: Life in Somalia and Life in Sweden, Understanding and enhancing health and Facilitators and barriers to physical activity. Great differences were seen between living in Somalia and in Sweden but also similarities such as finding time to manage housework, the family and the health of the woman. The extended family is non-existent in Sweden, making life more difficult. Health was considered a gift from God but living a healthy life was perceived as the responsibility of the individual. Misconceptions about enhancing health occurred depending on the woman's previous life experience and traditions. There was an awareness of the importance of physical activity among the participants but lack of knowledge of how to enhance activity on an individual basis. Enhancing factors to an active lifestyle were identified as being a safe and comfortable environment. Some barriers, such as climate, lack of motivation and time

  1. 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.

  2. Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.

    Science.gov (United States)

    Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

    2018-04-01

    NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. © British Journal of General Practice 2018.

  3. Women's reflections and actions regarding working after breast cancer surgery - a focus group study.

    Science.gov (United States)

    Nilsson, M I; Olsson, M; Wennman-Larsen, A; Petersson, L-M; Alexanderson, K

    2013-07-01

    To better understand processes affecting return to work (RTW) after breast cancer, more knowledge from the perspective of sickness absentees is warranted. Still, research based on women's own reasoning and actions in RTW is very scarce. This study aims to elucidate how women with breast cancer reflect and act on work-related issues. Thematic analyses of data from four focus group interviews with 23 women who had had breast cancer surgery in the previous 3-13 months were carried out. The five following themes of reflections regarding RTW were identified: 'health and functioning', 'self-esteem/integrity', 'value of work', 'relationships at work', and 'social circumstances'. These reflections were associated with the three identified themes of actions taken by the women: 'to work or to be sickness absent', 'to adjust work according to own needs or not', and 'to disclose or to hide one's cancer'. There was a distinct difference between women who experienced work as a source of well-being and those who needed a respite from work. This study adds knowledge to the process of RTW after breast cancer and focuses on factors that lead the women to an active role in this process. We point to the interplay between women's own preferences, perceived competence, outer opportunities, and the actions each woman take with regard to RTW, which need to be recognized by all stakeholders involved. Furthermore, it continues to be essential to address the specific issue of disclosure in the workplace because this may be distressing for women. Copyright © 2012 John Wiley & Sons, Ltd.

  4. A Modeling Study of Flow Diversion and Focusing in unsaturated Fractured Rocks

    International Nuclear Information System (INIS)

    Pan, Lehua; Wu, Yu-Shu; Zhang, Keni

    2002-01-01

    This study presents a systematic approach to analyze the flow diversion and flow focusing caused by the natural flow-barrier system in the unsaturated zone (UZ) of Yucca Mountain, Nevada, under ambient steady-state flow conditions. An existing analytical solution for analyzing capillary barrier in porous media has been extended to apply to the fractured porous rock. The new analytical solutions are used to identify the critical layers and to provide the guidance for generation of a proper three-dimensional (3-D), site-scale numerical grid. A large-scale 3-D numerical model (with more than a million grid blocks) has been developed with site-specific data to analyze the major flow patterns in the mountain. Our analyses show that large-scale lateral flow could take place in the UZ under ambient conditions, as a result of capillary barriers formed at the contacts of heterogeneous rock layers. This lateral flow runs generally toward the east (in the southern part) or southeast (in the northern part), which is consistent with the dip of the layer contacts. About 90 percent of the total lateral flow is found to be conducted by only a few critical rock layers. Faults that penetrate these rock layers act as vertical capillary barriers that stop the lateral flow. The combined effect of horizontal and vertical capillary barriers resulted in reduced percolation flow through repository horizon in general but focused downward flow along those penetrating faults. The model results were found to be consistent with the field water saturation. The findings of this study are consistent with a previously published two-dimensional (2-D) analysis and recent published modeling results using field-observed Cl-data

  5. Context, Focus and New Perspectives in the Study of Muslim Religiosity

    DEFF Research Database (Denmark)

    Jensen, Tina Gudrun

    2011-01-01

    This paper examines Muslim religiosities by focusing on the variety of Islam classes offered by Muslim organizations in Denmark. More specifically, the paper highlights conditions for studying religiosity among Muslims in Denmark, and suggests new focus areas. The paper argues against an ‘ethnic’...

  6. Studies on reducing the scale of a double focusing mass spectrometer

    International Nuclear Information System (INIS)

    Chambers, D.M.; Gregg, H.R.; Andresen, B.D.

    1993-05-01

    Several groups have developed miniaturized sector mass spectrometers with the goal of remote sensing in confined spaces or portability. However, these achievements have been overshadowed by more successful development of man-portable quadrupole and ion trap mass spectrometers. Despite these accomplishments the development of a reduced-scale sector mass spectrometer remains attractive as a potentially low-cost, robust instrument requiring very simple electronics and low power. Previous studies on miniaturizing sector instruments include the use of a Mattauch-Herzog design for a portable mass spectrograph weighing less than 10 kg. Other work has included the use of a Nier-Johnson design in spacecraft-mountable gas chromatography mass spectrometers for the Viking spacecraft as well as miniature sector-based MS/MS instrument. Although theory for designing an optimized system with high resolution and mass accuracy is well understood, such specifications have not yet been achieved in a miniaturized instrument. To proceed further toward the development of a miniaturized sector mass spectrometer, experiments were conducted to understand and optimize a practical, yet nonideal instrument configuration. The sector mass spectrometer studied in this work is similar to the ones developed for the Viking project, but was further modified to be low cost, simple and robust. Characteristics of this instrument that highlight its simplicity include the use of a modified Varian leak detector ion source, source ion optics that use one extraction voltage, and an unshunted fixed nonhomogeneous magnetic sector. The effects of these design simplifications on ion trajectory were studied by manipulating the ion beam along with the magnetic sector position. This latter feature served as an aid to study ion focusing amidst fringing fields as well as nonhomogeneous forces and permitted empirical realignment of the instrument

  7. 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.

  8. Study of different ultrasonic focusing methods applied to non destructive testing

    International Nuclear Information System (INIS)

    El Amrani, M.

    1995-01-01

    The work presented in this thesis concerns the study of different ultrasonic focusing techniques applied to Nondestructive Testing (mechanical focusing and electronic focusing) and compares their capabilities. We have developed a model to predict the ultrasonic field radiated into a solid by water-coupled transducers. The model is based upon the Rayleigh integral formulation, modified to take account the refraction at the liquid-solid interface. The model has been validated by numerous experiments in various configurations. Running this model and the associated software, we have developed new methods to optimize focused transducers and studied the characteristics of the beam generated by transducers using various focusing techniques. (author). 120 refs., 95 figs., 4 appends

  9. Self-consistent simulation studies of periodically focused intense charged-particle beams

    International Nuclear Information System (INIS)

    Chen, C.; Jameson, R.A.

    1995-01-01

    A self-consistent two-dimensional model is used to investigate intense charged-particle beam propagation through a periodic solenoidal focusing channel, particularly in the regime in which there is a mismatch between the beam and the focusing channel. The present self-consistent studies confirm that mismatched beams exhibit nonlinear resonances and chaotic behavior in the envelope evolution, as predicted by an earlier envelope analysis [C. Chen and R. C. Davidson, Phys. Rev. Lett. 72, 2195 (1994)]. Transient effects due to emittance growth are studied, and halo formation is investigated. The halo size is estimated. The halo characteristics for a periodic focusing channel are found to be qualitatively the same as those for a uniform focusing channel. A threshold condition is obtained numerically for halo formation in mismatched beams in a uniform focusing channel, which indicates that relative envelope mismatch must be kept well below 20% to prevent space-charge-dominated beams from developing halos

  10. Older Adults Perceptions of Technology and Barriers to Interacting with Tablet Computers: A Focus Group Study.

    Science.gov (United States)

    Vaportzis, Eleftheria; Clausen, Maria Giatsi; Gow, Alan J

    2017-10-04

    New technologies provide opportunities for the delivery of broad, flexible interventions with older adults. Focus groups were conducted to: (1) understand older adults' familiarity with, and barriers to, interacting with new technologies and tablets; and (2) utilize user-engagement in refining an intervention protocol. Eighteen older adults (65-76 years old; 83.3% female) who were novice tablet users participated in discussions about their perceptions of and barriers to interacting with tablets. We conducted three separate focus groups and used a generic qualitative design applying thematic analysis to analyse the data. The focus groups explored attitudes toward tablets and technology in general. We also explored the perceived advantages and disadvantages of using tablets, familiarity with, and barriers to interacting with tablets. In two of the focus groups, participants had previous computing experience (e.g., desktop), while in the other, participants had no previous computing experience. None of the participants had any previous experience with tablet computers. The themes that emerged were related to barriers (i.e., lack of instructions and guidance, lack of knowledge and confidence, health-related barriers, cost); disadvantages and concerns (i.e., too much and too complex technology, feelings of inadequacy, and comparison with younger generations, lack of social interaction and communication, negative features of tablets); advantages (i.e., positive features of tablets, accessing information, willingness to adopt technology); and skepticism about using tablets and technology in general. After brief exposure to tablets, participants emphasized the likelihood of using a tablet in the future. Our findings suggest that most of our participants were eager to adopt new technology and willing to learn using a tablet. However, they voiced apprehension about lack of, or lack of clarity in, instructions and support. Understanding older adults' perceptions of technology

  11. 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...

  12. 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.

  13. A modelling approach to study learning processes with a focus on knowledge creation

    NARCIS (Netherlands)

    Naeve, Ambjorn; Yli-Luoma, Pertti; Kravcik, Milos; Lytras, Miltiadis

    2008-01-01

    Naeve, A., Yli-Luoma, P., Kravcik, M., & Lytras, M. D. (2008). A modelling approach to study learning processes with a focus on knowledge creation. International Journal Technology Enhanced Learning, 1(1/2), 1–34.

  14. Parental illness perceptions and medication perceptions in childhood asthma, a focus group study

    NARCIS (Netherlands)

    Klok, Ted; Brand, Paul L.; Bomhof-Roordink, Hanna; Duiverman, Eric J.; Kaptein, Adrian A.

    Aim: Asthma treatment according to guidelines fails frequently, through patients' nonadherence to doctors' advice. This study aimed to explore how differences in asthma care influence parents' perceptions to inhaled corticosteroids (ICS). Methods: We conducted six semistructured focus groups,

  15. Without 'Focus'

    Directory of Open Access Journals (Sweden)

    Aldo Sevi

    2010-12-01

    Full Text Available It is widely accepted that a notion of 'focus', more or less as conceived of in Jackendoff (1972, must be incorporated into our theory of grammar, as a means of accounting for certain observed correlations between prosodic facts and semantic/pragmatic facts. In this paper, we put forth the somewhat radical idea that the time has come to give up this customary view, and eliminate 'focus' from our theory of grammar. We argue that such a move is both economical and fruitful.Research over the years has revealed that the correlations between prosody, 'focus', and the alleged semantic/pragmatic effects of focus are much less clear and systematic than we may have initially hoped. First we argue that this state of affairs detracts significantly from the utility of our notion of 'focus', to the point of calling into question the very motivation for including it in the grammar. Then we look at some of the central data, and show how they might be analyzed without recourse to a notion of 'focus'. We concentrate on (i the effect of pitch accent placement on discourse congruence, and (ii the choice of 'associate' for the so-called 'focus sensitive' adverb only. We argue that our focus-free approach to the data improves empirical coverage, and begins to reveal patterns that have previously been obscured by preconceptions about 'focus'.ReferencesBeaver, D. & Clark, B. 2008. Sense and Sensitivity: How Focus Determines Meaning. Blackwell.Beaver, D., Clark, B., Flemming, E., Jaeger, T. F. & Wolters, M. 2007. ‘When semantics meets phonetics: Acoustical studies of second occurrence focus’. Language 83.2: 245–76.http://dx.doi.org/10.1353/lan.2007.0053Beckman, M. & Hirschberg, J. 1994. ‘The ToBI Annotation Conventions’. Ms.,http://www.cs.columbia.edu/~julia/files/conv.pdf.Bolinger, D. 1972. ‘Accent is predictable (if you are a mind-reader’. Language 48.3: 633–44.http://dx.doi.org/10.2307/412039Büring, D. 2006. ‘Focus projection and default

  16. 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.

  17. Parent-focused treatment for adolescent anorexia nervosa: a study protocol of a randomised controlled trial.

    Science.gov (United States)

    Hughes, Elizabeth K; Le Grange, Daniel; Court, Andrew; Yeo, Michele S M; Campbell, Stephanie; Allan, Erica; Crosby, Ross D; Loeb, Katharine L; Sawyer, Susan M

    2014-04-08

    Family-based treatment is an efficacious outpatient intervention for medically stable adolescents with anorexia nervosa. Previous research suggests family-based treatment may be more effective for some families when parents and adolescents attend separate therapy sessions compared to conjoint sessions. Our service developed a novel separated model of family-based treatment, parent-focused treatment, and is undertaking a randomised controlled trial to compare parent-focused treatment to conjoint family-based treatment. This randomised controlled trial will recruit 100 adolescents aged 12-18 years with DSM-IV anorexia nervosa or eating disorder not otherwise specified (anorexia nervosa type). The trial commenced in 2010 and is expected to be completed in 2015. Participants are recruited from the Royal Children's Hospital Eating Disorders Program, Melbourne, Australia. Following a multidisciplinary intake assessment, eligible families who provide written informed consent are randomly allocated to either parent-focused treatment or conjoint family-based treatment. In parent-focused treatment, the adolescent sees a clinical nurse consultant and the parents see a trained mental health clinician. In conjoint family-based treatment, the whole family attends sessions with the mental health clinician. Both groups receive 18 treatment sessions over 6 months and regular medical monitoring by a paediatrician. The primary outcome is remission at end of treatment and 6 and 12 month follow up, with remission defined as being ≥ 95% expected body weight and having an eating disorder symptom score within one standard deviation of community norms. The secondary outcomes include partial remission and changes in eating pathology, depressive symptoms and self-esteem. Moderating and mediating factors will also be explored. This will be first randomised controlled trial of a parent-focused model of family-based treatment of adolescent anorexia nervosa. If found to be efficacious, parent-focused

  18. Employees’ Perspectives on Corporate Social Responsibility: A Focus Group Study in Izmir City

    OpenAIRE

    UGUR, Secil; YARIMOGLU, Emel KURSUNLUOGLU

    2015-01-01

    Abstract: The aim of this research is to examine how white collar employees working at the Izmir offices of large-sized international companies in Turkey understand and interpret Corporate Social Responsibility (CSR) concept. Focus group interview as one of the techniques of qualitative research method was used in this study. The focus group interview that was conducted with eight businesspeople brought out their opinions into light, and thus more profound data regarding CSR was collected and...

  19. 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.

  20. 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.

  1. 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...

  2. Children's Experiences and Meaning Construction on Parental Divorce: A Focus Group Study

    Science.gov (United States)

    Maes, Sofie D. J.; De Mol, Jan; Buysse, Ann

    2012-01-01

    The global aim of this study was to explore children's narratives of parental divorce. A convenience sample, composed of 11- and 14-year-old children, was recruited. A total of 22 children (12 male, 10 female) participated in this focus group study. The findings show that two components seem to be really important for children during the divorce…

  3. Big Data Science Education: A Case Study of a Project-Focused Introductory Course

    Science.gov (United States)

    Saltz, Jeffrey; Heckman, Robert

    2015-01-01

    This paper reports on a case study of a project-focused introduction to big data science course. The pedagogy of the course leveraged boundary theory, where students were positioned to be at the boundary between a client's desire to understand their data and the academic class. The results of the case study demonstrate that using live clients…

  4. People-, Process- and Goal-Focused Leadership Behaviour: An Empirical Study in a Global Company

    Directory of Open Access Journals (Sweden)

    Thanh Ha-Vikstrom

    2017-03-01

    Full Text Available This study explores the focus of leadership behaviours that perceived and experienced by leaders in a multinational company. By using triangulation method including questionnaires, in-depth interviews and observations, we analyse the data collected from twenty managers across organisational levels. The results reveal the patterns of managerial behaviour in three key focus areas for success: people, process and goal. Directors and general managers are more people-focused than line managers, who in turn tend to be more process-focused. The research findings bridge the gap in the field and initiate a new normative leadership behaviour model (people-, process and goal-focused, which can be used to directly support leaders in enhancing their leadership skills as well as for recruitment or promotion purposes. The model can be utilized as an aid to organisations when developing training programs to support leaders in different types of organisations (for-profit or non-profit to focus their development efforts on organizational success.

  5. Focused Ethnography as Research Method: A Case Study of Techno Music Producers in Home-Recording Studios

    Directory of Open Access Journals (Sweden)

    Jan Michael Kühn

    2013-05-01

    Full Text Available Translator's Introduction: Jan-Michael Kühn's essay introduces the reader to Hubert Knoblauch's focused ethnography [fokussierte Ethnographie] as an ethnographic fieldwork method. More than a decade after Knoblauch's first publications on this method, there are precious few guides to focused ethnography in the English language, save one (Knoblauch 2005. At any rate, there are certainly no introductions to this methodology that also use EDM scenes as a case study. Kühn's article was originally published in German in Soziologie Magazin, a student-run journal published from Martin Luther University in Halle (Saale but operated by an editorial network that spans Germany. As a result, Kühn orients his writing towards an audience of junior researchers, post-docs and graduate students, highlighting the ways in which focused ethnography suits the circumstances of early research careers, where one may have difficulty securing long-term research stays for fieldwork of broader scope. In particular, he notes that Knoblauch's methods require a very narrow scope for the project (i.e., a "field sector" rather than the whole field, a reliance on the researcher's previous knowledge of the field, and short bursts of intense ethnographic activity in order to create work that is tightly focused but still rigorous and generative of fresh knowledge and new concepts.KEYWORDS: qualitative methods; cultural production; music production; home-recording; technoculture

  6. 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.

  7. The effects of self-focus on attentional biases in social anxiety:An ERP study.

    Science.gov (United States)

    Judah, Matt R; Grant, DeMond M; Carlisle, Nancy B

    2016-06-01

    Cognitive theories of social anxiety disorder suggest that biased attention plays a key role in maintaining symptoms. These biases include self-focus and attention to socially threatening stimuli in the environment. The goal of this study was to utilize ERPs that are elicited by a change detection task to examine biases in selective attention (i.e., N2pc) and working memory maintenance (i.e., contralateral delay activity; CDA). Additionally, the effect of self-focus was examined using false heart rate feedback. In support of the manipulation, self-focus cues resulted in greater self-reported self-consciousness and task interference, enhanced anterior P2 amplitude and reduced SPN amplitude. Moreover, P2 amplitude for self-focus cues was correlated with reduced task performance for socially anxious subjects only. The difference in P2 amplitude between self-focus and standard cues was correlated with social anxiety independent of depression. As hypothesized, socially anxious participants (n = 20) showed early selection and maintenance of disgust faces relative to neutral faces as indicated by the N2pc and CDA components. Nonanxious controls (n = 22) did not show these biases. During self-focus cues, controls showed marginal evidence of biased selection for disgust faces, whereas socially anxious subjects showed no bias in this condition. Controls showed an ipsilateral delay activity after being cued to attend to one hemifield. Overall, this study supports early and persistent attentional bias for social threat in socially anxious individuals. Furthermore, self-focus may disrupt these biases. These findings and supplementary data are discussed in light of cognitive models of social anxiety disorder, recent empirical findings, and treatment.

  8. Solution Focused Financial Therapy: A Brief Report of a Pilot Study

    Directory of Open Access Journals (Sweden)

    Kristy L. Archuleta

    2015-07-01

    Full Text Available The financial counseling, financial planning, and financial therapy fields are hampered by a conceptual and empirical paucity of clinical and experimental evidence-based research. In an attempt to decrease this gap in the literature, a pilot study was developed to test the implementation of a solution-focused financial therapy client intervention approach, in which solution-focused therapy techniques were applied in a financial counseling setting. This paper reports findings from a clinical intervention study of college students (N = 8 who presented a variety of financial issues related to budgeting, investing, and debt repayment problems. Data were gathered prior to the start of treatment, after treatment ended, and three months later. Participants’ psychological well-being and financial behaviors improved, while financial distress decreased. The solution-focused financial therapy approach used is discussed.

  9. 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.

  10. Study on neutron beam probe. Study on the focused neutron beam

    Energy Technology Data Exchange (ETDEWEB)

    Kotajima, Kyuya; Suzuki, K.; Fujisawa, M.; Takahashi, T.; Sakamoto, I. [Tohoku Univ., Sendai (Japan). Faculty of Engineering; Wakabayashi, T.

    1998-03-01

    A monoenergetic focused neutron beam has been produced by utilizing the endoenergetic heavy ion reactions on hydrogen. To realize this, the projectile heavy ion energy should be taken slightly above the threshold energy, so that the excess energy converted to the neutron energy should be very small. In order to improve the capability of the focused neutron beam, some hydrogen stored metal targets have also been tested. Separating the secondary heavy ions (associated particles) from the primary ions (accelerated particles) by using a dipole magnet, a rf separator, and a particle identification system, we could directly count the produced neutrons. This will leads us to the possibility of realizing the standard neutron field which had been the empty dream of many neutron-related researchers in the world. (author)

  11. Attitudes towards obesity treatment in GP training practices: a focus group study

    NARCIS (Netherlands)

    Jochemsen-van der Leeuw, H. G. A.; van Dijk, N.; Wieringa-de Waard, M.

    2011-01-01

    Both patients and government expect the GP to treat obesity. Previous studies reported a negative attitude of GPs towards this task. Little is known about the attitude of GP trainees. To assess the attitude and other factors that influence the willingness and ability of GP trainees to provide

  12. Work-Focused Treatment of Common Mental Disorders and Return to Work: A Comparative Outcome Study

    NARCIS (Netherlands)

    Lagerveld, S.E.; Blonk, R.W.B.; Brenninkmeijer, V.; Wijngaards-de Meij, L.; Schaufeli, W.B.

    2012-01-01

    The aim of this study was to compare the effectiveness of two individual-level psychotherapy interventions: (a) treatment as usual consisting of cognitive– behavioral therapy (CBT) and (b) work-focused CBT (W-CBT) that integrated work aspects early into the treatment. Both interventions were carried

  13. A Focus Group Study of Child Nutrition Professionals' Attitudes about Food Allergies and Current Training Practices

    Science.gov (United States)

    Lee, Yee Ming; Kwon, Junehee; Sauer, Kevin

    2014-01-01

    Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial…

  14. Phytochemical and Biosynthetic Studies of Lignans, with a Focus on Indonesian Medicinal Plants

    NARCIS (Netherlands)

    Elfahmi, [No Value

    2006-01-01

    In this thesis phytochemical and biosynthetic studies of lignans are described. The focus is on the Indonesian medicinal plants Phyllanthus niruri and Piper cubeba and on two Linum species, Linum flavum and L. leonii, native to European countries. Both Indonesian plants are used in jamu. Jamu is the

  15. Designing and Developing a Programme-Focused Assessment Strategy: A Case Study

    Science.gov (United States)

    Brunton, James; Brown, Mark; Costello, Eamon; Walsh, Elaine

    2016-01-01

    This case study describes the process that the Humanities Programme Team, in Dublin City University's Open Education Unit, has undertaken with regard to developing a systematic, programme-focused assessment strategy. It charts the development of an Assessment Matrix that facilitated the enhancement of programme coherence in the context of a…

  16. FOCUSED FEASIBILITY STUDY OF PHYTOREMEDIATION ALTERNATIVE FOR THE INDUSTRIAL EXCESS LANDFILL SITE IN STARK COUNTY, OHIO.

    Science.gov (United States)

    Focused feasibility study of phytoremediation alternative for the Industrial Excess Landfill site in Stark County, Ohio. More information can be found on the NPL Fact Sheet for this site at www.epa.gov/region5/superfund/npl/ohio/OHD000377971.htm

  17. Cerebrovascular accident and abnormal focus of hyperactivity revealed by dynamic study in scintiangioencephalography

    International Nuclear Information System (INIS)

    Planchon, C.A.; Perez, R.; Lebourges, J.

    1980-01-01

    A 75-year-old female was admitted to the hospital for suspicion of a cerebrovascular accident. An important focus of hyperactivity was noted during a dynamic study by scintiangioencephalography, consistent with a highly vascular tumor, but corresponding in fact to a focal transitory hyperfusion with accompanying intense neuronal activity. (orig.)

  18. Tool Mediation in Focus on Form Activities: Case Studies in a Grammar-Exploring Environment

    Science.gov (United States)

    Karlstrom, Petter; Cerratto-Pargman, Teresa; Lindstrom, Henrik; Knutsson, Ola

    2007-01-01

    We present two case studies of two different pedagogical tasks in a Computer Assisted Language Learning environment called Grim. The main design principle in Grim is to support "Focus on Form" in second language pedagogy. Grim contains several language technology-based features for exploring linguistic forms (static, rule-based and statistical),…

  19. Communicating the Nature of Science through "The Big Bang Theory": Evidence from a Focus Group Study

    Science.gov (United States)

    Li, Rashel; Orthia, Lindy A.

    2016-01-01

    In this paper, we discuss a little-studied means of communicating about or teaching the nature of science (NOS)--through fiction television. We report some results of focus group research which suggest that the American sitcom "The Big Bang Theory" (2007-present), whose main characters are mostly working scientists, has influenced…

  20. Teen Perceptions of the Promotion of Safer Sexual Practices: A Focus Group Study

    Science.gov (United States)

    Herrman, Judith W.; Kelley, Andrea; Haigh, Katherine M.

    2017-01-01

    Teens' own thoughts on fostering safe sexual practice are important perspectives in promoting adolescent sexual health yet are relatively absent in the literature. This focus group study explored teens' perceptions about the supports and challenges that exist as teens strive to engage in healthy sexual practices. Seventy-five teens participated in…

  1. Listening to Voices of Children with a Visual Impairment: A Focus Group Study

    Science.gov (United States)

    Khadka, Jyoti; Ryan, Barbara; Margrain, Tom H.; Woodhouse, J. Margaret; Davies, Nathan

    2012-01-01

    The purpose of the study was to identify the educational, social and leisure activities and issues that matter to school children and young people with a visual impairment and to compare their lifestyle with fully sighted counterparts. Thirteen focus groups were conducted and the groups were stratified by age, gender, visual status and school…

  2. Sharp Focus on Soft Skills: A Case Study of Malaysian University Students' Educational Expectations

    Science.gov (United States)

    Nikitina, Larisa; Furuoka, Fumitaka

    2012-01-01

    In 2006, the Ministry of Higher Education, Malaysia, recommended that all public institutions of higher learning in the country incorporate soft skills formation into their curricula. This qualitative study aimed to explore Malaysian students' expectations of university education with a special focus on the acquisition of soft skills and to…

  3. Mental health professionals' family-focused practice with families with dependent children: a survey study.

    Science.gov (United States)

    Tungpunkom, Patraporn; Maybery, Darryl; Reupert, Andrea; Kowalenko, Nick; Foster, Kim

    2017-12-08

    Many people with a mental illness are parents caring for dependent children. These children are at greater risk of developing their own mental health concerns compared to other children. Mental health services are opportune places for healthcare professionals to identify clients' parenting status and address the needs of their children. There is a knowledge gap regarding Thai mental health professionals' family-focused knowledge and practices when working with parents with mental illness and their children and families. This cross -sectional survey study examined the attitudes, knowledge and practices of a sample (n = 349) of the Thai mental health professional workforce (nurses, social workers, psychologists, psychiatrists) using a translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ). The majority of clinicians reported no training in family (76.8%) or child-focused practice (79.7%). Compared to other professional groups, psychiatric nurses reported lower scores on almost all aspects of family-focused practice except supporting clients in their parenting role within the context of their mental illness. Social workers scored highest overall including having more workplace support for family-focused practice as well as a higher awareness of family-focused policy and procedures than psychiatrists; social workers also scored higher than psychologists on providing support to families and parents. All mental health care professional groups reported a need for training and inter-professional practice when working with families. The findings indicate an important opportunity for the prevention of intergenerational mental illness in whose parents have mental illness by strengthening the professional development of nurses and other health professionals in child and family-focused knowledge and practice.

  4. 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.

  5. Hotspots in trauma memories and their relationship to successful trauma-focused psychotherapy: a pilot study.

    Science.gov (United States)

    Nijdam, Mirjam J; Baas, Melanie A M; Olff, Miranda; Gersons, Berthold P R

    2013-02-01

    Imaginal exposure is an essential element of trauma-focused psychotherapies for posttraumatic stress disorder (PTSD). Exposure should in particular focus on the "hotspots," the parts of trauma memories that cause high levels of emotional distress which are often reexperienced. Our aim was to investigate whether differences in the focus on hotspots differentiate between successful and unsuccessful trauma-focused psychotherapies. As part of a randomized trial, 45 PTSD patients completed brief eclectic psychotherapy for PTSD. We retrospectively assessed audio recordings of therapy sessions of 20 patients. Frequency of hotspots and the associated emotions, cognitions, and characteristics were compared for the most successful (n = 10) versus the least successful (n = 10) treatments. The mean number of unique hotspots per patient was 3.20, and this number did not differ between successful and unsuccessful treatments. In successful treatments, however, hotspots were more frequently addressed (r = .48), and they were accompanied by more characteristics of hotspots (r = .39), such as an audible change in affect, indicating medium- to large-sized effects. Repeatedly focusing on hotspots and looking for associated characteristics of hotspots may help clinicians to enhance the efficacy of imaginal exposure for patients who would otherwise show insufficient response to treatment. Copyright © 2013 International Society for Traumatic Stress Studies.

  6. A Study on Techniques for Focusing Circumferential Array Guided Waves for Long Range Inspection of Pipes

    International Nuclear Information System (INIS)

    Kang, To; Kim, Hak Joon; Song, Sung Jin; Cho, Young Do; Lee, Dong Hoon; Cho, Hyun Joon

    2009-01-01

    Ultrasonic guided waves have been widely utilized for long range inspection of structures. Especially, development of array guided waves techniques and its application for long range gas pipe lines(length of from hundreds meters to few km) were getting increased. In this study, focusing algorithm for array guided waves was developed in order to improve long range inspectability and accuracy of the array guided waves techniques for long range inspection of gas pipes, and performance of the developed techniques was verified by experiments using the developed array guided wave system. As a result, S/N ratio of array guided wave signals obtained with the focusing algorithm was increased higher than that of signals without focusing algorithm

  7. 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

  8. Children’s experiences and meaning construction on parental divorce: A focus group study

    OpenAIRE

    Maes, Sofie DJ; De Mol, Jan; Buysse, Ann

    2011-01-01

    The global aim of this study was to explore children's narratives of parental divorce. A convenience sample, composed of 11- and 14-year-old children, was recruited. A total of 22 children (12 male, 10 female) participated in this focus group study. The findings show that two components seem to be really important for children during the divorce process: the ability to construct meaning about their parents' decision to divorce and their feeling to count in the process of family transition. Ch...

  9. Focused Ethnography

    Directory of Open Access Journals (Sweden)

    Hubert Knoblauch

    2005-09-01

    Full Text Available In this paper I focus on a distinctive kind of sociological ethnography which is particularly, though not exclusively, adopted in applied research. It has been proposed that this branch of ethno­graphy be referred to as focused ethnography. Focused ethnography shall be delineated within the context of other common conceptions of what may be called conventional ethnography. However, rather than being opposed to it, focused ethno­graphy is rather complementary to conventional ethnography, particularly in fields that are charac­teristic of socially and functionally differentiated contemporary society. The paper outlines the back­ground as well as the major methodological features of focused ethnography, such as short-term field visits, data intensity and time intensity, so as to provide a background for future studies in this area. URN: urn:nbn:de:0114-fqs0503440

  10. 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.

  11. Design study of superconducting sextupole magnet using HTS coated conductor for neutron-focusing device

    International Nuclear Information System (INIS)

    Tosaka, T.; Koyanagi, K.; Ono, M.; Kuriyama, T.; Watanabe, I.; Tsuchiya, K.; Suzuki, J.; Adachi, T.; Shimizu, H.M.

    2006-01-01

    We performed a design study of sextupole magnet using high temperature superconducting (HTS) wires. The sextupole magnet is used as a focusing lens for neutron-focusing devices. A neutron-focusing device is desired to have a large aperture and a high magnetic field gradient of G, where G = 2B/r 2 , B is the magnetic field and r is a distance from the sextupole magnet axis. Superconducting magnets offer promising prospects to meet the demands of a neutron-focusing device. Recently NbTi coils of low temperature superconducting (LTS) have been developed for a sextupole magnet with a 46.8 mm aperture. The maximum magnetic field gradient G of this magnet is 9480 T/m 2 at 4.2 K and 12,800 T/m 2 at 1.8 K. On the other hand, rapid progress on second generation HTS wire has been made in increasing the performance of critical current and in demonstrating a long length. The second generation HTS wire is referred to as coated conductor. It consists of tape-shaped base upon which a thin coating of superconductor, usually YBCO, is deposited or grown. This paper describes a design study of sextupole magnet using coated conductors

  12. Learning Analytics focused on student behavior. Case study: dropout in distance learning institutions

    Directory of Open Access Journals (Sweden)

    Jose Aguilar

    2017-04-01

    Full Text Available Normally, Learning Analytics (LA can be focused on the analysis of the learning process or the student behavior. In this paper is analyzed the use of LA in the context of distance learning universities, particularly focuses on the students’ behavior. We propose to use a new concept, called "Autonomic Cycle of Learning Analysis Tasks", which defines a set of tasks of LA, whose common objective is to achieve an improvement in the process under study. In this paper, we develop the "Autonomic Cycle of LA Tasks" to analyze the dropout in distance learning institutions. We use a business intelligence methodology in order to develop the "Autonomic Cycle of LA Tasks" for the analysis of the dropout in distance learning. The Autonomic Cycle identifies factors that influence the decision of a student to abandon their studies, predicts the potentially susceptible students to abandon their university studies, and define a motivational pattern for these students.

  13. Ion Motion in the Adiabatic Focuser

    International Nuclear Information System (INIS)

    Henestroza, E.; Sessler, A.M.; Yu, S.S.

    2006-01-01

    In this paper we numerically study the effect of ion motion in an adiabatic focuser, motivated by a recent suggestion that ion motion in an adiabatic focuser might be significant and even preclude operation of the focuser as previously envisioned. It is shown that despite ion motion the adiabatic focuser should work as well as originally envisioned

  14. 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.

  15. Effectiveness of music therapy on focused attention, working memory and stress in Type 2 diabetes: An exploratory study

    Directory of Open Access Journals (Sweden)

    Indira Tumuluri

    2017-01-01

    Full Text Available Cognitive deficits are reported in diabetes mellitus type 2 (DM2. Previous research has shown that music-based intervention can not only reduce hyperglycemia but also target cognitive functions as well as stress. The aim of this exploratory study was to understand the effect of active participation in music therapy (MT on the cognitive deficits of DM2 patients. MT of twenty sessions was carried out with three participants with DM2. Serum cortisol, perceived stress, Color Trail Test (1 and 2, and verbal n-back (1 and 2 tests were used to measure the outcomes. Feedback was taken for the subjective ratings and satisfaction of the participants. Stress and cortisol reduced and focused attention and working memory improved in varying degrees. Subjectively, participants reported having benefitted from the intervention. This is the first attempt to investigate the effect of music-based intervention on cognitive function in DM2 patients using case study approach.

  16. Effectiveness of Music Therapy on Focused Attention, Working Memory and Stress in Type 2 Diabetes: An Exploratory Study.

    Science.gov (United States)

    Tumuluri, Indira; Hegde, Shantala; Nagendra, H R

    2017-01-01

    Cognitive deficits are reported in diabetes mellitus type 2 (DM2). Previous research has shown that music-based intervention can not only reduce hyperglycemia but also target cognitive functions as well as stress. The aim of this exploratory study was to understand the effect of active participation in music therapy (MT) on the cognitive deficits of DM2 patients. MT of twenty sessions was carried out with three participants with DM2. Serum cortisol, perceived stress, Color Trail Test (1 and 2), and verbal n-back (1 and 2) tests were used to measure the outcomes. Feedback was taken for the subjective ratings and satisfaction of the participants. Stress and cortisol reduced and focused attention and working memory improved in varying degrees. Subjectively, participants reported having benefitted from the intervention. This is the first attempt to investigate the effect of music-based intervention on cognitive function in DM2 patients using case study approach.

  17. 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...

  18. Focus on focusing

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    The discovery and impact of the principle of strong focusing was celebrated at a history Symposium at Stanford on 25 July in the course of the 1985 US Summer School on Particle Accelerators. Burt Richter, Stanford Linac Director, who introduced all the speakers with well chosen reminders about their various contributions related to the theme of the symposium, remarked that it was an appropriate time to be lauding the great contributions of accelerator physicists following the Nobel Prize award to Simon van der Meer for outstanding achievements in accelerator physics

  19. Focus on focusing

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1985-10-15

    The discovery and impact of the principle of strong focusing was celebrated at a history Symposium at Stanford on 25 July in the course of the 1985 US Summer School on Particle Accelerators. Burt Richter, Stanford Linac Director, who introduced all the speakers with well chosen reminders about their various contributions related to the theme of the symposium, remarked that it was an appropriate time to be lauding the great contributions of accelerator physicists following the Nobel Prize award to Simon van der Meer for outstanding achievements in accelerator physics.

  20. Maternal knowledge and attitudes toward influenza vaccination: a focus group study in metropolitan Atlanta.

    Science.gov (United States)

    Gazmararian, Julie A; Orenstein, Walter; Prill, Mila; Hitzhusen, Hannah B; Coleman, Margaret S; Pazol, Karen; Oster, Natalia V

    2010-11-01

    To explore the knowledge and attitudes of mothers of school-aged children toward influenza vaccination and assess what methods of communication about vaccination and its delivery work best among this audience. The authors conducted focus groups with mothers of school-aged children. Prior to the focus groups, investigators agreed on key themes and discussion points. They independently reviewed transcripts using systematic content analysis and came to an agreement on outcome themes. Many study participants had misunderstandings about influenza vaccines and the definition of influenza. A common perception was that flu is a catch-all term for a variety of undefined illnesses, ranging from a severe cold to stomach upset. Few participants saw a societal benefit in vaccinating children to protect other populations (eg, the elderly). This study represents a first step in understanding how mothers perceive influenza vaccination and for crafting effective communication to increase vaccination among school-aged children.

  1. 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.

  2. 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.

  3. Developing a minimum dataset for nursing team leader handover in the intensive care unit: A focus group study.

    Science.gov (United States)

    Spooner, Amy J; Aitken, Leanne M; Corley, Amanda; Chaboyer, Wendy

    2018-01-01

    Despite increasing demand for structured processes to guide clinical handover, nursing handover tools are limited in the intensive care unit. The study aim was to identify key items to include in a minimum dataset for intensive care nursing team leader shift-to-shift handover. This focus group study was conducted in a 21-bed medical/surgical intensive care unit in Australia. Senior registered nurses involved in team leader handovers were recruited. Focus groups were conducted using a nominal group technique to generate and prioritise minimum dataset items. Nurses were presented with content from previous team leader handovers and asked to select which content items to include in a minimum dataset. Participant responses were summarised as frequencies and percentages. Seventeen senior nurses participated in three focus groups. Participants agreed that ISBAR (Identify-Situation-Background-Assessment-Recommendations) was a useful tool to guide clinical handover. Items recommended to be included in the minimum dataset (≥65% agreement) included Identify (name, age, days in intensive care), Situation (diagnosis, surgical procedure), Background (significant event(s), management of significant event(s)) and Recommendations (patient plan for next shift, tasks to follow up for next shift). Overall, 30 of the 67 (45%) items in the Assessment category were considered important to include in the minimum dataset and focused on relevant observations and treatment within each body system. Other non-ISBAR items considered important to include related to the ICU (admissions to ICU, staffing/skill mix, theatre cases) and patients (infectious status, site of infection, end of life plan). Items were further categorised into those to include in all handovers and those to discuss only when relevant to the patient. The findings suggest a minimum dataset for intensive care nursing team leader shift-to-shift handover should contain items within ISBAR along with unit and patient specific

  4. Simulation Studies of the Dielectric Grating as an Accelerating and Focusing Structure

    International Nuclear Information System (INIS)

    Soong, Ken; Peralta, E.A.; Byer, R.L.; Colby, E.

    2011-01-01

    A grating-based design is a promising candidate for a laser-driven dielectric accelerator. Through simulations, we show the merits of a readily fabricated grating structure as an accelerating component. Additionally, we show that with a small design perturbation, the accelerating component can be converted into a focusing structure. The understanding of these two components is critical in the successful development of any complete accelerator. The concept of accelerating electrons with the tremendous electric fields found in lasers has been proposed for decades. However, until recently the realization of such an accelerator was not technologically feasible. Recent advances in the semiconductor industry, as well as advances in laser technology, have now made laser-driven dielectric accelerators imminent. The grating-based accelerator is one proposed design for a dielectric laser-driven accelerator. This design, which was introduced by Plettner, consists of a pair of opposing transparent binary gratings, illustrated in Fig. 1. The teeth of the gratings serve as a phase mask, ensuring a phase synchronicity between the electromagnetic field and the moving particles. The current grating accelerator design has the drive laser incident perpendicular to the substrate, which poses a laser-structure alignment complication. The next iteration of grating structure fabrication seeks to monolithically create an array of grating structures by etching the grating's vacuum channel into a fused silica wafer. With this method it is possible to have the drive laser confined to the plane of the wafer, thus ensuring alignment of the laser-and-structure, the two grating halves, and subsequent accelerator components. There has been previous work using 2-dimensional finite difference time domain (2D-FDTD) calculations to evaluate the performance of the grating accelerator structure. However, this work approximates the grating as an infinite structure and does not accurately model a

  5. 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

  6. Registered nurses' perceptions of their professional work in nursing homes and home-based care: a focus group study.

    Science.gov (United States)

    Carlson, Elisabeth; Rämgård, Margareta; Bolmsjö, Ingrid; Bengtsson, Mariette

    2014-05-01

    In Sweden, as well as in most industrialised countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialised in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care. The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work. This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analysed in line with the tradition of naturalistic inquiry. Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing. Three categories of professional work emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness. The findings are important as they represent positive alternatives to the somewhat prevailing view on elderly care as depressing and undemanding. Nurse educators might use the key aspects as good examples, thus influencing student nurses' attitudes towards elderly care in a positive way. Elderly care agencies might find them helpful when recruiting and retaining nurses to a much needed area. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. High-intensity focused ultrasound to treat primary hyperparathyroidism: a feasibility study in four patients

    DEFF Research Database (Denmark)

    Kovatcheva, Roussanka D; Vlahov, Jordan D; Shinkov, Alexander D

    2010-01-01

    Many patients with primary hyperparathyroidism either decline or are not candidates for surgical parathyroidectomy. There are drawbacks to medical therapy as well as percutaneous ethanol injection as alternative therapies for primary hyperparathyroidism. Therefore, in this pilot study, our aim...... was to test the feasibility, safety, and efficacy of a newly developed noninvasive high-intensity focused ultrasound (HIFU) technique for the nonsurgical management of primary hyperparathyroidism....

  8. Job Satisfaction in the Hospitality Industry Focus: Greece Case Study: Porto Carras Grand Resort

    OpenAIRE

    Salpisti, Elisavet

    2004-01-01

    This dissertation focuses on the notion of Job Satisfaction in the Hospitality Industry. The organisational single-case study has been chosen as a research method, with research taking place in Porto Carras Grand Resort in Northern Greece. The purpose of this research has been to demonstrate the importance of employee job satisfaction in the hospitality industry in particular, since the quality of its services is greatly subject to the 'human chemistry' between employees and customers. Job...

  9. Laser-enhanced cavitation during high intensity focused ultrasound: An in vivo study

    OpenAIRE

    Cui, Huizhong; Zhang, Ti; Yang, Xinmai

    2013-01-01

    Laser-enhanced cavitation during high intensity focused ultrasound (HIFU) was studied in vivo using a small animal model. Laser light was employed to illuminate the sample concurrently with HIFU radiation. The resulting cavitation was detected with a passive cavitation detector. The in vivo measurements were made under different combinations of HIFU treatment depths, laser wavelengths, and HIFU durations. The results demonstrated that concurrent light illumination during HIFU has the potentia...

  10. FCC-hh final-focus for flat-beams: parameters and energy deposition studies

    CERN Document Server

    AUTHOR|(CDS)2081283; Cruz Alaniz, Emilia; Seryi, Andrei; Van Riesen-Haupt, Leon; Besana, Maria Ilaria

    2017-01-01

    The international Future Circular Collider (FCC) study comprises the study of a new scientific structure in a tunnel of 100 km. This will allow the installation of two accelerators, a 45.6–175 GeV lepton collider and a 100-TeV hadron collider. An optimized design of a final-focus system for the hadron collider is presented here. The new design is more compact and enables unequal ${\\beta}$$^{∗}$ in both planes, whose choice is justified here. This is followed by energy deposition studies, where the total dose in the magnets as a consequence of the collision debris is evaluated.

  11. Species identification of smoked and gravad fish products by sodium dodecylsulphate polyacrylamide gel electrophoresis, urea isoelectric focusing and native isoelectric focusing : a collaborative study

    DEFF Research Database (Denmark)

    Mackie, I.; Craig, A.; Etienne, M.

    2000-01-01

    A collaborative study on the use of sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE), urea-isoelectric focusing (urea-IEF) and native isoelectric focusing for the identification of species of smoked salmonids, gravad salmonids and smoked eels was carried out by eight laborator......A collaborative study on the use of sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE), urea-isoelectric focusing (urea-IEF) and native isoelectric focusing for the identification of species of smoked salmonids, gravad salmonids and smoked eels was carried out by eight...... laboratories. With SDS-PAGE, minor changes took place in the profiles of the processed salmonid species making it impossible or Very difficult to identify closely related species. With urea-IEF, there were fewer changes in the profiles due to processing and the system generally had greater species......-discriminating power for the processed salmonids than SDS-PAGE. The profiles of the eel species as obtained on SDS-PAGE or urea-IEF were not affected by smoking. Urea-IEF had greater species- discriminating power than SDS-PAGE for the eel species. Native IEF was useful in providing supplementary identification...

  12. Feasibility study of a single-element transcranial focused ultrasound system for blood-brain barrier opening

    Science.gov (United States)

    Marquet, Fabrice; Tung, Yao-Sheng; Teichert, Tobias; Ferrera, Vincent P.; Konofagou, Elisa E.

    2012-10-01

    The blood-brain barrier (BBB) is a specialized vascular system that impedes entry of all large and the vast majority of small molecules including the most potent CNS disease therapeutic agents from entering from the lumen into the brain parenchyma. Microbubble-enhanced, focused ultrasound (ME-FUS) has been previously shown to disrupt noninvasively, selectively, and transiently the BBB in small animals in vivo. The study addresses the focusing properties of single-element transducers at intermediate frequencies (500 kHz) through primate and human skulls, targeting clinically relevant targets extracted from 3D brain atlases such as the hippocampus and the basal ganglia, which are typically affected by early Alzheimer's and Parkinson's disease, respectively. A preliminary in vivo study was performed to study the frequency dependence of BBB opening parameters in mice. Then, feasibility of transcranial ME-FUS BBB opening in non-human primates was demonstrated with subsequent BBB recovery. Sonications were combined with two different types of microbubbles (custom made 4-5 μm and Definity®). 3T MRI was used to confirm the BBB disruption and to assess brain damage.

  13. Study of neutron focusing at the Texas Cold Neutron Source. Final report

    International Nuclear Information System (INIS)

    Wehring, B.W.; Uenlue, K.

    1995-01-01

    Funds were received for the first year of a three year DOE Nuclear Engineering Research Grant, ''Study of Neutron Focusing at the Texas Cold Neutron Source'' (FGO2-92ER75711). The purpose of this three year study was to develop a neutron focusing system to be used with the Texas Cold Neutron Source (TCNS) to produce an intense beam of neutrons. A prompt gamma activation analysis (PGAA) facility was also to be designed, setup, and tested under the three year project. During the first year of the DOE grant, a new procedure was developed and used to design a focusing converging guide consisting of truncated rectangular cone sections. Detailed calculations were performed using a 3-D Monte Carlo code which we wrote to trace neutrons through the curved guide of the TCNS into the proposed converging guide. Using realistic reflectivities for Ni-Ti supermirrors, we obtained gains of 3 to 5 for the neutron flux averaged over an area of 1 x 1 cm

  14. Why parents refuse childhood vaccination: a qualitative study using online focus groups

    Science.gov (United States)

    2013-01-01

    Background In high income countries, vaccine-preventable diseases have been greatly reduced through routine vaccination programs. Despite this success, many parents question, and a small proportion even refuse vaccination for their children. As no qualitative studies have explored the factors behind these decisions among Dutch parents, we performed a study using online focus groups. Methods In total, eight online focus groups (n = 60) which included Dutch parents with at least one child, aged 0–4 years, for whom they refused all or part of the vaccinations within the National Immunization Program (NIP). A thematic analysis was performed to explore factors that influenced the parents’ decisions to refuse vaccination. Results Refusal of vaccination was found to reflect multiple factors including family lifestyle; perceptions about the child’s body and immune system; perceived risks of disease, vaccine efficacy, and side effects; perceived advantages of experiencing the disease; prior negative experience with vaccination; and social environment. The use of online focus groups proved to be an effective qualitative research method providing meaningful data. Conclusion Information provided by the NIP turned out to be insufficient for this group of parents. More trust in the NIP and deliberate decisions might result from increased parental understanding of lifestyle and disease susceptibility, the impact of vaccinations on the immune system, and the relative risks of diseases and their vaccines. The public health institute should also inform parents that the NIP is recommended but non-mandatory. PMID:24341406

  15. Entomological and epidemiological study of a new focus of cutaneous leishmaniasis in Morocco.

    Science.gov (United States)

    Ramaoui, K; Guernaoui, S; Boumezzough, A

    2008-09-01

    Cutaneous leishmaniasis (CL) due to Leishmania tropica Wright has become an increasingly important problem in Al-Haouz province, Morocco. The objective of this paper was to undertake a retrospective analysis of CL between 2000 and 2006 and to study the sandfly fauna for the first time in this focus. The consultation of bulletins, registers and monthly and annual reports published by local and national medical services permitted a global synthesis of CL in Al-Haouz between 2000 and 2006. Sandflies were collected using sticky-paper traps in five selected stations in two communes, Ourika and Sti Fadma, the most affected by CL in Al-Haouz. Overall, 2,648 sandflies, belonging to five species of Phlebotomus and three of Sergentomyia, were collected. Phlebotomus sergenti Parrot (14.5%) was found in all studied stations where it was associated with domestic and peridomestic habitats. Based on this first report on ecology of sandflies and epidemiology of CL, Al-Haouz seems to be a typical focus of L. tropica and P. sergenti like the other Moroccan foci. Two communes, Sti Fadma and Ourika, constituted an important CL micro-focus in this region. Considering their economical importance (trade and tourism), they contribute probably to the dissemination of Leishmania parasite in bordering regions.

  16. Pediatric Early Warning Score Systems, Nurses Perspective - A Focus Group Study

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Nielsen, Pia Bonde; Olesen, Hanne Vebert

    2018-01-01

    PURPOSE: Pediatric early warning score (PEWS) systems are used to monitor pediatric patients' vital signs and facilitate the treatment of patients at risk of deteriorating. The aim of this study was to gain knowledge about nurses' experiences with PEWS and to highlight factors facilitating...... and impeding the use of PEWS tools in clinical practice. DESIGN AND METHODS: An exploratory qualitative design was chosen using focus group interviews to gain a deeper understanding of nurses' experiences with PEWS. A total of five focus group interviews were conducted at three hospitals, and a qualitative......'s - a challenge, v) PEWS helps to visualize the need for escalating care, vi) an inflexible and challenging tool, and vii) supportive tools enhance the nurses' experiences of PEWS positively. CONCLUSIONS: Our findings suggest that attention should be given to nurses' perceptions of how both clinical judgment...

  17. Customer complaints as a source of customer-focused process improvement: A constructive case study

    Directory of Open Access Journals (Sweden)

    Uusitalo, K.,

    2008-01-01

    Full Text Available Process-based thinking commonly focuses on enhancing the efficiency of processes, while it is often criticized for not paying enough attention to the customer. This paper argues that customer complaint information can be used as a basis for customer-focused process improvement. Thus, it is not enough to make the complaining customer satisfied, but the complaint information should also feed back to the actual processes where the fault causing the complaint arose and where it can be removed. The empirical component of the study includes the development of a novel construction to utilize customer complaints for process improvements, which was implemented in a large Finnish enterprise operating in the wholesale logistics environment. The results show benefits at both operational and strategic levels.

  18. Radiotracer studies on protein metabolism in different focuses of growth in vivo

    International Nuclear Information System (INIS)

    Rapoport, E.A.; Konikova, A.S.

    1979-01-01

    The role of various components of protein turnover in the liver growth induced by partial hepatectomy or phenobarbital as well as in malignant tumours has been studied with a radiotracer method. The ratio of the utilized precursors of exo- and endogenous origin during the formation of protein in focuses of growth, is labile, depends on a number of factors and varies even in the subcellular structures of the cell nucleus. It is probable that due to their reutilization through transreactions the protein structural units have in some focuses of growth and during formation of some proteins a definite superiority over the free aminoacids. It is also shown that the release of proteins and their degradation products from Walker 256 carcinosarcoma and the reutilization of proteins and their degradation products by sarcoma M-1 contribute to the protein turnover in the tumours. 8author)

  19. How young people communicate risks of snowmobiling in northern Norway: a focus group study.

    Science.gov (United States)

    Mehus, Grete; Germeten, Sidsel; Henriksen, Nils

    2011-04-01

    This study aims to understand how the risks of snowmobiling are communicated among northern Norwegian youths. Study design. A qualitative design with focus group interviews was chosen. Interviews centred on safety precautions and estimation of risks related to snowmobiling and driving patterns. Eighty-one students (31 girls and 50 boys) aged between 16 and 23 years from 8 high schools were interviewed in 17 focus groups that were segregated by gender. Interview data were analysed using qualitative content analysis. Boys and girls communicated differently about risks. Peer-group conformity appeared stronger among boys than girls. Boys did not spontaneously relate risks to their snowmobile activities, while girls did. Boys focused upon training, coping and balance between control and lack of control while driving. Girls talked about risks, were aware of risks and sought to avoid risky situations, in contrast to boys. Boys' risk communication in groups was about how to manage challenging situations. Their focus overall was on trying to maintain control while simultaneously testing their limits. Three risk categories emerged: those who drive as they ought to (mostly girls), those who occasionally take some risks (boys and girls) and those who are extreme risk-takers (a smaller number of boys). Perceptions of and communication about risk are related to gender, peer group and familiarity with risk-taking when snowmobiling. Northern Norwegian boys' driving behaviour highlights a specific need for risk reduction, but this must also draw upon factors such as acceptance of social and cultural codes and common sense related to snowmobiling.

  20. 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.

  1. 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

  2. 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.

  3. Limbic system, the main focus of dementia syndrome; A study with MRI and PET

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzawa, Taiju [Morinosato Hospital, Atsugi, Kanagawa (Japan)

    1990-12-01

    Alzheimer disease and multi-infarct dementia are two entirely different diseases producing almost the same abnormalities as dementia syndrome. The statistical studies with MRI to locate the focus of dementia syndrome in the neocortex was an absolute failure. With MRI there is drastic atrophy and destruction of the amygdala and hippocampus suggesting the limbic system as the focus of dementia syndrome. Destruction of the limbic system in particular amygdala and hippocampus produced the functional obstruction brought about by the marked reduction in the glucose utilization with PET in the bilateral temporal, parietal and occipital association cortices. Although this type constitutes only about 1/5 of all dementia patients. It is considered the fundamental type of dementia syndrome. Aside from this, there is a type wherein simultaneous and symmetrical reductions in glucose utilization of the frontal association cortex and the motor association cortex in the anterior part of the neocortex. This is referred to as type II. It constitutes about 4/5 of all dementia patients which is far more than type I. Based on these results, it is thought that limbic system is the main focus of dementia syndrome. (author).

  4. Implementing evidence-based medicine in general practice: a focus group based study

    Directory of Open Access Journals (Sweden)

    Aertgeerts Bert

    2005-09-01

    Full Text Available Abstract Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice, commercial and consumer organisations on the meso-level (institutions, organisations and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community. Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed.

  5. Iodine and Pregnancy—A Qualitative Study Focusing on Dietary Guidance and Information

    Directory of Open Access Journals (Sweden)

    Maria Bouga

    2018-03-01

    Full Text Available Iodine is essential for thyroid hormones synthesis and normal neurodevelopment; however, ~60% of pregnant women do not meet the WHO (World Health Organization recommended intake. Using a qualitative design, we explored the perceptions, awareness, and experiences of pregnancy nutrition, focusing on iodine. Women in the perinatal period (n = 48 were interviewed and filled in a food frequency questionnaire for iodine. Almost all participants achieved the recommended 150 μg/day intake for non-pregnant adults (99%, but only 81% met the increased demands of pregnancy (250 μg/day. Most were unaware of the importance, sources of iodine, and recommendations for iodine intake. Attitudes toward dairy products consumption were positive (e.g., helps with heartburn; easy to increase. Increased fish consumption was considered less achievable, with barriers around taste, smell, heartburn, and morning sickness. Community midwives were the main recognised provider of dietary advice. The dietary advice received focused most often on multivitamin supplements rather than food sources. Analysis highlighted a clear theme of commitment to change behaviour, motivated by pregnancy, with a desired focus on user-friendly documentation and continued involvement of the health services. The study highlights the importance of redirecting advice on dietary requirements in pregnancy and offers practical suggestions from women in the perinatal period as the main stakeholder group.

  6. The Bobath concept in stroke rehabilitation: a focus group study of the experienced physiotherapists' perspective.

    Science.gov (United States)

    Lennon, S; Ashburn, A

    2000-10-15

    The Bobath concept, usually known as neuro-developmental treatment (NDT) in America, is one of the major approaches used to rehabilitate patients following stroke; however since the last publication of Bobath (1990), the concept has been taught via an oral tradition on postgraduate courses. This study therefore aimed to explore with experienced therapists firstly how the Bobath concept had changed since 1990, and secondly what they considered its main theoretical assumptions to be using a focus group research design. Eight peer-nominated expert physiotherapists agreed to participate in two focus groups organized according to specialist interest in either neurology (group A) or elderly care (group B). Therapists were asked to discuss six topics based on a review of published literature. Data analysis involved several readings of verbatim transcriptions, from which key themes and concepts were developed. All therapists agreed on the following core themes defining Bobath: analysis of normal movement, control of tone and facilitation of movement. Neuroplasticity was described as the primary rationale for treatment with therapists using afferent information to target the damaged central nervous system. In addition group A discussed motor learning, whereas group B discussed patient focused goals and relating treatment to function. This study highlighted changes in theory, terminology, and techniques. Tone remained a major problem in the rehabilitation management of the hemiplegic patient; however much attention was also directed towards the musculoskeletal system. Both facilitation of normal movement components and task specific practice using specific manual guidance were considered critical elements of the Bobath concept. For Bobath therapists, physiotherapy has an important impact on both the performance components of movement and functional outcomes. In view of the small numbers involved in this preliminary study, further studies are now needed to determine if these

  7. Focusing on the Golden Ball Metaheuristic: An Extended Study on a Wider Set of Problems

    Directory of Open Access Journals (Sweden)

    E. Osaba

    2014-01-01

    Full Text Available Nowadays, the development of new metaheuristics for solving optimization problems is a topic of interest in the scientific community. In the literature, a large number of techniques of this kind can be found. Anyway, there are many recently proposed techniques, such as the artificial bee colony and imperialist competitive algorithm. This paper is focused on one recently published technique, the one called Golden Ball (GB. The GB is a multiple-population metaheuristic based on soccer concepts. Although it was designed to solve combinatorial optimization problems, until now, it has only been tested with two simple routing problems: the traveling salesman problem and the capacitated vehicle routing problem. In this paper, the GB is applied to four different combinatorial optimization problems. Two of them are routing problems, which are more complex than the previously used ones: the asymmetric traveling salesman problem and the vehicle routing problem with backhauls. Additionally, one constraint satisfaction problem (the n-queen problem and one combinatorial design problem (the one-dimensional bin packing problem have also been used. The outcomes obtained by GB are compared with the ones got by two different genetic algorithms and two distributed genetic algorithms. Additionally, two statistical tests are conducted to compare these results.

  8. Focusing on the Golden Ball Metaheuristic: An Extended Study on a Wider Set of Problems

    Science.gov (United States)

    Osaba, E.; Diaz, F.; Carballedo, R.; Onieva, E.; Perallos, A.

    2014-01-01

    Nowadays, the development of new metaheuristics for solving optimization problems is a topic of interest in the scientific community. In the literature, a large number of techniques of this kind can be found. Anyway, there are many recently proposed techniques, such as the artificial bee colony and imperialist competitive algorithm. This paper is focused on one recently published technique, the one called Golden Ball (GB). The GB is a multiple-population metaheuristic based on soccer concepts. Although it was designed to solve combinatorial optimization problems, until now, it has only been tested with two simple routing problems: the traveling salesman problem and the capacitated vehicle routing problem. In this paper, the GB is applied to four different combinatorial optimization problems. Two of them are routing problems, which are more complex than the previously used ones: the asymmetric traveling salesman problem and the vehicle routing problem with backhauls. Additionally, one constraint satisfaction problem (the n-queen problem) and one combinatorial design problem (the one-dimensional bin packing problem) have also been used. The outcomes obtained by GB are compared with the ones got by two different genetic algorithms and two distributed genetic algorithms. Additionally, two statistical tests are conducted to compare these results. PMID:25165742

  9. Doctors' learning experiences in end-of-life care - a focus group study from nursing homes.

    Science.gov (United States)

    Fosse, Anette; Ruths, Sabine; Malterud, Kirsti; Schaufel, Margrethe Aase

    2017-01-31

    Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors' learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death. House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger's theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home's community of practice. Newly qualified doctors explained how nursing home staff's attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members' hope and trust, they learnt how to adjust words and decisions according to family and patient's life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance. There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.

  10. Treatment of near-skull brain tissue with a focused device using shear-mode conversion: a numerical study

    International Nuclear Information System (INIS)

    Pichardo, Samuel; Hynynen, Kullervo

    2007-01-01

    Shear mode transmission through the skull has been previously proposed as a new trans-skull propagation technique for noninvasive therapeutic ultrasound (Clement 2004 J. Acoust. Soc. Am. 115 1356-64). The main advantage of choosing shear over longitudinal mode resides on the fact that there is less wavefront distortion with the former. In the present study, the regions of the brain suitable for shear-mode transmission were established for a simple focused ultrasound device. The device consists of a spherically curved transducer that has a focal length of 10 cm, an aperture between 30 0 and 60 0 and operates at 0.74 MHz. The regions suitable for shear-mode transmission were determined by the shear wave acoustic windows that matched the shape of the device acoustic field. The acoustic windows were calculated using segmentation and triangulation of outer and inner faces of skull from 3D-MRI head datasets. Nine heads of healthy adults were analyzed. The surface considered for the calculations was the head region found above the supra-orbital margin. For every inspected point in the brain volume, the axis of the device was determined by the vector between this inspection point and a point located in the center of the brain. Numerical predictions of the acoustic field, where shear-mode conversion through the skull was considered, were obtained and compared to the case of water-only conditions. The brain tissue that is close to the skull showed suitable acoustic windows for shear waves. The central region of the brain seems to be unreachable using shear-mode. Analysis of the acoustic fields showed a proportional relation between the acoustic window for shear mode and the effective degree of focusing. However, this relation showed significant differences among specimens. In general, highly focused fields were obtained when the acoustic window for shear waves (A SW ) intersected more than 67% of the entering acoustic window (A TX ) of the device. The average depth from the

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Simulation of complex data structures for planning of studies with focus on biomarker comparison.

    Science.gov (United States)

    Schulz, Andreas; Zöller, Daniela; Nickels, Stefan; Beutel, Manfred E; Blettner, Maria; Wild, Philipp S; Binder, Harald

    2017-06-13

    There are a growing number of observational studies that do not only focus on single biomarkers for predicting an outcome event, but address questions in a multivariable setting. For example, when quantifying the added value of new biomarkers in addition to established risk factors, the aim might be to rank several new markers with respect to their prediction performance. This makes it important to consider the marker correlation structure for planning such a study. Because of the complexity, a simulation approach may be required to adequately assess sample size or other aspects, such as the choice of a performance measure. In a simulation study based on real data, we investigated how to generate covariates with realistic distributions and what generating model should be used for the outcome, aiming to determine the least amount of information and complexity needed to obtain realistic results. As a basis for the simulation a large epidemiological cohort study, the Gutenberg Health Study was used. The added value of markers was quantified and ranked in subsampling data sets of this population data, and simulation approaches were judged by the quality of the ranking. One of the evaluated approaches, the random forest, requires original data at the individual level. Therefore, also the effect of the size of a pilot study for random forest based simulation was investigated. We found that simple logistic regression models failed to adequately generate realistic data, even with extensions such as interaction terms or non-linear effects. The random forest approach was seen to be more appropriate for simulation of complex data structures. Pilot studies starting at about 250 observations were seen to provide a reasonable level of information for this approach. We advise to avoid oversimplified regression models for simulation, in particular when focusing on multivariable research questions. More generally, a simulation should be based on real data for adequately reflecting

  16. Simulation of complex data structures for planning of studies with focus on biomarker comparison

    Directory of Open Access Journals (Sweden)

    Andreas Schulz

    2017-06-01

    Full Text Available Abstract Background There are a growing number of observational studies that do not only focus on single biomarkers for predicting an outcome event, but address questions in a multivariable setting. For example, when quantifying the added value of new biomarkers in addition to established risk factors, the aim might be to rank several new markers with respect to their prediction performance. This makes it important to consider the marker correlation structure for planning such a study. Because of the complexity, a simulation approach may be required to adequately assess sample size or other aspects, such as the choice of a performance measure. Methods In a simulation study based on real data, we investigated how to generate covariates with realistic distributions and what generating model should be used for the outcome, aiming to determine the least amount of information and complexity needed to obtain realistic results. As a basis for the simulation a large epidemiological cohort study, the Gutenberg Health Study was used. The added value of markers was quantified and ranked in subsampling data sets of this population data, and simulation approaches were judged by the quality of the ranking. One of the evaluated approaches, the random forest, requires original data at the individual level. Therefore, also the effect of the size of a pilot study for random forest based simulation was investigated. Results We found that simple logistic regression models failed to adequately generate realistic data, even with extensions such as interaction terms or non-linear effects. The random forest approach was seen to be more appropriate for simulation of complex data structures. Pilot studies starting at about 250 observations were seen to provide a reasonable level of information for this approach. Conclusions We advise to avoid oversimplified regression models for simulation, in particular when focusing on multivariable research questions. More generally

  17. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...... of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from...

  18. E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views

    OpenAIRE

    Hilton, Shona; Weishaar, Heide; Sweeting, Helen; Trevisan, Filippo; Katikireddi, Srinivasa Vital

    2016-01-01

    Objective: Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them.\\ud \\ud Design: 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14–17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analys...

  19. Factors influencing the development of end-of-life communication skills: A focus group study of nursing and medical students.

    Science.gov (United States)

    Gillett, Karen; O'Neill, Bernadette; Bloomfield, Jacqueline G

    2016-01-01

    Poor communication between health care professionals and dying patients and their families results in complaints about end-of-life care. End-of-life communication skills should be a core part of nursing and medical education but research suggests that qualified doctors and nurses find this a challenging area of practice. The aim of this study was to explore factors influencing the development of end-of-life communication skills by nursing and medical students. A qualitative study comprising five focus groups. Second year undergraduate nursing (n=9 across 2 focus groups) and fourth year undergraduate medical students (n=10 across 3 focus groups) from a London University. Barriers and facilitators influenced nursing and medical students' experience of communication with dying patients and their families in clinical practice. Extrinsic barriers included gatekeeping by qualified staff and lack of opportunity to make sense of experiences through discussion. Intrinsic barriers included not knowing what to say, dealing with emotional responses, wasting patients' time, and concerns about their own ability to cope with distressing experiences. Facilitating factors included good role models, previous experience, and classroom input. In addition to clinical placements, formal opportunities for reflective discussion are necessary to facilitate the development of students' confidence and skills in end-of-life communication. For students and mentors to view end-of-life communication as a legitimate part of their learning it needs to be specified written practice-learning outcome. Mentors and supervisors may require training to enable them to facilitate students to develop end-of-life communication skills. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. High-Intensity Focused Ultrasound (HIFU) in Uterine Fibroid Treatment: Review Study

    International Nuclear Information System (INIS)

    Mahmoud, Mustafa Z.; Alkhorayef, Mohammed; Alzimami, Khalid S.; Aljuhani, Manal Saud; Sulieman, Abdelmoneim

    2014-01-01

    High-intensity focused ultrasound (HIFU) is a highly precise medical procedure used locally to heat and destroy diseased tissue through ablation. This study intended to review HIFU in uterine fibroid therapy, to evaluate the role of HIFU in the therapy of leiomyomas as well as to review the actual clinical activities in this field including efficacy and safety measures beside the published clinical literature. An inclusive literature review was carried out in order to review the scientific foundation, and how it resulted in the development of extracorporeal distinct devices. Studies addressing HIFU in leiomyomas were identified from a search of the Internet scientific databases. The analysis of literature was limited to journal articles written in English and published between 2000 and 2013. In current gynecologic oncology, HIFU is used clinically in the treatment of leiomyomas. Clinical research on HIFU therapy for leiomyomas began in the 1990s, and the majority of patients with leiomyomas were treated predominantly with HIFUNIT 9000 and prototype single focus ultrasound devices. HIFU is a non-invasive and highly effective standard treatment with a large indication range for all sizes of leiomyomas, associated with high efficacy, low operative morbidity and no systemic side effects. Uterine fibroid treatment using HIFU was effective and safe in treating symptomatic uterine fibroids. Few studies are available in the literature regarding uterine artery embolization (UAE). HIFU provides an excellent option to treat uterine fibroids

  1. Electronic Commerce and Market Focus: some findings from a study of Swedish small to medium enterprises

    Directory of Open Access Journals (Sweden)

    Lejla Vrazalic

    2002-11-01

    Full Text Available In the past, organisations relied on traditional quantitative metrics, such as return on investment (ROI to make decisions when investing in technology. With the advent of electronic commerce (EC, these decisions are becoming less reliant on ROI measures. Instead different driving forces are taking precedence in the decision making process. This paper presents the findings of a study of 118 Swedish small to medium enterprises (SMEs that have adopted EC. The results of the study suggest that improvements to customer service, internal efficiency and organisational competitiveness have become equally important when making EC investment decisions. The study also examined whether major market focus (local, regional, national or international had an influence on the organisation’s decision to adopt EC. Findings indicate no associations between the market focus and the driving forces, however the existence of a fully developed plan for EC adoption and the size of the business were found to be highly associated with the development of new markets as an EC adoption criteria.

  2. 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.

  3. 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)

  4. Using archetypes to create user panels for usability studies: Streamlining focus groups and user studies.

    Science.gov (United States)

    Stavrakos, S-K; Ahmed-Kristensen, S; Goldman, T

    2016-09-01

    Designers at the conceptual phase of products such as headphones, stress the importance of comfort, e.g. executing comfort studies and the need for a reliable user panel. This paper proposes a methodology to issue a reliable user panel to represent large populations and validates the proposed framework to predict comfort factors, such as physical fit. Data of 200 heads was analyzed by forming clusters, 9 archetypal people were identified out of a 200 people's ear database. The archetypes were validated by comparing the archetypes' responses on physical fit against those of 20 participants interacting with 6 headsets. This paper suggests a new method of selecting representative user samples for prototype testing compared to costly and time consuming methods which relied on the analysis of human geometry of large populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Health care as perceived by persons with inflammatory bowel disease - a focus group study.

    Science.gov (United States)

    Lesnovska, Katarina Pihl; Hollman Frisman, Gunilla; Hjortswang, Henrik; Hjelm, Katarina; Börjeson, Sussanne

    2017-11-01

    The aim of this study was to explore the perceptions of health care among persons living with inflammatory bowel disease. The quality of care plays an important role in the life of persons with a chronic disease. To define what persons with inflammatory bowel disease perceive as high-quality care, greater focus must be placed on the individual's own perspective of living with the condition. A qualitative exploratory study was conducted based on focus groups. Five focus groups were conducted with adult persons living with inflammatory bowel disease, 14 men and 12 women aged 19-76 years. The interviews were performed between January-June 2014. The perceptions of health care from the perspective of persons living with inflammatory bowel disease were summarised in two categories: 'professional attitudes of healthcare staff' and 'structure of the healthcare organisation'. Persons with inflammatory bowel disease want to be encountered with respect, experience trust and obtain information at the right time. They also expect shared decision-making, communication and to encounter competent healthcare professionals. Furthermore, the expectations on and perceptions of the structure of the healthcare organisation comprise access to care, accommodation, continuity of care, as well as the pros and cons of specialised care. The findings show the importance of establishing a respectful and trusting relationship, facilitating healthcare staff and persons with inflammatory bowel disease to work as a team in fulfilling individual care needs - but there is room for improvement in terms of quality of care. A person-centred approach, which places the individual and her/his family at the centre, considering them experts on their own health and enabling them to collaborate with healthcare staff, seems important to reach a high-quality healthcare organisation for patients with Inflammatory bowel disease. © 2017 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

  6. Focus on Formative Feedback communication and self-regulated learning – a study in compulsory schools

    DEFF Research Database (Denmark)

    Kirkegaard, Preben Olund

    This study addresses the conceptual challenge of providing students in compulsory schools with good quality formative feedback to enhance self-regulated learning in social interactions. Resent educational research indicates that social communicative interactions in the classroom, with a focus...... qualitative data from video recorded teaching sessions and student group interviews. Methodologically we are inspired by the ethnographical classroom research method. The empirical basis for studying these aspects is data from two compulsory schools in Denmark. This study is a work in progress. Our findings...... on formative feedback, hold the potential to enhance students learning. Self-regulated learning is highly pertinent and can be seen as one of the most import skills for the 21st century learner. We argue that formative feedbackcommunication in interactions is crucial for students to develop self...

  7. Learning to create new solutions together: A focus group study exploring interprofessional innovation in midwifery education.

    Science.gov (United States)

    Johnsen, Helle

    2016-01-01

    Undergraduate students can learn how to be innovative in partnerships with health care institutions and private enterprises. This study portrays how a three phase innovation model was applied in an interprofessional health education context at a Danish university college. The aim of the study was to explore midwifery, nutrition and health as well physiotherapy students' perceptions of participating in a real-life innovation project situated in antenatal care. A total of eighteen students participated in five focus group interviews. Thematic analysis was used to interpret data findings. Data analysis revealed three themes: 'Navigating in uncertainty', 'Being part of a team' and 'Impact of project learning'. Students found project learning to be the most relevant with regards to their clinical practice. Furthermore, study findings suggest that innovation is promoted by teamwork, interprofessional participation, mentor support and external partnerships. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Recovering Process from Child Sexual Abuse During Adulthood from an Integrative Approach to Solution-Focused Therapy: A Case Study.

    Science.gov (United States)

    Gonzalez, Carolina

    2017-10-01

    In recent times, strengths-based recovery approaches that focus on the present and build strategies that look toward the future have become popular. However, some cases require the consideration of experiences from previous stages of the clients' development. This single-case study explores the psychotherapeutic process of a middle-aged woman who presented with a history of child sexual abuse (incest) and a long-term adult diagnosis of depression that was treated in public health services. This psychotherapy involved an integrative approach to solution-focused therapy; specifically, the approach proposed by Yvonne Dolan to work with adult survivors of sexual abuse, in conjunction with techniques and strategies from the transtheoretical model. Measures incorporating therapeutic working alliance and outcomes were administered over sessions. Results showed positive outcomes from this therapeutic intervention, which remained at 3-month and 12-month follow-ups. Implications for practitioners' specialist practice in health services are discussed, given the complexity of comorbid mental health conditions with a history of child sexual abuse.

  9. Consumer attitudes about opioid addiction treatment: a focus group study in New York City.

    Science.gov (United States)

    Sohler, Nancy L; Weiss, Linda; Egan, James E; López, Carolina M; Favaro, Jamie; Cordero, Robert; Cunningham, Chinazo O

    2013-01-01

    To develop effective programs for people who are opioid dependent and to impact the opioid epidemic in New York City, it is crucial to monitor attitudes about opioid addiction treatments among opioid users who have experienced barriers to engagement and retention in addiction treatment. The authors conducted a qualitative study using focus groups. Six focus groups in three needle exchanges in New York City were audio recorded, transcribed, and systematically coded. The authors report on the main themes related to the study objectives. Participants of each needle exchange who were opioid dependent and had some knowledge of both methadone and buprenorphine were eligible. There were four main findings. Participants felt the following: 1) buprenorphine is an appropriate option for those heroin users who are motivated to stop using, 2) they have less control over their addiction treatment with methadone than they would have with buprenorphine, 3) buprenorphine treatment is not accessible to many New York City residents who would benefit from this treatment, and 4) lack of access to buprenorphine treatment is a cause of treatment-related diversion. Both methadone maintenance and buprenorphine treatment opportunities are necessary to address the diverse treatment needs of opioid-dependent people in New York City. However, the current medical model of buprenorphine treatment may be too restrictive for some opioid-dependent people and may be contributing to the use of illicit buprenorphine. New models to deliver buprenorphine treatment may address these problems.

  10. Palliative sedation: a focus group study on the experiences of relatives.

    Science.gov (United States)

    Bruinsma, Sophie; Rietjens, Judith; van der Heide, Agnes

    2013-04-01

    Most studies that have investigated the practice of palliative sedation have focused on physicians' practices and attitudes. The aim of this study was to explore relatives' experiences with palliative sedation and to gain more insight in positive and negative elements in their evaluation of palliative sedation. Focus groups and individual interviews. Various care settings in the Netherlands. A total of 14 relatives of patients who received palliative sedation until death participated. Most relatives evaluated the provision of palliative sedation of their dying family member positively. Positive experiences were related to: the beneficial impact of palliative sedation on the patient's suffering, the opportunity that was offered to prepare for the patient's death, their involvement in the decision-making and care for the patient, and the pleasant care environment. However, the majority of the relatives were unsatisfied with one or more aspects of how information was being provided for. Some relatives were frustrated about the fact that nurses were not authorized to make decisions about the care for the patient and about the absence of physicians during weekends. None of the relatives mentioned the loss of the ability to communicate with the patient during the sedation and the possibility of "hastening death" as disadvantages of palliative sedation. Relatives tend to evaluate the provision of palliative sedation to their severely suffering family member positively because it contributes to a peaceful dying process. However, relatives indicated discontent with how information was being provided and with the communication in general.

  11. The perception of injury risk and safety in triathlon competition: an exploratory focus group study.

    Science.gov (United States)

    Gosling, Cameron McR; Donaldson, Alex; Forbes, Andrew B; Gabbe, Belinda J

    2013-01-01

    To explore stakeholder perceptions of triathlon competition safety and injury risk. Qualitative focus group study. Triathlon stakeholders from Melbourne, Australia. Competition organizers, coaches, and competitors of various skill levels, age, gender, and experience (n = 18). Focus groups were conducted, recorded, and transcribed for analysis. Key themes were identified using content analysis. The perceived risk of serious injury was highest for cycling. Running was most commonly linked to minor injuries. Physical and environmental factors, including course turning points, funneling of competitors into narrow sections, and the weather, were perceived as contributing to injury. Experience, skill level, feelings of vulnerability, personal awareness, club culture, and gender issues were perceived as the competitor-related factors potentially contributing to injury. The cycling mount/dismount area, cycling, and swim legs were the race sections perceived as the riskiest for competitors. Competition organizers were considered to generally have the competitors' best interest as a priority. Triathlons were acknowledged as risky activities and individual competitors accepted this risk. This study has highlighted the main risks and concerns perceived by triathlon competitors, coaches, and competition organizers, which will help identify potential, context-relevant intervention strategies to reduce injury risk.

  12. 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.

  13. 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

  14. 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.

  15. 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).

  16. Improving recruitment to pharmacological trials for illicit opioid use: findings from a qualitative focus group study.

    Science.gov (United States)

    Neale, Joanne; Tompkins, Charlotte N E; McDonald, Rebecca; Strang, John

    2018-06-01

    To explore potential study participants' views on willingness to join clinical trials of pharmacological interventions for illicit opioid use to inform and improve future recruitment strategies. Qualitative focus group study [six groups: oral methadone (two groups); buprenorphine tablets (two groups); injectable opioid agonist treatment (one group); and former opioid agonist treatment (one group)]. Drug and alcohol services and a peer support recovery service (London, UK). Forty people with experience of opioid agonist treatment for heroin dependence (26 males, 14 females; aged 33-66 years). Data collection was facilitated by a topic guide that explored willingness to enrol in clinical pharmacological trials. Groups were audio-recorded and transcribed. Transcribed data were analysed inductively via Iterative Categorization. Participants' willingness to join pharmacological trials of medications for opioid dependence was affected by factors relating to study burden, study drug, study design, study population and study relationships. Participants worried that the trial drug might be worse than, or interfere with, their current treatment. They also misunderstood aspects of trial design despite the researchers' explanations. Recruitment of participants for clinical trials of pharmacological interventions for illicit opioid use could be improved if researchers became better at explaining clinical trials to potential participants, dispelling misconceptions about trials and increasing trust in the research process and research establishment. A checklist of issues to consider when designing pharmacological trials for illicit opioid use is proposed. © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  17. 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

  18. Knowledge deficit of patients with stage 1-4 CKD: a focus group study.

    Science.gov (United States)

    Lopez-Vargas, Pamela A; Tong, Allison; Phoon, Richard K S; Chadban, Steven J; Shen, Yvonne; Craig, Jonathan C

    2014-04-01

    Patients with early-stage chronic kidney disease (CKD) must make lifestyle modifications and adhere to treatment regimens to prevent their progression to end-stage kidney disease. The aim of this study was to elicit the perspectives of patients with stage 1-4 CKD about their disease, with a specific focus on their information needs in managing and living with CKD and its sequelae. Patients with CKD stages 1-4 were purposively sampled from three major hospitals in Sydney, Australia to participate in focus groups. Transcripts were thematically analysed. From nine focus groups including 38 participants, six major themes were identified: medical attentiveness (shared decision-making, rapport, indifference and insensitivity); learning self-management (diet and nutrition, barriers to physical activity, medication safety); contextualizing comorbidities (prominence of CKD, contradictory treatment); prognostic uncertainty (hopelessness, fear of disease progression, disbelief regarding diagnosis); motivation and coping mechanisms (engage in research, pro-active management, optimism, feeling normal); and knowledge gaps (practical advice, access to information, comprehension of pathology results and CKD diagnosis, education for general practitioners). Patients capacity to slow the progression of CKD may be limited by their lack of knowledge about the disease, its comorbidities, psychosocial influences and their ability to interact and communicate effectively with their health-care provider. Support from a multidisciplinary care team, combined with provision of comprehensive, accessible and practical educational resources may enhance patients' ability and motivation to access and adhere to therapeutic and lifestyle interventions to retard progression of CKD. © 2014 Asian Pacific Society of Nephrology.

  19. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

    Directory of Open Access Journals (Sweden)

    Kaberi Dasgupta

    Full Text Available OBJECTIVE: We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2 prevention program. RESEARCH DESIGN AND METHODS: Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. RESULTS: Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. CONCLUSIONS: Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  20. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

    Science.gov (United States)

    Dasgupta, Kaberi; Da Costa, Deborah; Pillay, Sabrina; De Civita, Mirella; Gougeon, Réjeanne; Leong, Aaron; Bacon, Simon; Stotland, Stephen; Chetty, V Tony; Garfield, Natasha; Majdan, Agnieszka; Meltzer, Sara

    2013-01-01

    We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM) diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2) prevention program. Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  1. GPs' perspectives on preventive care for older people: a focus group study.

    Science.gov (United States)

    Drewes, Yvonne M; Koenen, Julia M; de Ruijter, Wouter; van Dijk-van Dijk, D J Annemarie; van der Weele, Gerda M; Middelkoop, Barend J C; Reis, Ria; Assendelft, Willem J J; Gussekloo, Jacobijn

    2012-11-01

    Preventive care traditionally aims to prevent diseases or injuries. For older people, different aims of prevention, such as maintenance of independence and wellbeing, are increasingly important. To explore GPs' perspectives on preventive care for older people. Qualitative study comprising six focus groups with GPs in the Netherlands. The focus-group discussions with 37 GPs were analysed using the framework analysis method. Whether or not to implement preventive care for older people depends on the patient's individual level of vitality, as perceived by the GP. For older people with a high level of vitality, GPs confine their role to standardised disease-oriented prevention on a patient's request; when the vitality levels in older people fall, the scope of preventive care shifts from prevention of disease to prevention of functional decline. For older, vulnerable people, GPs expect most benefit from a proactive, individualised approach, enabling them to live as independently as possible. Based on these perspectives, a conceptual model for preventive care was developed, which describes GPs' different perspectives toward older people who are vulnerable and those with high levels of vitality. It focuses on five main dimensions: aim of care (prevention of disease versus prevention of functional decline), concept of care (disease model versus functional model), initiator (older persons themselves versus GP), target groups (people with requests versus specified risk groups), and content of preventive care (mainly cardiovascular risk management versus functional decline). GPs' perspectives on preventive care are determined by their perception of the level of vitality of their older patients. Preventive care for older people with high levels of vitality may consist of a standardised disease-oriented approach; those who are vulnerable will need an individualised approach to prevent functional decline.

  2. Therapist competencies necessary for the delivery of compassion-focused therapy: A Delphi study.

    Science.gov (United States)

    Liddell, Alice E; Allan, Steven; Goss, Ken

    2017-06-01

    Compassion-focused therapy (CFT) has shown promising results for a range of clinical presentations. This study explored the therapeutic competencies required to deliver CFT and organized these into a coherent framework. The Delphi method was used to explore and refine competencies for delivering CFT in three rounds of data collection. The first round involved interviews with 12 experts in CFT. Data were analysed using template analysis to generate a draft competency framework. The main competencies were used to create a survey for rounds two and three involving CFT experts and practitioners. Data collected from the surveys were used to refine the competencies. The CFT competency framework (CFT-CF) that was produced comprised 25 main competencies within six key areas of competence. The areas were as follows: competencies in creating safeness, meta-skills, non-phase-specific skills, phase-specific skills, knowledge and understanding and use of supervision. The main competencies included several subcompetencies specifying knowledge, skills and attributes needed to demonstrate the main competence. Overall, there was consensus on 14 competencies and 20 competencies exceeded an 80% agreement level. Some of the CFT competencies overlapped with existing therapies, whilst others were specific to CFT. The CFT-CF provides useful guidance for clinicians, supervisors and training programmes. Further research could develop the CFT-CF into a therapist rating scale in order to measure the outcome of training and to assess treatment fidelity in clinical trials. The compassion-focused therapy competency framework (CFT-CF) identifies therapeutic competencies that overlap with existing treatments as well as those specific to compassion-focused therapy (CFT). The CFT-CF builds guidance for the competencies required to deliver CFT in a range of clinical settings. The CFT-CF provides guidance for those training CFT therapists. The CFT-CF could be used as a basis to develop a therapist

  3. The postoperative handover: a focus group interview study with nurse anaesthetists, anaesthesiologists and PACU nurses.

    Science.gov (United States)

    Randmaa, Maria; Engström, Maria; Swenne, Christine Leo; Mårtensson, Gunilla

    2017-08-04

    To investigate different professionals' (nurse anaesthetists', anaesthesiologists', and postanaesthesia care unit nurses') descriptions of and reflections on the postoperative handover. A focus group interview study with a descriptive design using qualitative content analysis of transcripts. One anaesthetic clinic at two hospitals in Sweden. Six focus groups with 23 healthcare professionals involved in postoperative handovers. Each group was homogeneous regarding participant profession, resulting in two groups per profession: nurse anaesthetists (n=8), anaesthesiologists (n=7) and postanaesthesia care unit nurses (n=8). Patterns and five categories emerged: (1) having different temporal foci during handover, (2) insecurity when information is transferred from one team to another, (3) striving to ensure quality of the handover, (4) weighing the advantages and disadvantages of the bedside handover and (5) having different perspectives on the transfer of responsibility. The professionals' perceptions of the postoperative handover differed with regard to temporal foci and transfer of responsibility. All professional groups were insecure about having all information needed to ensure the quality of care. They strived to ensure quality of the handover by: focusing on matters that deviated from the normal course of events, aiding memory through structure and written information and cooperating within and between teams. They reported that the bedside handover enhances their control of the patient but also that it could threaten the patient's privacy and that frequent interruptions could be disturbing. The present findings revealed variations in different professionals' views on the postoperative handover. Healthcare interventions are needed to minimise the gap between professionals' perceptions and practices and to achieve a shared understanding of postoperative handover. Furthermore, to ensure high-quality and safe care, stakeholders/decision makers need to pay attention

  4. Perspectives of Mobile Versus Fixed Mammography in Santa Clara County, California: A Focus Group Study.

    Science.gov (United States)

    Chen, Yi-Ren; Chang-Halpenny, Christine; Kumarasamy, Narmadan A; Venegas, Angela; Braddock Iii, Clarence H

    2016-02-12

    Our aim was to examine underserved women's perceptions on mobile versus fixed mammography in Santa Clara, California through a focus group study.  Research has shown that medically underserved women have higher breast cancer mortality rates correlated with under-screening and a disproportional rate of late-stage diagnosis. The Community Health Partnership in Santa Clara County, California runs the Community Mammography Access Project (CMAP) that targets nearly 20,000 medically underserved women over the age of 40 in the county through the collaborative effort of an existing safety net of healthcare providers. However, little data exists on the advantages or disadvantages of mobile mammography units from the patient perspective.   We assessed underserved women's perspectives on mammography services in Santa Clara County through two focus groups from women screened at mobile or fixed site programs. Patients were recruited from both CMAP clinics and a county hospital, and focus group data were analyzed using content analysis.  We found that women from both the mobile and fixed sites shared similar motivating factors for getting a mammogram. Both groups recognized that screening was uncomfortable but necessary for good health and had positive feedback about their personal physicians. However, mobile participants, in particular, appreciated the atmosphere of mobile screening, reported shorter wait times, and remarked on the good communication from the clinic staff and empathetic treatment they received. However, mobile participants also expressed concern about the quality of films at mobile sites due to delayed initial reading of the films.   Mobile mammography offers a unique opportunity for women of underserved populations to access high satisfaction screenings, and it encourages a model similar to CMAP in other underserved areas. However, emphasis should be placed on providing a warm and welcoming environment for patients and ensuring the quality of

  5. Coaching and Mentoring as a Tool for Internal Customer Focus: A Regional Study in Sao Paulo

    Directory of Open Access Journals (Sweden)

    Graziela Oste Graziano

    2014-03-01

    Full Text Available The research had as objective identifies the dimensions involved in the implementation of Coaching, for the manager's performance as manager close to your team, in real situation of work; the study includes the same investigation in relation to Mentoring, taking as study people's that work area of São Paulo focus. The data collected in the research they were collected through a questionnaire with open and closed subjects. The research showed as results of the pertinent subjects to the coaching and the mentoring that the great majority, or almost all had some training type, that happened in group, with the managers' presence just in the beginning and adding 8 hours, could end like this with that subject that in the researched respondents the work of the coaching is accomplished inside of the retail organizations. Concerning the mentoring, it can be concluded that she is inside present of the organization and it is represented by the leader. 

  6. Travel industry as a focus on regional development: Case study of the Mediterranean France

    Directory of Open Access Journals (Sweden)

    Terzić Aleksandra

    2015-01-01

    Full Text Available This paper presents a regionalization of the Mediterranean France with regard to tourism, as well as basic economic sectors present in the region. The study included three administrative regions of this part of France: Provence - Alpes - Cote d'Azur, Languedoc - Roussillon and the Island of Corsica, where the travel industry is defined as dominant. The subject of this research is to study the area of the Mediterranean France, primarily from the aspect of tourism. Special attention is focused on the identification of economic and socioeconomic importance that tourism has on the overall economic development of the region, in order to enable the implementation of tourism regionalization. In order to tourism regionalization of this area carried out, it is necessary to include research components, such as geographic environment, tourist motives and attractions that are located in this area, as well as other elements relevant to the separation of the region from the neighboring regions of France.

  7. Using Focus Groups to Study Consumer Understanding and Experiences with Tamper-Evident Packaging Devices

    Science.gov (United States)

    Pascall, Melvin A.; Lee, Ken; Fraser, Angela; Halim, Linna

    2009-01-01

    A focus group with an educational component was used to help initiate a new research hypothesis. Early-stage development of a new tamper-evident invention was improved with input from a consumer focus group. The focus group comprised consumers who were shown several tamper-evident devices, including a new color-changing cap under active…

  8. Exploring types of focused factories in hospital care: a multiple case study.

    NARCIS (Netherlands)

    Bredenhoff, E.; Bredenhoff, Eelco; van Lent, W.A.M.; van Harten, Willem H.

    2010-01-01

    Background: Focusing on specific treatments or diseases is proposed as a way to increase the efficiency of hospital care. The definition of "focus" or "focused factory", however, lacks clarity. Examples in health care literature relate to very different organizations. Our aim was to explore the

  9. Engaging Focus Group Methodology: The 4-H Middle School-Aged Youth Learning and Leading Study

    Science.gov (United States)

    Scott, Siri; Grant, Samantha; Nippolt, Pamela Larson

    2015-01-01

    With young people, discussing complex issues such as learning and leading in a focus group can be a challenge. To help prime youth for the discussion, we created a focus group approach that featured a fun, interactive activity. This article includes a description of the focus group activity, lessons learned, and suggestions for additional…

  10. Pharmacist-Physician Collaboration at a Family Medicine Residency Program: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Keri Hager

    2018-02-01

    Full Text Available Background: In response to transforming healthcare and pursuit of the Triple Aim, many health systems have added team members to expand the capabilities and effectiveness of the team to facilitate these aims. The objective of this study was to explore knowledge and perceptions of pharmacist-physician collaboration among family medicine residents (FMR, family medicine faculty (FMF, and pharmacist faculty and residents in a practice where clinical pharmacy services were relatively new. Understanding the nuances of pharmacist-physician interactions will provide insight into how to improve FMR education to prepare learners for patient-centered, team-based practice. Methods: An exploratory descriptive qualitative study design was used to articulate perceptions of professional roles and team-based care in an interprofessional family medicine community-based clinical practice. Five, 60-minute focus groups were conducted in a clinical training setting that focuses on preparing family medicine physicians for collaborative rural primary care practice. Results: Twenty-one FMRs, eight FMF, and six clinical pharmacists participated. Three themes emerged from the focus groups and were consistent across the groups: 1 roles of pharmacists recognized by physicians in different settings, 2 benefits to collaboration, and 3 keys to successful pharmacist-physician collaboration which include a developing the relationship, b optimizing communication, c creating beneficial clinical workflow, d clarifying roles and responsibilities, and e increasing opportunities for meaningful interactions. Conclusion: This study demonstrated that by co-locating physicians and pharmacists in the same environment, and providing a basic structure for collaboration, a collaborative working relationship can be initiated. Practices looking to have more effective collaborative working relationships should strive to increase the frequency of interactions of the professions, help the

  11. SU-F-J-225: Histology Study of MR Guided Pulsed Focused Ultrasound On Treatment of Prostate Cancer in Vivo

    Energy Technology Data Exchange (ETDEWEB)

    Chen, L; Cvetkovic, D; Chen, X; Wang, B; Gupta, R; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States)

    2016-06-15

    Purpose: Our previous study demonstrated significant tumor growth delay in the mice treated with pulsed high intensity focused ultrasound (pHIFU). The purpose of this study is to understand the cell killing mechanisms of pHIFU. Methods: Prostate cancer cells (LNCaP), were grown orthotopically in 17 nude mice. Tumor-bearing mice were treated using pHIFU with an acoustic power of 25W, pulse width 100msec and 300 pulses in one sonication under MR guidance. Mutiple sonications were used to cover the whole tumor volume. The temperature (less than 40 degree centigrade in the focal spot) was monitored using MR thermometry. Animals were euthanized at pre-determined time points (n=2) after treatment: 0 hours; 6 hrs; 24 hrs; 48 hrs; 4 days and 7 days. Two tumorbearing mice were used as control. Three tumor-bearing mice were treated with radiation (RT, 2 Gy) using 6 MV photon beams. RT treated mice were euthanized at 0 hr, 6 hrs and 24 hrs. The tumors were processed for immunohistochemical (IHC) staining for PARP (a surrogate of apoptosis). A multispectral imaging analysis system was used to quantify the expression of PARP staining. Cell apoptosis was calculated based on the PARP expression level using the DAB analysis software. Results: Our data showed that PARP related apoptosis peaked at 48 hrs and 7 days in pHIFU treated mice, which is comparable to that for the RT group at 24 hrs. The preliminary results from this study were consistent with our previous study on tumor growth delay using pHIFU. Conclusion: Our results demonstrated that non-thermal pHIFU increased apoptotic tumor cell death through the PARP related pathway. MR guided pHIFU may have a great potential as a safe, noninvasive treatment modality for cancer therapy. This treatment modality may synergize with PARP inhibitors to achieve better therapeutic result.

  12. SU-F-J-225: Histology Study of MR Guided Pulsed Focused Ultrasound On Treatment of Prostate Cancer in Vivo

    International Nuclear Information System (INIS)

    Chen, L; Cvetkovic, D; Chen, X; Wang, B; Gupta, R; Ma, C

    2016-01-01

    Purpose: Our previous study demonstrated significant tumor growth delay in the mice treated with pulsed high intensity focused ultrasound (pHIFU). The purpose of this study is to understand the cell killing mechanisms of pHIFU. Methods: Prostate cancer cells (LNCaP), were grown orthotopically in 17 nude mice. Tumor-bearing mice were treated using pHIFU with an acoustic power of 25W, pulse width 100msec and 300 pulses in one sonication under MR guidance. Mutiple sonications were used to cover the whole tumor volume. The temperature (less than 40 degree centigrade in the focal spot) was monitored using MR thermometry. Animals were euthanized at pre-determined time points (n=2) after treatment: 0 hours; 6 hrs; 24 hrs; 48 hrs; 4 days and 7 days. Two tumorbearing mice were used as control. Three tumor-bearing mice were treated with radiation (RT, 2 Gy) using 6 MV photon beams. RT treated mice were euthanized at 0 hr, 6 hrs and 24 hrs. The tumors were processed for immunohistochemical (IHC) staining for PARP (a surrogate of apoptosis). A multispectral imaging analysis system was used to quantify the expression of PARP staining. Cell apoptosis was calculated based on the PARP expression level using the DAB analysis software. Results: Our data showed that PARP related apoptosis peaked at 48 hrs and 7 days in pHIFU treated mice, which is comparable to that for the RT group at 24 hrs. The preliminary results from this study were consistent with our previous study on tumor growth delay using pHIFU. Conclusion: Our results demonstrated that non-thermal pHIFU increased apoptotic tumor cell death through the PARP related pathway. MR guided pHIFU may have a great potential as a safe, noninvasive treatment modality for cancer therapy. This treatment modality may synergize with PARP inhibitors to achieve better therapeutic result.

  13. Influence of environmental factors on mental health within prisons: focus group study.

    Science.gov (United States)

    Nurse, Jo; Woodcock, Paul; Ormsby, Jim

    2003-08-30

    To increase understanding of how the prison environment influences the mental health of prisoners and prison staff. Qualitative study with focus groups. A local prison in southern England. Prisoners and prison staff. Prisoners reported that long periods of isolation with little mental stimulus contributed to poor mental health and led to intense feelings of anger, frustration, and anxiety. Prisoners said they misused drugs to relieve the long hours of tedium. Most focus groups identified negative relationships between staff and prisoners as an important issue affecting stress levels of staff and prisoners. Staff groups described a "circle of stress," whereby the prison culture, organisation, and staff shortages caused high staff stress levels, resulting in staff sickness, which in turn caused greater stress for remaining staff. Staff shortages also affected prisoners, who would be locked up for longer periods of time, the ensuing frustration would then be released on staff, aggravating the situation still further. Insufficient staff also affected control and monitoring of bullying and reduced the amount of time in which prisoners were able to maintain contact with their families. Greater consideration should be given to understanding the wider environmental and organisational factors that contribute to poor mental health in prisons. This information can be used to inform prison policy makers and managers, and the primary care trusts who are beginning to work in partnership with prisons to improve the mental health of prisoners.

  14. The Power of Urban Planning on Environmental Sustainability: A Focus Group Study in Finland

    Directory of Open Access Journals (Sweden)

    Eeva-Sofia Säynäjoki

    2014-09-01

    Full Text Available Sustainable communities are promoted as a desirable policy goal and, in particular, local authorities are encouraged to contribute to climate change mitigation through urban planning. Furthermore, recent research takes a broad perspective on the environmental sustainability of urban areas and considers the environmental impact of all consumption. A focus group study was conducted in Finland for the purpose of examining how increased environmental awareness influences urban land use. The 32 participants of three focus groups were professionals of urban planning and environmental sustainability, at both a municipal and a state level. The main finding was that urban planning is viewed as being unable to support environmental sustainability in the broader sense. In general, the participants did not see a connection between urban structure and sustainable lifestyles and only the influence of planning on housing and daily journeys was recognised. Three main reasons for this were identified. Firstly, environmental sustainability in its broader definition is seen as too complex for urban planners to influence alone. Secondly, the dominance of short-term economic issues in decision-making and the lack of co-operation from other stakeholders to achieve environmental aims demotivate land use planners. Thirdly, the prioritisation of urban density may overrule alternative means of promoting environmental sustainability, such as the encouragement of sustainable suburban or non-urban lifestyles.

  15. Defining fitness to practise in Australian radiation therapy: A focus group study

    International Nuclear Information System (INIS)

    Wright, Caroline A.; Jolly, Brian; Schneider-Kolsky, Michal E.; Baird, Marilyn A.

    2011-01-01

    Purpose: This paper presents the results of a study undertaken to investigate how Australian radiation therapists define fitness to practise. Method: A qualitative approach was taken to data collection with focus groups being employed to gather the data. Analysis was informed by grounded theory. Following ethics approval, three homogeneous focus groups were conducted comprising a total of 21 participants, with 5-8 participants per group. The discussions were transcribed, verified by the researcher and participants, then unitised, coded and a sample checked by a second coder. Findings: There was no consensus on the definition of fitness to practise. The terms professionalism and competence were used interchangeably in some definitions. Four themes emerged from the data, these were; fitness as a continuum (individual differences and longevity in the profession), fitness as behaviour and conduct (professionalism and competence), fitness as a state of mind (attitudes and intangible elements) and fitness as being qualified (course completion means fitness to practise). Three concepts which were not raised were illegal behaviour, impaired practice and dose errors. Conclusion: There is no consensus among radiation therapists about fitness to practise. There was confusion with how Fitness to practise relates to professionalism and competence with little mention of how impairment is interwoven into the notion of fitness to practise. Without an unambiguous definition and robust criteria, making the 'judgement call' as to whether a practitioners' fitness to practise is impaired will continue to be a challenge for educators, departmental managers and registration boards.

  16. Defining fitness to practise in Australian radiation therapy: A focus group study

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Caroline A., E-mail: caroline.wright@med.monash.edu.a [Monash University, Medical Imaging and Radiation Sciences, Clayton Campus, Wellington Road Clayton, Melbourne, Victoria 3800 (Australia); Jolly, Brian [Monash University, Centre for Medical and Health Sciences Education (Australia); Schneider-Kolsky, Michal E.; Baird, Marilyn A. [Monash University, Medical Imaging and Radiation Sciences, Clayton Campus, Wellington Road Clayton, Melbourne, Victoria 3800 (Australia)

    2011-02-15

    Purpose: This paper presents the results of a study undertaken to investigate how Australian radiation therapists define fitness to practise. Method: A qualitative approach was taken to data collection with focus groups being employed to gather the data. Analysis was informed by grounded theory. Following ethics approval, three homogeneous focus groups were conducted comprising a total of 21 participants, with 5-8 participants per group. The discussions were transcribed, verified by the researcher and participants, then unitised, coded and a sample checked by a second coder. Findings: There was no consensus on the definition of fitness to practise. The terms professionalism and competence were used interchangeably in some definitions. Four themes emerged from the data, these were; fitness as a continuum (individual differences and longevity in the profession), fitness as behaviour and conduct (professionalism and competence), fitness as a state of mind (attitudes and intangible elements) and fitness as being qualified (course completion means fitness to practise). Three concepts which were not raised were illegal behaviour, impaired practice and dose errors. Conclusion: There is no consensus among radiation therapists about fitness to practise. There was confusion with how Fitness to practise relates to professionalism and competence with little mention of how impairment is interwoven into the notion of fitness to practise. Without an unambiguous definition and robust criteria, making the 'judgement call' as to whether a practitioners' fitness to practise is impaired will continue to be a challenge for educators, departmental managers and registration boards.

  17. The unethical focus on access: a study of medical ethics and the waiting-time guarantee.

    Science.gov (United States)

    Karlberg, H I; Brinkmo, B-M

    2009-03-01

    All civilized societies favour ethical principles of equity. In healthcare, these principles generally focus on needs for medical care. Methods for establishing priorities among such needs are instrumental in this process. In this study, we analysed whether rules on access to healthcare, waiting-time guarantees, conflict with ethical principles of distributive justice. We interviewed directors, managers and other decision-makers of various healthcare providers of hospitals, primary care organizations and purchasing offices. We also conducted focus group interviews with professionals from a number of distinct medical areas. Our informants and their co-workers were reasonably familiar with the ethical platforms for priority-setting established by the Swedish parliament, giving the sickest patients complete priority. However, to satisfy the waiting-time guarantees, the informants often had to make priority decisions contrary to the ethical principles by favouring access before needs to keep waiting times within certain limits. The common opinion was that the waiting-time guarantee leads to crowding-out effects, overruling the ethical principles based on needs. For more than a decade, the interpretation in Sweden of the equitable principle based on medical needs has been distorted through political decisions, leading to healthcare providers giving priority to access rather than needs for care.

  18. Healthcare managers in negative media focus: a qualitative study of personification processes and their personal consequences.

    Science.gov (United States)

    Wramsten Wilmar, Maria; Ahlborg, Gunnar; Jacobsson, Christian; Dellve, Lotta

    2014-01-07

    Over the last decade healthcare management and managers have increasingly been in focus in public debate. The purpose of the present study was to gain a deeper understanding of how prolonged, unfavorable media focus can influence both the individual as a person and his or her managerial practice in the healthcare organization. In-depth interviews (n = 49) with 24 managers and their superiors, or subordinate human resources/information professionals, and partners were analyzed using a grounded theory approach. The conceptual model explains how perceived uncertainties related to the managerial role influence personification and its negative consequences. The role ambiguities comprised challenges regarding the separation of individual identity from the professional function, the interaction with intra-organizational support and political play, and the understanding and acceptance of roles in society. A higher degree of uncertainty in role ambiguity increased both personification and the personal reaction to intense media pressure. Three types of reactions were related to the feeling of being infringed: avoidance and narrow-mindedness; being hard on self, on subordinates, and/or family members; and resignation and dejection. The results are discussed so as to elucidate the importance of support from others within the organization when under media scrutiny. The degree of personification seems to determine the personal consequences as well as the consequences for their managerial practice. Organizational support for managers appearing in the media would probably be beneficial for both the manager and the organization.

  19. Should body image programs be inclusive? A focus group study of college students.

    Science.gov (United States)

    Ciao, Anna C; Ohls, Olivia C; Pringle, Kevin D

    2018-01-01

    Most evidence-based body image programs for college students (e.g., the Body Project) are designed for female-only audiences, although body dissatisfaction is not limited to female-identified individuals. Furthermore, programs do not explicitly discuss diversity, although individuals with marginalized gender, racial, and sexual identities may be particularly vulnerable to body image disturbances. Making programs more inclusive may increase their disseminability. This qualitative study examined the feasibility of adapting the Body Project for universal and inclusive use with college students. Participants (N = 36; M age = 21.66 years; 73% female-identified; 20% sexual minority; 23% racial minority) attended one of five semi-structured focus groups to explore the inclusivity of appearance-based cultural norms using adapted Body Project activities and discuss the feasibility of universal and inclusive interventions. Inductive qualitative content analysis with three-rater consensus identified focus group themes. There was consensus that inclusive interventions could have a positive impact (broadening perspectives, normalizing body image concerns, increasing awareness) despite potential barriers (poor diversity representation, vulnerability). There was strong consensus regarding advice for facilitating inclusive interventions (e.g., skilled facilitation, education, increasing diversity). Results suggest that inclusive body image programs are desirable and provide a framework for creating the EVERYbody Project, a program for more universal audiences. © 2017 Wiley Periodicals, Inc.

  20. Study of the effects of focused high-energy boron ion implantation in diamond

    Science.gov (United States)

    Ynsa, M. D.; Agulló-Rueda, F.; Gordillo, N.; Maira, A.; Moreno-Cerrada, D.; Ramos, M. A.

    2017-08-01

    Boron-doped diamond is a material with a great technological and industrial interest because of its exceptional chemical, physical and structural properties. At modest boron concentrations, insulating diamond becomes a p-type semiconductor and at higher concentrations a superconducting metal at low temperature. The most conventional preparation method used so far, has been the homogeneous incorporation of boron doping during the diamond synthesis carried out either with high-pressure sintering of crystals or by chemical vapour deposition (CVD) of films. With these methods, high boron concentration can be included without distorting significantly the diamond crystalline lattice. However, it is complicated to manufacture boron-doped microstructures. A promising alternative to produce such microstructures could be the implantation of focused high-energy boron ions, although boron fluences are limited by the damage produced in diamond. In this work, the effect of focused high-energy boron ion implantation in single crystals of diamond is studied under different irradiation fluences and conditions. Micro-Raman spectra of the sample were measured before and after annealing at 1000 °C as a function of irradiation fluence, for both superficial and buried boron implantation, to assess the changes in the diamond lattice by the creation of vacancies and defects and their degree of recovery after annealing.

  1. Focused Ultrasound Lipolysis in the Treatment of Abdominal Cellulite: An Open-Label Study

    Science.gov (United States)

    Moravvej, Hamideh; Akbari, Zahra; Mohammadian, Shahrzad; Razzaghi, Zahra

    2015-01-01

    Introduction: Despite a growing popularity of noninvasive ultrasonic lipolysis procedure, there is a lack of evidence about the efficacy of this method. This study was performed to evaluate the efficacy of focused ultrasonic lipolysis on abdominal cellulite treatment. Methods: Twenty-eight consecutive subjects (age: 37.8 ± 8 years) underwent weekly transdermal focused ultrasonic lipolysis (Med Contour, General Project Ltd., Florence, Italy) and vacuum drainage for a maximum of eight sessions. Largest abdominal girth and 2 lines at 4 cm to 7 cm distance above and under it were located as fixed points of measurements. The mean value of the three fixed lines was considered as the abdominal circumference. Subjects were evaluated using measurements of circumference, immediately after and 3 weeks after the final treatment and compared using paired t test. Results: One hundred ninety-four ultrasonic lipolysis procedures were performed on 28 subjects. A statistically significant (P cellulite, although some amount of circumference reduction reversal may be observed in long term follow-up visit. PMID:26464776

  2. An fMRI study of caring vs self-focus during induced compassion and pride.

    Science.gov (United States)

    Simon-Thomas, Emiliana R; Godzik, Jakub; Castle, Elizabeth; Antonenko, Olga; Ponz, Aurelie; Kogan, Aleksander; Keltner, Dacher J

    2012-08-01

    This study examined neural activation during the experience of compassion, an emotion that orients people toward vulnerable others and prompts caregiving, and pride, a self-focused emotion that signals individual strength and heightened status. Functional magnetic resonance images (fMRI) were acquired as participants viewed 55 s continuous sequences of slides to induce either compassion or pride, presented in alternation with sequences of neutral slides. Emotion self-report data were collected after each slide condition within the fMRI scanner. Compassion induction was associated with activation in the midbrain periaqueductal gray (PAG), a region that is activated during pain and the perception of others' pain, and that has been implicated in parental nurturance behaviors. Pride induction engaged the posterior medial cortex, a region that has been associated with self-referent processing. Self-reports of compassion experience were correlated with increased activation in a region near the PAG, and in the right inferior frontal gyrus (IFG). Self-reports of pride experience, in contrast, were correlated with reduced activation in the IFG and the anterior insula. These results provide preliminary evidence towards understanding the neural correlates of important interpersonal dimensions of compassion and pride. Caring (compassion) and self-focus (pride) may represent core appraisals that differentiate the response profiles of many emotions.

  3. Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.

    Science.gov (United States)

    Aamland, Aase; Werner, Erik L; Malterud, Kirsti

    2013-06-01

    Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality. Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

  4. The discourse around usefulness, morality, risk and trust: a focus group study on prenatal genetic testing.

    Science.gov (United States)

    Pivetti, Monica; Montali, Lorenzo; Simonetti, Giorgia

    2012-12-01

    This study explores the underlying values and beliefs that guide women's reasoning on prenatal genetic test (PGT) uptake, as framed by their own words, during a group discussion, in a Catholic country such as Italy. Women's reasoning was explored by means of five focus group consisting of seven pregnant women and 13 new mothers. The focus group material content was analysed using the Nudist software. The discourse around PGT was rooted into four frames of reference: The usefulness dimension was used to express the positions in favour of PGT, whereas morality, risk and trust were used to express negative evaluations on such a technology. Participants advocated for themselves the choice of being tested, besides giving some credit to the partner's opinion. Moreover, participants reported little knowledge on PGT. The research shed some light on the frames of reference used by participants to build their positions on PGT uptake, confirming the public's ability to translate scientific accounts into personally meaningful information. A more complete understanding of the reasons for decisions to test would help counsellors to better communicate with women and couples, and to better assist them to make a better informed testing decision. © 2012 John Wiley & Sons, Ltd.

  5. The Dutch 'Focus on Strength' intervention study protocol: programme design and production, implementation and evaluation plan.

    Science.gov (United States)

    Ten Hoor, G A; Kok, G; Rutten, G M; Ruiter, R A C; Kremers, S P J; Schols, A M J W; Plasqui, G

    2016-06-10

    Overweight youngsters are better in absolute strength exercises than their normal-weight counterparts; a physiological phenomenon with promising psychological impact. In this paper we describe the study protocol of the Dutch, school-based program 'Focus on Strength' that aims to improve body composition of 11-13 year old students, and with that to ultimately improve their quality of life. The development of this intervention is based on the Intervention Mapping (IM) protocol, which starts from a needs assessment, uses theory and empirical research to develop a detailed intervention plan, and anticipates program implementation and evaluation. This novel intervention targets first year students in preparatory secondary vocational education (11-13 years of age). Teachers are the program implementers. One part of the intervention involves a 30 % increase of strength exercises in the physical education lessons. The other part is based on Motivational Interviewing, promoting autonomous motivation of students to become more physically active outside school. Performance and change objectives are described for both teachers and students. The effectiveness of the intervention will be tested in a Randomized Controlled Trial in 9 Dutch high schools. Intervention Mapping is a useful framework for program planning a school-based program to improve body composition and motivation to exercise in 11-13 year old adolescents by a "Focus on Strength". NTR5676 , registered 8 February 2016 (retrospectively registered).

  6. Diagnosing and managing anorexia nervosa in UK primary care: a focus group study.

    Science.gov (United States)

    Hunt, D; Churchill, R

    2013-08-01

    Anorexia is a leading cause of adolescent hospital admission and death from psychiatric disorder. Despite the potential role of general practitioners in diagnosis, appropriate referral and coordinating treatment, few existing studies provide fine-grained accounts of GPs' beliefs about anorexia. To identify GPs' understandings and experiences of diagnosing and managing patients with anorexia in primary care. Case-based focus groups with co-working general practitioners in the East Midlands region of England were used to explore attitudes towards issues common to patients with eating disorders. Group discussions were transcribed and analysed using corpus linguistic and discourse analytic approaches. Participants' discussion focused on related issues of making hesitant diagnoses, the utility of the body mass index, making referrals and overcoming patient resistance. Therapeutic relationships with patients with anorexia are considered highly complex, with participants using diagnostic tests as rhetorical strategies to help manage communicative obstacles. Overcoming patient repudiation and securing referrals are particular challenges with this patient group. Successfully negotiating these problems appears to require advanced communication skills.

  7. 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

    exposed to torture in their home country were interviewed at a Danish rehabilitation clinic on average 8 years after their final release from confinement and re-interviewed 10 years later. Interviews focused on history of exposure to physical and mental torture and on pain in the head, back and feet...

  8. Feasibility study of a family-focused intervention to improve outcomes for children with FASD.

    Science.gov (United States)

    Reid, Natasha; Dawe, Sharon; Harnett, Paul; Shelton, Doug; Hutton, Lauren; O'Callaghan, Frances

    2017-08-01

    Growing evidence shows that children with fetal alcohol spectrum disorder (FASD) can benefit from interventions, and specifically interventions focused on improving self-regulation. However, novel ways of improving outcomes for children with FASD need further investigation so that programs target not only the individual child but also the family context, which includes the parent-child relationship. The current study aimed to evaluate the feasibility of an adapted version of the Parents under Pressure (PuP) program that addresses self-regulatory processes, through improving the parent-child relationship and the use of mindfulness-based strategies for both children and parents. This was a mixed methods study. Feasibility was examined by evaluating recruitment, data collection/outcome measures, and intervention procedures. The study used a phenomenological approach to obtain qualitative information from caregivers and a single-case experimental design to evaluate the preliminary participant responses to the intervention. Two out of three families completed treatment. The recruitment and intervention procedures were found to be suitable for and acceptable to the families involved. Some concerns were identified regarding the outcome measures that would need to be addressed in future research. Quantitative and qualitative outcomes were positive. The results provide preliminary support for the feasibility of an adapted version of the PuP program. Thus, offering a potential multi-component option, that aims to improve self-regulatory skills for children with FASD, through focusing on improving the parent-child relationship and incorporating mindfulness-based techniques for both parents and children. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: a pilot study.

    Science.gov (United States)

    Martínez-Fernández, Raul; Rodríguez-Rojas, Rafael; Del Álamo, Marta; Hernández-Fernández, Frida; Pineda-Pardo, Jose A; Dileone, Michele; Alonso-Frech, Fernando; Foffani, Guglielmo; Obeso, Ignacio; Gasca-Salas, Carmen; de Luis-Pastor, Esther; Vela, Lydia; Obeso, José A

    2018-01-01

    Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease. This prospective, open-label pilot study was done at CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur in Madrid, Spain. Eligible participants had Parkinson's disease with markedly asymmetric parkinsonism. Patients with severe dyskinesia, history of stereotactic surgery or brain haemorrhage, a diagnosis of an unstable cardiac or psychiatric disease, or a skull density ratio of 0·3 or less were excluded. Enrolled patients underwent focused ultrasound unilateral subthalamotomy. The subthalamic nucleus was targeted by means of brain images acquired with a 3-Tesla MRI apparatus. Several sonications above the definitive ablation temperature of 55°C were delivered and adjusted according to clinical response. The primary outcomes were safety and a change in the motor status of the treated hemibody as assessed with part III of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS III) in both off-medication and on-medication states at 6 months. Adverse events were monitored up to 48 h after treatment and at scheduled clinic visits at 1, 3, and 6 months after treatment. The study is registered with ClinicalTrials.gov, number NCT02912871. Between April 26 and June 14, 2016, ten patients with markedly asymmetric parkinsonism that was poorly controlled pharmacologically were enrolled for focused ultrasound unilateral subthalamotomy. By 6 months follow-up, 38 incidents of adverse events had been recorded, none of which were serious or severe. Seven adverse events were present at 6 months. Three of these adverse events were directly related to subthalamotomy: off-medication dyskinesia in the treated arm

  10. Healthcare Engagement and Encounters in a Rural State: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Reshmi Singh

    2018-01-01

    Full Text Available Introduction: Rural populations have many barriers to quality health care including lack of access to primary care and specialty care and a greater likelihood to be underinsured or uninsured. They are also less likely to use preventive screening, or to participate in self-care and engage in their health when compared to urban residents. The purpose of this paper was to describe patients’ healthcare experiences in a rural western state focusing on their healthcare expectations and engagement. Methods: This qualitative study was conducted using a focus group protocol to elicit rural patients’ healthcare experiences. A purposeful sample of English speaking adult residents from a single county who were willing to discuss their healthcare experiences was included. Patients and community members (21 years and older were recruited through a local hospital as well as via flyers posted throughout the community. Each audio-recorded group took about two hours. A total of 15 focus groups were conducted to obtain sufficient text for theoretical saturation and thematic analysis. Each group had a range of 3-8 participants. A $25 visa gift card and lunch were provided for each participant as an incentive. Results: ‘Encounters with Healthcare Professionals’ and ‘Engagement in Health’ were the two dominant dimensions with two themes each. Themes centered around what characterized the best or worst encounters. Trust and Communication - both were based on time spent with the provider and establishment of rapport with the providers. The best encounters were those with health care providers or pharmacists who had sufficient time, adequately explained a diagnosis and new medications did not dismiss patient concerns, and treated individuals with respect. Typical responses describing the worst encounters included examples of misdiagnosis, dismissing patient’s symptoms, healthcare professionals whose attention was not focused on the patient, pushing too

  11. THE INCLUSION OF / FOCUS ON CHILDREN IN FAMILY MEDIATION: A REVIEW OF STUDIES AND FUTURE PROPOSALS

    Directory of Open Access Journals (Sweden)

    Carles Rodríguez-Domínguez

    2015-09-01

    Full Text Available Mediation is an established model for conflict resolution, backed by the international community in relation to family law, to help parents seeking solutions to family problems in child custody cases. The aim of this article is to review the advantages and/or disadvantages presented in the studies with child-inclusive or child-focused interventions in family mediation processes. In the present research, we carry out a review of studies realised in Australia, New Zealand, some counties in the US and in Europe; meta-analysis and review studies of 'child inclusive' investigations, international guidelines that support listening to children and also studies that criticise it. While mediation has existed for four decades in other countries, in Spain it has only arisen since the enactment of Law (1/2001 of Family Mediation in Catalonia, followed by other local regulations, which explains why sufficient studies might not yet exist. In some countries a new paradigm is emerging, aimed at the inclusion of children due to the favourable findings in family mediation processes, although a multiple and flexible approach in the field of family mediation intervention is necessary.

  12. Studies on the Ecology, Biogeography and Evolution of Palms (Arecaceae) with Focus on the Americas

    DEFF Research Database (Denmark)

    Eiserhardt, Wolf L.

    and evolutionary processes. These topics fall into four categories: (i) Previous empirical evidence on the factors influencing palm species distributions, community composition, and species richness was summarised in a hierarchical scale framework. The effects of different components of the abiotic environment......, biotic interactions, and dispersal are integrally dependent on spatiotemporal scale. Historical, including evolutionary factors are clearly important for palm distributions and diversity. (ii) Broad-scale patterns of palm species richness and phylogenetic turnover were studied across the Americas....... Richnessenvironment relationships were found to be spatially variable; richness-water correlations decreased in strength, and richness-energy correlations increased in strength with latitude, indicating complex and systematic interactions between factors. Evolutionary history has a significant impact on continental...

  13. Focusing studies of an applied Br extraction diode on the LION accelerator

    International Nuclear Information System (INIS)

    Struckman, C.K.; Kusse, B.R.; Rondeau, G.

    1990-01-01

    The LION Accelerator, 1.5 MV, 4 Ω, is being used to study the characteristics of an applied B r extraction diode. The diode utilizes both an inner and outer cathode and has been observed to operate at high ion current efficiencies compared to previous extraction diodes. Typical efficiencies were measured to be ∼80% which compares very favorably with the efficiencies seen in applied B z diodes. In this paper, the authors report the results of a series of experiments examining the role of the inner cathode in electron loss and ion emission. In addition, operation with an argon gas cell is reported. The ion beam appears to be space-charge neutralized by the gas cell foil alone, and current neutralized when the gas cell pressure is above 100 mT

  14. Treatment Development and Feasibility Study of Family-Focused Treatment for Adolescents with Bipolar Disorder and Comorbid Substance Use Disorders

    Science.gov (United States)

    Goldstein, Benjamin I.; Goldstein, Tina R.; Collinger, Katelyn A.; Axelson, David A.; Bukstein, Oscar G.; Birmaher, Boris; Miklowitz, David J.

    2014-01-01

    Background Comorbid substance use disorders (SUD) are associated with increased illness severity and functional impairment among adolescents with bipolar disorder (BD). Previous psychosocial treatment studies have excluded adolescents with both BD and SUD. Studies suggest that integrated interventions are optimal for adults with BD and SUD. Methods We modified family-focused treatment for adolescents with BD (FFT-A) in order to explicitly target comorbid SUD (FFT-SUD). Ten adolescents with BD who had both SUD and an exacerbation of manic, depressed, or mixed symptoms within the last 3 months were enrolled. FFT-SUD was offered as an adjunct to pharmacotherapy, with a target of 21 sessions over 12 months of treatment. The FFT-SUD manual was iteratively modified to integrate a concurrent focus on SUD. Results Six subjects completed a mid-treatment 6-month assessment (after a mean of 16 sessions was completed). Of the 10 subjects, 3 dropped out early ( after ≤ 1 session); in the case of each of these subjects, the participating parent had active SUD. No other subjects in the study had a parent with active SUD. Preliminary findings suggested significant reductions in manic symptoms and depressive symptoms and improved global functioning. Reduction in cannabis use was modest and did not reach significance. Limitations Limitations included a small sample, open treatment, concurrent medications, and no control group. Conclusions These preliminary findings suggest that FFT-SUD is a feasible intervention, particularly for youth without parental SUD. FFT-SUD may be effective in treating mood symptoms, particularly depression, despite modest reductions in substance use. Integrating motivation enhancing strategies may augment the effect of this intervention on substance use. Additional strategies, such as targeting parental substance use, may prevent early attrition. PMID:24847999

  15. Self-consistent beam halo studies ampersand halo diagnostic development in a continuous linear focusing channel

    International Nuclear Information System (INIS)

    Jameson, R.A.

    1994-01-01

    Beam halos are formed via self-consistent motion of the beam particles. Interactions of single particles with time-varying density distributions of other particles are a major source of halo. Aspects of these interactions are studied for an initially equilibrium distribution in a radial, linear, continuous focusing system. When there is a mismatch, it is shown that in the self-consistent system, there is a threshold in space-charge and mismatch, above which a halo is formed that extends to ∼1.5 times the initial maximum mismatch radius. Tools are sought for characterizing the halo dynamics. Testing the particles against the width of the mismatch driving resonance is useful for finding a conservative estimate of the threshold. The exit, entering and transition times, and the time evolution of the halo, are also explored using this technique. Extension to higher dimensions is briefly discussed

  16. Justifying continuous sedation until death: a focus group study in nursing homes in Flanders, Belgium.

    Science.gov (United States)

    Rys, Sam; Deschepper, Reginald; Deliens, Luc; Mortier, Freddy; Bilsen, Johan

    2013-01-01

    Continuous Sedation until Death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, has become a common practice in nursing homes in Flanders (Belgium). Quantitative research has suggested that CSD is not always properly applied. This qualitative study aims to explore and describe the circumstances under which nursing home clinicians consider CSD to be justified. Six focus groups were conducted including 10 physicians, 24 nurses, and 14 care assistants working in either Catholic or non-Catholic nursing homes of varying size. Refractory suffering, limited life expectancy and respecting patient autonomy are considered essential elements in deciding for CSD. However, multiple factors complicate the care of nursing home residents at the end of life, and often hinder clinicians from putting these elements into practice. Nursing home clinicians may benefit from more information and instruction about managing CSD in the complex care situations which typically occur in nursing homes. Copyright © 2013 Mosby, Inc. All rights reserved.

  17. Focused feasibility study of engineered barriers for waste management units in the 200 areas

    International Nuclear Information System (INIS)

    1996-08-01

    This Focused Feasibility Study (FFS) evaluates a total of four conceptual barrier designs for different types of waste sites. The Hanford Barrier, the Modified RCRA Subtitle C Barrier, and the Modified RCRA Subtitle D Barrier are being considered as the baseline design for the purpose of the FFS evaluation. A fourth barrier design, the Standard RCRA Subtitle C Barrier, is also evaluated in this FFS; it is commonly applied at other waste sites across the country. These four designs provide a range of cover options to minimize health and environmental risks associated with a site and specific waste categories for active design life periods of 30, 100, 500, and 1,000 years. Design criteria for the 500 and 1,000-year design life barriers include design performance to extend beyond active institutional control and monitoring periods

  18. All is quiet next to the polluting factory? A focus group study in Belgium

    International Nuclear Information System (INIS)

    Keune, Hans

    2003-01-01

    We discuss here a case study about risk communication. It concerns a consultation of citizens who live in the direct vicinity of a heavily polluting factory. While this pollution has been going on for decades, local residents have only recently been given an opportunity to participate in focus group debates on improvement measures. Government and experts tend to believe that the population loses no sleep over the issue. Consultation of the population has shown that the lack of visible concern over health risks does not mean that people do not worry. However, different aspects of the situation appear to be competing for attention, which creates the impression that diverging, contradictory responses are drawn from the population. Which lessons can be learnt in the context of contemporary risk communication?

  19. Barriers related to physical activity practice in adolescents. A focus-group study

    Directory of Open Access Journals (Sweden)

    Ciro Romélio Rodriguez Añez

    2010-04-01

    Full Text Available The aim of study was to identify barriers to physical activity in adolescents. Focus group interviews were conducted with subjects aged 15 to 18 years (n=59, 50.8% girls and divided according to gender. Content analysis was used to classify the reports into specific dimensions. Descriptive statistics employing relative and absolute frequencies of similar reports was performed using the SPSS 11.0 software. The most frequent barriers among adolescents were those associated with “psychological, cognitive and emotional” and “cultural and social” dimensions. For boys, the most frequently reported barriers were “feeling lazy”, “lack of company” and “lack of time”. For girls, “feeling lazy”, “lack of com-pany” and “occupation” were the most common barriers. In conclusion, the perception of barriers by adolescents varies according to gender, a fact requiring specific actions for the promotion of physical activity in this group.

  20. Community responses to communication campaigns for influenza A (H1N1: a focus group study

    Directory of Open Access Journals (Sweden)

    Gray Lesley

    2012-03-01

    Full Text Available Abstract Background This research was a part of a contestable rapid response initiative launched by the Health Research Council of New Zealand and the Ministry of Health in response to the 2009 influenza A pandemic. The aim was to provide health authorities in New Zealand with evidence-based practical information to guide the development and delivery of effective health messages for H1N1 and other health campaigns. This study contributed to the initiative by providing qualitative data about community responses to key health messages in the 2009 and 2010 H1N1 campaigns, the impact of messages on behavioural change and the differential impact on vulnerable groups in New Zealand. Methods Qualitative data were collected on community responses to key health messages in the 2009 and 2010 Ministry of Health H1N1 campaigns, the impact of messages on behaviour and the differential impact on vulnerable groups. Eight focus groups were held in the winter of 2010 with 80 participants from groups identified by the Ministry of Health as vulnerable to the H1N1 virus, such as people with chronic health conditions, pregnant women, children, Pacific Peoples and Māori. Because this study was part of a rapid response initiative, focus groups were selected as the most efficient means of data collection in the time available. For Māori, focus group discussion (hui is a culturally appropriate methodology. Results Thematic analysis of data identified four major themes: personal and community risk, building community strategies, responsibility and information sources. People wanted messages about specific actions that they could take to protect themselves and their families and to mitigate any consequences. They wanted transparent and factual communication where both good and bad news is conveyed by people who they could trust. Conclusions The responses from all groups endorsed the need for community based risk management including information dissemination. Engaging

  1. Health beliefs and practices related to dengue fever: a focus group study.

    Science.gov (United States)

    Wong, Li Ping; AbuBakar, Sazaly

    2013-01-01

    This qualitative study aimed to provide an in-depth understanding of the meaning of dengue fever (DF) amongst people living in a dengue endemic region, dengue prevention and treatment-seeking behaviours. The Health Belief Model was used as a framework to explore and understand dengue prevention behaviours. A total of 14 focus group discussions were conducted with 84 Malaysian citizens of different socio-demographic backgrounds between 16(th) December, 2011 and 12(th) May, 2012. The study revealed that awareness about DF and prevention measures were high. The pathophysiology of dengue especially dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) were rarely known; as a result, it was seen as deadly by some but was also perceived as easily curable by others without a basis of understanding. Young adults and elderly participants had a low perception of susceptibility to DF. In general, the low perceived susceptibility emerged as two themes, namely a perceived natural ability to withstand infection and a low risk of being in contact with the dengue virus vector, Aedes spp. mosquitoes. The barriers to sustained self-prevention against dengue prevention that emerged in focus groups were: i) lack of self-efficacy, ii) lack of perceived benefit, iii) low perceived susceptibility, and iv) unsure perceived susceptibility. Low perceived benefit of continued dengue prevention practices was a result of lack of concerted action against dengue in their neighborhood. Traditional medical practices and home remedies were widely perceived and experienced as efficacious in treating DF. Behavioural change towards attaining sustainability in dengue preventive practices may be enhanced by fostering comprehensive knowledge of dengue and a change in health beliefs. Wide use of unconventional therapy for DF warrants the need to enlighten the public to limit their reliance on unproven alternative treatments.

  2. Midwives' perceptions of women's preferences related to midwifery care in Germany: A focus group study.

    Science.gov (United States)

    Lohmann, Susanne; Mattern, Elke; Ayerle, Gertrud M

    2018-06-01

    To explore how midwives perceive patient preferences related to midwifery care in Germany. This qualitative study, which was part of a larger study, used a hermeneutic-interpretive approach and involved focus group interviews with midwives. Data collection and analysis were done in a conjoined fashion between April 2015 and September 2016. Four focus group interviews were conducted in four different federal states of Germany. The sample of 20 qualified midwives was heterogeneous with regards to age, educational level, professional experience, type of midwifery care provided, and setting (employed, caseload, education) in which they provided services. Three main themes were identified: Strengths and limitations of midwives' present professional profile (midwives' area of responsibility, range of services, and competency); lack of midwives and midwifery services; women's experiences of conflict in interprofessional care. Each main theme is broken down into several aspects of content. Many women are not aware of the scope of professional knowledge and expertise of midwives. Moreover, the poor delineation of midwives' and obstetricians' areas of competency in Germany's hospitals seems to be disadvantageous for the women. Midwives feel that due to context implications they cannot live up to the quality of midwifery care they aspire to. Lack of midwives results in midwives being overwhelmed, women underserved, and both disappointed. On the one hand, new models of midwifery/maternity care need to be developed to solve some of the existing problems; on the other hand, new forms of interprofessional cooperation and management of transition of care points are required. Overall it is important that changes are implemented in such a way that women are enabled, and welcome, to clearly state their preferences for midwifery and maternity care. Particularly in Germany, tertiary education of midwives is needed to broaden their expertise and place them on an equal footing with

  3. An Experimental Study on the Heat Focusing of the Metallic layer in a Severe Accident

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Je-Young; Chung, Bum-Jin [Kyung Hee Univ., Yongin (Korea, Republic of)

    2014-10-15

    By flooding the reactor cavity that surrounds the vessel, significant energy can be removed from relocated corium materials through the vessel wall. The aim of this study is to investigate the heat focusing depending on the aspect ratios and heat transfer characteristic of upper boundary for applications related to severe accident phenomena. Experiments were carried out for Rayleigh numbers and aspect ratio in the range of 8.49x10{sup 7}-5.49x10{sup 9}, 0.128-0.512 respectively. Also, the conditions of the top wall and the side wall are considered: (a) top plate cooling, side wall adiabatic, (b) top plate adiabatic, side wall cooling, (c) both walls cooling. In order to achieve high Rayleigh numbers, the heat transfer experiments were replaced by mass transfer experiments based on heat and mass transfer analogy concept. A sulfuric acid-copper sulfate (H{sub 2}SO{sub 4}-CuSO{sub 4}) electroplating system was adopted as the mass transfer system.An experimental study was performed to investigate the focusing effect appeared in the metallic layer in a severe accident condition. Mass transfer experiments, based on the analogy concept, carried out in order to achieve high Rayleigh number. The height of the side wall was varied for three different cooling conditions: top only, side only, and both top and side. The experimental results agreed well with the Rayleigh-Benard convection correlations of Dropkin and Somerscales and Globe and Dropkin. The test results for the three configurations (only top cooling, only side wall cooling and both walls cooling) presented that the heat transfer on side wall cooling condition without top cooling is biggest. Also, the heat transfer was enhanced by decreasing the aspect ratio (H/R)

  4. Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study.

    Science.gov (United States)

    Merrett, Alexandra; Jones, Daniel; Sein, Kim; Green, Trish; Macleod, Una

    2017-04-01

    A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment. A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery. Audio recordings were transcribed verbatim and thematic analysis undertaken. Foundation Year 1 doctors' thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work-life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice. This study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues. © British Journal of General Practice 2017.

  5. 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.

  6. Material focus

    DEFF Research Database (Denmark)

    Sokoler, Tomas; Vallgårda, Anna K. A.

    2009-01-01

    In this paper we build on the notion of computational composites, which hold a material perspective on computational technology. We argue that a focus on the material aspects of the technology could be a fruitful approach to achieve new expressions and to gain a new view on the technology's role...... in design. We study two of the computer's material properties: computed causality and connectability and through developing two computational composites that utilize these properties we begin to explore their potential expressions....

  7. Application of holographic interferometric studies of underwater shock-wave focusing to medicine

    Science.gov (United States)

    Takayama, Kazuyoshi; Nagoya, H.; Obara, Tetsuro; Kuwahara, M.

    1993-01-01

    Holographic interferometric flow visualization was successfully applied to underwater shock wave focusing and its application to extracorporeal shock wave lithotripsy (ESWL). Real time diffuse holograms revealed the shock wave focusing process in an ellipsoidal reflector made from PMMA and double exposure holographic interferometry also clarified quantitatively the shock focusing process. Disintegration of urinary tract stones and gallbladder stones was observed by high speed photogrammetry. Tissue damage associated with the ESWL treatment is discussed in some detail.

  8. Anatomy by whole body dissection: a focus group study of students' learning experience.

    Science.gov (United States)

    Burgess, Annette; Ramsey-Stewart, George

    2015-01-01

    The social construction of knowledge within medical education is essential for learning. Students' interactions within groups and associated learning artifacts can meaningfully impact learning. Situated cognition theory poses that knowledge, thinking, and learning are located in experience. In recent years, there has been a reported decline in time spent on anatomy by whole body dissection (AWBD) within medical programs. However, teaching by surgeons in AWBD provides unique opportunities for students, promoting a deeper engagement in learning. In this study, we apply situated cognition theory as a conceptual framework to explore students' perceptions of their learning experience within the 2014 iteration of an 8-week elective AWBD course. At the end of the course, all students (n=24) were invited to attend one of three focus groups. Framework analysis was used to code and categorize data into themes. In total, 20/24 (83%) students participated in focus groups. Utilizing situated cognition theory as a conceptual framework, we illustrate students' learning experiences within the AWBD course. Students highlighted opportunities to create and reinforce their own knowledge through active participation in authentic dissection tasks; guidance and clinical context provided by surgeons as supervisors; and the provision of an inclusive learning community. Situated cognition theory offers a valuable lens through which to view students' learning experience in the anatomy dissection course. By doing so, the importance of providing clinical relevance to medical teaching is highlighted. Additionally, the value of having surgeons teach AWBD and the experience they share is illustrated. The team learning course design, with varying teaching methods and frequent assessments, prompting student-student and student-teacher interaction, was also beneficial for student learning.

  9. Teen Use of Marijuana Edibles: A Focus Group Study of an Emerging Issue.

    Science.gov (United States)

    Friese, Bettina; Slater, Michael D; Annechino, Rachelle; Battle, Robynn S

    2016-06-01

    Recent research indicates that marijuana-infused food product (i.e., edible) use is becoming nearly as common as smoking marijuana where medical marijuana is available. This study explores edible use among teens. We conducted four focus groups in the San Francisco Bay Area with youth, ages 15-17. The focus groups were divided by gender and whether they used marijuana. Some teens mentioned edible use at school. Youth reported that teens consume edibles, primarily to reduce the likelihood of getting caught. Edibles are also attractive to those who do not like to smoke or have concerns about smoking. Both male and female respondents suggested that females are more likely than males to prefer edibles over smoking, one reason for which may be to avoid smelling like marijuana smoke. For some young women, edibles may be a way to avoid publicly presenting themselves as marijuana users. Findings also suggest that youth have access to edibles through multiple sources. Youth reported that they can purchase edibles at school from other students who either make the edibles themselves or are reselling edibles obtained from dispensaries. Both users and non-users were aware of potentially negative consequences related to edible use. Some youth mentioned that they have heard of youth dying from edibles, and several reported being concerned about the high produced by edibles. Female non-users appeared to be more concerned than others about edibles and compared them to drinks that could be spiked with drugs. However, sentiment among some male marijuana users was that if you cannot handle edibles you should not be using them. These findings suggest that strategies to curb access to edibles and use among youth, such as restricting sales of edibles with strong youth appeal and educating youth on the risks of edibles, will need to be developed.

  10. Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

    Science.gov (United States)

    Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

    2018-02-01

    In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

  11. Australians' views on personal genomic testing: focus group findings from the Genioz study.

    Science.gov (United States)

    Metcalfe, Sylvia A; Hickerton, Chriselle; Savard, Jacqueline; Terrill, Bronwyn; Turbitt, Erin; Gaff, Clara; Gray, Kathleen; Middleton, Anna; Wilson, Brenda; Newson, Ainsley J

    2018-04-30

    Personal genomic testing provides healthy individuals with access to information about their genetic makeup for purposes including ancestry, paternity, sporting ability and health. Such tests are available commercially and globally, with accessibility expected to continue to grow, including in Australia; yet little is known of the views/expectations of Australians. Focus groups were conducted within a multi-stage, cross-disciplinary project (Genioz) to explore this. In mid-2015, 56 members of the public participated in seven focus groups, allocated into three age groups: 18-24, 25-49, and ≥50 years. Three researchers coded transcripts independently and generated themes. Awareness of personal genomic testing was low, but most could deduce what "personal genomics" might entail. Very few had heard of the term "direct-to-consumer" testing, which has implications for organisations developing information to support individuals in their decision-making. Participants' understanding of genetics was varied and drawn from several sources. There were diverse perceptions of the relative influence of genetics and environment on health, mental health, behavior, talent, or personality. Views about having a personal genomic test were mixed, with greater interest in health-related tests if they believed there was a reason for doing so. However, many expressed scepticisms about the types of tests available, and how the information might be used; concerns were also raised about privacy and the potential for discrimination. These exploratory findings inform subsequent stages of the Genioz study, thereby contributing to strategies of supporting Australians to understand and make meaningful and well-considered decisions about the benefits, harms, and implications of personal genomic tests.

  12. Advantages of asynchronous online focus groups and face-to-face focus groups as perceived by child, adolescent and adult participants: a survey study.

    Science.gov (United States)

    Zwaanswijk, Marieke; van Dulmen, Sandra

    2014-10-24

    Online focus groups (OFGs) are increasingly used as a method of data collection. Although their advantages for research have repeatedly been described, participants' opinions about OFGs have seldom been studied. We investigated OFG participants' preference for participation in an OFG or a face-to-face focus group (FTF), as well as their perceptions of the advantages of both methods. We also investigated whether any differences exist between the perceptions of child, adolescent, and adult participants. Participants' opinions were studied by means of a questionnaire completed by 284 persons (aged 8-72 years) after their participation in one of 50 OFGs. The OFGs were conducted between December 2005 and December 2013 as part of 19 separate studies. Chi square tests with p advantages of OFGs and FTFs between children, adolescents and adults. The most important advantage of OFGs as perceived by OFG participants was the possibility to participate at a moment most convenient to them. Adolescents and adults (90.5% and 95.9%) more often reported this as an advantage than children did (30.8%, p advantage of OFGs was the possibility to participate from home (69.1%). The most important advantage of FTFs was respondents' perception that it is easier to have a discussion with the whole group when there is personal contact with others (48.5%). This advantage was mentioned significantly more often by adults (78.4%) than by children and adolescents (4.8% and 17.7%, p advantages of OFGs as a research method. Whereas respondents generally value the convenience of participating at their own time and place, the anonymity of OFGs and the increased ease to discuss personal issues were mentioned less often as advantages by the participants. An aspect that may need more attention when conducting an OFG, is the absence of a fluid discussion, which is, according to our respondents, easier to achieve in an FTF. This underlines the importance of the moderator in enabling a constructive

  13. Study of charge-sharing in MEDIPIX3 using a micro-focused synchrotron beam

    International Nuclear Information System (INIS)

    Gimenez, E N; Horswell, I; Marchal, J; Sawhney, K J S; Tartoni, N; Ballabriga, R; Campbell, M; Llopart, X; Turecek, D

    2011-01-01

    X-ray photon-counting detectors consisting of a silicon pixel array sensor bump-bonded to a CMOS electronic readout chip offer several advantages over traditional X-ray detection technologies used for synchrotron applications. They offer high frame rate, dynamic range, count rate capability and signal-to-noise ratio. A survey of the requirements for future synchrotron detectors carried out at the Diamond Light Source synchrotron highlighted the needs for detectors with a pixel size of the order of 50μm. Reducing the pixel size leads to an increase of charge-sharing events between adjacent pixels and, therefore, to a degradation of the energy resolution and image quality of the detector. This effect was observed with MEDIPIX2, a photon-counting readout chip with a pixel size of 55μm. The latest generation of the MEDIPIX family, MEDIPIX3, is designed to overcome this charge-sharing effect in an implemented readout operating mode referred to as Charge Summing Mode. MEDIPIX3 has the same pixel size as MEDIPIX2, but it is implemented in an 8-metal 0.13μm CMOS technology which enables increased functionality per pixel. The present work focuses on the study of the charge-sharing effect when the MEDIPIX3 is operated in Charge Summing Mode compared to the conventional readout mode, referred to as Single Pixel Mode. Tests of a standard silicon photodiode array bump-bonded to MEDIPIX3 were performed in beamline B16 at the Diamond Light Source synchrotron. A monochromatic micro-focused beam of 2.9μm x 2.2μm size at 15keV was used to scan a cluster of nine pixels in order to study the charge collection and X-ray count allocation process for each readout mode, Single Pixel Mode and Charge Summing Mode. The study showed that charge-shared events were eliminated when Medipix3 was operated in Charge Summing Mode.

  14. Hotspots in trauma memories and their relationship to successful trauma-focused psychotherapy: a pilot study

    NARCIS (Netherlands)

    Nijdam, Mirjam J.; Baas, Melanie A. M.; Olff, Miranda; Gersons, Berthold P. R.

    2013-01-01

    Imaginal exposure is an essential element of trauma-focused psychotherapies for posttraumatic stress disorder (PTSD). Exposure should in particular focus on the "hotspots," the parts of trauma memories that cause high levels of emotional distress which are often reexperienced. Our aim was to

  15. Preparing Teachers to Deliver Gender-Focused Sexuality/HIV Education: A Case Study from Nigeria

    Science.gov (United States)

    Wood, Susan Y.; Rogow, Deborah; Stines, Frederica

    2015-01-01

    Evidence shows that a focus on gender and power in sexuality/HIV education increases the likelihood of achieving positive sexual health outcomes, and international agencies have called for a shift to a gender-focused approach. However, questions remain about the implementation of such programmes, including how best to prepare teachers to deliver…

  16. Electron backscatter diffraction studies of focused ion beam induced phase transformation in cobalt

    Energy Technology Data Exchange (ETDEWEB)

    Jones, H.G., E-mail: helen.jones@npl.co.uk [National Physical Laboratory, Hampton Road, Teddington, Middlesex TW11 0LW (United Kingdom); Day, A.P. [Aunt Daisy Scientific Ltd, Claremont House, High St, Lydney GL15 5DX (United Kingdom); Cox, D.C. [National Physical Laboratory, Hampton Road, Teddington, Middlesex TW11 0LW (United Kingdom); Advanced Technology Institute, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2016-10-15

    A focused ion beam microscope was used to induce cubic to hexagonal phase transformation in a cobalt alloy, of similar composition to that of the binder phase in a hardmetal, in a controlled manner at 0°, 45° and 80° ion incident angles. The cobalt had an average grain size of ~ 20 μm, allowing multiple orientations to be studied, exposed to a range of doses between 6 × 10{sup 7} and 2 × 10{sup 10} ions/μm{sup 2}. Electron backscatter diffraction (EBSD) was used to determine the original and induced phase orientations, and area fractions, before and after the ion beam exposure. On average, less phase transformation was observed at higher incident angles and after lower ion doses. However there was an orientation effect where grains with an orientation close to (111) planes were most susceptible to phase transformation, and (101) the least, where grains partially and fully transformed at varying ion doses. - Highlights: •Ion-induced phase change in FCC cobalt was observed at multiple incidence angles. •EBSD was used to study the relationship between grain orientation and transformation. •Custom software analysed ion dose and phase change with respect to grain orientation. •A predictive capability of ion-induced phase change in cobalt was enabled.

  17. Usage patterns of aromatherapy among the French general population: A descriptive study focusing on dermal exposure.

    Science.gov (United States)

    Dornic, N; Ficheux, A S; Roudot, A C; Saboureau, D; Ezzedine, K

    2016-04-01

    Although likely benefits of aromatherapy are well documented, little is known about essential oils consumption and exposure to molecules present in the oils. The aim of our study was to determine usage patterns of 12 types of essential oils among a quite large panel, sorted per sex and quintile of age from birth to 70. A survey was conducted in September 2014 among 1507 French individuals, selected to build a representative panel of the general population. The key point of our study, apart from the fact that it has never been done among general population, was the focus on dermal exposure. Information about types of essential oils used, skin areas exposed, frequencies and quantities were collected. Our work revealed that some sub-populations could be significantly exposed to molecules of toxicological concern, especially in terms of skin sensitization. This work is the first step to assess human exposure to these molecules, and will help safety authorities and risk managers to protect the population. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Understanding motivations for dietary supplementation during pregnancy: A focus group study.

    Science.gov (United States)

    Malek PhD, Lenka; Umberger PhD, Wendy J; Makrides PhD, Maria; Collins PhD, Carmel T; Zhou PhD, Shao Jia

    2018-02-01

    to increase understanding of psychosocial factors (behavioural, normative and control beliefs) motivating vitamin and mineral supplement use during pregnancy. ten focus group discussions and two in-depth interviews were conducted using a script comprising questions based on study objectives. All discussions were recorded, transcribed verbatim and analysed using a framework approach. South Australia, Australia. 40 women aged 21-45 years who were either pregnant oreducation level (secondary education only vs. post-secondary) and gravidity (first vs. subsequent pregnancy). all women, except one, used dietary supplements during pregnancy. Most women took supplements to achieve peace of mind knowing that nutrient requirements were 'definitely' being met. Other common factors motivating supplement use were the beliefs that supplementation: benefits maternal and fetal health; corrects known nutritional deficiencies; and is a more efficient method of obtaining required nutrients relative to food. Advice received from healthcare providers and marketing of supplements also motivated supplementation, while forgetting to take supplements was the most common barrier to use. Cost was only a barrier when considering whether or not to continue supplementation post-birth. women believe that supplements are an easier and more reliable source of nutrients than food intake alone, and rely on dietary supplementation as an insurance policy during pregnancy. Further studies are needed in larger and more representative samples to validate these findings and to test the effectiveness of information and intervention strategies targeting appropriate supplement use during pregnancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. 100-HR-1 Operable Unit focused feasibility study report. Draft A

    International Nuclear Information System (INIS)

    1994-09-01

    The standard Comprehensive Environmental Response, Compensation, and Liability Act of 1980 Feasibility Study (FS) includes development and screening of alternatives (phases 1 and 2) and the detailed analysis of alternatives (phase 3). This focused feasibility study (FFS) constitutes the phase 3 portion of the FS process. The FFS process is conducted in two stages, a Process Document (DOE-RL 1994a) and an operable unit-specific FFS document, such as this one. The FFS process is performed by implementing a ''plug-in'' style approach as defined in great detail in the Process Document. The objective of this operable unit-specific FFS is to provide decision makers with sufficient information to allow appropriate and timely selection of interim remedial measures (IRM) for sites associated with the 100-HR-1 Operable Unit. The IRM candidate waste sites are determined in the limited field investigation. Site profiles are developed for each of these waste sites. The site profiles are used in the application of the plug-in approach. The waste site either plugs into the analysis of the alternatives for the group, or deviations from the developed group alternatives are described and documented

  20. Spin-resolved magnetic studies of focused ion beam etched nano-sized magnetic structures

    International Nuclear Information System (INIS)

    Li Jian; Rau, Carl

    2005-01-01

    Scanning ion microscopy with polarization analysis (SIMPA) is used to study the spin-resolved surface magnetic structure of nano-sized magnetic systems. SIMPA is utilized for in situ topographic and spin-resolved magnetic domain imaging as well as for focused ion beam (FIB) etching of desired structures in magnetic or non-magnetic systems. Ultra-thin Co films are deposited on surfaces of Si(1 0 0) substrates, and ultra-thin, tri-layered, bct Fe(1 0 0)/Mn/bct Fe(1 0 0) wedged magnetic structures are deposited on fcc Pd(1 0 0) substrates. SIMPA experiments clearly show that ion-induced electrons emitted from magnetic surfaces exhibit non-zero electron spin polarization (ESP), whereas electrons emitted from non-magnetic surfaces such as Si and Pd exhibit zero ESP, which can be used to calibrate sputtering rates in situ. We report on new, spin-resolved magnetic microstructures, such as magnetic 'C' states and magnetic vortices, found at surfaces of FIB patterned magnetic elements. It is found that FIB milling has a negligible effect on surface magnetic domain and domain wall structures. It is demonstrated that SIMPA can evolve into an important and efficient tool to study magnetic domain, domain wall and other structures as well as to perform magnetic depth profiling of magnetic nano-systems to be used in ultra-high density magnetic recording and in magnetic sensors

  1. Impact of music on the quality of life of cochlear implant users: a focus group study.

    Science.gov (United States)

    Dritsakis, Giorgos; van Besouw, Rachel M; O' Meara, Aoife

    2017-07-01

    To study the aspects of the quality of life (QoL) on which music has an impact in adult cochlear implant (CI) users. Thirty adult CI users aged between 18 and 81 years old with a wide range of patient characteristics and musical backgrounds participated in the study. Six focus group discussions about music in everyday life were conducted and data were analysed using template analysis based on the QoL model of the World Health Organisation Quality of Life BREF questionnaire. A theoretical framework of the impact of music on the QoL was developed. Music was reported to contribute to many aspects of physical, psychological, and social well-being in adult CI users. These positive effects of music on QoL were similar to what has been reported in the literature for normal-hearing adults. However, difficulties in music perception and enjoyment were found to have a negative impact on CI users' QoL, especially by causing unpleasant feelings and limited participation in music-related or routine daily activities. These findings suggest that an improvement in music experiences of CI users may lead to improvements in QoL and therefore support the need for music rehabilitation. However, the relative importance of music overall and of specific aspects of music for each individual should be measured for an accurate assessment of the impact of music on the QoL of CI users.

  2. Temporal focus, temporal distance, and mind-wandering valence: Results from an experience sampling and an experimental study.

    Science.gov (United States)

    Spronken, Maitta; Holland, Rob W; Figner, Bernd; Dijksterhuis, Ap

    2016-04-01

    When mind-wandering, people may think about events that happened in the past, or events that may happen in the future. Using experience sampling, we first aimed to replicate the finding that future-oriented thoughts show a greater positivity bias than past-oriented thoughts. Furthermore, we investigated whether there is a relation between the temporal distance of past- and future-oriented thoughts and the frequency of positive thoughts, a factor that has received little attention in previous work. Second, we experimentally investigated the relation between temporal focus, temporal distance, and thought valence. Both studies showed that future-oriented thoughts were more positive compared to past-oriented thoughts. Regarding temporal distance, thoughts about the distant past and future were more positive than thoughts about the near past and future in the experiment. However, the experience sampling study did not provide clear insight into this relation. Potential theoretical and methodological explanations for these findings are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The internal and external customer focused process improvement and the performance analysis studies in healthcare systems

    Directory of Open Access Journals (Sweden)

    Piril Tekin

    2017-07-01

    Full Text Available Purpose: The main contribution of this paper is to generate an optimum solution for capacity planning and appointment scheduling issues, which are frequently encountered in clinical flows with various route and treatment periods at dental hospitals. Design/methodology/approach: It is essential to define the system well in order to ensure that the working staff and patients use their time very efficiently and that the process flows continuously. By having examined a sample healthcare system through the help of a study addressed in such context, studies on process improvement in line with the dissatisfactions of the working staff and patients have been carried out. Within the scope of the study, the operation of 7 Departments in a dental hospital undergoing a treatment process have been reviewed and examined. The problems encountered as result of the observations made are discussed in detail, and formerly and recently designed system performance analyses are conducted by having performed the respective process improvement studies. The relevant samplings of this study are modeled via the Arena Simulation Program. The data of the previous four months is used in the parameters, which are used through the modellings. The system data are entered by taking into account seasonal characteristics of the data. Findings: The analyses are made as a consequence of such study that has been addressed, it is established that the efficiency of the internal customers of the hospital increases substantially, and that the waiting durations of the dental patients decrease and in turn, the external customer satisfaction increases drastically. Research limitations/implications: Under the scope of the present study, 7 different treatment processes are analysed in a dental hospital in Cukurova Region with a significant patient potential. The treatment clinics present in the hospital are radiology, periodontology, surgery, treatment, orthodontics and prosthesis. These

  4. Focus Studies of Geographically Connected Countries: Analysis of Regionally Oriented Studies in Political Science Publications 1996-2012

    Directory of Open Access Journals (Sweden)

    Andreja Petković

    2013-01-01

    Full Text Available This article studies the focus studies of geographically connected and geographically not connected countries, i.e. regional and comparative regional studies. In the first part of the article, a description of the role and development of this type of studies as a subdiscipline of comparative politics is provided. In the second part, I present the results of quantitative analysis of the content of articles published in the academic journals published or co-published by the Faculty of Political Science, University of Zagreb. The objects of analysis are regional studies of South-East Europe published in the journals. The main goal of this article is to determine which countries in their regional surroundings are researched the most by Croatian political scientists (and other authors who publish such articles in Croatian or English language in those journals, and which countries Croatia is most often compared to. This research has shown that, with regard to studies of the region, Croatian political scientists mostly focus on the countries of the former Yugoslavia.

  5. Evaluation of focused multipolar stimulation for cochlear implants: a preclinical safety study

    Science.gov (United States)

    Shepherd, Robert K.; Wise, Andrew K.; Enke, Ya Lang; Carter, Paul M.; Fallon, James B.

    2017-08-01

    Objective. Cochlear implants (CIs) have a limited number of independent stimulation channels due to the highly conductive nature of the fluid-filled cochlea. Attempts to develop highly focused stimulation to improve speech perception in CI users includes the use of simultaneous stimulation via multiple current sources. Focused multipolar (FMP) stimulation is an example of this approach and has been shown to reduce interaction between stimulating channels. However, compared with conventional biphasic current pulses generated from a single current source, FMP is a complex stimulus that includes extended periods of stimulation before charge recovery is achieved, raising questions on whether chronic stimulation with this strategy is safe. The present study evaluated the long-term safety of intracochlear stimulation using FMP in a preclinical animal model of profound deafness. Approach. Six cats were bilaterally implanted with scala tympani electrode arrays two months after deafening, and received continuous unilateral FMP stimulation at levels that evoked a behavioural response for periods of up to 182 d. Electrode impedance, electrically-evoked compound action potentials (ECAPs) and auditory brainstem responses (EABRs) were monitored periodically over the course of the stimulation program from both the stimulated and contralateral control cochleae. On completion of the stimulation program cochleae were examined histologically and the electrode arrays were evaluated for evidence of platinum (Pt) corrosion. Main results. There was no significant difference in electrode impedance between control and chronically stimulated electrodes following long-term FMP stimulation. Moreover, there was no significant difference between ECAP and EABR thresholds evoked from control or stimulated cochleae at either the onset of stimulation or at completion of the stimulation program. Chronic FMP stimulation had no effect on spiral ganglion neuron (SGN) survival when compared with

  6. Candida infective endocarditis: an observational cohort study with a focus on therapy.

    Science.gov (United States)

    Arnold, Christopher J; Johnson, Melissa; Bayer, Arnold S; Bradley, Suzanne; Giannitsioti, Efthymia; Miró, José M; Tornos, Pilar; Tattevin, Pierre; Strahilevitz, Jacob; Spelman, Denis; Athan, Eugene; Nacinovich, Francisco; Fortes, Claudio Q; Lamas, Cristiane; Barsic, Bruno; Fernández-Hidalgo, Nuria; Muñoz, Patricia; Chu, Vivian H

    2015-04-01

    Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  7. Candida Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy

    Science.gov (United States)

    Johnson, Melissa; Bayer, Arnold S.; Bradley, Suzanne; Giannitsioti, Efthymia; Miró, José M.; Tornos, Pilar; Tattevin, Pierre; Strahilevitz, Jacob; Spelman, Denis; Athan, Eugene; Nacinovich, Francisco; Fortes, Claudio Q.; Lamas, Cristiane; Barsic, Bruno; Fernández-Hidalgo, Nuria; Muñoz, Patricia; Chu, Vivian H.

    2015-01-01

    Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis. PMID:25645855

  8. Farm and rural adolescents′ perspective on hearing conservation: Reports from a focus group study

    Directory of Open Access Journals (Sweden)

    Marie-Anne S Rosemberg

    2015-01-01

    Full Text Available This study explored the attitudes, beliefs, and behaviors of rural and farm adolescents regarding hearing conservation strategies. This qualitative study took place at two high schools in rural Michigan. Twenty-five adolescents living and working on farms or living in rural areas participated in one of two focus groups. Interviews were audio-recorded and transcribed verbatim. Transcripts were coded and analyzed by two researchers and checked by an additional researcher to ensure reliability. Noise exposure was ubiquitous among participants, both in farm-related (e.g., equipment, livestock and non-farm-related (e.g., music, firearms activities. Perceived barriers to use of hearing protection devices outweighed perceived benefits, resulting in uncommon use of protection. When hearing protection was used, it was usually earmuffs or earplugs. Participants indicated a lack of training in noise hazards and protective strategies. Despite their acknowledged risk of hearing loss, participants did not associate their use of hearing protection today with their hearing ability later in life. Categories emerging that relate to hearing protector use included: Barriers, benefits, self-efficacy, situational influences, impersonal influences, cues to action, susceptibility, and severity. Farm and rural adolescents are at risk for noise exposure and hearing loss. The findings stress the significance of work environment and adult modeling in facilitating hearing conservation behaviors. As indicated by the youths′ recommendations, school-based interventions may be an effective approach to address this health concern. Intervention studies are needed to test various approaches that can effectively promote use of hearing conservation strategies among rural and farm adolescents.

  9. RF EMF Risk Perception Revisited: Is the Focus on Concern Sufficient for Risk Perception Studies?

    Science.gov (United States)

    Wiedemann, Peter M; Freudenstein, Frederik; Böhmert, Christoph; Wiart, Joe; Croft, Rodney J

    2017-06-08

    An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study's multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the

  10. [On the Way to Culture-Sensitive Patient Information Materials: Results of a Focus Group Study].

    Science.gov (United States)

    Ries, Zivile; Frank, Fabian; Bermejo, Isaac; Kalaitsidou, Chariklia; Zill, Jördis; Dirmaier, Jörg; Härter, Martin; Bengel, Jürgen; Hölzel, Lars

    2018-06-01

    This study was part of a double-blind randomised controlled trial aimed to evaluate the effects of culture-sensitive patient information materials (PIM) compared with standard translated material. The study aimed to obtain the data for the development of culture sensitive PIM about unipolar depression for the 4 largest migrant groups in Germany (Turkish, Polish, Russian and Italian migration background). A qualitative study using 4 manual-based focus groups (FG), one for each migrant group, with 29 participants (9 with a Turkish (TüG), 8 with a Polish (PoG), 5 with a Russian (RuG) and 7 with an Italian (ItG) migration background) was conducted. The discussions were recorded, transcribed and analyzed using qualitative content analysis. 7 categories were identified. For the (1.) development of a good culture-sensitive PIM an easy language, a clear structure, an assessable extent of information and the avoidance of stereotypes were highlighted cross-culturally in all four FG. RuG and PoG had the largest (2.) lack of information about the German health care system. Concerning the (3.) illness perception RuG named problems with recognizing and understanding depression. PoG, RuG and TüG thematized (4.) feared consequences of the illness and of professional helpseeking. ItG, PoG, RuG had fears concerning (5.) psychotropic drugs as a result from insufficient knowledge about medication. For (6.) doctor-patient relationship cultural specifics were identified in RuG and TüG and for (7.) migration or culture specific reasons for depression in RuG, ItG and TüG. Although the identified categories were relevant for all or for the majority of migrant groups, for most categories specific cultural aspects were discovered. These findings show the importance of a culture sensitive adaptation of PIM. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

    Science.gov (United States)

    van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

    2016-05-28

    The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional

  12. High-intensity focused ultrasound treatment of placenta accreta after vaginal delivery: a preliminary study.

    Science.gov (United States)

    Bai, Y; Luo, X; Li, Q; Yin, N; Fu, X; Zhang, H; Qi, H

    2016-04-01

    To evaluate the safety and efficiency of high-intensity focused ultrasound (HIFU) in the treatment of placenta accreta after vaginal delivery. Enrolled into this study between September 2011 and September 2013 were 12 patients who had been diagnosed with placenta accreta following vaginal delivery and who had stable vital signs. All patients were treated using an ultrasound-guided HIFU treatment system. As indication of the effectiveness of the treatment we considered decreased vascular index on color Doppler imaging, decrease in size of residual placenta compared with pretreatment size on assessment by three-dimensional ultrasound with Virtual Organ Computer-aided Analysis, reduced signal intensity and degree of enhancement on magnetic resonance imaging and avoidance of hysterectomy following treatment. To assess the safety of HIFU treatment, we recorded side effects, hemorrhage, infection, sex steroid levels, return of menses and subsequent pregnancy. Patients were followed up in this preliminary study until December 2013. The 12 patients receiving HIFU treatment had an average postpartum hospital stay of 6.8 days and an average period of residual placental involution of 36.9 days. HIFU treatment did not apparently increase the risk of infection or hemorrhage and no patient required hysterectomy. In all patients menstruation recommenced after an average of 80.2 days, and sex steroid levels during the middle luteal phase of the second menstrual cycle were normal. Two patients became pregnant again during the follow-up period. This preliminary study suggests that ultrasound-guided HIFU is a safe and effective non-invasive method to treat placenta accreta patients after vaginal delivery who have stable vital signs and desire to preserve fertility. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  13. Experiences of employees with arm, neck or shoulder complaints: a focus group study.

    Science.gov (United States)

    Hutting, Nathan; Heerkens, Yvonne F; Engels, Josephine A; Staal, J Bart; Nijhuis-van der Sanden, Maria W G

    2014-04-29

    Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an

  14. 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.

  15. 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

  16. A Preliminary Study of Work-Focused Cognitive Behavioural Group Therapy for Japanese Workers.

    Science.gov (United States)

    Ito, Daisuke; Watanabe, Asuka; Takeichi, Sakino; Ishihara, Ayako; Yamamoto, Kazuyoshi

    2018-06-06

    In Japan, cognitive behavioural therapy (CBT) has been introduced in the 'Rework Programme', but its impact on return to work (RTW) has not been fully clarified. This pilot study investigated the initial efficacy of a work-focused cognitive behavioural group therapy (WF-CBGT) for Japanese workers on sick leave due to depression. Twenty-three patients on leave due to depression were recruited from a mental health clinic. WF-CBGT including behavioural activation therapy, cognitive therapy, and problem-solving therapy techniques was conducted for eight weekly 150-minute sessions. Participants completed questionnaires on depression and anxiety (Kessler-6), social adaptation (Social Adaptation Self-Evaluation Scale), and difficulty in RTW (Difficulty in Returning to Work Inventory) at pre- and post-intervention time points. Rates of re-instatement after the intervention were examined. One participant dropped out, but 22 participants successfully completed the intervention. All scale scores significantly improved after intervention and, except for difficulty in RTW related to physical fitness, all effect sizes were above the moderate classification. All participants who completed the intervention succeeded in RTW. Results suggested the possibility that WF-CBGT may be a feasible and promising intervention for Japanese workers on leave due to depression regardless of cross-cultural differences, but that additional research examining effectiveness using controlled designs and other samples is needed. Future research should examine the efficacy of this programme more systematically to provide relevant data to aid in the continued development of an evidence-based intervention.

  17. Age-dependent impairment of auditory processing under spatially focused and divided attention: an electrophysiological study.

    Science.gov (United States)

    Wild-Wall, Nele; Falkenstein, Michael

    2010-01-01

    By using event-related potentials (ERPs) the present study examines if age-related differences in preparation and processing especially emerge during divided attention. Binaurally presented auditory cues called for focused (valid and invalid) or divided attention to one or both ears. Responses were required to subsequent monaurally presented valid targets (vowels), but had to be suppressed to non-target vowels or invalidly cued vowels. Middle-aged participants were more impaired under divided attention than young ones, likely due to an age-related decline in preparatory attention following cues as was reflected in a decreased CNV. Under divided attention, target processing was increased in the middle-aged, likely reflecting compensatory effort to fulfill task requirements in the difficult condition. Additionally, middle-aged participants processed invalidly cued stimuli more intensely as was reflected by stimulus ERPs. The results suggest an age-related impairment in attentional preparation after auditory cues especially under divided attention and latent difficulties to suppress irrelevant information.

  18. Attitudes towards patient gender among psychiatric hospital staff: results of a case study with focus groups.

    Science.gov (United States)

    Krumm, Silvia; Kilian, Reinhold; Becker, Thomas

    2006-03-01

    There is an increasing awareness of gender-related issues in psychiatry. However, empirical findings on attitudes of psychiatric staff towards patient gender are limited. Gender-related issues are particularly relevant in the debate about mixed versus segregated sex wards, yet while the appropriateness of mixed-sex wards is questioned in Great Britain this is not the case in Germany. To investigate attitudes of psychiatric staff towards both patient gender and mixed versus segregated sex wards, we conducted a case study using focus groups with members of professional teams. We evaluated the transition process from two single-sex wards to two mixed-sex wards in a 330-bed psychiatric hospital in a rural area in south Germany. Staff described female patients as more externally oriented, motivating of others, demanding, and even sexually aggressive. Male patients, on the other hand, were described as more quiet, modest, or lazy. Furthermore, participants described the mixing process as a positive development whereas they did not see a need for gender-separated wards in order to protect vulnerable female patients. Some gender descriptions by professionals are "reversed" in comparison with gender stereotypes supposed to be present in wider society. The perception of crossed gender norms may affect staff attitudes towards the vulnerability of female patients in psychiatric settings and the provision of single-sex wards in in-patient psychiatric care. Practical implications are discussed against the background of a high rate of female patients with sexual abuse histories.

  19. Computerised working-memory focused cognitive remediation therapy for psychosis--A preliminary study.

    Science.gov (United States)

    Hargreaves, A; Dillon, R; Anderson-Schmidt, H; Corvin, A; Fitzmaurice, B; Castorina, M; Robertson, I H; Donohoe, G

    2015-12-01

    Cognitive deficits are a core feature of schizophrenia and related psychotic disorders and are associated with decreased levels of functioning. Behavioural interventions have shown success in remediating these deficits; determining how best to maximise this benefit while minimising the cost is an important next step in optimising this intervention for clinical use. To examine the effects of a novel working-memory focused cognitive remediation (CR) training on cognitive difficulties based on internet delivery of training and weekly telephone support. Participants with a diagnosis of psychosis (n=56) underwent either 8 weeks of CR (approximately 20 h) or 8 weeks of treatment as usual (TAU). General cognitive ability, working memory and episodic memory were measured both pre and post intervention for all participants. In addition to improvements on trained working memory tasks, CR training was associated with significant improvements in two tests of verbal episodic memory. No association between CR and changes in general cognitive ability was observed. Effect sizes for statistically significant changes in memory were comparable to those reported in the literature based primarily on 1:1 training. The cognitive benefits observed in this non-randomised preliminary study indicate that internet-based working memory training can be an effective cognitive remediation therapy. The successes and challenges of an internet-based treatment are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Designing Tailored Messages about Smoking and Breast Cancer: A Focus Group Study with Youth.

    Science.gov (United States)

    Bottorff, Joan L; Haines-Saah, Rebecca; Oliffe, John L; Struik, Laura L; Bissell, Laura J L; Richardson, Chris P; Gotay, Carolyn; Johnson, Kenneth C; Hutchinson, Peter

    2014-03-01

    The purpose of this study was to design an approach to supporting the development of gender- and Aboriginal-specific messages regarding the link between tobacco exposure and breast cancer, drawing on youth perspectives. Focus groups were held with 18 girls (8 First Nations and Métis) and 25 boys (12 First Nations and Métis) to solicit advice in the design of messages. Transcribed data were analyzed for themes. Girls preferred messages that included the use of novel images, a personal story of breast cancer, and ways to avoid secondhand smoke. Boys endorsed messages that were "catchy" but not "cheesy" and had masculine themes. First Nations and Métis participants confirmed the use of Aboriginal symbols in messages as signalling their relevance to youth in their communities. The results can be used as a guide in developing tailored health promotion messages. Challenges in developing gender-appropriate messages for youth are described. Copyright© by Ingram School of Nursing, McGill University.

  1. Women's experience of SLE-related fatigue: a focus group interview study.

    Science.gov (United States)

    Pettersson, Susanne; Möller, Sonia; Svenungsson, Elisabet; Gunnarsson, Iva; Welin Henriksson, Elisabet

    2010-10-01

    The aim of this study was to describe women's experience of SLE-related fatigue, how they express the feeling of fatigue, impact on life and strategies developed to manage fatigue in daily living. Seven, semi-structured focus group discussions with 33 women were audio-taped, transcribed verbatim and analysed according to qualitative content analysis. Perceptions of SLE-related fatigue were sorted into four themes. Nature of Fatigue, involved the sensation, occurrence and character. Aspects Affected by Fatigue described emotions that arose together with fatigue as well as aspects of work, family life, social contacts and leisure activities that were affected by fatigue. Striving Towards Power and Control concluded the array of ways used to manage daily life and were categorized into the mental struggle, structure, restrict and provide. Factors Influencing the Perception of Fatigue described understanding from their surroundings and pain as strongly influencing the experience and perception of fatigue. SLE-related fatigue was portrayed as an overwhelming phenomenon with an unpredictable character, resulting in the feeling that fatigue dominates and controls most situations in life. The choice of strategies was described as a balance with implications for how fatigue limited a person's life. Health care professionals are advised to take a more active role to empower people with SLE to find their own balance as a way to achieve a feeling of being in control.

  2. Study for effective use of fishery byproducts as alternative earth materials focusing on their water retention

    International Nuclear Information System (INIS)

    Kobayashi, Kaoru; Nakafusa, Satoru; Nishimura, Tomoyoshi; Morii, Toshihiro

    2011-01-01

    Capillary barriers have been known and widely used in geoenvironmental engineering applications as soil cover for typical rainfall infiltration control systems. The capillary barrier is consisting of a fine-grained soil layer placed over a coarse-grained soil layer. The applications of capillary barriers are significantly useful to preventing infiltration into waste materials. Natural gravel or coarse-grained soil material had a exhaustion problems in practices. On the contrary, shells a kind of fishery byproduct, are classified as industrial waste in laws concerning waste disposal. The majority of shells are piled and left near the fishing port without controlling system. Therefore, it is proposed that the crushed shells are available to layer material instead of natural coarse-grained soil. This solution is considered to great contribute developing of recycle for fisher byproduct shells and is related to environment conservation. Water retention for crushed shells, however, never been fully investigate. This study focuses on the ability of crushed shells to capillary barrier applications. The soil-water characteristic curve for crushed shells with three different grain size distributions was determined using the modified SWCC testing apparatus. Also, it is observed using a conventional model equipment that the getting of fine sand into crushed shell layer is prevented. (author)

  3. Confidence in public institutions: A focus group study on views on the Swedish Social Insurance Agency.

    Science.gov (United States)

    Holmgren, K; Rosstorp, F; Rohdén, H

    2016-09-27

    From a public health perspective among the working population, it is very important that confidence in the welfare system is high, ensuring the citizens economic security and protecting them from economic stress when falling ill. The aim of this study was to explore how people with experience of health insurance perceive their confidence in the Swedish Social Insurance Agency (SSIA). Eight focus groups (n = 41) were conducted and each group met on one occasion. The participants described a systemic change in the work of the SSIA where the rule-of-law was disregarded, with arbitrary assessment, and no transparency. The reception by the SSIA shaped the image of the SSIA. The participants described vulnerability in relation to the SSIA. They felt mistrusted, which left a feeling of impotence that worsened their health. Experiencing vulnerability left a strong impression and affected the participants' confidence negatively. The following has to be acknowledged to prevent clients from experiencing impaired health, promote return-to-work possibilities, and to push public confidence in the institution in a more positive direction: Politicians and public administrators need to clarify the regulations. The decision-making process needs to be transparent and just. The entire procedure, including continuity as well as a personal, nice reception, has to be ensured.

  4. Strategic planning as a focus for continuous improvement. A case study

    Science.gov (United States)

    Oneill, John W.; Gordon-Winkler, Lyn

    1992-01-01

    What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

  5. 100 Area source operable unit focused feasibility study report. Draft A

    International Nuclear Information System (INIS)

    1994-09-01

    In accordance with the Hanford Past-Practice Strategy (HPPS), a focused feasibility study (FFS) is performed for those waste sites which have been identified as candidates for interim remedial measures (IRM) based on information contained in applicable work plans and limited field investigations (LFI). The FFS process for the 100 Area source operable units will be conducted in two stages. This report, hereafter referred to as the Process Document, documents the first stage of the process. In this stage, IRM alternatives are developed and analyzed on the basis of waste site groups associated with the 100 Area source operable units. The second stage, site-specific evaluation of the IRM alternatives presented in this Process Document, is documented in a series of operable unit-specific reports. The objective of the FFS (this Process Document and subsequent operable unit-specific reports) is to provide decision makers with sufficient information to allow appropriate and timely selection of IRM for sites associated with the 100 Area source operable units. Accordingly, the following information is presented: a presentation of remedial action objectives; a description of 100 Area waste site groups and associated group profiles; a description of IRM alternatives; and detailed and comparative analyses of the IRM alternatives

  6. What young people want from health-related online resources: a focus group study.

    Science.gov (United States)

    Fergie, Gillian; Hunt, Kate; Hilton, Shona

    2013-08-01

    The growth of the Internet as an information source about health, particularly amongst young people, is well established. The aim of this study was to explore young people's perceptions and experiences of engaging with health-related online content, particularly through social media websites. Between February and July 2011 nine focus groups were facilitated across Scotland with young people aged between 14 and 18 years. Health-related user-generated content seems to be appreciated by young people as a useful, if not always trustworthy, source of accounts of other people's experiences. The reliability and quality of both user-generated content and official factual content about health appear to be concerns for young people, and they employ specialised strategies for negotiating both areas of the online environment. Young people's engagement with health online is a dynamic area for research. Their perceptions and experiences of health-related content seem based on their wider familiarity with the online environment and, as the online environment develops, so too do young people's strategies and conventions for accessing it.

  7. The design of a focused ultrasound transducer array for the treatment of stroke: a simulation study

    International Nuclear Information System (INIS)

    Pajek, Daniel; Hynynen, Kullervo

    2012-01-01

    High intensity focused ultrasound (HIFU) is capable of mechanically disintegrating blood clots at high pressures. Safe thrombolysis may require frequencies higher than those currently utilized by transcranial HIFU. Since the attenuation and focal distortion of ultrasound in bone increases at higher frequencies, resulting focal pressures are diminished. This study investigated the feasibility of using transcranial HIFU for the non-invasive treatment of ischemic stroke. The use of large aperture, 1.1–1.5 MHz phased arrays in targeting four clinically relevant vessel locations was simulated. Resulting focal sizes decreased with frequency, producing a maximum –3 dB depth of field and lateral width of 2.0 and 1.2 mm, respectively. Mean focal gains above an order of magnitude were observed in three of four targets and transducer intensities required to achieve thrombolysis were determined. Required transducer element counts are about an order of magnitude higher than what currently exists and so, although technically feasible, new arrays would need to be developed to realize this as a treatment modality for stroke. (paper)

  8. Exploring teams of learners becoming "WE" in the Intensive Care Unit--a focused ethnographic study.

    Science.gov (United States)

    Conte, Helen; Scheja, Max; Hjelmqvist, Hans; Jirwe, Maria

    2015-08-16

    Research about collaboration within teams of learners in intensive care is sparse, as is research on how the learners in a group develop into a team. The aim of this study was to explore the collaboration in teams of learners during a rotation in an interprofessional education unit in intensive care from a sociocultural learning perspective. Focused Ethnographic methods were used to collect data following eight teams of learners in 2009 and 2010. Each team consisted of one resident, one specialist nurse student and their supervisors (n = 28). The material consisted of 100 hours of observations, interviews, and four hours of sound recordings. A qualitative analysis explored changing patterns of interplay through a constant comparative approach. The learners' collaboration progressed along a pattern of participation common to all eight groups with a chronological starting point and an end point. The progress consisted of three main steps where the learners' groups developed into teams during a week's training. The supervisors' guided the progress by gradually stepping back to provide latitude for critical reflection and action. Our main conclusion in training teams of learners how to collaborate in the intensive care is the crucial understanding of how to guide them to act like a team, feel like a team and having the authority to act as a team.

  9. PISC II: Parametric studies. Effect of defect characteristics on immersion focusing probe testing results

    International Nuclear Information System (INIS)

    Dombret, P.

    1989-09-01

    The results of the Round-Robin trials conducted under the PISC I exercise (1976-1980) showed large discrepancies in the defect detection and sizing capability among different flaws. To identify the causes of such dispersions and quantify the effects, a Parametric Study was included in the PISC II project, taking into consideration most characteristics of planar flaws. A number of steel specimens containing various artificial defects was made available for the measurements. The defects were ultrasonically scanned by standard methods and by some advanced techniques the high performance of which had been established in the PISC Round-Robin Tests. This report deals with the beam focusing technique: 2 MHz 45 0 shear wave transducers have been used in immersion to collect the signals generated by the reference reflectors. The results show that the depth and the size of a defect do not affect significantly its detection and sizing, provided that the natural variation of sensitivity and of beam diameter along the propagation axis is taken into account. On the other hand, parameters such as the orientation and the roughness modify the conditions of impact and interference of the acoustic beam with the defect surface, and therefore strongly influence the energy partition in diffracted and specularly reflected rays. As an example, sharp smooth defects insonified under an angle of 45 0 return to the transducer signals approximately 10 times smaller than the ASME code calibration level

  10. Strategic planning as a focus for continuous improvement. A case study

    Science.gov (United States)

    Oneill, John W.; Gordon-Winkler, Lyn

    What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

  11. Vaccination decision-making of immigrant parents in the Netherlands; a focus group study.

    Science.gov (United States)

    Harmsen, Irene A; Bos, Helien; Ruiter, Robert A C; Paulussen, Theo G W; Kok, Gerjo; de Melker, Hester E; Mollema, Liesbeth

    2015-12-10

    Although the vaccination coverage in most high income countries is high, variations in coverage rates on the national level among different ethnic backgrounds are reported. A qualitative study was performed to explore factors that influence decision-making among parents with different ethnic backgrounds in the Netherlands. Six focus groups were conducted with 33 mothers of Moroccan, Turkish and other ethnic backgrounds with at least one child aged 0-4 years. Data were analysed using thematic analysis. Parents had a positive attitude towards childhood vaccination and a high confidence in the advices of Child Vaccine Providers (CVPs). Vaccinating their children was perceived as self-evident and important. Parents do perceive a language barrier in understanding the provided NIP-information, and they had a need for more NIP- information, particularly about the targeted diseases. Another barrier parents perceived was the distance to the Child Welfare Center (CWC), especially when the weather was bad and when they had no access to a car. More information about targeted diseases and complete information regarding benefits and drawbacks of the NIP should be provided to the parents. To fulfill parents' information needs, NIP information meetings can be organized at CWCs in different languages. Providing NIP information material in Turkish, Arabic and Berber language with easy access is also recommended. Providing information tailored to these parents' needs is important to sustain high vaccination participation, and to ensure acceptance of future vaccinations.

  12. Sickness certification difficulties in Ireland--a GP focus group study.

    Science.gov (United States)

    Foley, M; Thorley, K; Von Hout, M-C

    2013-07-01

    Sickness certification causes problems for general practitioners (GPs). Difficulty with the assessment of capacity to work, conflict with patients and other non-medical factors have been shown to influence GPs' decision-making. Inadequate leadership and management of certification issues add to GPs' difficulties. To explore problems associated with sickness certification, as part of a larger mixed method research project exploring GPs' experiences and perceptions of sickness certification in Ireland. A qualitative study in an urban region of Ireland. A focus group of four male and four female GPs explored problems encountered by GPs in certifying sickness absence. Thematic data analysis was used. Three major themes emerged: perception of the sickness certification system, organization of health care and cultural factors in sickness absence behaviour. Employment structures in public and private sectors and lack of communication with other health care providers and employers were identified as complicating sickness certification. GPs encounter a complexity of issues in sick certification and are dissatisfied with their role in certifying sickness absence. Our results open the debate for policy change and development in Ireland.

  13. X-ray polarization studies of plasma focus experiments with a single hot spots

    International Nuclear Information System (INIS)

    Jakubowski, L.; Sadowski, M.J.; Baronova, E.O.

    2004-01-01

    In high current pulse discharges of the plasma focus (PF) type, inside the collapsing pinch column, there are formed local micro-regions of high-density and high-temperature plasma, so-called hot spots. Individual hot spots are separated in space and time. Each hot spot is characterized by its specific electron concentration and temperature, as well as by the emission of x-ray lines with different polarization. When numerous hot spots are produced it is impossible to determine local plasma parameters and to interpret the polarization effects. To eliminate this problem this study was devoted to the realization of PF-type discharges with single hot spot only. It has been achieved by a choice of the electrode configuration, which facilitated the formation of a single hot spot emitting intense x-ray lines. At the chosen experimental conditions it was possible to determine local plasma parameters and to demonstrate evident differences in the polarization of the observed x-ray lines. (author)

  14. Young adolescents' perceptions, patterns, and contexts of energy drink use. A focus group study.

    Science.gov (United States)

    Costa, Beth M; Hayley, Alexa; Miller, Peter

    2014-09-01

    Caffeinated energy drinks (EDs) are purported to increase energy and improve performance, but have been associated with adverse health effects and death. EDs are popular among adolescents and young adults, yet little is known about their use among young adolescents. This study explored perceptions, patterns, and contexts of ED use in six focus groups with 40 adolescents aged 12-15 years from two regional Australian schools. A thematic analysis of the data was used to investigate knowledge about ED brands and content, ED use, reasons for ED use, physiological effects, and influences on ED use. Participants were familiar with EDs and most had used them at least once but had limited knowledge of ED ingredients, and some had difficulty differentiating them from soft and sports drinks. EDs were used as an alternative to other drinks, to provide energy, and in social contexts, and their use was associated with short-term physiological symptoms. Parents and advertising influenced participants' perceptions and use of EDs. These findings suggest young adolescents use EDs without knowing what they are drinking and how they are contributing to their personal risk of harm. The advertising, appeal, and use of EDs by adolescents appear to share similarities with alcohol and tobacco. Further research is needed to replicate and extend the current findings, informed by the lessons learned in alcohol research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Corporate Sustainability Strategies: A Case Study in Brazil Focused on High Consumers of Electricity

    Directory of Open Access Journals (Sweden)

    Fabricio Casarejos

    2016-08-01

    Full Text Available The decline of socio-ecological resilience has emerged as an unprecedented truth with high risks to local and global economies, thereby increasing the vulnerability of businesses and markets while potentially threatening the wellbeing of civil society as a whole. From a business perspective, corporate strategies towards sustainability are crucial to strengthen the social and economic foundations that foster sustainable development. In order to assist enterprises pursuing leading market positions, this work proposes a set of strategic actions towards sustainability and an evaluation scheme to assess the effectiveness of their implementation process. This proposed global strategy encompasses five key sustainability indices—commitment, investment, difficulty, proactivity and vulnerability—focusing the investigation on a sample of enterprises representing the highest consumers of electricity in the state of Rio de Janeiro, Brazil. Addressing the energy consumption, this study also discusses the concerning level of GHG emissions that are associated with the generation of electricity. Although 85% of the enterprises participating in this survey recognized the relevance of the actions proposed, the current degree of proactivity and vulnerability associated with these enterprises indicate that very few of them have effectively implemented and invested in corporate sustainability programs, certainly a symptom of their institutional vulnerability.

  16. Perceptions of telecare training needs in home healthcare services: a focus group study.

    Science.gov (United States)

    Guise, Veslemøy; Wiig, Siri

    2017-02-23

    The implementation and use of telecare requires significant changes to healthcare service organisation and delivery, including new ways of working for staff. Competency development and training for healthcare professionals is therefore required to enable necessary adaptation of clinical practice and ensure competent provision of telecare services. It is however unclear what skills healthcare staff need when providing care at a distance and there is little empirical evidence on effective training strategies for telecare practice. Training should however emphasise the experiences and preferences of prospective trainees to ensure its relevance to their educational needs. The aim of this study was to explore healthcare professionals' perceptions of training related to the general use of telecare, and to identify specific training needs associated with the use of virtual visits in the home healthcare services. Six focus group interviews were held with a total of 26 participants working in the home healthcare services in Norway, including registered nurses, enrolled nurses, physiotherapists, occupational therapists, social workers, health workers, and healthcare assistants. The data material was analysed by way of systematic text condensation. The analysis resulted in five categories relevant to telecare training for healthcare professionals: Purposeful training creates confidence and changes attitudes; Training needs depend on ability to cope with telecare; The timing of training; Training must facilitate practical insight into the patients' perspective; and Training content must focus on the telecare process. Findings are discussed in light of implications for the form and content of a training program for healthcare professionals on how to undertake virtual home healthcare visits. Appropriate preparation and training for telecare use is important for healthcare professionals and must be taken seriously by healthcare organisations. To facilitate the knowledge, skills

  17. Midwives' experiences of performing maternal observations and escalating concerns: a focus group study.

    Science.gov (United States)

    Jeffery, Justine; Hewison, Alistair; Goodwin, Laura; Kenyon, Sara

    2017-09-02

    For the past decade, Maternal Mortality Reports, published in the United Kingdom every three years, have consistently raised concerns about maternal observations in maternity care. The reports identify that observations are not being done, not being completed fully, are not recorded on Early Warning Score systems, and/or are not escalated appropriately. This has resulted in delays in referral, intervention and increases the risk of maternal morbidity or mortality. However there has been little exploration of the possible reasons for non-completion of maternal observations. The aim of this study was to explore midwives' experiences of performing maternal observations and escalating concerns in rural and urban maternity settings in the West Midlands of England. A qualitative design involving a series of six focus groups with midwives and Supervisors of Midwives was employed to investigate the facilitators of, and barriers to the completion of maternal observations. Eighteen Midwives and 8 Supervisors of Midwives participated in a total of 6 focus groups. Three key themes emerged from the data: (1) Organisation of Maternal Observations (including delegation of tasks to Midwifery Support Workers, variation in their training, the care model used e.g. one to one care, and staffing issues); (2) Prioritisation of Maternal Observations (including the role of professional judgement and concerns expressed by midwives that they did not feel equipped to care for women with complex clinical needs; and (3) Negotiated Escalation (including the inappropriate response from senior staff to use of Modified Early Warning Score systems, and the emotional impact of escalation). A number of organisational and cultural barriers exist to the completion of maternal observations and the escalation of concerns. In order to address these the following actions are recommended: standardised training for Midwifery Support Workers, review of training of midwives to ensure it addresses the

  18. A couple-focused intervention to prevent postnatal smoking relapse: PRISM study design.

    Science.gov (United States)

    Meghea, Cristian Ioan; Brînzaniuc, Alexandra; Mihu, Dan; Iuhas, Cristian Ioan; Stamatian, Florin; Caracostea, Gabriela; Sidor, Alexandra; Alexa, Paula Mădălina; Brînza, Cătălina; Pop, Oana Maria; Cherecheș, Răzvan Mircea

    2015-03-01

    Maternal smoking is one of the most modifiable factors with clear adverse effects for the fetus and the entire family. Addressing the dearth of pregnancy smoking interventions with partner support, PRISM (Prevent Relapse In SMoking) is a partnership between a research institution and the two largest state-owned obstetrics and gynecology clinics in Cluj-Napoca, Romania. The study will assess the efficacy of a couple-focused telephone-counseling program to prevent smoking relapse among mothers who quit smoking closely before or during pregnancy. The intervention is a program for couples based on motivational interviewing delivered over the phone after birth. The study is an ongoing randomized controlled trial of 250 Romanian women recruited soon after childbirth, who quit smoking in the six months before pregnancy or no later than the end of the first pregnancy trimester and remained abstinent (which was biochemically verified) until delivery. Participants were randomized to: (1) a control arm (usual care); and (2) an intervention arm consisting of up to 4 postnatal counseling calls for mothers and their partners using motivational interviewing to encourage the woman to remain smoke-free and the partner to support her decision. The primary outcome is maternal smoking abstinence at 6 months postpartum (biochemically verified). PRISM has the potential to identify strategies to reduce maternal postnatal relapse and increase partner quitting. If successful, the program may be an effective method to prevent and reduce smoking, which may lead to improved child, mother, and partner health both in the short and the long term. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Role modelling of clinical tutors: a focus group study among medical students.

    Science.gov (United States)

    Burgess, Annette; Goulston, Kerry; Oates, Kim

    2015-02-14

    Role modelling by clinicians assists in development of medical students' professional competencies, values and attitudes. Three core characteristics of a positive role model include 1) clinical attributes, 2) teaching skills, and 3) personal qualities. This study was designed to explore medical students' perceptions of their bedside clinical tutors as role models during the first year of a medical program. The study was conducted with one cohort (n = 301) of students who had completed Year 1 of the Sydney Medical Program in 2013. A total of nine focus groups (n = 59) were conducted with medical students following completion of Year 1. Data were transcribed verbatim. Thematic analysis was used to code and categorise data into themes. Students identified both positive and negative characteristics and behaviour displayed by their clinical tutors. Characteristics and behaviour that students would like to emulate as medical practitioners in the future included: 1) Clinical attributes: a good knowledge base; articulate history taking skills; the ability to explain and demonstrate skills at the appropriate level for students; and empathy, respect and genuine compassion for patients. 2) Teaching skills: development of a rapport with students; provision of time towards the growth of students academically and professionally; provision of a positive learning environment; an understanding of the student curriculum and assessment requirements; immediate and useful feedback; and provision of patient interaction. 3) Personal qualities: respectful interprofessional staff interactions; preparedness for tutorials; demonstration of a passion for teaching; and demonstration of a passion for their career choice. Excellence in role modelling entails demonstration of excellent clinical care, teaching skills and personal characteristics. Our findings reinforce the important function of clinical bedside tutors as role models, which has implications for faculty development and

  20. Social support contributes to resilience among physiotherapy students: a cross sectional survey and focus group study.

    Science.gov (United States)

    Bíró, Éva; Veres-Balajti, Ilona; Kósa, Karolina

    2016-06-01

    The present study, taking a resource-oriented approach to mental health, aimed at investigating mental resilience and its determinants among undergraduate physiotherapy students using quantitative and qualitative tools. A questionnaire-based cross-sectional survey supplemented by 2 focus groups. One university in Hungary. 130 physiotherapy students at years 1, 2, and 3. Sense of coherence, a measure of dynamic self-esteem, as well as social support from family and peers were used to assess mental well-being. A screening instrument for psychological morbidity and perceived stress were used as deficiency-oriented approaches. Student opinions were gathered on positive and negative determinants of mental health. Resilience was lower [mean difference 4.8 (95% CI -3.4; 13.1)], and the occurrence of psychological morbidity (32.5% vs. 0%) was higher among female compared to male students. However, the proportion of students fully supported by their peers was higher among females (63% vs. 37.5%). Female students, unlike their male counterparts, experienced higher stress compared to their peers in the general population. Social support declined as students progressed in their studies though this proved to be the most important protective factor for their mental well-being. Results were fed back to the course organizers recommending the implementation of an evidence-based method to improve social support as delineated by the Guide to Community Preventive Services of the US the outcomes of which are to be seen in the future. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  1. Perceptions of mental workload in Dutch university employees of different ages: a focus group study

    Science.gov (United States)

    2013-01-01

    Background As academic workload seems to be increasing, many studies examined factors that contribute to the mental workload of academics. Age-related differences in work motives and intellectual ability may lead to differences in experienced workload and in the way employees experience work features. This study aims to obtain a better understanding of age differences in sources of mental workload. 33 academics from one faculty discussed causes of workload during focus group interviews, stratified by age. Findings Among our participants, the influence of ageing seems most evident in employees’ actions and reactions, while the causes of workload mentioned seemed largely similar. These individual reactions to workload may also be driven by differences in tenure. Most positively assessed work characteristics were: interaction with colleagues and students and autonomy. Aspects most often indicated as increasing the workload, were organisational aspects as obstacles for ‘getting the best out of people’ and the feeling that overtime seems unavoidable. Many employees indicated to feel stretched between the ‘greediness’ of the organisation and their own high working standards, and many fear to be assigned even less time for research if they do not meet the rigorous output criteria. Moreover, despite great efforts on their part, promotion opportunities seem limited. A more pronounced role for the supervisor seems appreciated by employees of all ages, although the specific interpretation varied between individuals and career stages. Conclusions To preserve good working conditions and quality of work, it seems important to scrutinize the output requirements and tenure-based needs for employee supervision. PMID:23506458

  2. "Teaching is like nightshifts …": a focus group study on the teaching motivations of clinicians.

    Science.gov (United States)

    Dybowski, Christoph; Harendza, Sigrid

    2014-01-01

    To ensure the highest quality of education, medical schools have to be aware of factors that influence the motivation of teachers to perform their educational tasks. Although several studies have investigated motivations for teaching among community-based practitioners, there is little data available for hospital-based physicians. This study aimed to identify factors influencing hospital-based physicians' motivations to teach. We conducted 3 focus group discussions with 15 clinical teachers from the Medical Faculty at Hamburg University. Using a qualitative inductive approach, we extracted motivation-related factors from the transcripts of the audio-recorded discussions. Three main multifaceted categories influencing the motivation of teachers were identified: the teachers themselves, the students, and the medical faculty as an organization. Participants showed individual sets of values and beliefs about their roles as teachers as well as personal notions of what comprises a "good" medical education. Their personal motives to teach comprised a range of factors from intrinsic, such as the joy of teaching itself, to more extrinsic motives, such as the perception of teaching as an occupational duty. Teachers were also influenced by the perceived values and beliefs of their students, as well as their perceived discipline and motivation. The curriculum organization and aspects of leadership, human resource development, and the evaluation system proved to be relevant factors as well, whereas extrinsic incentives had no reported impact. Individual values, beliefs, and personal motives constitute the mental framework upon which teachers perceive and assess motivational aspects for their teaching. The interaction between these personal dispositions and faculty-specific organizational structures can significantly impair or enhance the motivation of teachers and should therefore be accounted for in program and faculty development.

  3. Thrombolysis using multi-frequency high intensity focused ultrasound at MHz range: an in vitro study

    International Nuclear Information System (INIS)

    Suo, Dingjie; Guo, Sijia; Jiang, Xiaoning; Jing, Yun; Lin, Weili

    2015-01-01

    High intensity focused ultrasound (HIFU) based thrombolysis has emerged as a promising drug-free treatment approach for ischemic stroke. The large amount of acoustic power required by this approach, however, poses a critical challenge to the future clinical translation. In this study, multi-frequency acoustic waves at MHz range (near 1.5 MHz) were introduced as HIFU excitations to reduce the required power for treatment as well as the treatment time. In vitro bovine blood clots weighing around 150 mg were treated by single-frequency and multi-frequency HIFU. The pulse length was 2 ms for all experiments except the ones where the duty cycle was changed. It was found that dual-frequency thrombolysis efficiency was statistically better than single-frequency under the same acoustic power and excitation condition. When varying the acoustic power but fixing the duty cycle at 5%, it was found that dual-frequency ultrasound can save almost 30% power in order to achieve the same thrombolysis efficiency. In the experiment where the duty cycle was increased from 0.5% to 10%, it was shown that dual-frequency ultrasound can achieve the same thrombolysis efficiency with only half of the duty cycle of single-frequency. Dual-frequency ultrasound could also accelerate the thrombolysis by a factor of 2–4 as demonstrated in this study. No significant differences were found between dual-frequencies with different frequency differences (0.025, 0.05, and 0.1 MHz) and between dual-frequency and triple-frequency. The measured cavitation doses of dual-frequency and triple-frequency excitations were at about the same level but both were significantly higher than that of single-frequency. (paper)

  4. RF EMF Risk Perception Revisited: Is the Focus on Concern Sufficient for Risk Perception Studies?

    Science.gov (United States)

    Wiedemann, Peter M.; Freudenstein, Frederik; Böhmert, Christoph; Wiart, Joe; Croft, Rodney J.

    2017-01-01

    An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study’s multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the

  5. Big hearts, small hands: a focus group study exploring parental food portion behaviours

    Directory of Open Access Journals (Sweden)

    Kristina Curtis

    2017-09-01

    Full Text Available Abstract Background The development of healthy food portion sizes among families is deemed critical to childhood weight management; yet little is known about the interacting factors influencing parents’ portion control behaviours. This study aimed to use two synergistic theoretical models of behaviour: the COM-B model (Capability, Opportunity, Motivation – Behaviour and Theoretical Domains Framework (TDF to identify a broad spectrum of theoretically derived influences on parents’ portion control behaviours including examination of affective and habitual influences often excluded from prevailing theories of behaviour change. Methods Six focus groups exploring family weight management comprised of one with caseworkers (n = 4, four with parents of overweight children (n = 14 and one with parents of healthy weight children (n = 8. A thematic analysis was performed across the dataset where the TDF/COM-B were used as coding frameworks. Results To achieve the target behaviour, the behavioural analysis revealed the need for eliciting change in all three COM-B domains and nine associated TDF domains. Findings suggest parents’ internal processes such as their emotional responses, habits and beliefs, along with social influences from partners and grandparents, and environmental influences relating to items such as household objects, interact to influence portion size behaviours within the home environment. Conclusion This is the first study underpinned by COM-B/TDF frameworks applied to childhood weight management and provides new targets for intervention development and the opportunity for future research to explore the mediating and moderating effects of these variables on one another.

  6. A description of the "event manager" role in resuscitations: A qualitative study of interviews and focus groups of resuscitation participants.

    Science.gov (United States)

    Taylor, Katherine L; Parshuram, Christopher S; Ferri, Susan; Mema, Briseida

    2017-06-01

    Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication. This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital. The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred. "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. 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.

  8. 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.

  9. TOURISM STUDIES IN THE HIGHER EDUCATION IN SWEDEN: FOCUSING ON SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Olga Milinchuk

    2017-11-01

    programs is supported by the increasing number of international students obtaining degree program in Sweden. Practical implications. This paper presents the Swedish experience of institutionalization of tourism studies into the higher education, which may be interesting for program administrators, faculty, and prospective graduate students. Value/originality. The analysed data shows the specific features of master’s programs in tourism studies and identifies the focusing of Swedish higher education on sustainability.

  10. Multi-parametric monitoring and assessment of high-intensity focused ultrasound (HIFU) boiling by harmonic motion imaging for focused ultrasound (HMIFU): an ex vivo feasibility study

    International Nuclear Information System (INIS)

    Hou, Gary Y; Marquet, Fabrice; Wang, Shutao; Konofagou, Elisa E

    2014-01-01

    Harmonic motion imaging for focused ultrasound (HMIFU) is a recently developed high-intensity focused ultrasound (HIFU) treatment monitoring method with feasibilities demonstrated in vitro and in vivo. Here, a multi-parametric study is performed to investigate both elastic and acoustics-independent viscoelastic tissue changes using the Harmonic Motion Imaging (HMI) displacement, axial compressive strain and change in relative phase shift during high energy HIFU treatment with tissue boiling. Forty three (n = 43) thermal lesions were formed in ex vivo canine liver specimens (n = 28). Two-dimensional (2D) transverse HMI displacement maps were also obtained before and after lesion formation. The same method was repeated in 10 s, 20 s and 30 s HIFU durations at three different acoustic powers of 8, 10, and 11 W, which were selected and verified as treatment parameters capable of inducing boiling using both thermocouple and passive cavitation detection (PCD) measurements. Although a steady decrease in the displacement, compressive strain, and relative change in the focal phase shift (Δϕ) were obtained in numerous cases, indicating an overall increase in relative stiffness, the study outcomes also showed that during boiling, a reverse lesion-to-background displacement contrast was detected, indicating potential change in tissue absorption, geometrical change and/or, mechanical gelatification or pulverization. Following treatment, corresponding 2D HMI displacement images of the thermal lesions also mapped consistent discrepancy in the lesion-to-background displacement contrast. Despite the expectedly chaotic changes in acoustic properties with boiling, the relative change in phase shift showed a consistent decrease, indicating its robustness to monitor biomechanical properties independent of the acoustic property changes throughout the HIFU treatment. In addition, the 2D HMI displacement images confirmed and indicated the increase in the thermal lesion size with

  11. Study of correlations between photoproduced pairs of charmed particles at Experiment E831/FOCUS

    Energy Technology Data Exchange (ETDEWEB)

    Castromonte Flores, Cesar Manuel [Brazilian Center for Physics Research, Rio de Janeiro (Brazil)

    2008-08-01

    The authors present the study of the charm-pair correlations produced in photon-nucleon interactions at $\\langle$Eγ$\\rangle$ = 175 GeV/c, by the Fermilab fixed target experiment E831/FOCUS. The E831/FOCUS experiment produced and reconstructed over one million charm particles. This high statistics allows the reconstruction of more than 7000 charm-pair mesons D$\\bar{D}$, 10 times the statistic of former experiments, and also allows to get, for the first time, about 600 totally reconstructed charm-pairs in the DDs and DΛc channels. They were able to study, with some detail, the kinematical correlations between the charm and anticharm particle forming a pair, in the square transverse momentum (pT2), azimuthal angle difference (ΔΦ), rapidity difference (Δy) and the charm-pair mass variables. They observe some correlation for the longitudinal momenta, and a significant correlation for the transverse momenta of the charm and anticharm particles. They compare the experimental distributions with theoretical predictions based on the photon-gluon fusion model (PGF), for the production of c$\\bar{c}$ quarks, and the standard Lund hadronization model. These models are implemented by the PYTHIA Monte Carlo event generator. The PYTHIA program allows the inclusion, in the simulation, of non-perturbative effects that have been shown to be important for charm production. In order to compare data and simulation, they have generated two Monte Carlo samples, the first one set to favor the production of D$\\bar{D}$ pairs (MCDD2), and the second one set to favor the production of DDsand DΛc pairs, where each one uses different functions and parameters values for the theoretical models in the simulation. They observe, for the correlation distributions, that the set of parameters used by the MCDD2 model together with the intrinsic transverse momentum (k$\\perp$) of the partons inside the

  12. Adolescents' and Young Adults' Perceptions of Electronic Cigarettes for Smoking Cessation: A Focus Group Study.

    Science.gov (United States)

    Camenga, Deepa R; Cavallo, Dana A; Kong, Grace; Morean, Meghan E; Connell, Christian M; Simon, Patricia; Bulmer, Sandra M; Krishnan-Sarin, Suchitra

    2015-10-01

    Research has shown that adults perceive that electronic cigarettes (e-cigarettes) are effective for smoking cessation, yet little is known about adolescents and young adults' perceptions of e-cigarettes for quitting cigarette smoking. This study describes middle, high school, and college students' beliefs about, and experiences with, e-cigarettes for cigarette smoking cessation. We conducted 18 focus groups (n = 127) with male and female cigarette smokers and nonsmokers in 2 public colleges, 2 high schools, and 1 middle school in Connecticut between November 2012 and April 2013. Participants discussed cigarette smoking cessation in relation to e-cigarettes. Verbatim transcripts were analyzed using thematic analysis. All participants, regardless of age and smoking status, were aware that e-cigarettes could be used for smoking cessation. College and high school participants described different methods of how e-cigarettes could be used for smoking cessation: (a) nicotine reduction followed by cessation; (b) cigarette reduction/dual use; and (c) long-term exclusive e-cigarette use. However, overall, participants did not perceive that e-cigarette use led to successful quitting experiences. Participants described positive attributes (maintenance of smoking actions, "healthier" alternative to cigarettes, and parental approval) and negative attributes (persistence of craving, maintenance of addiction) of e-cigarettes for cessation. Some college students expressed distrust of marketing of e-cigarettes for smoking cessation. Adolescent and young adult smokers and nonsmokers perceive that there are several methods of using e-cigarettes for quitting and are aware of both positive and negative aspects of the product. Future research is needed to determine the role of e-cigarettes for smoking cessation in this population. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions

  13. E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views.

    Science.gov (United States)

    Hilton, Shona; Weishaar, Heide; Sweeting, Helen; Trevisan, Filippo; Katikireddi, Srinivasa Vittal

    2016-11-16

    Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them. 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14-17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed. Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as 'fun' and having 'great flavourings'. Seeing websites or social media featuring e-cigarettes, especially YouTube 'vaping tricks', prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit. Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Adolescents’ and Young Adults’ Perceptions of Electronic Cigarettes for Smoking Cessation: A Focus Group Study

    Science.gov (United States)

    Camenga, Deepa R.; Cavallo, Dana A.; Kong, Grace; Morean, Meghan E.; Connell, Christian M.; Simon, Patricia; Bulmer, Sandra M.

    2015-01-01

    Introduction: Research has shown that adults perceive that electronic cigarettes (e-cigarettes) are effective for smoking cessation, yet little is known about adolescents and young adults’ perceptions of e-cigarettes for quitting cigarette smoking. This study describes middle, high school, and college students’ beliefs about, and experiences with, e-cigarettes for cigarette smoking cessation. Methods: We conducted 18 focus groups (n = 127) with male and female cigarette smokers and nonsmokers in 2 public colleges, 2 high schools, and 1 middle school in Connecticut between November 2012 and April 2013. Participants discussed cigarette smoking cessation in relation to e-cigarettes. Verbatim transcripts were analyzed using thematic analysis. Results: All participants, regardless of age and smoking status, were aware that e-cigarettes could be used for smoking cessation. College and high school participants described different methods of how e-cigarettes could be used for smoking cessation: (a) nicotine reduction followed by cessation; (b) cigarette reduction/dual use; and (c) long-term exclusive e-cigarette use. However, overall, participants did not perceive that e-cigarette use led to successful quitting experiences. Participants described positive attributes (maintenance of smoking actions, “healthier” alternative to cigarettes, and parental approval) and negative attributes (persistence of craving, maintenance of addiction) of e-cigarettes for cessation. Some college students expressed distrust of marketing of e-cigarettes for smoking cessation. Conclusions: Adolescent and young adult smokers and nonsmokers perceive that there are several methods of using e-cigarettes for quitting and are aware of both positive and negative aspects of the product. Future research is needed to determine the role of e-cigarettes for smoking cessation in this population. PMID:25646346

  15. Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study.

    Science.gov (United States)

    Somerville, Claire; Marteau, Theresa M; Kinmonth, Ann Louise; Cohn, Simon

    2015-12-01

    Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300,000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

  16. Coping strategies used by traumatic spinal cord injury patients in Sri Lanka: a focus group study.

    Science.gov (United States)

    Arya, Sumedha; Xue, Siqi; Embuldeniya, Amanda; Narammalage, Harsha; da Silva, Tricia; Williams, Shehan; Ravindran, Arun

    2016-10-01

    Psychosocial consequences of traumatic spinal cord injury (SCI) have been well documented in Western populations, but there is no published literature on such incidence in the Sri Lankan population. The purpose of this study was to explore the psychosocial impact of SCI in a Sri Lankan population and to examine this population's coping mechanisms. Participants were recruited purposively at the Ragama Rheumatology and Rehabilitation Hospital, the sole rehabilitation facility for SCI patients in Sri Lanka. Focus groups were conducted with 23 consenting individuals. Interview transcripts were analysed using descriptive thematic analysis. Four domains of life impact, three types of active coping strategies and four types of external supports were identified. Decreased ambulation and burden on family life were significant concerns for male and female participants alike. Religious practices were reported most frequently as active coping strategies, followed by positive reframing and goal-setting. Reported external supports included guided physiotherapy, informational workshops, social support and peer networks. Rehabilitation efforts for Sri Lankan SCI patients should be sensitive to psychosocial concerns in addition to physical concerns in order to help patients re-integrate into their family lives and community. Furthermore, religious practices should be respected as possible aids to rehabilitation. Implications for Rehabilitation Rehabilitative efforts should be conscientious of patients' psychosocial well-being in addition to their physical well-being. Hospital-based rehabilitative efforts for traumatic spinal cord injury patients should promote functional independence and community re-integration. Spiritual and/or religious practices should be respected as ways by which traumatic spinal cord injury patients may confront personal challenges that arise following injury.

  17. General practitioners' perspectives on management of early-stage chronic kidney disease: a focus group study.

    Science.gov (United States)

    van Dipten, Carola; van Berkel, Saskia; de Grauw, Wim J C; Scherpbier-de Haan, Nynke D; Brongers, Bouke; van Spaendonck, Karel; Wetzels, Jack F M; Assendelft, Willem J J; Dees, Marianne K

    2018-06-06

    Guideline adherence in chronic kidney disease management is low, despite guideline implementation initiatives. Knowing general practitioners' (GPs') perspectives of management of early-stage chronic kidney disease (CKD) and the applicability of the national interdisciplinary guideline could support strategies to improve quality of care. Qualitative focus group study with 27 GPs in the Netherlands. Three analysts open-coded and comparatively analysed the data. Mind-mapping sessions were performed after data-saturation. Five themes emerged: defining CKD, knowledge and awareness, patient-physician interaction, organisation of CKD care and value of the guideline. A key finding was the abstractness of the CKD concept. The GPs expressed various perspectives about defining CKD and interpreting estimated glomerular filtration rates. Views about clinical relevance influenced the decision-making, although factual knowledge seems lacking. Striving to inform well enough without creating anxiety and to explain suitably for the intellectual ability of the patient caused tension in the patient-physician interaction. Integration with cardiovascular disease-management programmes was mentioned as a way of implementing CKD care in the future. The guideline was perceived as a rough guide rather than a leading document. CKD is perceived as an abstract rather than a clinical concept. Abstractness plays a role in all formulated themes. Management of CKD patients in primary care is complex and is influenced by physician-bound considerations related to individual knowledge and perception of the importance of CKD. Strategies are needed to improve GPs' understanding of the concept of CKD by education, a holistic approach to guidelines, and integration of CKD care into cardiovascular programmes. Not applicable.

  18. Attractiveness of working in home care: An online focus group study among nurses.

    Science.gov (United States)

    De Groot, Kim; Maurits, Erica E M; Francke, Anneke L

    2018-01-01

    Many western countries are experiencing a substantial shortage of home-care nurses due to the increasing numbers of care-dependent people living at home. In-depth knowledge is needed about what home-care nurses find attractive about their work in order to make recommendations for the recruitment and retention of home-care nursing staff. The aims of this explorative, qualitative study were to gain in-depth knowledge about which aspects home-care nurses find attractive about their work and to explore whether these aspects vary for home-care nurses with different levels of education. Discussions were conducted with six online focus groups in 2016 with a total of 38 Dutch home-care nurses. The transcripts were analysed using the principles of thematic analysis. The findings showed that home-care nurses find it attractive that they are a "linchpin", in the sense of being the leading professional and with the patient as the centre of care. Home-care nurses also find having autonomy attractive: autonomy over decision-making about care, freedom in work scheduling and working in a self-directed team. Variety in patient situations and activities also makes their work attractive. Home-care nurses with a bachelor's degree did not differ much in what they found attractive aspects from those with an associate degree (a nursing qualification after completing senior secondary vocational education). It is concluded that autonomy, variety and being a "linchpin" are the attractive aspects of working in home care. To help recruit and retain home-care nursing staff, these attractive aspects should be emphasised in nursing education and practice, in recruitment programmes and in publicity material. © 2017 John Wiley & Sons Ltd.

  19. FOCUS FORECASTING IN SUPPLY CHAIN: THE CASE STUDY OF FAST MOVING CONSUMER GOODS COMPANY IN SERBIA

    Directory of Open Access Journals (Sweden)

    Zoran Rakićević

    2015-04-01

    Full Text Available This paper presents an application of focus forecasting in a fast moving consumer goods (FMCG supply chain. Focus forecasting is tested in a real business case in a Serbian enterprise. The data used in the simulation refers to the historical sales of two types of FMCG with several different products. The data were collected and summarized across the whole distribution channel in the Serbian market from January 2012 to December 2013. We applied several well-known time series forecasting models using the focus forecasting approach, where for the future time period we used the method which had the best performances in the past. The focus forecasting approach mixes different standard forecasting methods on the data sets in order to find the one that was the most accurate during the past period. The accuracy of forecasting methods is defined through different measures of errors. In this paper we implemented the following forecasting models in Microsoft Excel: last period, all average, moving average, exponential smoothing with constant and variable parameter α, exponential smoothing with trend, exponential smoothing with trend and seasonality. The main purpose was not to evaluate different forecasting methods but to show a practical application of the focus forecasting approach in a real business case.

  20. Study of tapered glass capillary focusing MeV ion beam

    International Nuclear Information System (INIS)

    Gong Zhiyu; Yan Sha; Ma Hongji; Nie Rui; Xue Jianming; Wang Yugang

    2012-01-01

    In recent years, tapered glass capillary ion beam focusing is developing rapidly. It is attractive for simple, compact, low cost and easy use. However, the focusing mechanism for MeV ion beams is still indistinct. We present several experimental results of focusing 2 MeV He + beam. Ion beams were focused by tapered glass capillaries with various outlet inner diameters from several micron to hundred micron. The current densities, angle divergences and energy spectra of the transmitted ion beams are measured. The results proved that 2 MeV He + ions can focused and guided by our capillaries. The energy spectra show that a great part of transmitted ions experienced obvious energy loss, which is different from results of others research groups. We discussed the reason and charged it to the larger incident angle. Considered the incident ions with larger incident angle, the charge will distribute in a layer of micro meter depth in the capillary’s inner wall, but not the surface. The energy loss and many other spectra characters can be explained in this way.

  1. Harmonic focus versus electrocautery in axillary lymph node dissection for breast cancer: a randomized clinical study.

    Science.gov (United States)

    He, Qingqing; Zhuang, Dayong; Zheng, Luming; Fan, Ziyi; Zhou, Peng; Zhu, Jian; Lv, Zhen; Chai, Jixin; Cao, Lei

    2012-12-01

    Electrocautery has been proven to be associated with prolonged serous drainage that might result in several complications in patients requiring axillary lymph node dissection for breast cancer. We proposed that the Harmonic Focus might outperform electrocautery in axillary lymph node dissection, resulting in shorter operative times and reduced postoperative complications. One hundred twenty-eight women with confirmed T1-3 N1-2 breast cancer were randomly assigned to undergo mastectomy or breast-conserving surgery with axillary dissection by using Harmonic Focus or electrocautery. Sixty-four has surgery with Harmonic Focus (group A) and 64 with electrocautery (group B) by the same surgical team. Operative time, blood loss, total drainage volume and days, incidence of seroma, hematoma, pain score, and flap necrosis were recorded. Using Harmonic Focus significantly diminished operative time, blood loss, total drainage volume, days of stay, and visual analogue scale as compared with traditional electrocautery. There was no statistical difference between the 2 groups regarding seroma, hematoma, and flap necrosis. Axillary lymph node dissection using Harmonic Focus is feasible, safe, and a more comfortable design for the surgeon. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Determinants of eating behaviour in university students: a qualitative study using focus group discussions.

    Science.gov (United States)

    Deliens, Tom; Clarys, Peter; De Bourdeaudhuij, Ilse; Deforche, Benedicte

    2014-01-18

    College or university is a critical period regarding unhealthy changes in eating behaviours in students. Therefore, the purpose of this study was to explore which factors influence Belgian (European) university students' eating behaviour, using a qualitative research design. Furthermore, we aimed to collect ideas and recommendations in order to facilitate the development of effective and tailored intervention programs aiming to improve healthy eating behaviours in university students. Using a semi-structured question guide, five focus group discussions have been conducted consisting of 14 male and 21 female university students from a variety of study disciplines, with a mean age of 20.6 ± 1.7 yrs. Using Nvivo9, an inductive thematic approach was used for data analysis. After the transition from secondary school to university, when independency increases, students are continuously challenged to make healthful food choices. Students reported to be influenced by individual factors (e.g. taste preferences, self-discipline, time and convenience), their social networks (e.g. (lack of) parental control, friends and peers), physical environment (e.g. availability and accessibility, appeal and prices of food products), and macro environment (e.g. media and advertising). Furthermore, the relationships between determinants and university students' eating behaviour seemed to be moderated by university characteristics, such as residency, student societies, university lifestyle and exams. Recommendations for university administrators and researchers include providing information and advice to enhance healthy food choices and preparation (e.g. via social media), enhancing self-discipline and self-control, developing time management skills, enhancing social support, and modifying the subjective as well as the objective campus food environment by e.g. making healthy foods price-beneficial and by providing vending machines with more healthy products. This is the first European

  3. Generation Mix Study Focusing on Nuclear Power by Practical Peak Forecast

    International Nuclear Information System (INIS)

    Shin, Jung Ho; Roh, Myung Sub

    2013-01-01

    The excessive underestimation can lead to a range of problem; expansion of LNG plant requiring short construction period, the following increase of electricity price, low reserve margin and inefficient configuration of power source. With regard to nuclear power, the share of the stable and economic base load plant, nuclear power, can reduce under the optimum level. Amongst varied factors which contribute to the underestimate, immoderate target for demand side management (DSM) including double deduction of the constraint amount by DSM from peak demand forecast is one of the causes. The hypothesis in this study is that the better optimum generation mix including the adequate share of nuclear power can be obtained under the condition of the peak demand forecast without deduction of DSM target because this forecast is closer to the actual peak demand. In this study, the hypothesis is verified with comparison between peak demand forecast before (or after) DSM target application and the actual peak demand in the 3 rd through 5 th BPE from 2006 to 2010. Furthermore, this research compares and analyzes several generation mix in 2027 focusing on the nuclear power by a few conditions using the WASP-IV program on the basis of the 6 th BPE in 2013. According to the comparative analysis on the peak demand forecast and actual peak demand from 2006 to 2010, the peak demand forecasts without the deduction of the DSM target is closer to the actual peak demand than the peak demand forecasts considering the DSM target in the 3 th , 4 th , 5 th entirely. In addition, the generation mix until 2027 is examined by the WASP-IV. As a result of the program run, when considering the peak demand forecast without DSM reflection, since the base load plants including nuclear power take up adequate proportion, stable and economic supply of electricity can be achieved. On the contrary, in case of planning based on the peak demand forecast with DSM reflected and then compensating the shortage by

  4. Generation Mix Study Focusing on Nuclear Power by Practical Peak Forecast

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jung Ho; Roh, Myung Sub [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-10-15

    The excessive underestimation can lead to a range of problem; expansion of LNG plant requiring short construction period, the following increase of electricity price, low reserve margin and inefficient configuration of power source. With regard to nuclear power, the share of the stable and economic base load plant, nuclear power, can reduce under the optimum level. Amongst varied factors which contribute to the underestimate, immoderate target for demand side management (DSM) including double deduction of the constraint amount by DSM from peak demand forecast is one of the causes. The hypothesis in this study is that the better optimum generation mix including the adequate share of nuclear power can be obtained under the condition of the peak demand forecast without deduction of DSM target because this forecast is closer to the actual peak demand. In this study, the hypothesis is verified with comparison between peak demand forecast before (or after) DSM target application and the actual peak demand in the 3{sup rd} through 5{sup th} BPE from 2006 to 2010. Furthermore, this research compares and analyzes several generation mix in 2027 focusing on the nuclear power by a few conditions using the WASP-IV program on the basis of the 6{sup th} BPE in 2013. According to the comparative analysis on the peak demand forecast and actual peak demand from 2006 to 2010, the peak demand forecasts without the deduction of the DSM target is closer to the actual peak demand than the peak demand forecasts considering the DSM target in the 3{sup th}, 4{sup th}, 5{sup th} entirely. In addition, the generation mix until 2027 is examined by the WASP-IV. As a result of the program run, when considering the peak demand forecast without DSM reflection, since the base load plants including nuclear power take up adequate proportion, stable and economic supply of electricity can be achieved. On the contrary, in case of planning based on the peak demand forecast with DSM reflected and then

  5. 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.

  6. 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.

  7. Study on cooling model for debris in lower plenum and countermeasures for prevention of focusing effect

    International Nuclear Information System (INIS)

    Guan Zhonghua; Yu Hongxing; Jiang Guangming

    2008-01-01

    From the basic energy conservation equations and experimental or empirical correlations, an intact model is constructed for the thermal calculation of the core debris in the lower plenum. For verification of this model, the results of two calculations for AP600 and AP1000 plants are compared with those presented in relevant literature. The analysis highlights on the impact of the decay heat power density and the focusing effect. In order to mitigate the focusing effect, it is proposed in this paper to change the lower head profile from hemisphere to parabola. The results show that this change of lower head profile can change the heat flux distribution of the debris, and mitigate the focusing effect. (authors)

  8. Study protocol: cross-national comparative case study of recovery-focused mental health care planning and coordination (COCAPP).

    Science.gov (United States)

    Simpson, Alan; Hannigan, Ben; Coffey, Michael; Jones, Aled; Barlow, Sally; Cohen, Rachel; Všetečková, Jitka; Faulkner, Alison; Haddad, Mark

    2015-07-03

    The collaborative care planning study (COCAPP) is a cross-national comparative study of care planning and coordination in community mental healthcare settings. The context and delivery of mental health care is diverging between the countries of England and Wales whilst retaining points of common interest, hence providing a rich geographical comparison for research. Across England the key vehicle for the provision of recovery-focused, personalised, collaborative mental health care is the care programme approach (CPA). The CPA is a form of case management introduced in England in 1991, then revised in 2008. In Wales the CPA was introduced in 2003 but has now been superseded by The Mental Health (Care Co-ordination and Care and Treatment Planning) (CTP) Regulations (Mental Health Measure), a new statutory framework. In both countries, the CPA/CTP requires providers to: comprehensively assess health/social care needs and risks; develop a written care plan (which may incorporate risk assessments, crisis and contingency plans, advanced directives, relapse prevention plans, etc.) in collaboration with the service user and carer(s); allocate a care coordinator; and regularly review care. The overarching aim of this study is to identify and describe the factors that ensure CPA/CTP care planning and coordination is personalised, recovery-focused and conducted collaboratively. COCAPP will employ a concurrent transformative mixed methods approach with embedded case studies. Phase 1 (Macro-level) will consider the national context through a meta-narrative mapping (MNM) review of national policies and the relevant research literature. Phase 2 (Meso-level and Micro-level) will include in-depth micro-level case studies of everyday 'frontline' practice and experience with detailed qualitative data from interviews and reviews of individual care plans. This will be nested within larger meso-level survey datasets, senior-level interviews and policy reviews in order to provide

  9. Bibliographic Management Software: A Focus Group Study of the Preferences and Practices of Undergraduate Students

    Science.gov (United States)

    Salem, Jamie; Fehrmann, Paul

    2013-01-01

    With the growing population of undergraduate students on our campus and an increased focus on their success, librarians at a large midwestern university were interested in the citation management styles of this university cohort. Our university library spends considerable resources each year to maintain and promote access to the robust…

  10. A focus group study of consumer attitudes toward genetic testing and newborn screening for deafness.

    Science.gov (United States)

    Burton, Sarah K; Withrow, Kara; Arnos, Kathleen S; Kalfoglou, Andrea L; Pandya, Arti

    2006-12-01

    Progress in identifying genes for deafness together with implementation of universal audiologic screening of newborns has provided the opportunity for more widespread use of molecular tests to detect genetic forms of hearing loss. Efforts to assess consumer attitudes toward these advances have lagged behind. Consumer focus groups were held to explore attitudes toward genetic advances and technologies for hearing loss, views about newborn hearing screening, and reactions to the idea of adding molecular screening for hearing loss at birth. Focus group discussions were recorded, transcribed and analyzed. Five focus groups with 44 participants including hearing parents of deaf children, deaf parents and young deaf adults were held. Focus group participants supported the use of genetic tests to identify the etiology of hearing loss but were concerned that genetic information might influence reproductive decisions. Molecular newborn screening was advocated by some; however, others expressed concern about its effectiveness. Documenting the attitudes of parents and other consumers toward genetic technologies establishes the framework for discussions on the appropriateness of molecular newborn screening for hearing loss and informs specialists about potential areas of public education necessary prior to the implementation of such screening.

  11. Overcoming Workplace Barriers: A Focus Group Study Exploring African American Mothers' Needs for Workplace Breastfeeding Support.

    Science.gov (United States)

    Johnson, Angela Marie; Kirk, Rosalind; Muzik, Maria

    2015-08-01

    Persistent racial disparities in breastfeeding show that African American women breastfeed at the lowest rates. Return to work is a critical breastfeeding barrier for African American women who return to work sooner than other ethnic groups and more often encounter unsupportive work environments. They also face psychosocial burdens that make breastfeeding at work uniquely challenging. Participants share personal struggles with combining paid employment and breastfeeding and suggest workplace and personal support strategies that they believe will help continue breastfeeding after a return to work. To explore current perspectives on ways to support African American mothers' workplace breastfeeding behavior. Pregnant African American women (n = 8), African American mothers of infants (n = 21), and lactation support providers (n = 9) participated in 1 of 6 focus groups in the Greater Detroit area. Each focus group audiotape was transcribed verbatim. Thematic analysis was used to inductively analyze focus group transcripts and field notes. Focus groups explored thoughts, perceptions, and behavior on interventions to support African American women's breastfeeding. Participants indicate that they generally believed breastfeeding was a healthy option for the baby; however, paid employment is a critical barrier to successful breastfeeding for which mothers receive little help. Participants felt breastfeeding interventions that support working African American mothers should include education and training for health care professionals, regulation and enforcement of workplace breastfeeding support policies, and support from peers who act as breastfeeding role models. Culturally appropriate interventions are needed to support breastfeeding among working African American women. © The Author(s) 2015.

  12. A study of non-ideal focus properties of 30deg parallel plate energy analyzers

    International Nuclear Information System (INIS)

    Fujisawa, A.; Iguchi, H.; Hamada, Y.

    1993-12-01

    A succinct model is proposed to describe non-ideal characteristics owing to electric field penetration into the drift region in actual parallel plate energy analyzers. A good agreement has been obtained between the theoretically expected and experimentally observed focus properties of the 30deg parallel plate analyzer. (author)

  13. Portable test bench for the studies concerning ion sources and ion beam extraction and focusing systems

    International Nuclear Information System (INIS)

    Cordero Lopez, F.

    1961-01-01

    A portable test bench is described, which was designed to check ion sources, ion beam extraction and focusing systems before its use in a 600 KeV Cockcroft-Walton accelerator. The vacuum possibilities of the system are specially analyzed in connection with its particular use. The whole can be considered as a portable accelerator of low energy (50 keV). (Author)

  14. Parental decisional strategies regarding HPV vaccination before media debates: a focus group study

    NARCIS (Netherlands)

    Hofman, R.; Empelen, P. van; Vogel, I.; Raat, H.; Ballegooijen, M. van; Korfage, I.J.

    2013-01-01

    Before the introduction of the human papillomavirus (HPV) vaccine, decisional strategies and factors that could guide HPV vaccination intentions were explored. The authors conducted 4 focus group discussions with 36 parents of children 8-15 years of age. Three groups consisted primarily of Dutch

  15. Effects of Immediate Repetition in L2 Speaking Tasks: A Focused Study

    Science.gov (United States)

    Bei, Gavin Xiaoyue

    2013-01-01

    This paper reports on a focused investigation into the immediate effects of oral narrative task repetition by two adult EFL learners of intermediate and high proficiency. Two participants performed a narrative speaking task after watching a cartoon video clip and repeated their performance three times, followed by a retrospective report in an…

  16. X-ray and neutron emission studies in a new Filippov type plasma focus

    Energy Technology Data Exchange (ETDEWEB)

    Babazadeh, A.R.; Banoushi, A. [Technical University of Amirkabir, Tehran (Iran, Islamic Republic of). Dept. of Physics; Roshan, M.V.; Habibi, H.; Nasiry, A.; Memarzadeh, M.; Lamehi, M.; Kiai, S.M. Sadat [Atomic Energy Organization of Iran (AEOI), Tehran (Iran, Islamic Republic of). Nuclear Fusion Research Center

    2002-03-01

    We have performed experimental comparative studies of the X-ray and neutron emission generated by the new Filippov-type plasma focus 'Dena', (90 kJ, 25 kV, 288{mu}F) in the pressure range of 0.6-1 torr. Time-integrated and time-resolved detectors, together with an X-ray pin-hole camera, along with a Be filter of 10{mu}m thickness have been used. For a working gas of neon and a at insert anode, the maximum soft and hard X-rays (SXR-HXR) yield obtained was 16 V and 1.5 V/shot over a 4{pi} solid angle, respectively, for a charging voltage range of 16-20 kV. As for the argon gas, the similar results such as 3.5 and 2 V/shot have been found, leading to a total conversion efficiency of X-ray emission of 0.09 % (for neon) and 0.03 % (for argon) of the stored energy. These efficiencies have been improved by the employment of a conic insert anode up to 0.4% and 0.1%. With deuterium puffing gas and a at insert anode, the maximum emission yield has been found to be 2.5 V for SXR and 1 V for HXR/shot which produce an ultimate emission profile width (FWHM) of 70-90 ns for X-rays and neutrons, giving rise to a maximum neutron yield of 1.2 x 10{sup 9}. Nevertheless, the maximum yield has been increased up to 5.5 times with the conic insert anode. In order to increase the neutron yield, we have introduced a krypton admixture to the deuterium filling gas and found that, for a krypton pressure of about 0.1 torr, the neutron yield increases by a factor of 3.5 for the flat insert and 1.5 for the conic insert anodes. (author)

  17. Engaging families in physical activity research: a family-based focus group study.

    Science.gov (United States)

    Brown, Helen Elizabeth; Schiff, Annie; van Sluijs, Esther M F

    2015-11-25

    Family-based interventions present a much-needed opportunity to increase children's physical activity levels. However, little is known about how best to engage parents and their children in physical activity research. This study aimed to engage with the whole family to understand how best to recruit for, and retain participation in, physical activity research. Families (including a 'target' child aged between 8 and 11 years, their parents, siblings, and others) were recruited through schools and community groups. Focus groups were conducted using a semi-structured approach (informed by a pilot session). Families were asked to order cards listing the possible benefits of, and the barriers to, being involved in physical activity research and other health promotion activities, highlighting the items they consider most relevant, and suggesting additional items. Duplicate content analysis was used to identify transcript themes and develop a coding frame. Eighty-two participants from 17 families participated, including 17 'target' children (mean age 9.3 ± 1.1 years, 61.1% female), 32 other children and 33 adults (including parents, grandparents, and older siblings). Social, health and educational benefits were cited as being key incentives for involvement in physical activity research, with emphasis on children experiencing new things, developing character, and increasing social contact (particularly for shy children). Children's enjoyment was also given priority. The provision of child care or financial reward was not considered sufficiently appealing. Increased time commitment or scheduling difficulties were quoted as the most pertinent barriers to involvement (especially for families with several children), but parents commented these could be overcome if the potential value for children was clear. Lessons learned from this work may contribute to the development of effective recruitment and retention strategies for children and their families. Making the wide

  18. Why people use herbal medicine: insights from a focus-group study in Germany.

    Science.gov (United States)

    Welz, Alexandra N; Emberger-Klein, Agnes; Menrad, Klaus

    2018-03-15

    The use of herbal medicine, as one element of complementary and alternative medicine, is increasing worldwide. Little is known about the reasons for and factors associated with its use. This study derives insights for the use of herbal medicine in Germany regarding the usage aims, role played by the type of illness, reasons for preferred usage and sources of information. Using a qualitative methodological approach, six focus groups (n = 46) were conducted. Two groups with young, middle-aged and elderly participants, respectively. After audiotaping and verbatim transcription, the data were analysed with a qualitative content analysis. We found that treating illnesses was the most frequently discussed aim for using herbal medicine over all age groups. Preventing illnesses and promoting health were less frequently mentioned overall, but were important for elderly people. Discussions on herbal medicine were associated with either mild/moderate diseases or using herbal medicine as a starting treatment before applying conventional medicine. In this context, participants emphasized the limits of herbal medicine for severe illnesses. Dissatisfaction with conventional treatment, past good experiences, positive aspects associated with herbal medicine, as well as family traditions were the most commonly-mentioned reasons why herbal medicine was preferred as treatment. Concerning information sources, independent reading and family traditions were found to be equally or even more important than consulting medicinal experts. Although herbal medicine is used mostly for treating mild to moderate illnesses and participants were aware of its limits, the combination of self-medication, non-expert consultation and missing risk awareness of herbal medicine is potentially harmful. This is particularly relevant for elderly users as, even though they appeared to be more aware of health-related issues, they generally use more medicine compared to younger ones. In light of our finding

  19. Model study of multiphase DMS oxidation with a focus on halogens

    Directory of Open Access Journals (Sweden)

    R. von Glasow

    2004-01-01

    Full Text Available We studied the oxidation of dimethylsulfide (DMS in the marine boundary layer (MBL with a one-dimensional numerical model and focused on the influence of halogens. Our model runs show that there is still significant uncertainty about the end products of the DMS addition pathway, which is especially caused by uncertainty in the product yield of the reaction of the intermediate product methyl sulfinic acid (MSIA with OH. BrO strongly increases the importance of the addition branch in the oxidation of DMS even when present at mixing ratios smaller than 0.5pmol mol-1. The inclusion of halogen chemistry leads to higher DMS oxidation rates and smaller DMS to SO2 conversion efficiencies. The DMS to SO2 conversion efficiency is also drastically reduced under cloudy conditions. In cloud-free model runs between 5 and 15% of the oxidized DMS reacts further to particulate sulfur, in cloudy runs this fraction is almost 100%. Sulfate production by HOClaq and HOBraq is important in cloud droplets even for small Br- deficits and related small gas phase halogen concentrations. In general, more particulate sulfur is formed when halogen chemistry is included. A possible enrichment of HCO3- in fresh sea salt aerosol would increase pH values enough to make the reaction of S(IV* (=SO2,aq+HSO3-+SO32- with O3 dominant for sulfate production. It leads to a shift from methyl sulfonic acid (MSA to non-sea salt sulfate (nss-SO42- production but increases the total nss-SO42- only somewhat because almost all available sulfur is already oxidized to particulate sulfur in the base scenario. We discuss how realistic this is for the MBL. We found the reaction MSAaq+OH to contribute about 10% to the production of nss-SO42- in clouds. It is unimportant for cloud-free model runs. Overall we find that the presence of halogens leads to processes that decrease the albedo of stratiform clouds in the MBL.

  20. 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

  1. 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

  2. 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...

  3. 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.

  4. Transverse characterization of focused Bessel beams with angular momentum applied to study degree of coherence

    International Nuclear Information System (INIS)

    He, Xi; Wu, Fengtie; Chen, Ziyang; Pu, Jixiong; Chavez-Cerda, Sabino

    2016-01-01

    The transverse focusing properties at the ‘pseudo-focal’ plane of coherent Bessel beams with angular momentum are analyzed in detail. The transverse magnification of the central dark region of Bessel beams at this pseudo-focal plane is derived for the first time by calculating the ratio of the magnitude of the transverse components of the corresponding wave vectors before and after the focusing lens. We test our results experimentally with coherent laser Bessel beams and excellent agreement is observed. Then, an LED light source is used to generate Bessel beams. By modifying the coherence of the LED light source, we observe that by reducing coherence a smaller and shallower central dark region of Bessel beams with angular momentum is produced at the pseudo-focal plane. This technique can be used as a method to characterize the degree of coherence of vortex beams. (paper)

  5. A study on the performance of an electrostatic focusing mirror for Rydberg positronium

    Science.gov (United States)

    Jones, Adric C. L.; Cecchini, Gabriel G.; Moxom, Jeremy; Osorno, Kevin; Rutbeck-Goldman, Harris J.; Fuentes-Garcia, Melina; Greaves, Rod G.; Adams, Daniel J.; Tom, Harry W. K.; Mills, Allen P., Jr.

    2018-01-01

    Recently, we demonstrated an electrostatic mirror that focuses a beam of Rydberg positronium atoms over a 6 m path to a 32 ± 1 mm FWHM diameter spot on a position sensitive detector. The mirror is comprised of 360 wires arranged in the shape of a nearly-cylindrical revolved truncated ellipse 96 mm in radius, with potentials of equal and opposite magnitude applied to alternating wires to create a short-ranged electric field that decreases in magnitude exponentially with e-folding length = 0.53 mm. Here, we explore in detail the observed resolution and discuss the factors contributing to its broadening from the ideal point focus of a perfect embodiment of the mirror. Improvements to the design are considered, with the aim to achieve a mirror with a resolution of <0.5 mm, which is necessary for a proposed measurement of the gravitational deflection of positronium.

  6. Preliminary study on development of 300 Kv compact focused gaseous ion beam system

    Energy Technology Data Exchange (ETDEWEB)

    Ohkubo, T.; Ishii, Y.; Kamiya, T. [Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency (JAEA) 1233 Watanuki-machi, Takasaki, Gunma, 370-1292 (Japan); Miyake, Y. [Beam Seiko Instruments Inc., 2-10-1 Kamata, Ohta-ku, Tokyo, 144-0052 (Japan)

    2013-04-19

    A new 300 kV compact focused gaseous ion beam (gas-FIB) system with three-stage acceleration lens was constructed at JAEA. The preliminary experiments of formation of the focused gaseous ion beams were carried out to show the availability of the gas-FIB system as a writing tool for 3D proton lithography. As a result of the experiments, it was proved that the focal point was kept at the same position under changing the kinetic energy but with keeping the kinetic energy ratio constant, which was defined as the ratio of kinetic energy in object side to that in image side for the third acceleration lens. This characteristic of the gas-FIB is a good point to advance the 3D proton lithography changing penetration depth in a sample by varying the beam energy.

  7. Preliminary study on development of 300 Kv compact focused gaseous ion beam system

    International Nuclear Information System (INIS)

    Ohkubo, T.; Ishii, Y.; Kamiya, T.; Miyake, Y.

    2013-01-01

    A new 300 kV compact focused gaseous ion beam (gas-FIB) system with three-stage acceleration lens was constructed at JAEA. The preliminary experiments of formation of the focused gaseous ion beams were carried out to show the availability of the gas-FIB system as a writing tool for 3D proton lithography. As a result of the experiments, it was proved that the focal point was kept at the same position under changing the kinetic energy but with keeping the kinetic energy ratio constant, which was defined as the ratio of kinetic energy in object side to that in image side for the third acceleration lens. This characteristic of the gas-FIB is a good point to advance the 3D proton lithography changing penetration depth in a sample by varying the beam energy.

  8. [Professionalization of Legal Dental Experts in Germany: Results of Studies on Structured Focus Groups].

    Science.gov (United States)

    Brauer, H U; Walther, W; Dick, M

    2018-04-01

    Legal expert opinions are a crucial instrument of professional self-control in medicine. To give impulses for further development, focus groups were initiated to reflect upon the perspective of legal dental experts. 5 focus group discussions on the topic "Professionalization of legal dental experts" were conducted. A total of 32 experienced legal dental experts participated in the discussions. The results were evaluated by qualitative content analysis. A catalogue of 68 ideas was generated for improvement and divided into 15 categories. Among these were periodic quality circles, interprofessional exchange, supervision of novices and periodic feedback for legal dental experts and dentists. Self-reflection can be included as an instrument for quality improvement of legal dental expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

  9. 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...

  10. Study the Output Characteristics of a 90 kJ Filippove-Type Plasma Focus

    Science.gov (United States)

    Sadat Kiai, S. M.; Talaei, A.; Adlparvar, S.; Zirak, A.; Elahi, M.; Safarian, A.; Farhangi, S.; Alhooie, S.; Dabirzadeh, A. A.; Khalaj, M. M.; Mahlooji, M. S.; Talaei, M.; KaKaei, S.; Sheibani, S.; Kashani, A.; Zahedi, F.

    2010-08-01

    The output characteristics of a Filippove-Type plasma focus "Dena" (288 μF, 25 kV, 90 kJ) is numerically investigated by considering the voltage, current, current derivative, and maximum current as a function of capacitor bank energy in the constant Argon gas pressure and compared to the experiment. It is shown that increase on the bank energy leads to the increment on the maximum current and decrement on the pinch time.

  11. Realignment process of actin stress fibers in single living cells studied by focused femtosecond laser irradiation

    OpenAIRE

    Yasukuni, Ryohei; Spitz, Jean-Alexis; Meallet-Renault, Rachel; Negishi, Takayuki; Tada, Takuji; Hosokawa, Yoichiroh; Asahi, Tsuyoshi; Shukunami, Chisa; Hiraki, Yuji; Masuhara, Hiroshi

    2007-01-01

    Three-dimensional dissection of a single actin stress fiber in a living cell was performed based on multi-photon absorption of a focused femtosecond laser pulse. The realignment process of an actin stress fiber was investigated after its direct cutting by a single-shot femtosecond laser pulse irradiation by high-speed transmission and fluorescence imaging methods. It was confirmed that mechanical force led by the femtosecond laser cutting propagates to entire cell through the cytockelton in a...

  12. A Simulation Study of Mutations in the Genetic Regulatory Hierarchy for Butterfly Eyespot Focus Determination

    OpenAIRE

    Marcus, Jeffrey M.; Evans, Travis M.

    2008-01-01

    The color patterns on the wings of butterflies have been an important model system in evolutionary developmental biology. A recent computational model tested genetic regulatory hierarchies hypothesized to underlie the formation of butterfly eyespot foci (Evans and Marcus, 2006). The computational model demonstrated that one proposed hierarchy was incapable of reproducing the known patterns of gene expression associated with eyespot focus determination in wild-type butterflies, but that two sl...

  13. Youth Understanding of Healthy Eating and Obesity: A Focus Group Study

    OpenAIRE

    Sylvetsky, Allison C.; Hennink, Monique; Comeau, Dawn; Welsh, Jean A.; Hardy, Trisha; Matzigkeit, Linda; Swan, Deanne W.; Walsh, Stephanie M.; Vos, Miriam B.

    2013-01-01

    Introduction. Given the high prevalence of childhood obesity in the United States, we aimed to investigate youth's understanding of obesity and to investigate gaps between their nutritional knowledge, dietary habits, and perceived susceptibility to obesity and its co-morbidities. Methods. A marketing firm contracted by Children's Healthcare of Atlanta facilitated a series of focus group discussions (FGD) to test potential concepts and sample ads for the development of an obesity awareness cam...

  14. 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)

  15. [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.

  16. An ex vivo feasibility experimental study on targeted cell surgery by high intensity focused ultrasound

    Science.gov (United States)

    Wang, Zhi Biao; Wu, Junru; Fang, Liao Qiong; Wang, Hua; Li, Fa Qi; Tian, Yun Bo; Gong, Xiao Bo; Zhang, Hong; Zhang, Lian; Feng, Ruo

    2012-10-01

    High intensity focused ultrasound (HIFU) has become a new noninvasive surgical modality in medicine. A portion of tissue seated inside a patient's body may experience coagulative necrosis after a few seconds of insonification by high intensity focused ultrasound (US) generated by an extracorporeal focusing US transducer. The region of tissue affected by coagulative necrosis (CN) usually has an ellipsoidal shape when the thermal effect due to US absorption plays the dominant role. Its long and short axes are parallel and perpendicular to the US propagation direction respectively. It was shown by ex vivo experiments that the dimension of the short and long axes of the tissue which experiences CN can be as small as 50 μm and 250 μm respectively after one second exposure of US pulse (the spatial and pulse average acoustic power is on the order of tens of Watts and the local acoustic spatial and temporal pulse averaged intensity is on the order of 3 × 104 W/cm2) generated by a 1.6 MHz HIFU transducer of 12 cm diameter and 11 cm geometric focal length (f-number = 0.92). The numbers of cells which suffered CN were estimated to be on the order of 40. This result suggests that HIFU is able to interact with tens of cells at/near its focal zone while keeping the neighboring cells minimally affected, and thus the targeted cell surgery may be achievable.

  17. Ti film deposition process of a plasma focus: Study by an experimental design

    Directory of Open Access Journals (Sweden)

    M. J. Inestrosa-Izurieta

    2017-10-01

    Full Text Available The plasma generated by plasma focus (PF devices have substantially different physical characteristics from another plasma, energetic ions and electrons, compared with conventional plasma devices used for plasma nanofabrication, offering new and unique opportunities in the processing and synthesis of Nanomaterials. This article presents the use of a plasma focus of tens of joules, PF-50J, for the deposition of materials sprayed from the anode by the plasma dynamics in the axial direction. This work focuses on the determination of the most significant effects of the technological parameters of the system on the obtained depositions through the use of a statistical experimental design. The results allow us to give a qualitative understanding of the Ti film deposition process in our PF device depending on four different events provoked by the plasma dynamics: i an electric erosion of the outer material of the anode; ii substrate ablation generating an interlayer; iii electron beam deposition of material from the center of the anode; iv heat load provoking clustering or even melting of the deposition surface.

  18. 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.

  19. 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.

  20. Exploring the switching of the focus of attention within working memory: A combined event-related potential and behavioral study.

    Science.gov (United States)

    Frenken, Marius; Berti, Stefan

    2018-04-01

    Working memory enables humans to maintain selected information for cognitive processes and ensures instant access to the memorized contents. Theories suggest that switching the focus of attention between items within working memory realizes the access. This is reflected in object-switching costs in response times when the item for the task processing is to be changed. Another correlate of attentional allocation in working memory is the P3a-component of the human event-related potential. The aim of this study was to demonstrate that switching of attention within working memory is a separable processing step. Participants completed a cued memory-updating task in which they were instructed to update one memory item at a time out of a memory list of four digits by applying a mathematical operation indicated by a target sign. The hypotheses predicted (1) prolonged updating times in switch (different item compared to previous trial) versus repetition trials (same item), (2) an influence of cues (valid/neutral) presented before the mathematical target on switching costs, and (3) that the P3a-component is more pronounced in the cue-target interval in the valid cue condition and more pronounced in the post-target interval in the neutral cue condition. A student's t-test verified the first hypothesis, repeated-measurement analyses of variance demonstrated that hypotheses 2 and 3 should be rejected. Results suggest that switching of attention within working memory could not be separated from further processing steps and retro-cue benefits are not due to a head start of retrieval as well as that switch costs represent internal processes. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Focusing ethnography

    DEFF Research Database (Denmark)

    Woermann, Niklas

    2018-01-01

    underpinnings of focusing ethnographic research by comparing different schools of thought and suggesting a practice theory-based approach. It argues that many research projects are focused but do not reflect on the process of focusing, describes how to identify focal settings or practices, and introduces......Building theory with ethnography and filmic research increasingly requires focussing on key practices or settings, instead of painting a broad panorama of a culture. But few authors discuss why and how to focus. This article provides a systematic discussion of the theoretical and methodological...

  2. 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.

  3. 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

  4. 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.

  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. What constitutes an excellent allied health care professional? A multidisciplinary focus group study

    Directory of Open Access Journals (Sweden)

    Paans W

    2013-09-01

    Full Text Available Wolter Paans, Inge Wijkamp, Egbert Wiltens, Marca V Wolfensberger Research and Innovation Group Talent Development in Higher Education and Society, Hanze University of Applied Sciences, Groningen, The Netherlands. Background: Determining what constitutes an excellent allied health care professional (AHCP is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care. Aim: To describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP. Methods: AHCPs' perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts. Results: According to the survey, a combination of the following characteristics defines an excellent AHCP: (1 cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2 cooperativity, to effectively work with others in a multidisciplinary context; (3 communicative, to communicate effectively at different levels in complex situations; (4 initiative, to initiate new ideas, to act proactively, and to follow them through; (5 innovative, to devise new ideas and to implement alternatives beyond current practices; (6 introspective, to self-examine and to reflect; (7 broad perspective, to capture the big picture; and (8 evidence-driven, to find and to use scientific evidence to guide one's decisions. Conclusion: The AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves. Keywords: clinical

  7. Study and utilization of ion beams created in the Focus experiment

    International Nuclear Information System (INIS)

    Bernard, A.; Garconnet, J.P.; Jolas, A.; Le Breton, J.P.; Mascureau, J. de.

    1982-06-01

    Ion beams created in a plasma focus electrical discharge are evidenced and measured from interaction with CD 2 and DLi targets. Aluminum targets are also used with observation of the radiation temperature and material expansion velocity. Comparison between experimental measurements and numerical computations allows to determine energy deposition in the aluminum foil as well as beams values. With the 200 kJ Actime facility 2 to 3 MJ/g deposition is obtained in aluminum on approximately one square centimeter. A fast valve gas injection has been developed on another facility and preliminary results are given [fr

  8. A numerical study of two-phase Stokes flow in an axisymmetric flow-focusing device

    DEFF Research Database (Denmark)

    Jensen, Mads Jakob; Stone, H.A.; Bruus, Henrik

    2006-01-01

    We present a numerical investigation of the time-dependent dynamics of the creation of gas bubbles in an axisymmetric flow-focusing device. The liquid motion is treated as a Stokes flow, and using a generic framework we implement a second-order time-integration scheme and a free-surface model...... in MATLAB, which interfaces with the finite-element software FEMLAB. We derive scaling laws for the volume of a created bubble and for the gas flow rate, and confirm them numerically. Our results are consistent with existing experimental results by Garstecki et al. [Phys. Rev. Lett. 94, 164501 (2005...

  9. Study on Differential Algebraic Method of Aberrations up to Arbitrary Order for Combined Electromagnetic Focusing Systems

    Institute of Scientific and Technical Information of China (English)

    CHENG Min; TANG Tiantong; YAO Zhenhua; ZHU Jingping

    2001-01-01

    Differential algebraic method is apowerful technique in computer numerical analysisbased on nonstandard analysis and formal series the-ory. It can compute arbitrary high order derivativeswith excellent accuracy. The principle of differentialalgebraic method is applied to calculate high orderaberrations of combined electromagnetic focusing sys-tems. As an example, third-order geometric aberra-tion coefficients of an actual combined electromagneticfocusing system were calculated. The arbitrary highorder aberrations are conveniently calculated by dif-ferential algebraic method and the fifth-order aberra-tion diagrams are given.

  10. A QUALITATIVE EVALUATION ON SOP HRD 2007-2013 IN ROMANIA - FOCUS-GROUP STUDY

    Directory of Open Access Journals (Sweden)

    Bud Angelica Mariana

    2015-07-01

    Full Text Available This paper seeks to underline the main problems faced in implementing and using European Union (EU funds in Romania within the Sectoral Operational Programme Human Resources Development (SOP HRD during the first programing period 2007-2013. The problems and barriers revealed were identified during a focus-group for the second interim evaluation of SOPHRD, organized by the Management Authority of this program in Nord-Vest region, in November 2014. The focus-group represents a small part of the entire process of evaluating the programme for the development of human resources during its implementation, with the purpose of finding beneficiaries opinions about the efficiency, effectiveness and relevance of interventions financed through SOP HRD. Beliefs, personal recommendations from the participants are presented in order to improve the use of European funds for development of human resources (in particular and the use of structural instruments (in general. These results and solutions can be efficiently used during the next financial period 2014-2020 to create the framework for every priority axis and key areas of intervention, during the implementation of new projects and within the entire process that these funds require in order to successfully use the structural instruments to catch up with developed countries. Moreover, some of the problems identified can be found in other operational programmes and therefore, this research can be useful for every one that wants to use this kind of financing or has a project of this kind in implementation, without taking into account the European funding source. Besides the qualitative approach given by focus-group research method, this paper is going to present a general approach over SOP HRD in Romania during 2007-2013, from a quantitative perspective (number of projects submitted, approved, contracted, payment rate, absorption rate. Moreover solutions linked to knowledge management practices will be proposed

  11. Barriers and facilitators of treatment for depression in a latino community: a focus group study.

    Science.gov (United States)

    Uebelacker, Lisa A; Marootian, Beth A; Pirraglia, Paul A; Primack, Jennifer; Tigue, Patrick M; Haggarty, Ryan; Velazquez, Lavinia; Bowdoin, Jennifer J; Kalibatseva, Zornitsa; Miller, Ivan W

    2012-02-01

    We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician, and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes: vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments, healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead to interventions better able to meet the needs of this particular group.

  12. Study of the thermal effect on silicon surface induced by ion beam from plasma focus device

    Energy Technology Data Exchange (ETDEWEB)

    Ahmad, Z., E-mail: pscientific5@aec.org.sy [Scientific Service Department, Atomic Energy Commission of Syria, P.O. Box: 6091, Damascus (Syrian Arab Republic); Ahmad, M. [IBA Laboratory, Atomic Energy Commission of Syria, P.O. Box: 6091, Damascus (Syrian Arab Republic); Chemistry Department, Atomic Energy Commission of Syria, P.O. Box: 6091, Damascus (Syrian Arab Republic); Al-Hawat, Sh.; Akel, M. [Physics Department, Atomic Energy Commission of Syria, P.O. Box: 6091, Damascus (Syrian Arab Republic)

    2017-04-01

    Structural modifications in form of ripples and cracks are induced by nitrogen ions from plasma focus on silicon surface. The investigation of such structures reveals correlation between ripples and cracks formation in peripheral region of the melt spot. The reason of such correlation and structure formation is explained as result of thermal effect. Melting and resolidification of the center of irradiated area occur within one micro second of time. This is supported by a numerical simulation used to investigate the thermal effect induced by the plasma focus ion beams on the silicon surface. This simulation provides information about the temperature profile as well as the dynamic of the thermal propagation in depth and lateral directions. In accordance with the experimental observations, that ripples are formed in latter stage after the arrival of last ion, the simulation shows that the thermal relaxation takes place in few microseconds after the end of the ion beam arrival. Additionally, the dependency of thermal propagation and relaxation on the distance of the silicon surface from the anode is presented.

  13. Supervisors’ Strategies to Facilitate Work Functioning among Employees with Musculoskeletal Complaints: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Tove Ask

    2015-01-01

    Full Text Available Aim. To explore what strategies the supervisors found beneficial to prevent or reduce sickness absence among employees with musculoskeletal complaints. Methods. Five focus groups were conducted and 26 supervisors from health and social sector participated. Commonly used strategies to prevent sickness absence and interdisciplinary cooperation in this work were discussed in the focus groups. Systematic text condensation was used to analyse the data. Results. The supervisors described five strategies for sick leave management: (1 promoting well-being and a healthy working environment, (2 providing early support and adjustments, (3 making employees more responsible, (4 using confrontational strategies in relation to employees on long-term sick leave, and (5 cooperation with general practitioners (GPs. Conclusions. Strategies of promoting a healthy working environment and facilitating early return to work were utilised in the follow-up of employees with musculoskeletal complaints. Supportive strategies were found most useful especially in the early phases, while finding a balance between being supportive, on one side, and confronting the employee, on the other, was endeavoured in cases of recurrent or long-term sick leave. Further, the supervisors requested a closer cooperation with the GPs, which they believed would facilitate return to work.

  14. A Comparative Study on Java Technologies for Focus and Cursor Handling in Accessible Dynamic Interactions.

    Science.gov (United States)

    Jitngernmadan, Prajaks; Miesenberger, Klaus

    2015-01-01

    For an interactive application, supporting and guiding the user in fulfilling tasks is most important. The behavior of the application that will guide users through the procedures until they finish the task has to be designed intuitively and well guiding, especially if the users has only restricted or no access to the visual and spatial arrangement on the screen. Therefore, the focus/cursor management plays an important role for orientation and navigating through the interaction. In the frame of ongoing research on a software tool supporting blind people in more efficiently doing mathematical calculations, we researched how Java technologies support implementing an accessible Graphical User Interface (GUI) with an additional focus on usable accessibility in terms of guiding blind users through the process of solving mathematical calculations. We used Java Swing [1] and Eclipse SWT [2] APIs for creating a series of prototypes. We tested a) accessibility and usability of the prototypes for blind people when using screen reader software and refreshable Braille display and b) the implementation support to developers provided by both technologies. It turned out that Eclipse SWT API delivered best results under Windows operating system.

  15. Resilience of primary healthcare professionals working in challenging environments: a focus group study.

    Science.gov (United States)

    Matheson, Catriona; Robertson, Helen D; Elliott, Alison M; Iversen, Lisa; Murchie, Peter

    2016-07-01

    The modern primary healthcare workforce needs to be resilient. Early research framed professional resilience as avoiding 'burnout'; however, more recent literature has introduced the concept of positive adaptation to professional challenges, which results in individuals thriving in their role. To explore what primary health professionals working in challenging environments consider to be characteristics of resilience and what promotes or challenges professional resilience. A qualitative focus group in north east Scotland. Five focus groups were held with 20 health professionals (six GPs, nine nurses, four pharmacists, and a practice manager) based in rural or deprived city areas in the north east of Scotland. Inductive thematic analysis identified emerging themes. Personal resilience characteristics identified were optimism, flexibility and adaptability, initiative, tolerance, organisational skills, being a team worker, keeping within professional boundaries, assertiveness, humour, and a sense of self-worth. Workplace challenges were workload, information overload, time pressures, poor communication, challenging patients, and environmental factors (rural location). Promoters of professional resilience were strong management support, teamwork, workplace buffers, and social factors such as friends, family, and leisure activities. A model of health professional resilience is proposed that concurs with existing literature but adds the concept of personal traits being synergistic with workplace features and social networks. These facilitate adaptability and enable individual health professionals to cope with adversity that is inevitably part of the everyday experience of those working in challenging healthcare environments. © British Journal of General Practice 2016.

  16. Exploring Sources of Emotional Distress among People Living with Scleroderma: A Focus Group Study.

    Directory of Open Access Journals (Sweden)

    Stephanie T Gumuchian

    Full Text Available Systemic sclerosis, or scleroderma, is a chronic and rare connective tissue disease with negative physical and psychological implications. Sources of emotional distress and the impact they have on the lives of people with scleroderma are not well understood.To gain an in-depth understanding of the emotional experiences and sources of emotional distress for women and men living with scleroderma through focus group discussions.Three semi-structured focus group discussions were conducted (two in English, one in French with a total of 22 people with scleroderma recruited through the Scleroderma Society of Ontario in Hamilton, Ontario and a scleroderma clinic in Montreal, Canada. Interviews were recorded, transcribed, and then coded for emerging themes using thematic inductive analysis.Core themes representing sources of emotional distress were identified, including: (a facing a new reality; (b the daily struggle of living with scleroderma; (c handling work, employment and general financial burden; (d changing family roles; (e social interactions; and (f navigating the health care system. Collectively, these themes refer to the stressful journey of living with scleroderma including the obstacles faced and the emotional experiences beginning prior to receiving a diagnosis and continuing throughout the participants' lives.Scleroderma was portrayed as being an unpredictable and overwhelming disease, resulting in many individuals experiencing multiple sources of emotional distress. Interventions and supportive resources need to be developed to help individuals with scleroderma and people close to them manage and cope with the emotional aspects of the disease.

  17. Coping with asthma in immigrant Hispanic families: a focus group study.

    Science.gov (United States)

    Mosnaim, Giselle; Kohrman, Claire; Sharp, Lisa K; Wolf, Marion E; Sadowski, Laura S; Ramos, Lori; Grammer, Leslie C

    2006-10-01

    Little is known about how childhood asthma affects immigrant Hispanic families in the United States. Qualitative research is effective for understanding the social, cultural, functional, and structural aspects of asthma in the family context. Furthermore, such knowledge is necessary to develop culturally appropriate interventions for these families. To describe participants' perceptions of their roles in caring for an asthmatic child, to compare family patterns of caring for an asthmatic child by parents' country of origin, to identify barriers to caring for an asthmatic child, and to evaluate specific coping needs of low-income immigrant Hispanic families caring for an asthmatic child. Five focus groups were conducted with low-income, immigrant, Spanish-speaking Hispanic adults caring for an asthmatic child, including community health workers, mothers, fathers, and grandparents, along with women with asthma. Audiotaped focus groups were transcribed verbatim in Spanish, forward translated into English, and back translated into Spanish. Data analysis was performed using qualitative analytic methods. Forty-one participants represented a range of countries of origin. Different themes emerged for community health workers vs parents and grandparents and for women vs men caring for a child with asthma. All the participants reported strong beliefs in using folk medicines. Barriers identified included language, culture, poverty, lack of health insurance, and poor living conditions. Results highlight the lack of asthma self-management skills, diagnostic uncertainty, and the use of folk medicine as factors that should be taken into consideration when tailoring interventions to improve asthma outcomes in this vulnerable population.

  18. Neutron and X-ray emission studies in a low energy plasma focus

    Energy Technology Data Exchange (ETDEWEB)

    Zakaullah, M. [Quaid-i-Azam Univ., Islamabad (Pakistan). Dept. of Physics; Murtaza, G. [Quaid-i-Azam Univ., Islamabad (Pakistan). Dept. of Physics; Qamar, S. [Quaid-i-Azam Univ., Islamabad (Pakistan). Dept. of Physics; Ahmad, I. [Quaid-i-Azam Univ., Islamabad (Pakistan). Dept. of Physics; Beg, M.M. [Quaid-i-Azam Univ., Islamabad (Pakistan). Dept. of Physics

    1996-03-01

    In a low energy Mather-type plasma focus energized by a single 32 {mu}F capacitor, the X-ray and neutron emission is investigated using time-integrated and time-resolved detectors. The X-ray emission profile has a width (FWHM) of 40-50 ns. The neutron emission profile is broader compared to the X-ray emission profile and also delayed by 30-40 ns. To identify different regimes of X-ray emission, an X-ray pin-hole camera along with different absorption filters is employed. While the X-ray emission is high within a narrow pressure range of 2.0-2.5 mbar, the neutron emission is intense for a wider range of 1.0-4.5 mbar. The intense X-ray emission seems to originate from the axially moving shock wave. These results also indicate rather different production mechanisms for X-ray and neutron emission. Also on comparing the X-ray images with Al(2 {mu}m), Al(5 {mu}m), Al(9 {mu}m) filters, we find that the bulk of X-rays from the focus filament have energies less than 2 keV. (orig.).

  19. Youth understanding of healthy eating and obesity: a focus group study.

    Science.gov (United States)

    Sylvetsky, Allison C; Hennink, Monique; Comeau, Dawn; Welsh, Jean A; Hardy, Trisha; Matzigkeit, Linda; Swan, Deanne W; Walsh, Stephanie M; Vos, Miriam B

    2013-01-01

    Given the high prevalence of childhood obesity in the United States, we aimed to investigate youth's understanding of obesity and to investigate gaps between their nutritional knowledge, dietary habits, and perceived susceptibility to obesity and its co-morbidities. A marketing firm contracted by Children's Healthcare of Atlanta facilitated a series of focus group discussions (FGD) to test potential concepts and sample ads for the development of an obesity awareness campaign. Data were collected in August and September of 2010 with both overweight and healthy weight 4th-5th grade and 7th-8th grade students. We conducted a secondary analysis of the qualitative FGD transcripts using inductive thematic coding to identify key themes related to youth reports of family eating habits (including food preparation, meal frequency, and eating environment), perceived facilitators and barriers of healthy diet, and knowledge about obesity and its complications. Across focus group discussions, mixed attitudes about healthy eating, low perceived risk of being or becoming obese, and limited knowledge about the health consequences of obesity may contribute to the rising prevalence of obesity among youth in Georgia. Most youth were aware that obesity was a problem; yet most overweight youth felt that their weight was healthy and attributed overweight to genetics or slow metabolism. Our analysis suggests that urban youth in Georgia commonly recognize obesity as a problem, but there is less understanding of the link to lifestyle choices or the connection to future morbidities, suggesting a need for education to connect lifestyle behaviors to development of obesity.

  20. 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 ...

  1. Multiple sessions of liposomal doxorubicin delivery via focused ultrasound mediated blood-brain barrier disruption: a safety study.

    Science.gov (United States)

    Aryal, Muna; Vykhodtseva, Natalia; Zhang, Yong-Zhi; McDannold, Nathan

    2015-04-28

    Transcranial MRI-guided focused ultrasound is a rapidly advancing method for delivering therapeutic and imaging agents to the brain. It has the ability to facilitate the passage of therapeutics from the vasculature to the brain parenchyma, which is normally protected by the blood-brain barrier (BBB). The method's main advantages are that it is both targeted and noninvasive, and that it can be easily repeated. Studies have shown that liposomal doxorubicin (Lipo-DOX), a chemotherapy agent with promise for tumors in the central nervous system, can be delivered into the brain across BBB. However, prior studies have suggested that doxorubicin can be significantly neurotoxic, even at small concentrations. Here, we studied whether multiple sessions of Lipo-DOX administered after FUS-induced BBB disruption (FUS-BBBD) induces severe adverse events in the normal brain tissues. First, we used fluorometry to measure the doxorubicin concentrations in the brain after FUS-BBBD to ensure that a clinically relevant doxorubicin concentration was achieved in the brain. Next, we performed three weekly sessions with FUS-BBBD±Lipo-DOX administration. Five to twelve targets were sonicated each week, following a schedule described previously in a survival study in glioma-bearing rats (Aryal et al., 2013). Five rats received three weekly sessions where i.v. injected Lipo-DOX was combined with FUS-BBBD; an additional four rats received FUS-BBBD only. Animals were euthanized 70days from the first session and brains were examined in histology. We found that clinically-relevant concentrations of doxorubicin (4.8±0.5μg/g) were delivered to the brain with the sonication parameters (0.69MHz; 0.55-0.81MPa; 10ms bursts; 1Hz PRF; 60s duration), microbubble concentration (Definity, 10μl/kg), and the administered Lipo-DOX dose (5.67mg/kg) used. The resulting concentration of Lipo-DOX was reduced by 32% when it was injected 10min after the last sonication compared to cases where the agent was

  2. Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study

    Directory of Open Access Journals (Sweden)

    Röder Christoph

    2010-09-01

    Full Text Available Abstract Background In addition to general health and pain, sleep is highly relevant to judging the well-being of an individual. Of these three important outcome variables, however, sleep is neglected in most outcome studies. Sleep is a very important resource for recovery from daily stresses and strains, and any alteration of sleep will likely affect mental and physical health, especially during disease. Sleep assessment therefore should be standard in all population-based or clinical studies focusing on the locomotor system. Yet current sleep assessment tools are either too long or too specific for general use. Methods Based on a literature review and subsequent patient-based rating of items, an expert panel designed a four-item questionnaire about sleep. Construct validation of the questionnaire in a random sample of the German-speaking Swiss population was performed in 2003. Reliability, correlation, and tests for internal consistency and validity were analyzed. Results Overall, 16,634 (70% out of 23,763 eligible individuals participated in the study. Test-retest reliability coefficients ranged from 0.72 to 0.87, and a Cronbach's alpha of 0.83 indicates good internal consistency. Results show a moderate to good correlation between sleep disturbances and health perception, and between sleep disturbances and overall pain. Conclusions The Sleep Standard Evaluation Questionnaire (SEQ-Sleep is a reliable and short tool with confirmed construct validity for sleep assessment in population-based observational studies. It is easy to administer and therefore suitable for postal surveys of the general population. Criterion validity remains to be determined.

  3. A case study investigation of practices and beliefs of teachers at a STEM-focused elementary school

    Science.gov (United States)

    Martin, Billy J.

    Proponents of STEM education have highlighted the need for increasing STEM skills among students. To address this need, there have been recommendations to create new STEM-focused schools, a majority of which are to be STEM-focused elementary and middle schools. However, STEM school research remains focused on outcomes at the secondary and postsecondary level, with little attention being given to knowing more about the role that elementary education plays in STEM outcomes. Case study design was used to investigate teachers at one STEM-focused elementary school to identify the practices and beliefs reported as important in STEM teaching and learning. Using survey and in-depth interviews, it was found that designation as a STEM-focused school promotes the use of more inquiry-oriented teaching practices and facilitates the use of strategies for developing confidence and competence in STEM among staff and students. The information uncovered in this study could provide leaders of any organization desiring to become a STEM-focused institution information about specific beliefs and practices that have the greatest potential to support changes in teaching.

  4. Experimental study of transmission of a pulsed focused beam through a skull phantom in nonlinear regime

    Energy Technology Data Exchange (ETDEWEB)

    Tsysar, S. A., E-mail: sergey@acs366.phys.msu.ru; Nikolaeva, A. V.; Khokhlova, V. A.; Yuldashev, P. V. [Physics Faculty, Moscow State University, Leninskie Gory, Moscow 119991 (Russian Federation); Svet, V. D. [Andreyev Acoustics Institute, 4, Shvernik Street, Moscow 117036 (Russian Federation); Sapozhnikov, O. A. [Physics Faculty, Moscow State University, Leninskie Gory, Moscow 119991 (Russian Federation); Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States)

    2015-10-28

    In the paper the use of receiving and radiating system, which allows to determine the parameters of bone by nonlinear pulse-echo technique and to image of brain structures through the skull bones, was proposed. Accuracy of the skull bone characterization is due to higher measured harmonic and is significantly better than in linear case. In the experimental part focused piezoelectric transducer with diameter 100 mm, focal distance 100 mm, the frequency of 1.092 MHz was used. It was shown that skull bone profiling can be performed with the use of 3rd harmonic since 1st harmonic can be used for visualization of the underlying objects. The use of wideband systems for both skull profiling and brain visualization is restricted by skull attenuation and resulting low effective sensitivity.

  5. Spectral study of the electron beam emitted from a 3 kJ plasma focus

    International Nuclear Information System (INIS)

    Patran, A; Tan, L C; Stoenescu, D; Rafique, M S; Rawat, R S; Springham, S V; Tan, T L; Lee, P; Zakaullah, M; Lee, S

    2005-01-01

    In a 3 kJ Mather-type plasma focus device operated in neon, the electron beam emission is investigated using both a magnetic electron energy analyser (in the 30-660 keV range) and a Rogowski coil (coupled with an appropriate RC passive integrator). Several electron emission features are identified and correlated with the x-ray emission in different energy ranges. The electron beam output shows very strong correlation with the general plasma dynamics (breakdown, axial and radial acceleration, pinch and post-pinch phases). The electrons' energy spectra showed most of the electron emission concentrating below 200 keV and negligible emission with energy above 350 keV. At 4 mbar neon, the electron emission, as well as the beam energy, is the highest and has a good shot-to-shot reproducibility

  6. Service-learning from the views of university teachers: a qualitative study based on focus groups.

    Science.gov (United States)

    Shek, Daniel T L; Chan, Stephen C F

    2013-01-01

    Under the New Undergraduate Curriculum at The Hong Kong Polytechnic University (PolyU), students are required to take a 3-credit subject to fulfill service-learning requirements. To understand the views of teachers regarding service-learning, five focus group interviews (n=33) are conducted to examine the perceived characteristics and myths of service-learning as well as colleagues' views on the policy at PolyU. Results showed that most informants are aware of service-learning and have seen its benefits to both students and teachers. Most informants also possess positive views about service-learning. Nevertheless, in terms of service-learning at PolyU, three different groups of views on service-learning are observed, namely, positive, negative, and mixed views. This paper also discusses teachers' views on the anticipated difficulties of service-learning implementation and the ways, by which to promote the subject in the PolyU context.

  7. Experimental study of transmission of a pulsed focused beam through a skull phantom in nonlinear regime

    International Nuclear Information System (INIS)

    Tsysar, S. A.; Nikolaeva, A. V.; Khokhlova, V. A.; Yuldashev, P. V.; Svet, V. D.; Sapozhnikov, O. A.

    2015-01-01

    In the paper the use of receiving and radiating system, which allows to determine the parameters of bone by nonlinear pulse-echo technique and to image of brain structures through the skull bones, was proposed. Accuracy of the skull bone characterization is due to higher measured harmonic and is significantly better than in linear case. In the experimental part focused piezoelectric transducer with diameter 100 mm, focal distance 100 mm, the frequency of 1.092 MHz was used. It was shown that skull bone profiling can be performed with the use of 3rd harmonic since 1st harmonic can be used for visualization of the underlying objects. The use of wideband systems for both skull profiling and brain visualization is restricted by skull attenuation and resulting low effective sensitivity

  8. Studies of the Hard X-ray Emission from the Filippov Type Plasma Focus Device, Dena

    Science.gov (United States)

    Tafreshi, M. A.; Saeedzadeh, E.

    2006-12-01

    This article is about the characteristics of the hard X-ray (HXR) emission from the Filippov type plasma focus (PF) device, Dena. The article begins with a brief presentation of Dena, and the mechanism of the HXR production in PF devices. Then using the differential absorption spectrometry, the energy resolved spectrum of the HXR emission from a 37 kJ discharge in Dena, is estimated. The energy flux density and the energy fluence of this emission have also been calculated to be 1.9 kJ cm-2 s-1 and 9.4 × 10-5 J cm-2. In the end, after presentation of radiography of sheep bones and calf ribs, the medical application of the PF devices has been discussed.

  9. Experimental studies of fast deuterons, impurity- and admixture-ions emitted from a plasma focus

    International Nuclear Information System (INIS)

    Mozer, A.; Sadowski, M.; Herold, H.; Schmidt, H.

    1982-01-01

    The energy and mass analysis of ions emitted from a 50-kJ, 18-kV, plasma focus machine was performed with a Thomson analyzer. Energy distribution functions of fast deuterons (E> or =350 keV) and those of impurity ions have been determined. The energy distributions of the O, N, and C impurity ions in different ionization states have similar character. They usually increase exponentially and after reaching the maximum at E/Zroughly-equal1.0 MeV they decrease exponentially to E/Zroughly-equal1.8 MeV. For deuterons at lower operating pressures (p 0 + -Ar 7+ ions of energy from 0.5 to 14 MeV are produced

  10. A study of x-ray emission from the anode region in a plasma focus device

    International Nuclear Information System (INIS)

    Jia Wang; Tsinchi Yang

    1988-01-01

    The physical process of x-ray emission from the anode region in a plasma focus device due to the interaction of a powerful electron beam with the metal anode and with ionised metallic vapour from the anode is investigated. The influence of the magnetic field of the beam is taken into consideration. A MC-PIC model (Monte Carlo-particle in cell) is proposed for the process, in which an electron-photon collision cascade is simulated by the MC approach and the time-dependent state of metallic vapour is determined by PIC computation. The time-resolved energy spectra and angular distributions of x-ray emission from the extending anode region are calculated. The time-integrated characteristics of the x-ray emission can be compared with the results of experiments as far as they are available. (author)

  11. FOCUS-GROUP” STUDY CONCERNING MEAT CONSUMER`S BEHAVIOR IN THE CITY OF TIMISOARA

    Directory of Open Access Journals (Sweden)

    GENOVEVA BUZAMĂT

    2007-10-01

    Full Text Available Focus-group is an exploratory qualitative research, a demi-structured interview whichallows us to get to know the consumer`s perceptions, reasons, feelings, needs andattitudes. This technique has been used to make evident what especially determines theconsumers to choose a certain meat sort. The research has been carried out on twogroups, in the city of Timisoara. The objectives aimed at within this research were:determination of the consumer`s motivation for a certain meat sort; correlation betweenlifestyle and meat sort; consumption habits. The main tool was represented by theinterview guide, in which we have used open questions in order to hear our subjects`opinions concerning the meat consumption, open questions for their familiarization andintroductive questions, with the help of which we introduced the subjects to the theme ofthis research.

  12. Youth Understanding of Healthy Eating and Obesity: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Allison C. Sylvetsky

    2013-01-01

    Full Text Available Introduction. Given the high prevalence of childhood obesity in the United States, we aimed to investigate youth's understanding of obesity and to investigate gaps between their nutritional knowledge, dietary habits, and perceived susceptibility to obesity and its co-morbidities. Methods. A marketing firm contracted by Children's Healthcare of Atlanta facilitated a series of focus group discussions (FGD to test potential concepts and sample ads for the development of an obesity awareness campaign. Data were collected in August and September of 2010 with both overweight and healthy weight 4th-5th grade and 7th-8th grade students. We conducted a secondary analysis of the qualitative FGD transcripts using inductive thematic coding to identify key themes related to youth reports of family eating habits (including food preparation, meal frequency, and eating environment, perceived facilitators and barriers of healthy diet, and knowledge about obesity and its complications. Results. Across focus group discussions, mixed attitudes about healthy eating, low perceived risk of being or becoming obese, and limited knowledge about the health consequences of obesity may contribute to the rising prevalence of obesity among youth in Georgia. Most youth were aware that obesity was a problem; yet most overweight youth felt that their weight was healthy and attributed overweight to genetics or slow metabolism. Conclusions. Our analysis suggests that urban youth in Georgia commonly recognize obesity as a problem, but there is less understanding of the link to lifestyle choices or the connection to future morbidities, suggesting a need for education to connect lifestyle behaviors to development of obesity.

  13. Immigrant families' perceptions on walking to school and school breakfast: a focus group study

    Directory of Open Access Journals (Sweden)

    Busby Katie

    2007-12-01

    Full Text Available Abstract Background Immigrant children face an increased risk of being overweight. Little is known about how immigrant families perceive school programs that may help prevent obesity, such as walking to school and school breakfast. Methods Six focus groups (n = 53 were conducted with immigrant parents of school-aged children, two each in three languages: Vietnamese, Spanish, and Somali. A facilitator and translator conducted the focus groups using a script and question guide. Written notes and audio transcripts were recorded in each group. Transcripts were coded for themes by two researchers and findings classified according to an ecological model. Results Participants in each ethnic group held positive beliefs about the benefits of walking and eating breakfast. Barriers to walking to school included fear of children's safety due to stranger abductions, distrust of neighbors, and traffic, and feasibility barriers due to distance to schools, parent work constraints, and large families with multiple children. Barriers to school breakfast participation included concerns children would not eat due to lack of appealing/appropriate foods and missing breakfast due to late bus arrival or lack of reminders. Although some parents acknowledged concerns about child and adult obesity overall, obesity concerns did not seem personally relevant. Conclusion Immigrant parents supported the ideals of walking to school and eating breakfast, but identified barriers to participation in school programs across domains of the ecological model, including community, institution, and built environment factors. Schools and communities serving immigrant families may need to address these barriers in order to engage parents and children in walking and breakfast programs.

  14. Sex-related differences in foot shape of adult Caucasians--a follow-up study focusing on long and short feet.

    Science.gov (United States)

    Krauss, I; Langbein, C; Horstmann, T; Grau, S

    2011-03-01

    The study's purpose was to substantiate findings on sex-related differences in foot morphology focusing on fringe sizes. Altogether, 287 Caucasian adults with long or short feet were scanned. Data were analysed together with data from 847 subjects from a previous study with comparable inclusion criteria and anthropometric data by: (1)comparing absolute measures within 237-277 mm foot length (FL); (2) comparing averaged measures across sizes in % of foot length for 203-323 mm FL; (3) reclassifying the additional subjects into a previously defined foot type classification. Male feet were wider and higher for the same FL. Averaged across sizes, no relevant differences between sexes were found for widths and heights. Slender or flat-pointed foot types were more common in longer feet, shorter feet tended to be bigger. Definitions for 'long' and 'short' are sex-related with an offset of three shoe sizes (EU). Results of this follow-up study on long and short feet can substantiate previous findings mainly described for the most common sizes. STATEMENT OF RELEVANCE: Improper footwear can cause pain and injury and proper fit is a major criterion for shoe buyers. Knowledge about sex-related differences in foot shape is important for shoe design. This study supplements the field of knowledge for very small and large feet.

  15. 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.

  16. Magnetic Resonance-Guided High-Intensity-Focused Ultrasound for Palliation of Painful Skeletal Metastases: A Pilot Study.

    Science.gov (United States)

    Chan, Michael; Dennis, Kristopher; Huang, Yuexi; Mougenot, Charles; Chow, Edward; DeAngelis, Carlo; Coccagna, Jennifer; Sahgal, Arjun; Hynynen, Kullervo; Czarnota, Gregory; Chu, William

    2017-10-01

    Bone is one of the most common sites of metastases, with bone metastases-related pain representing a significant source of morbidity among patients with cancer. Magnetic resonance-guided focused ultrasound is a noninvasive, outpatient modality with the potential for treating painful bone metastases. The aim of this study is to report our initial experience with magnetic resonance-guided focused ultrasound in the treatment of bone metastases and our preliminary analysis of urinary cytokine levels after therapy. This was a single-center pilot study of 10 patients with metastatic cancer to investigate the feasibility of magnetic resonance-guided focused ultrasound for primary pain control in device-accessible skeletal metastases. Treatments were performed on a clinical magnetic resonance-guided focused ultrasound system using a volumetric ablation technique. Primary efficacy was assessed using Brief Pain Inventory scores and morphine equivalent daily dose intake at 3 time points: before, day 14, and day 30 after the magnetic resonance-guided focused ultrasound treatment. Urine cytokines were measured 3 days before treatment and 2 days after the treatment. Of the 10 patients, 8 were followed up 14 days and 6 were followed up 30 days after the treatment. At day 14, 3 patients (37.5%) exhibited partial pain response and 4 patients (50%) exhibited an indeterminate response, and at day 30 after the treatment, 5 patients (83%) exhibited partial pain response. No treatment-related adverse events were recorded. Of the urine cytokines measured, only Transforming growth factor alpha (TGFα) demonstrated an overall decrease, with a trend toward statistical significance ( P = .078). Our study corroborates magnetic resonance-guided focused ultrasound as a feasible and safe modality as a primary, palliative treatment for painful bone metastases and contributes to the limited body of literature using magnetic resonance-guided focused ultrasound for this clinical indication.

  17. Asymmetric focusing study from twin input power couplers using realistic rf cavity field maps

    Directory of Open Access Journals (Sweden)

    Colwyn Gulliford

    2011-03-01

    Full Text Available Advanced simulation codes now exist that can self-consistently solve Maxwell’s equations for the combined system of an rf cavity and a beam bunch. While these simulations are important for a complete understanding of the beam dynamics in rf cavities, they require significant time and computing power. These techniques are therefore not readily included in real time simulations useful to the beam physicist during beam operations. Thus, there exists a need for a simplified algorithm which simulates realistic cavity fields significantly faster than self-consistent codes, while still incorporating enough of the necessary physics to ensure accurate beam dynamics computation. To this end, we establish a procedure for producing realistic field maps using lossless cavity eigenmode field solvers. This algorithm incorporates all relevant cavity design and operating parameters, including beam loading from a nonrelativistic beam. The algorithm is then used to investigate the asymmetric quadrupolelike focusing produced by the input couplers of the Cornell ERL injector cavity for a variety of beam and operating parameters.

  18. Study on optimum aseismic design of complex structure system focusing on damping effect

    International Nuclear Information System (INIS)

    Takahashi, Yoshitaka; Suzuki, Kohei

    1995-01-01

    Optimum design technique for the purpose of aseismic design of complex plant structures such as piping and boiler structures is proposed. Particular attention is focused on the evaluation of the optimum damping and stiffness of the structures and components. Pseudo least square algorithm is introduced to determine the optimum design parameters. Under the requirement of certain allowable maximum response to a given earthquake excitation, optimum stiffness and damping values of the structure can be simultaneously calculated by this proposed method. The applicability of the method is demonstrated through three structural models; (1) linear multi-storied building model in which stiffness and damping constant of each floor are optimized; (2) nonlinear multi-storied building model having the isolated floor in which hysteretic energy absorber of the isolator is optimized; (3) combined boiler-supporting structure model connected by the inelastic seismic ties with each other is optimized. In this model, optimum values of damping characteristic of the seismic ties are evaluated. This work is particularly important for the aseismic design of complex plant structures like integrated boiler-supporting structure in thermal power plant and piping-containment vessel structure in nuclear power plant

  19. Older drivers' opinions of criteria that inform the cars they buy: A focus group study.

    Science.gov (United States)

    Zhan, Jenny; Porter, Michelle M; Polgar, Jan; Vrkljan, Brenda

    2013-12-01

    Safe driving in older adulthood depends not only on health and driving ability, but also on the driving environment itself, including the type of vehicle. However, little is known about how safety figures into the older driver's vehicle selection criteria and how it ranks among other criteria, such as price and comfort. For this purpose, six focus groups of older male and female drivers (n=33) aged 70-87 were conducted in two Canadian cities to explore vehicle purchasing decisions and the contribution of safety in this decision. Themes emerged from the data in these categories: vehicle features that keep them feeling safe, advanced vehicular technologies, factors that influence their car buying decisions, and resources that inform this decision. Results indicate older drivers have gaps with respect to their knowledge of safety features and do not prioritize safety at the time of vehicle purchase. To maximize the awareness and uptake of safety innovations, older consumers would benefit from a vehicle design rating system that highlights safety as well as other features to help ensure that the vehicle purchased fits their lifestyle and needs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Abdominal fat thickness measurement using Focused Impedance Method (FIM) - phantom study

    Science.gov (United States)

    Haowlader, Salahuddin; Baig, Tanveer Noor; Siddique-e Rabbani, K.

    2010-04-01

    Abdominal fat thickness is a risk indicator of heart diseases, diabetes, etc., and its measurement is therefore important from the point of view of preventive care. Tetrapolar electrical impedance measurements (TPIM) could offer a simple and low cost alternative for such measurement compared to conventional techniques using CT scan and MRI, and has been tried by different groups. Focused Impedance Method (FIM) appears attractive as it can give localised information. An intuitive physical model was developed and experimental work was performed on a phantom designed to simulate abdominal subcutaneous fat layer in a body. TPIM measurements were performed with varying electrode separations. For small separations of current and potential electrodes, the measured impedance changed little, but started to decrease sharply beyond a certain separation, eventually diminishing gradually to negligible values. The finding could be explained using the intuitive physical model and gives an important practical information. TPIM and FIM may be useful for measurement of SFL thickness only if the electrode separations are within a certain specific range, and will fail to give reliable results if beyond this range. Further work, both analytical and experimental, are needed to establish this technique on a sound footing.

  1. Development and experimental study of oil-free capacitor module for plasma focus device

    Science.gov (United States)

    Sharma, Ravindra Kumar; Sharma, Archana

    2017-03-01

    This development is concerned with the compact capacitor module for a plasma focus device. Oil-free, non-standard geometry capacitors are designed and developed for high current delivery in sub-microseconds time. Metalized dielectric film based pulse capacitor becomes progressively less viable at currents above 10 kA. It is due to reliability and energy scaling difficulties, based on effects such as vaporization, high resistivity, and end connection. Bipolar electrolytic capacitors are also not preferred due to their limited life and comparatively low peak current delivery. Bi-axially oriented polypropylene (BOPP) film with extended aluminum foil is a combination to deliver moderately high power. But, electrically weak points, relative permittivity, and the edge gap margins have made its adoption difficult. A concept has been developed in lab for implementing the above combination in a less complex and costly manner. This paper concerns the development and testing process techniques for quite different hollow cylindrical, oil-free capacitors (4 μ F , 10 kV, 20 nH). Shot life of 1000 has been experimentally performed on the test bed at its rated energy density level. The technological methods and engineering techniques are now available and utilized for manufacturing and testing of BOPP film based oil-free capacitors.

  2. Study of phosphoric acid crystallization using a focused beam reflectance measurement method

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Yong [School of Chemistry and Resource Environment, Linyi Normal University, Linyi Shandong 276005 (China); Chen, Kui; Wu, Yanyang; Zhu, Jiawen [Chemical Engineering Research Center, East China University of Science and Technology, Shanghai 200237 (China); Sheng, Yong [SINOCHEN Fuling Chemical Industrial Co., Ltd, Chongqing 226005 (China)

    2010-10-15

    A way for restoring the crystal size distributions (CSD) from measured chord length distributions (CLD) was reported in this paper. The kinetics of phosphoric acid crystallization process was investigated in cooling mode using focused beam reflectance measurement (FBRM) and digital photo technique. In order to restore the CSD from measured CLD and verify the reliability of FBRM data, digital photo technique in real time and optical microscope were applied in large crystal size and small range, respectively. Results indicated a converting constant A existed between CLD and CSD when crystal growth follows size-independent growth (Mcabe's {delta}L law) law. It was verified by Malvern particles size analysis method. The converting constant A varied with crystal morphology. The crystal growth order increased with the stirring increasing speed during phosphoric acid crystallization process. The trend was especially notable at higher speed situations. It can illustrate that the state of phosphoric acid hemihydrate crystal growth was controlled by both diffusion and surface-integration with the increasing stirring speed. (copyright 2010 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  3. Perceptions of Playing-Related Musculoskeletal Disorders (PRMDs) in Irish traditional musicians: a focus group study.

    Science.gov (United States)

    Wilson, Iseult M; Doherty, Liz; McKeown, Laura

    2014-01-01

    Playing-related musculoskeletal disorders (PRMDs) are common in musicians and interfere with the ability to play an instrument at the accustomed level. There is limited research into injuries affecting folk musicians. To explore the Irish traditional musicians' experience of PRMDs. Focus group interviews were conducted in 2011 and 2012, in two venues in Ireland. Data were recorded and transcribed verbatim. Data collection ended when no new findings emerged from the analysis of interviews. The inclusion criteria were: males or females aged 18 and above, and who taught or played Irish traditional music on any instrument. The data were analysed using the interpretative phenomenological method. All participants (n=22) believed there was a link between playing music and musculoskeletal problems. The main body areas affected were the back, shoulders, arms and hands. The main theme that emerged was: 'PRMDs are an integral part of being a traditional musician', and that the musical experience was generally prioritised over the health of the musician. There were sub-themes of 'fear' and 'stresses that contributed to PRMDs'. PRMDs are an occupational hazard for Irish musicians. There is an awareness of PRMDs, but changes (technique, environment) may threaten identity.

  4. Adolescents' Views on Active and Non-Active Videogames: A Focus Group Study.

    Science.gov (United States)

    Simons, Monique; de Vet, Emely; Hoornstra, Sjoukje; Brug, Johannes; Seidell, Jaap; Chinapaw, Mai

    2012-06-01

    Active games require whole-body movement and may be an innovative tool to substitute sedentary pastime with more active time and may therefore contribute to adolescents' health. To inform strategies aimed at reducing sedentary behavior by replacing non-active with active gaming, perceptions and context of active and non-active gaming are explored. Six focus groups were conducted with adolescents 12-16 years old representing a range of education levels. A semistructured question route was used containing questions about perceptions and the context of gaming. The adolescents had positive attitudes toward active gaming, especially the social interactive aspect, which was greatly appreciated. A substantial number of adolescents enjoyed non-active games more than active ones, mainly because of better game controls and more diversity in non-active games. Active games were primarily played when there was a social gathering. Few game-related rules and restrictions at home were reported. Given the positive attitudes of adolescents and the limited restrictions for gaming at home, active videogames may potentially be used in a home setting as a tool to reduce sedentary behavior. However, to make active games as appealing as non-active games, attention should be paid to the quality, diversity, and sustainability of active games, as these aspects are currently inferior to those of traditional non-active games.

  5. Developmental Immunotoxicity, Perinatal Programming, and Noncommunicable Diseases: Focus on Human Studies

    Science.gov (United States)

    Dietert, Rodney R.

    2014-01-01

    Developmental immunotoxicity (DIT) is a term given to encompass the environmentally induced disruption of normal immune development resulting in adverse outcomes. A myriad of chemical, physical, and psychological factors can all contribute to DIT. As a core component of the developmental origins of adult disease, DIT is interlinked with three important concepts surrounding health risks across a lifetime: (1) the Barker Hypothesis, which connects prenatal development to later-life diseases, (2) the hygiene hypothesis, which connects newborns and infants to risk of later-life diseases and, (3) fetal programming and epigenetic alterations, which may exert effects both in later life and across future generations. This review of DIT considers: (1) the history and context of DIT research, (2) the fundamental features of DIT, (3) the emerging role of DIT in risk of noncommunicable diseases (NCDs) and (4) the range of risk factors that have been investigated through human research. The emphasis on the human DIT-related literature is significant since most prior reviews of DIT have largely focused on animal research and considerations of specific categories of risk factors (e.g., heavy metals). Risk factors considered in this review include air pollution, aluminum, antibiotics, arsenic, bisphenol A, ethanol, lead (Pb), maternal smoking and environmental tobacco smoke, paracetamol (acetaminophen), pesticides, polychlorinated biphenyls, and polyfluorinated compounds. PMID:26556429

  6. Interim report deliverable 3.2 : focus group management process of the restricted use technology study

    Science.gov (United States)

    2005-09-30

    The Altarum Institute, under contract to the Michigan Department of Transportation (MDOT), currently is engaged in a project called the Altarum Restricted Use Technology Study. This study, an 18-month effort, seeks to apply restricted use techn...

  7. Effects of oxytocin on high intensity focused ultrasound (HIFU) ablation of adenomysis: A prospective study

    International Nuclear Information System (INIS)

    Zhang, Xin; Zou, Min; Zhang, Cai; He, Jia; Mao, Shihua; Wu, Qingrong; He, Min; Wang, Jian; Zhang, Ruitao; Zhang, Lian

    2014-01-01

    Objective: To investigate the effects of oxytocin on high-intensity focused ultrasound (HIFU) ablation for the treatment of adenomyosis. Materials and methods: Eighty-six patients with adenomyosis from three hospitals were randomly assigned to the oxytocin group or control group for HIFU treatment. During HIFU treatment, 80 units of oxytocin was added in 500 ml of 0.9% normal saline running at the rate of 2 ml/min (0.32 U/min) in the oxytocin group, while 0.9% normal saline was used in the control group. Both patients and HIFU operators were blinded to oxytocin or saline application. Treatment results, adverse effects were compared. Results: When using oxytocin, the non-perfused volume (NPV) ratio was 80.7 ± 11.6%, the energy-efficiency factor (EEF) was 8.1 ± 9.9 J/mm 3 , and the sonication time required to ablate 1 cm 3 was 30.0 ± 36.0 s/cm 3 . When not using oxytocin, the non-perfused volume ratio was 70.8 ± 16.7%, the EEF was 15.8 ± 19.6 J/mm 3 , and the sonication time required to ablate 1 cm 3 was 58.2 ± 72.7 S/cm 3 . Significant difference in the NPV ratio, EEF, and the sonication time required to ablate 1 cm 3 between the two groups was observed. No oxytocin related adverse effects occurred. Conclusion: Oxytocin could significantly decrease the energy for ablating adenomyosis with HIFU, safely enhance the treatment efficiency

  8. Internet addiction: a descriptive clinical study focusing on comorbidities and dissociative symptoms.

    Science.gov (United States)

    Bernardi, Silvia; Pallanti, Stefano

    2009-01-01

    Internet addiction (IAD) is an emerging cause of morbidity and has been recently considered to merit inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Given the paucity of knowledge about IAD, we conducted a descriptive clinical analysis of patients focusing on clinical, demographic features, and comorbidities. The detachment has been suggested as a reason for the attractiveness of the Internet; thus, we assessed dissociative symptoms and their association with IAD disability. A cohort of 50 adult outpatients were screened using the Internet Addiction Scale. Exclusion criterion was using the Internet for only one purpose such as gaming or gambling. Nine women and 6 men constituted the sample of Internet addicts; each of them had a score of 70 or higher on the Internet Addiction Scale. Comorbidities and subthreshold symptoms were screened carefully. Dissociative symptoms were analyzed with the Dissociative Experience Scale, and disability was assessed using the Sheehan Disability Scale. Hours/week spent on the Internet were 42.21 +/- 3.09. Clinical diagnoses included 14% attention deficit and hyperactivity disorder, 7% hypomania, 15% generalized anxiety disorder, 15% social anxiety disorder; 7% dysthymia, 7% obsessive compulsive personality disorder, 14% borderline personality disorder, and 7% avoidant personality disorder. One patient met criteria for binge eating disorder. Severity measures of IAD were associated with higher perception of family disability (r = 0.814; P

  9. 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

  10. Risk Based Monitoring (RBM: A global study focusing on perception and merits among clinical investigational sites

    Directory of Open Access Journals (Sweden)

    Prajna P. Kumar

    2016-12-01

    Conclusion: This unique study performed across ten emerging and developed countries strongly supported the need for systematic global training, education, and implementation of RBM regulatory guidance, with an aim for better safety of subjects and improved quality of clinical trial data. Furthermore, studies with larger sample sizes are recommended to provide an evidence-based approach.

  11. TRIGLYCERIDES, ATHEROSCLEROSIS, AND CARDIOVASCULAR OUTCOME STUDIES: FOCUS ON OMEGA-3 FATTY ACIDS.

    Science.gov (United States)

    Handelsman, Yehuda; Shapiro, Michael D

    2017-01-01

    To provide an overview of the roles of triglycerides and triglyceride-lowering agents in atherosclerosis in the context of cardiovascular outcomes studies. We reviewed the published literature as well as ClinicalTrials.gov entries for ongoing studies. Despite improved atherosclerotic cardiovascular disease (ASCVD) outcomes with statin therapy, residual risk remains. Epidemiologic data and recent genetic insights provide compelling evidence that triglycerides are in the causal pathway for the development of atherosclerosis, thereby renewing interest in targeting triglycerides to improve ASCVD outcomes. Fibrates, niacin, and omega-3 fatty acids (OM3FAs) are three classes of triglyceride-lowering drugs. Outcome studies with triglyceride-lowering agents have been inconsistent. With regard to OM3FAs, the JELIS study showed that eicosapentaenoic acid (EPA) significantly reduced major coronary events in statin-treated hypercholesterolemic patients. Regarding other agents, extended-release niacin and fenofibrate are no longer recommended as statin add-on therapy (by some guidelines, though not all) because of the lack of convincing evidence from outcome studies. Notably, subgroup analyses from the outcome studies have generated the hypothesis that triglyceride lowering may provide benefit in statin-treated patients with persistent hypertriglyceridemia. Two ongoing OM3FA outcome studies (REDUCE-IT and STRENGTH) are testing this hypothesis in high-risk, statin-treated patients with triglyceride levels of 200 to 500 mg/dL. There is consistent evidence that triglycerides are in the causal pathway of atherosclerosis but inconsistent evidence from cardiovascular outcomes studies as to whether triglyceride-lowering agents reduce cardiovascular risk. Ongoing outcomes studies will determine the role of triglyceride lowering in statin-treated patients with high-dose prescription OM3FAs in terms of improved ASCVD outcomes. AACE = American Association of Clinical Endocrinologists

  12. Interprofessional collaboration regarding patients' care plans in primary care : a focus group study into influential factors

    NARCIS (Netherlands)

    Stephanie Anna Lenzen; Trudy van der Weijden; Anna Beurskens; Marloes Amantia van Bokhoven; Ramon Daniëls; Jerôme Jean Jacques van Dongen

    2016-01-01

    Background: The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding

  13. Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors

    NARCIS (Netherlands)

    Dongen, J.J. van; Lenzen, S.A.; Bokhoven, M.A. van; Daniels, R.; Weijden, T.T. van der; Beurskens, A.

    2016-01-01

    BACKGROUND: The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding

  14. Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study

    NARCIS (Netherlands)

    Boeft, M. den; Huisman, D.; Wouden, J.C. van der; Numans, M.E.; Horst, H.E. van der; Lucassen, P.L.B.J.; Olde Hartman, T.C.

    2016-01-01

    BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) form a heterogeneous group and frequently attend their family physician (FP). Little is known about how FPs recognize MUPS in their patients. We conducted a focus group study to explore how FPs recognize MUPS and whether they

  15. User Perceptions of the Library's Web Pages: A Focus Group Study at Texas A&M University.

    Science.gov (United States)

    Crowley, Gwyneth H.; Leffel, Rob; Ramirez, Diana; Hart, Judith L.; Armstrong, Tommy S., II

    2002-01-01

    This focus group study explored library patrons' opinions about Texas A&M library's Web pages. Discusses information seeking behavior which indicated that patrons are confused when trying to navigate the Public Access Menu and suggests the need for a more intuitive interface. (Author/LRW)

  16. No Natives Here: A Focus Group Study of Student Perceptions of Web 2.0 and the Academic Library

    Science.gov (United States)

    Burhanna, Kenneth J.; Seeholzer, Jamie

    2009-01-01

    This study explores Web 2.0 technologies in an academic library through focus groups with undergraduates at Kent State University. Results reveal that students, despite being heavy users, are less sophisticated and expressive in their use of Web 2.0 than presumed. Students set clear boundaries between educational and social spaces on the Web, and…

  17. Combining focus group discussions and choice experiments for economic valuation of peatland restoration : A case study in Central Kalimantan, Indonesia

    NARCIS (Netherlands)

    Schaafsma, M.; van Beukering, P. J.H.; Oskolokaite, I.

    2017-01-01

    This study explores the benefits of combining results of qualitative focus group discussions (FGDs) with a quantitative choice experiment (CE) in a low-income country context. The assessment addresses the compensation needed by local communities in Central Kalimantan to cooperate in peatland

  18. Brand Avoidance : A study focusing on Marketing Communication within the Sportswear Industry in Sweden

    OpenAIRE

    Holmström, Anna-Sara; Almqvist, Therese; Forsberg, Moa

    2016-01-01

    Background Until today, branding in positive forms has been widely researched. It has been studied why consumers choose certain brands and how companies can increase brand loyalty. On the other hand, literature lacks studies on negative branding, which now becomes more interesting to gain more knowledge about. One knows that it is of equal importance to investigate why people would avoid a brand as what makes them purchase a brand. Hence, the topic of anti-consumption and in particular brand ...

  19. Study of self-focusing of Non Gaussian laser beam in a plasma with density variation using moment theory approach

    Science.gov (United States)

    Pathak, Nidhi; Kaur, Sukhdeep; Singh, Sukhmander

    2018-05-01

    In this paper, self-focusing/defocusing effects have been studied by taking into account the combined effect of ponder-motive and relativistic non linearity during the laser plasma interaction with density variation. The formulation is based on the numerical analysis of second order nonlinear differential equation for appropriate set of laser and plasma parameters by employing moment theory approach. We found that self-focusing increases with increasing the laser intensity and density variation. The results obtained are valuable in high harmonic generation, inertial confinement fusion and charge particle acceleration.

  20. Use of animal models for space flight physiology studies, with special focus on the immune system

    Science.gov (United States)

    Sonnenfeld, Gerald

    2005-01-01

    Animal models have been used to study the effects of space flight on physiological systems. The animal models have been used because of the limited availability of human subjects for studies to be carried out in space as well as because of the need to carry out experiments requiring samples and experimental conditions that cannot be performed using humans. Experiments have been carried out in space using a variety of species, and included developmental biology studies. These species included rats, mice, non-human primates, fish, invertebrates, amphibians and insects. The species were chosen because they best fit the experimental conditions required for the experiments. Experiments with animals have also been carried out utilizing ground-based models that simulate some of the effects of exposure to space flight conditions. Most of the animal studies have generated results that parallel the effects of space flight on human physiological systems. Systems studied have included the neurovestibular system, the musculoskeletal system, the immune system, the neurological system, the hematological system, and the cardiovascular system. Hindlimb unloading, a ground-based model of some of the effects of space flight on the immune system, has been used to study the effects of space flight conditions on physiological parameters. For the immune system, exposure to hindlimb unloading has been shown to results in alterations of the immune system similar to those observed after space flight. This has permitted the development of experiments that demonstrated compromised resistance to infection in rodents maintained in the hindlimb unloading model as well as the beginning of studies to develop countermeasures to ameliorate or prevent such occurrences. Although there are limitations to the use of animal models for the effects of space flight on physiological systems, the animal models should prove very valuable in designing countermeasures for exploration class missions of the future.

  1. Physical therapy intervention studies on idiopathic scoliosis-review with the focus on inclusion criteria1

    Science.gov (United States)

    2012-01-01

    Background Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT). Materials and methods A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used. Results Real outcome papers (start of treatment in immature samples/end results after the end of growth; controlled studies in adults with scoliosis with a follow-up of more than 5 years) have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. Conclusion There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents. PMID:22277541

  2. Physical therapy intervention studies on idiopathic scoliosis-review with the focus on inclusion criteria1

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2012-01-01

    Full Text Available Abstract Background Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT. Materials and methods A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used. Results Real outcome papers (start of treatment in immature samples/end results after the end of growth; controlled studies in adults with scoliosis with a follow-up of more than 5 years have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. Conclusion There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents.

  3. Study on the Pollution-heaven Hypothesis Focusing on Pollution-Intensive Industries

    Energy Technology Data Exchange (ETDEWEB)

    Lho, S.W. [Kyungnam University, Masan (Korea)

    2002-03-01

    The purpose of this study is to test pollution-heaven hypothesis on the Korean pollution-intensive industries, that is, textile and clothing, petrochemical and primary metal industry. The empirical study examines that foreign direct investment(FDI) of Korean pollution-intensive industries regresses on couple of exogenous variables and the environmental regulation on FDI. As the environmental regulation is not directly observed, it uses C0{sub 2} emissions as the pollutant. The results of the study show that the environmental regulation in a host country is an insignificant determinant of FDI for the Korean polluting industries. That is, they do not support Leonard (1988), Xing and Kolstad (2000) that the hypothesis is a significant for heavily polluting industries. (author). 34 refs., 10 tabs.

  4. Elderly, depression and suicide: focusing the problem (The way the geriatrician reads the PROSPECT study

    Directory of Open Access Journals (Sweden)

    A. Salsi

    2013-05-01

    Full Text Available BACKGROUND PROSPECT study involved people over 60 treated for depression state in a context of community primary care with collaborative care approach. Results confirmed effectiveness of treatment on suicidal ideation and on depressive symptoms so that also reduction in suicide risk is presumed. DISCUSSION The protocol of the study and results are intriguing for the geriatrician. Nevertheless some aspects must be watched at as not exactly old-oriented. Mainly the need to ameliorate operative multidimensional assessment, the missing of attention to fall-risk when prescribing psychotropic drugs and, consequently, the lack of gerontologically correct analysis of benefit/risk ratio.

  5. How physical therapists instruct patients with stroke: an observational study on attentional focus during gait rehabilitation after stroke

    NARCIS (Netherlands)

    Kal, Elmar; van den Brink, Henrieke; Houdijk, Han; van der Kamp, John; Goossens, Paulien Helena; van Bennekom, Coen; Scherder, Erik

    2018-01-01

    People without neurological impairments show superior motor learning when they focus on movement effects (external focus) rather than on movement execution itself (internal focus). Despite its potential for neurorehabilitation, it remains unclear to what extent external focus strategies are

  6. Program Experiences of Adults with Autism, Their Families, and Providers: Findings from a Focus Group Study

    Science.gov (United States)

    Koffer Miller, Kaitlin H.; Mathew, Mary; Nonnemacher, Stacy L.; Shea, Lindsay L.

    2018-01-01

    A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum…

  7. Investigating the Knowledge Needed for Teaching Mathematics: An Exploratory Validation Study Focusing on Teaching Practices

    Science.gov (United States)

    Charalambous, Charalambos Y.

    2016-01-01

    Central in the frameworks proposed to capture the knowledge needed for teaching mathematics is the assumption that teachers need more than pure subject-matter knowledge. Validation studies exploring this assumption by recruiting contrasting populations are relatively scarce. Drawing on a sample of 644 Greek-Cypriots preservice and inservice…

  8. Integrative invasion science: model systems, multi-site studies, focused meta-analysis, and invasion syndromes

    Czech Academy of Sciences Publication Activity Database

    Kueffer, C.; Pyšek, Petr; Richardson, D. M.

    2013-01-01

    Roč. 200, č. 3 (2013), s. 615-633 ISSN 1469-8137 R&D Projects: GA ČR(CZ) GAP504/11/1028; GA ČR GA206/09/0563 Institutional support: RVO:67985939 Keywords : model systems * invasion syndromes * multi-site studies Subject RIV: EF - Botanics Impact factor: 6.545, year: 2013

  9. Justifying continuous sedation until death: A focus group study in nursing homes in Flanders, Belgium

    NARCIS (Netherlands)

    Rys, S.; Deschepper, R.; Deliens, L.; Mortier, F.; Bilsen, J.

    2013-01-01

    Continuous Sedation until Death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, has become a common practice in nursing homes in Flanders (Belgium). Quantitative research has suggested that CSD is not always properly applied. This qualitative study

  10. A Study of Two English Language Coursebooks in Turkey: Focus on Multiple Intelligences

    Science.gov (United States)

    Arikan, Arda; Soydan, Elif; Isler, Özlem

    2014-01-01

    This study aims to analyze two coursebooks, namely, "Texture of English 4" and "My English 5" on the basis of to what extent the activities and tasks included reflect the intelligent types proposed by multiple intelligences theory. Taking the general characteristics of the intelligences into account, a checklist has been…

  11. Economic decline and residential segregation : A Swedish study with focus on Malmö

    NARCIS (Netherlands)

    Andersson, R.; Hedman, L.K.

    2016-01-01

    Economic crises are often associated with increasing levels of income segregation and income polarization. Poor neighborhoods generally hit more severely, with unemployment levels increasing and income levels dropping more than in better-off neighborhoods. In this article, we study the correlation

  12. Focus on variability : New tools to study intra-individual variability in developmental data

    NARCIS (Netherlands)

    van Geert, P; van Dijk, M

    2002-01-01

    In accordance with dynamic systems theory, we assume that variability is an important developmental phenomenon. However, the standard methodological toolkit of the developmental psychologist offers few instruments for the study of variability. In this article we will present several new methods that

  13. Case studies of Kenyan digital villages with a focus on women and ...

    African Journals Online (AJOL)

    areas are more vulnerable compared to those in urban areas (Project Africa, 2010). ... (2005) draw from a case study on stages of telecentre development in New Zealand. ..... that social networking sites are of major interest among users. .... equal society nonetheless, not much of this is done on regional or local levels.

  14. Vaccination decision-making of immigrant parents in the Netherlands; a focus group study

    NARCIS (Netherlands)

    Harmsen, I.A.; Bos, H.; Ruiter, R.A.C.; Paulussen, T.G.W.; Kok, G.; Melker, H.E. de; Mollema, L.

    2015-01-01

    Background Although the vaccination coverage in most high income countries is high, variations in coverage rates on the national level among different ethnic backgrounds are reported. A qualitative study was performed to explore factors that influence decision-making among parents with different

  15. Positive and Negative Aspects of Using Social Networks in Higher Education: A Focus Group Study

    Science.gov (United States)

    Vural, Ömer Faruk

    2015-01-01

    Social Networking Sites (SNS) have become popular among students and faculties, especially for all young population. SNSs are a relatively new technology, and little research has been conducted on the beliefs of the teacher candidates about using Social Network as an instructional tool. The study was conducted to find out for what purposes…

  16. Self-management: challenges for allied healthcare professionals in stroke rehabilitation--a focus group study

    NARCIS (Netherlands)

    Satink, T.J.; Cup, E.H.; Swart, B.J.M. de; Sanden, M.W. van der

    2015-01-01

    PURPOSE: Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions.

  17. A retrospective study of magnetic resonance-guided focused ultrasound ablation for uterine myoma in Taiwan

    Directory of Open Access Journals (Sweden)

    Sheng-Ling Tung

    2016-10-01

    Conclusion: The results obtained from this study demonstrated that MRgFUS can be safely and effectively used to ablate uterine fibroids to produce a significant decrease in mean fibroid volume and improve SSS for up to 6 months after treatment.

  18. Focus on the studies in support of fire safety analysis. IRSN modelling approach for nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Espargilliere, Julien; Meyrand, Raphael; Vinot, Thierry [Institut de Radioprotection et de Surete Nucleaire (IRSN), Fontenay-aux-Roses (France)

    2015-12-15

    For a fire safety analysis, in order to comply with nuclear safety goals, a nuclear fuel facility operator has to define the elements important for safety to be maintained, even in the case of a fire. One of the key points of this fire analysis is the assessment of possible fire scenarios in the facility. This paper presents the IRSN method applied to a case study to assess fire scenarios which have the most harmful effects on safety targets. The layout consists in a central room (fire cell) containing three glove boxes with radioactive material and three electrical cabinets. This room is linked to two connecting compartments (the fire cell and these two compartments define the containment cell) and then to two corridors. Each room is equipped with a mechanical ventilation system, and a pressure cascade is established from the corridors to the central room. A fire scenario was studied with fire ignition occurring in an electrical cabinet. This scenario has a set of safety goals (prevention of fire cell and containment device failure, propagation of the fire). This case study was conducted with the IRSN code SYLVIA based on two zones modelling. Safety goals were associated with key parameters and performance criteria to be fulfilled. Modelling assumptions were defined in order to maximize physical effects of the fire. Sensitivity studies were also conducted on key parameters such as oxygen limitation, equivalent-fuel definition. Eventually, a critical analysis of the code models was carried out.

  19. Alternative Conceptions in Animal Classification Focusing on Amphibians and Reptiles: A Cross-Age Study

    Science.gov (United States)

    Yen, Chiung-Fen; Yao, Tsung-Wei; Chiu, Yu-Chih

    2004-01-01

    This study examined students' alternative conceptions of reptiles and amphibians and the extent to which these conceptions remain intact through the elementary (grades 4 and 6), junior, and senior high school years. We administered multiple-choice and free-response instruments to a total of 513 students and interviewed at least 20 students at each…

  20. Application of plasma focus installations for a study of the influence ...

    Indian Academy of Sciences (India)

    The appearance of a large number of cracks on the surface of vanadium under the impulse influence of deuterium plasma shows that pure vanadium cannot be used for the construction of thermonuclear fusion reactors. Such PF installations could also be used effectively for the study of other material and construction ...

  1. Genetic moderation of the association between regulatory focus and reward responsiveness: a proof-of-concept study.

    Science.gov (United States)

    Goetz, Elena L; Hariri, Ahmad R; Pizzagalli, Diego A; Strauman, Timothy J

    2013-02-01

    Recent studies implicate individual differences in regulatory focus as contributing to self-regulatory dysfunction, part